Endodontic management of central incisor associated with large periapical lesion and fused supernumerary root: a conservative approach

Fusion and gemination are developmental anomalies of teeth that may require endodontic treatment. Fusion may cause various clinical problems related to esthetics, tooth spacing, and other periodontal complications. Additional diagnostic tools are required for the diagnosis and the treatment planning of fused tooth. The present case report describes a case of unilateral fusion of a supernumerary root to an upper permanent central incisor with large periapical lesion in which a conservative approach was used without extraction of supernumerary tooth and obturated with mineral trioxide aggregate to reach a favorable outcome.

Evaluation of antimicrobial activity and efficacy of herbal oils and extracts in disinfection of gutta percha cones before obturation

OBJECTIVES: Literature has shown that micro-organisms contaminate gutta percha (GP) during storage and manipulation. Till date herbal extracts are not explored as an alternative medicament for pre-operative chairside disinfection of GP cones. The purpose of our study was to evaluate the antimicrobial activity and efficacy of lemon grass oil (LG), basil oil (BO), and obicure tea extract (OT) in disinfecting GP cones before obturation. MATERIALS AND METHODS: Agar diffusion method was used to evaluate the antimicrobial efficacy of LG, BO, OT, and sodium hypochlorite (control) against common contaminants, namely, Enterococcus faecalis, Staphylococcus aureus, and Candida albicans. One hundred and twenty GP cones were contaminated and cut into 2. First half was placed in the broth and incubated; whereas the second was treated with herbal extracts for 1 minute and then incubated for 24 hours in the broth. Any inhibition in bacterial growth was noted with presence/absence of turbidity. Two-way analysis of variance and χ² test were used to assess the effectiveness of herbal extracts to decontaminate GP. RESULTS: LG showed the highest inhibition zones (29.9 ± 6.9 mm) for all tested organisms, followed by OT extract (16.3 ± 1.8 mm), sodium hypochlorite (16.0 ± 1.6 mm), and BO (14.5 ± 5.3 mm). Statistically significant difference was observed between LG and other herbal extracts (p < 0.05). CONCLUSIONS: All extracts proved to be potential rapid chairside disinfectants of GP cones with LG showing the highest antimicrobial activity.