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This report illustrates a rare case of a geminated maxillary right second molar tooth using CBCT in a 23‐year‐old man with severe pain. Nonsurgical endodontic treatment was performed, which gave rise to an asymptomatic tooth at the 12‐month follow‐up.

Objectives: This study aimed to assess root canal transportation of curved canals following glide path preparation by PathFile and Scout RaCe rotary systems compared with manual instrumentation with stainless steel (SS) hand files using cone-beam computed tomography (CBCT). Materials and Methods: This in-vitro experimental study was conducted on extracted human mandibular first and second molars (n=51) with 25-45° canal curvature in their mesiobuccal root. All teeth underwent CBCT and were randomly divided into three groups (n=17). In group 1, a glide path in the mesiobuccal canal was created using SS hand files to the working length. In groups 2 and 3, after canal negotiation with a #8 SS hand file, a glide path was created with PathFile and Scout RaCe systems, respectively. The teeth underwent CBCT. Pre- and postoperative CBCT scans were compared to calculate the magnitude of canal transportation at 3, 6, and 9 mm from the apex. The results were analyzed using the Kruskal-Wallis and Freedman tests (P

Objectives: The aim of this study was to evaluate the effect of the precipitate that was formed by combining Sodium Hypochlorite (NaOCl) and Chlorhexidine Gluconate (CHX) on the sealing ability of root canal obturation materials. Materials and Methods: The fluid filtration method was conducted on a total of 100 roots. Samples were randomly divided into two control (n=5) and three experimental groups (n=30). The samples in group 1 were irrigated with 1.5 mL of 2.5% NaOCl, and then the smear layers of the teeth were removed by 17% EDTA, while the specimens of group 2 were irrigated by 1.5 mL of 2.5% NaOCl and 1.5 mL of 2% CHX; after the smear layer removal, a final flush with 1.5 mL of 2.5% NaOCl was performed. The samples of group 3 were irrigated the same as group 1 but after the smear layer removal canals were irrigated again with 1.5 mL of 2.5% NaOCl and then a final flush with 1.5 mL of 2% CHX was performed. Teeth were obturated with gutta-percha and AH26 sealer and after seven days, microleakage was evaluated by the fluid filtration technique. The results were analyzed by the ANOVA and Tukey's test. Results: The samples in group 3 had significantly greater microleakage compared to teeth in group 1, 2 (p Conclusion: The presence of the precipitate that is formed due to interaction between NaOCl and CHX has negative effect on the sealing ability of gutta-percha and AH26 sealer.

Root fracture diagnosis is a clinical difficulty that in most cases can only be detected through radiography. The objective of this study was to compare the diagnostic accuracy of two types of digitally enhanced images (reverse-contrast and colorization) with original digital radiographies in detecting experimental root fractures. Two hundred extracted single-rooted human teeth were endodontically instrumented and then divided in two groups, one control group and one test group, including fractured teeth. Vertical root fractures were experimentally made in the fractured group. The digital image of each tooth was taken, using the paralleling technique. There were three groups of images: (i) original, (ii) reverse contrast, and (iii) colorized. Three experienced dental specialists examined the images with no prior knowledge of the distribution of the root fractures. Two-way analysis of variance was used to assess the differences in accuracy, sensitivity, and specificity of each technique in detecting root fractures. Cohen's kappa coefficients were calculated to investigate the degree of interobserver agreement. The accuracy, sensitivity, and specificity of original images were 67.4%, 66.7%, and 68%, respectively; these amounts were 61.5%, 61%, and 65.5% in reverse contrast images and 66.4%, 70.7%, and 62% in colorized digital radiography. The original images had the best inter observer kappa coefficients (between 0.45 and 0.55). The results showed that the accuracy of original images is better than reverse contrast and colorized images. Use of reverse-contrast and colorization digital images in root fracture detection should be regarded as an adjunct to other diagnostic methods not as a highly critical diagnostic aid.

Thorough knowledge of root canal morphology is essential for the endodontic therapy. There are rare variations in canal number and configuration in maxillary molars, which could affect treatment outcome. This paper presents the endodontic management of a maxillary first molar with two palatal canals in one root (Vertucci type IV) and a single buccal canal. In this paper cone-beam computed tomography was made to asses this morphology. This paper is intended to reinforce clinician’s awareness of the rare morphology of root canals.

Introduction.Tooth avulsion in the young permanent dentition is a frequent finding, and its prognosis depends on the treatment of the avulsed tooth before replantation, the extra-alveolar time, the storage medium, and the patient’s general health. The present report describes management of an immature avulsed lower central incisor 90 minutes after the accident.Methods.A right lower central incisor of a 7-year-old girl was avulsed, and it was soaked in a glass of milk. 90 minutes after avulsion, replantation was performed, and the tooth was splinted; but after two weeks the replanted tooth’s pulp was necrotic. Thus, endodontic treatment was performed and root canal was filled using a calcium hydroxide and iodoform paste (Metapex). Three months later, the intracanal medication was washed out and the canal was sealed using an apical plug of calcium enriched mixture (CEM) cement.Results.20 months after replantation the tooth was completely asymptomatic, with physiologic mobility. Also, continued root formation including an apical segment beyond the artificial apical plug was observed.Conclusion.Creation of an appropriate apical barrier following the disinfection of root canal system promoted continued root-end growth in a replanted immature permanent tooth.

Objectives. To evaluate the effect of apical foramen diameter and apical barrier thickness on the sealing ability of mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM) plugs in open apices. Materials and Methods. The fluid filtration method was conducted on a total of 136 roots. Samples were randomly divided into two control (n=8) and four experimental groups (n=30). Apical foramen diameters measuring 1.1 and 1.7 mm were shaped for groups “1 and 3” and “2 and 4”, respectively. In groups 1 and 2 MTA plug and in groups 3 and 4 CEM plug was inserted. The groups were further divided into subgroups according to the thickness of the apical plugs (3- or 5-mm). Microleakage was measured at 1, 7, and 30 days. Results. Mixed ANOVA test showed that the microleakage in groups 1 and 3 as well as all 5-mm plug subgroups were significantly less than groups 2 and 4 (P<0.05) and 3-mm subgroups (P<0.05), respectively. Microleakage was significantly lower at 30th day (P<0.05). Conclusions. Reducing canal diameter or increasing apical plug thickness and the time interval increases the sealing ability of apical barriers. Furthermore, in comparison to MTA, CEM plugs demonstrated superior sealing ability.