Guided endodontics: a case report of maxillary lateral incisors with multiple dens invaginatus

Navigation of the main root canal and dealing with a dens invaginatus (DI) is a challenging task in clinical practice. Recently, the guided endodontics technique has become an alternative method for accessing root canals, surgical cavities, and calcified root canals without causing iatrogenic damage to tissue. In this case report, the use of the guided endodontics technique for two maxillary lateral incisors with multiple DIs is described. A 16-year-old female patient was referred with the chief complaint of pain and discoloured upper front teeth. Based on clinical and radiographic findings, a diagnosis of pulp necrosis and chronic periapical abscess associated with double DI (Oehler's type II) was established for the upper left lateral maxillary incisor (tooth #22). Root canal treatment and the sealing of double DI with mineral trioxide aggregate was planned for tooth #22. For tooth #12 (Oehler's type II), preventive sealing of the DI was planned. Minimally invasive access to the double DI and the main root canal of tooth #22, and to the DI of tooth #12, was achieved using the guided endodontics technique. This technique can be a valuable tool because it reduces chair-time and, more importantly, the risk of iatrogenic damage to the tooth structure.

Tremors; myths and misconceptions; a 7-year clinical survey 2002-2009

To determine the myths and misconceptions about [Tremors] among those who developed this disorder and their health seeking behavior, and also among those who never had tremors, at the psycho-neurology and medical OPD of Sindh Govt. Hospital, Liaqatabad no. 10, Karachi. A single centre based cross-sectional survey, conducted from year 2002 to 2009 at Sindh Govt. Hospital [SGH] Liaqatabad no.10, Karachi. 403 adult patients of either sex with tremors were selected from medical and psycho-neurology OPD's. For comparison 100 healthy individuals from general population, who never had tremors, of the same area were also included. Questionnaires regarding different myths and misconceptions about tremors were filled by the patients/normal healthy people after obtaining the consent. Out of 403 selected patients [61.53% males and 38.47% females] majority belonged to the urban areas. Out of hundred normal healthy people 73 [73%] were males and 27 [27%] were females. Only 8% of the patients considered tremor was a neurological illness, while 33% of the patients and 41% of the general population related it to magic or witchcraft. Overall, females were more inclined to choose alternative medicine and spiritual therapy than males. Myths and Misconceptions about tremors are present in our society because of strong belief and observations. Provision of primary education, health education and using electronic media can play a key role in abolishing these misconceptions