Surendra Kumar Mishra

Prevalence of Three-rooted Mandibular Permanent First Molars among the Indian Population

INTRODUCTION The aim of this retrospective study was to determine the prevalence of three-rooted mandibular permanent first molars among the Indian population by using periapical radiographs. METHODS Five hundred eighty-six patients (320 females and 266 males) were selected, with at least 1 mandibular first molar. A total of 1054 periapical radiographs of mandibular first molars, comprising 526 right side and 528 left side, were included. The radiographs were taken at 30-degree mesial angulation and were evaluated by using the magnifying lens. The incidence, gender, and symmetry of three-rooted mandibular first molars were recorded and analyzed by using the chi(2) test. RESULTS The prevalence of three-rooted mandibular first molars was 5.97% for all patients and 4.55% for all teeth, respectively. The incidence of bilateral symmetrical distribution was 37.14%. The incidence was 6.88% for female patients and 4.89% for male patients (chi(2) = 1.02, P > .05) and 4.94% for the right side and 4.17% for the left side, respectively (chi(2) = 0.36, P > .05). No statistically significant differences were found between female and male patients and between the right-side and left-side occurrences. CONCLUSIONS Clinicians should be aware of the high racial prevalence of this unusual root morphology in mandibular first molars among the Indian population before and during the root canal treatment of three-rooted mandibular first molars.

Double Dens Invaginatus with Multiple Canals in a Maxillary Central Incisor: Retreatment and Managing Complications

Dens invaginatus is a developmental anomaly that often presents a perplexing challenge to the endodontist. It involves the maxillary central incisor less commonly than the maxillary lateral incisor. Double dens invaginatus is even rarer. Herein a unique case of dens invaginatus in a maxillary central incisor is presented. The tooth had an inadequate previous root canal treatment. On retreatment, multiple canals and double dens invaginatus were found. The invaginations were Oehlers type 3b and type 2. The complex morphology was diagnosed and confirmed with cone-beam computed tomography imaging and managed with a combined surgical and orthograde approach. Four canals and a blind sac along with an open apex were found. There were many intercommunications between the canals. During the treatment, a complication of a separated instrument occurred, which was managed successfully. The 1-year follow-up shows successful outcome of the treatment. Dens invaginatus may be more complicated than it seems. It needs meticulous treatment by a specialist. Failure or a delay in referring the case to a specialty setting may further increase the complications. With the advancements in equipment and materials, it is possible to save even severe cases of dens invaginatus.

Newer Endodontic irrigation devices: An update

The ultimate aim of endodontic therapy is thorough debridement of root canal system. The aim of this review is to give a brief description of endodontic irrigation devices and their efficacy in root canal therapy. Recently developed irrigation devices and their application mode also discussed. Mechanism of these devices and the phenomenon that governs the irrigation efficacy discussed briefly. 5 Irrigation allows for cleaning beyond what might be achieved by root canal instrumentation alone so it is an essential part of root canal debridement. Till date none of the irrigant posses ideal quality that is why in contemporary endodontic practice, dual irrigants such as sodium hypochlorite (NaOCl) with ethylenediaminetetraacetic acid (EDTA) or chlorhexidine (CHX) are often used as initial and final rinses to complement the shortcomings that are associated with the use of a single irrigant. Irrigants must be brought into direct contact with the entire canal wall surfaces for effective action particularly for the apical portions of small root canals. Various methods have been developed in order to provide effective delivery. These systems might be divided into 2 broad categories, manual agitation techniques and machine-assisted agitation devices. The objective of this review was to present an overview of contemporary irrigation methods available in endodontics. II. Manual irrigation techniques Manual irrigation system using needles is still widely accepted by both general practitioners and endodontists. In this technique the dispensing of an irrigant into a canal through needles/cannulas of variable gauges, either passively or with agitation. The agitation might be achieved by moving the needle up and down the canal space. The design of these needles can be closed-ended, side-vented channels. III. Max-i-probe

Management of C-shaped root canal configuration with three different obturation systems

Unusual root canal anatomy always poses a diagnostic and treatment challenge. Identification of such variation is important for the success of the root canal treatment outcome. The C-shaped root canal configuration is one of the aberrant morphology of molar teeth, commonly the mandibular second molar. In this configuration, the canals are connected by slit or web. The presence of fin, slit and web makes through debridement obstacle for the clinician. This case reports present successful management of C-shaped mandibular molars with three different obturation systems.

Hemisection as a conservative management of grossly carious permanent mandibular first molar

Hemisection of a molar denotes removal or separation of a root along with its accompanying part of crown. It is a suitable treatment option when the caries, resorption, perforation, or periodontal damage is restricted to one root while the other root is relatively healthy. Hemisection of the affected tooth helps to retain the tooth structure, surrounding alveolar bone, and may also facilitate the placement of fixed prosthesis. This case report describes the hemisection as a successful treatment method to save a grossly carious mandibular first molar with periodontal and periapical involvement. Hemisection and prosthetic rehabilitation yielded a satisfactory result. With careful treatment planning and precise surgical management, undesirable consequences of tooth loss were prevented.

Root canal morphology of mandibular first molars in a North Indian subpopulation: An in vitro clearing study

Introduction: Limited information is available about the canal morphology of mandibular first molars in North Indian population. The purpose of this study was to evaluate the root canal morphology of North Indian mandibular first molars by clearing and staining technique. Materials and Methods: A total of 863 mandibular first molars collected from various places in North India were subjected to canal staining and decalcification procedures. Access cavities were prepared, and pulp tissue dissolved with sodium hypochlorite. Indian ink was injected into the root canals aided by negative pressure applied at the root tips. The stained teeth were decalcified with 7% hydrochloric acid. Instead of ascending concentrations of alcohol, a nonalcohol-based drying agent (anhydrous calcium chloride) was used to remove traces of acid and water from the specimens. The dried specimens were immersed in methyl salicylate to render them transparent. The following features were observed under operating microscope at ×6 magnification: (i) Number of root canals per tooth, (ii) number of root canals per root, (iii) root canal configuration in each root (Vertuccis classification), and (iv) lateral canals, intercanal communications, and their location. Results: Majority had two roots (85%) with three (61%) and four (30%) canals. Three roots were present in 15% of the specimens. Type IV (49%) and type I (48%) were the most common configurations in mesial and distal roots, respectively. Conclusion: First molars with two roots and three canals are a common feature in North Indian patients. Both roots showed wide variations in canal anatomy with type IV and type I configurations predominating in mesial and distal roots, respectively.

Esthetic recovery of permanent Mandibular Lateral Incisor using biological post after non-surgical healing of Periradicular Lesion: A Case Report

Statement of the problem: Anterior tooth fracture, as a result of traumatic injuries, frequently occurs in dentistry. This leads to necrosis of pulp and periapical pathology. The goal of endodontic and restorative dentistry is to retain natural teeth with maximum function and pleasing esthetics. Purpose of the study: This study aimed at proper reconstruction of extensively damaged teeth through the procedure known as “Biological Restoration.” Materials and methods: Biological post obtained through natural, extracted teeth from another individual represents a low-cost option and alternative technique for the morphofunctional recovery of damaged anterior teeth that provides highly functional and esthetic outcomes. Conclusions: This case report refers to the esthetics and functional recovery of mandibular left lateral incisor after non-surgical healing of periradicular lesion. Case Report Esthetic recovery of permanent Mandibular Lateral Incisor using biological post after non-surgical healing of Periradicular Lesion: A Case Report Amit Kumar Garg1, Neha Agrawal2*, Rajendra Kumar Tewari3 and Surendra Kumar Mishra4 1Associate Professor, Dept. of Conservative Dentistry and Endodontics, K.D. Dental College and Hospital, Mathura, India 2Associate Professor, Dept. of Periodontics and Community Dentistry, Dr. Z. A. Dental College, A.M.U., Aligarh, UP, India 3Professor and Principal, Dept. of Conservative Dentistry and Endodontics, Dr Z. A. Dental College, AMU., Aligarh,, UP, Indore, India 4Professor and Chairman, Dept. of Conservative Dentistry and Endodontics, Dr. Z. A. Dental College, A.M.U., Aligarh, UP, India *Address for Correspondence: Dr. Neha Agrawal, MDS, Associate Professor, Dept of Periodontics and Community Dentistry, Dr. Z. A. Dental College, A.M.U., Aligarh, UP, India, Tel: 917895335770; Email: dr.n_agrawal@yahoo.co.in Submitted: 25 May 2017 Approved: 20 June 2017 Published: 22 June 2017 Copyright: 2017 Garg AK, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Endoactivator And Diode Laser Assisted Disinfection for Treating C-Shaped Canal in Mandibular Second Molar: Report of 3 Cases.

C-shaped root canals are most frequently seen in the mandibular second molar. Their complex anatomy makes chemomechanical preparation an arduous and difficult task. The present case series describes the endodontic management of 3 cases of Cshaped canals using sonic irrigation system and laser assisted disinfection.

Frequency of middle mesial canals in mandibular first molars in North Indian population - An in vivo study

Objectives: The primary aim of the study was to determine the frequency of middle mesial (MM) canals in mandibular first molars in North Indian population. The secondary aim was to analyze whether an association exists between the detection rate of MM canals and age, gender, and number of distal canals. Materials and Methods: All mature mandibular first molars endodontically treated between March 2013 and March 2015 were included in the study. After instrumenting the main canals, the clinician inspected the mesial developmental groove under dental operating microscope (DOM) using ultrasonic tips and endodontic explorer to detect accessory mesial canals. The canal, if found, was negotiated, cleaned, shaped, and recorded. Results were analyzed using Chi-square test. Results: A total of 258 first molars from 243 patients were treated during the specified period, of which 28.3% had negotiable MM canals. The frequency of MM canals was 36.6% in patients 11-30 years old, 22.6% in patients 31-50 years old, and 18.4% in patients >50 years. Statistical analysis revealed a significant relationship of different age groups with the incidence of MM canals (P < 0.05). A significant relationship was also found between the detection rate of two canals in distal root and the presence of MM canals (P < 0.05) with gender having no influence. Conclusion: The presence of MM canals is quite high in North Indian population. Younger patients had a higher incidence of MM canals. Mandibular first molars with two separate distal canals showed a tendency to have MM canals.

Endodontic management of maxillary first molar with atypical canal morphology: Report of three cases

Maxillary first molar with three roots and 3–4 canals is a common occurrence. However, extreme variations in their canal morphology have been reported ranging from one single canal and one root to as many as eight root canals. This article presents three cases of successful endodontic management of maxillary first molars with atypical canal morphologies, thus highlighting the fact that variations do occur and an endodontist should always be aware of aberrancies in root canal system apart from the knowledge of normal root canal anatomy.