Unraveling the Enigma of Managing a Large Periapical Lesion: A Case Report.

This case report documents the diagnosis and successful management of a substantial periapical lesion located in the lower left region of the jaw. The patient presented with clinical symptoms indicative of periapical pathology, and radiographic examination revealed an extensive radiolucent lesion. The chosen treatment approach involved endodontic intervention coupled with surgical decompression, leading to the resolution of the lesion and restoration of oral health. This case underscores the significance of an accurate diagnosis and a multidisciplinary treatment approach in addressing large periapical lesions.

Enhancing Aesthetics and Functionality of the Teeth Using Injectable Composite Resin Technique.

In order to prepare composite restorations without the requirement for tooth preparation, the injectable composite resin technique uses a clear silicone index in a minimally invasive direct approach to imitate a diagnostic wax-up. This case report features a 34-year-old female patient having aesthetic and functional concerns, notably spacing between the teeth, insufficient tooth visibility, and diastema in the upper anterior region. Upon clinical examination, spacing and midline diastema were observed. The maxillary incisors and canines were to have composite veneers made as part of the treatment plan. A wax-up and transparent silicone index was prepared following the assessment of a try-in of the prepared mock-up. Subsequenty, for restoring the teeth, a clear silicone index was used to inject and polymerize the flowable composite. The desired outcomes included elongated teeth to enhance visibility, closure of diastemas, and reshaping of the canines. Over a 12-month follow-up period, the patient exhibited no signs of soft tissue inflammation or significant wear. The described technique is characterized by its minimal invasiveness, cost-effectiveness, and suitability for definitive and provisional restorations. Desirable results can be achieved by appropriate planning and adhering to a meticulous planning while minimizing tooth structure loss.

New Frontiers in Endodontics: Tackling the Mesiobuccal 2 (MB2) Canal Challenge in the Maxillary First Molar.

Molars have been observed to have a variety of morphological forms. The least understood and most treatable tooth in the posterior region is the upper first molar. The maxillary first molar has a complex anatomy with a wide variation in the number, size, and shape of the root canals. The case documentation highlights the endodontic treatment of the upper first molar with an anomalous position of the mesiobuccal 2 (MB2) canal. Endodontic therapy success is contingent upon the awareness of the dentist about the differences i.e. morphology and outline of the root and its canal.

From Crisis to Victory: Rescuing Root Canal Treatment With Bioactive Material in a Nail-Biting Case of Furcal Perforation.

This case report illustrates the successful treatment of an iatrogenic furcal perforation using mineral trioxide aggregate (MTA) and its reinforcement with fiber-reinforced composites (FRCs). Endodontic perforations, particularly in the furcal area, present unique challenges that demand effective management strategies. MTA, known for its multifaceted properties including osteoinductive activity and sealing capabilities, has emerged as the gold standard material for perforation repair. This case report demonstrates the application of MTA in repairing the perforation site following thorough cleaning and shaping of the root canals. Furthermore, the use of FRCs, specifically glass fiber-reinforced composite (GFRC), is introduced to reinforce the repaired site, enhancing its mechanical properties and long-term stability. The discussion emphasizes the importance of selecting appropriate materials for endodontic perforation repair and highlights the advantages of FRCs in preventing structural failures. Future directions suggest further research to refine FRC formulations and standardize clinical protocols to maximize treatment outcomes. This case report contributes valuable insights to the advancement of endodontic therapy, showcasing the combined benefits of MTA and FRCs in achieving favorable treatment outcomes for iatrogenic furcal perforations.

Reattachment of Fractured Tooth: A Comprehensive Review.

Dental trauma is one of the most prevalent problems encountered in clinical practice. Traumatic injuries involving fractures of the anterior tooth are one of the most common problems among children and adolescents. There is a physical and social impact on patients' quality of life due to traumatic dental injuries (TDIs). Children and adolescents frequently present with a crown fracture that necessitates immediate intervention. Clinicians need to be aware of various treatment modalities for TDIs and have to address these injuries immediately. Due to advances in adhesive technologies, fragment reattachment is the treatment of choice when the fragment is available and well stored. The purpose of this article is to cover various techniques for reattaching fractured fragments and the most current developments in adhesive systems for this purpose.

Challenges Faced in Treating Maxillary Second Premolars With Three Canals: A Case Report.

The maxillary second premolar has long been regarded as a tooth with a straight root canal anatomy, typically featuring a single root with two canals. However, emerging evidence suggests this tooth may harbor a more intricate internal morphology, challenging conventional perceptions, and treatment approaches. One such variation is three root canals within the upper second premolar, which has been gaining increasing attention in endodontic literature. Root canal treatment of maxillary second premolars with three canals demands meticulous debridement, shaping, and disinfection. A combination of magnification, illumination, and appropriate instrumentation aids in locating, negotiating, and cleaning the accessory canals effectively. Thorough cleaning of accessory canals can be achieved through effective irrigation solutions such as sodium hypochlorite, ethylenediaminetetraacetic (EDTA), and chlorhexidine, which help dissolve organic tissues and remove debris. Techniques like ultrasonic and sonic activation, as well as negative pressure irrigation systems, enhance the penetration and effectiveness of these irrigants. Additionally, the use of modern nickel-titanium rotary files, ultrasonic irrigation, and supplementary chelating agents enhances the management of complex canal configurations.

Elevating Restorative Dentistry: Use of the Art of Stamp Techniques in Mandibular Posterior Regions.

In modern dentistry, restorations that are more aesthetically pleasing have now replaced the amalgam restorations. The "stamp technique" is one of the more recently developed techniques for combining aesthetics and functionality. When caries are visible on radiographs or clinical examinations of teeth with complete marginal ridges and an ideal tooth structure, this method can be used. This novel stamp technique involves creating an index beforehand, which is essentially a miniature impression or negative copy of the occlusal topography. The advantage of the stamp technique is that it replicates the actual occlusion and its anatomy, reducing the need for additional corrections. The amount of time required for the restoration's polishing and finishing is also decreased. In comparison to manual methods, for the posterior teeth, the occlusal stamp is approachable as it is a biomimetic direct composite restoration that helps to restore hidden caries with the impaired occlusal surface. It produces better outcomes as it takes less post-restoration filling adjustments.

Innovative Pulp Preservation: The Use of Platelet-Rich Fibrin (PRF) and Mineral Trioxide Aggregate (MTA) in Treating Dental Pulp Exposure.

The dental pulp, essential for tooth vitality, often becomes inflamed when exposed due to caries, fractures, or dislodged restorations. Untreated inflammation can lead to pulpal death, necessitating vital pulp therapies (VPTs) such as pulp capping and pulpotomy. Recent trends favor partial caries removal to avoid overtreatment and preserve pulp health. This shift is illustrated through two cases of young female patients with dislodged restorations and deep caries. Both underwent direct pulp capping using platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA), followed by composite restorations. These cases underscore the importance of biocompatible materials like MTA and PRF in maintaining pulp vitality and promoting dental tissue repair.

Morphometric Analysis of Radix Entomolaris: Implications for Endodontic Access and Treatment.

Radix entomolaris (RE) is an anatomical variation that involves the existence of an extra root in lower molars, particularly the first molar. This variant, although less common, has significant clinical implications in endodontic treatment and dental surgeries. Appropriate detection of radix entomolaris is crucial for treatment planning and prognosis. Various diagnostic aids like radiography, cone-beam computed tomography, and intraoperative exploration aid in identifying this anatomical variant.

Diving Deep: Exploring Dual Palatal Canals in the Upper Second Molar.

Dental anatomy exhibits considerable variation with the presence of additional canals being a common occurrence. The upper second molar typically presents with three canals and three roots; however, variations such as the existence of an extra canal or a root can pose challenges during endodontic treatment. Maxillary molar is characterized by an additional canal located within the palatal root, often exhibiting complex configurations and variations in morphology. Access refinement is critical to gaining adequate visibility and facilitating instrumentation. Meticulous exploration of the pulp chamber floor and careful examination of radiographs from different angles are essential for accurate diagnosis. Careful negotiation and cleaning of the extra canal with appropriate files and irrigants are essential to remove pulp tissue and debris effectively. Furthermore, obturation of the canal space with biocompatible materials is crucial to ensure a three-dimensional seal and prevent bacterial ingress. Clinically, the inability to detect and treat the extra palatal canal can lead to persistent infection, incomplete debridement, and compromised treatment outcomes. This case report delves into the significance of this anatomical variation, diagnostic modalities, and effective management strategies.

Preserving Vitality: A Case Report of Partial Pulpotomy in Dental Practice.

This paper aims to evaluate the outcomes of a partial pulpotomy with mineral trioxide aggregate (MTA) in a maxillary first premolar with reversible pulpitis symptoms and signs. An intraoral periapical radiograph revealed a deep pulp-involving carious lesion without any indications of a periapical lesion, no history of night pain, and no tooth tenderness when percussion was applied. Caries removal is done using a round bur, 2-3 mm of inflamed pulp from the crown portion was removed, and bleeding was controlled within four minutes using 2.5% sodium hypochlorite, over which MTA was placed. After the setting of MTA, resin-modified glass ionomer cement was placed over it, and the tooth was restored using composite. The patient was asymptomatic in six months and one-year follow-up with no periapical changes and showed dentin bridge formation. Careful case selection, a precise selection of biomimetic material, and long-term follow-up validate the success of the treatment.

Anatomical Variations in Mandibular Molars: Focus on Midmesial Canals.

Endodontic therapy focuses on the root canal system to treat infected or damaged pulp tissue within the tooth, ultimately preserving the tooth and restoring its function. The root canal space should be cleaned with the use of proper instruments and chemical disinfectants to eradicate infected pulpal tissue and its remnants. The failure of endodontic therapy is attributed to a lack of understanding of the differences in anatomy among teeth, as evidenced by research. Canals are identified, and endodontic treatment is facilitated by the use of dental operating microscopes. Therefore, to achieve a favorable endodontic result, it is imperative to use all available methods to identify additional aberrant root canals. Failure to detect and adequately treat the midmesial canal (MMC) can lead to persistent infection, treatment failure, and the need for retreatment. This case underscores the importance of meticulous assessment and advanced techniques in treating complex canal configurations, ultimately leading to favorable outcomes in endodontic therapy. The MMC, a challenging anatomical feature, was located through careful clinical and radiographic examination. Advanced techniques, including ultrasonic activation and meticulous instrumentation, were employed to navigate and clean the canal effectively. Sodium hypochlorite irrigation and passive ultrasonic activation were utilized for thorough disinfection. The MMC was sealed with biocompatible materials, ensuring comprehensive obturation of the root canal system.

Management of a Case of a Large Perforation Repair With Biodentine.

Perforations, which are artificial contact connections among teeth and supporting tissues, have a substantial impact on the success of root canal therapy, whether caused by iatrogenic or pathological causes. This case report describes a 51-year-old female who had intermittent jaw pain that was diagnosed as perforation and was successfully controlled with endodontic intervention following a referral due to procedural problems. The perforation in the furcation zone of a molar was treated with biodentine, demonstrating its sealing, biocompatibility, and tissue restoration properties. The discussion emphasizes the necessity of choosing the right repair materials and techniques based on perforation size and location. Biodentine emerges as a viable option due to its capacity to form a dependable seal in demanding settings.  The study concluded by emphasizing the need for physician competence, tooth morphology understanding, and operative proficiency in preventing and properly treating perforations for the best treatment outcomes.

Successful Management of a Tooth With an Endodontic-Periodontal Lesion Using a Bone Graft.

As periodontal and endodontic tissues have a close association, they come into close touch and have a lot of possible places for communication. In a clinical setting, this correlation promotes infection spread and results in the typical endo-perio lesion appearance. Because the two tissues are in close touch with one another, managing such lesions can be difficult. The success of treatment depends on a thorough examination and careful planning, with the sole focus on repair and regeneration. In these situations, bone graft materials with such characteristics have demonstrated encouraging outcomes. The treatment outcome along with a follow-up for a case of an endo-perio lesion with furcation involvement is shown in the accompanying case report. In treating such instances, a multidisciplinary approach is necessary, emphasizing regeneration.

Hemisection: A Paradigm Shift in Prolonging Tooth Viability.

Splitting a molar means removing or separating the root and the accompanying crown portion. Hemisection of a damaged tooth aids in preserving the tooth structure and the existing alveolar bone surrounding the preserved root while also enabling the installation of a fixed prosthesis. This case report defines hemisection as an effective modality for preserving carious mandibular first molars with periodontal and periapical pathology.

Effortless Precision: A Case Report on the Stamp Technique for Posterior Teeth.

The stamping technique, a pivotal process, has undergone significant advancements with the integration of composites. Traditionally, direct or indirect restorative cements, e.g., amalgam or composite resin, have been used to restore teeth, often presenting challenges in achieving optimal fit, esthetics, and durability. This process begins with creating an accurate impression of the prepared tooth, which serves as a blueprint for crafting the restoration. In contrast, the stamp technique, also known as the indirect restoration technique, offers several distinct advantages. The stamping technique enables the use of advanced materials that offer superior esthetics and durability. Composite resins used in stamp restorations can be shade-matched to the patient's natural teeth, resulting in seamless integration with the smile. These materials also exhibit excellent strength and wear resistance, ensuring restorations that last longer and are capable of withstanding stresses without fracture.

Management of an Intracanal Separated Instrument in the Lower Right First Molar: A Case Report.

Separating an endodontic instrument is one of the most frequent errors during a root canal treatment. If endodontic instruments get separated, it could hinder disinfection and prevent access to the apical portion of the root. It compromises the success of the treatment by impeding the proper debris removal from the canal. But now that techniques and tools have advanced, it is feasible to remove a separated instrument from the root canal successfully. This case report presents the management of a separated instrument, demonstrating the successful removal of the separated instrument.

Overview of Interim and Temporary Restorations of Teeth During Endodontic Treatment.

Root canal treatment of vital, non-infected teeth can often be completed in a single visit, negating the necessity for dressing and provisionalization. Conversely, cases involving infected canals typically demand multiple visits, during which antibacterial medicaments are applied, making effective provisionalization crucial for varying durations. The key components of a successful root canal treatment include adequate canal shape to promote efficient obturation, thorough chemical and mechanical debridement, and complete removal of pulp tissue remnants and bacteria. The primary cause of pain following the initiation of endodontic treatments is often attributed to inadequate debridement or incomplete removal of the pulp tissue, closely followed by insufficient temporary restorations. This review aims to comprehensively overview provisionalization materials used during and immediately after endodontic procedures.