ABSTRACT
BACKGROUND: The presence of dens invaginatus (DI) complicates treatment of any tooth, from diagnosis to access cavity and biomechanical preparation and obturation. Reports of successful non-surgical management of DI type IIIB in maxillary lateral incisor are rare. Here, we report such a case, with three root canals and a long follow-up. CASE SUMMARY: A 13-year-old female patient presented with mild pain in the maxillary right lateral incisor (#7) for 10-15 d. On examination, the tooth was slightly rotated, with slight tenderness on percussion and grade I mobility but with no caries, pockets or restorations and non-vital pulp (via vitality tests). Radiographic examination revealed unusual configuration of the tooth's root canals, with an enamel-lined invagination extending to the apex, suggesting the possibility of DI Oehler's type IIIB and a periapical radiolucency. Widening the access cavity lingually revealed one distinct buccal orifice and two distinct palatal orifices; under higher magnification of a dental operating microscope (DOM), the mesio-palatal and disto-palatal orifices were observed as connected by a C-shaped groove. The root canals were prepared with hand K-files following a step-back technique, and obturated using a combination technique of lateral condensation and vertical compaction. At the 6-year follow-up, the patient was asymptomatic, and the periapical radiography displayed significant healing around the apical end of the root. CONCLUSION: Proper knowledge of unusual root canal anatomy is required in treating DI. Conventional methods of root canal treatment can successfully resolve such complex cases, facilitated by DOM and cone-beam computed tomography.
ABSTRACT
BACKGROUND: The current recommendations for the apical preparation diameter, one of the most important mechanical imperatives in the apical third preparation, are to preserve the apical foramen in its original position along with its narrowest diameter to avoid any complication such as tearing, zipping, or transport of the foramen. The aim of our study was to see the correlation between apical seal and apical preparation diameter. MATERIALS AND METHODS: In total, 90 extracted maxillary incisors were randomly allocated into three groups of 30 teeth each according to the apical preparation size: Group 1: finishing file F1 corresponding to size 20 reached the working length, Group 2: prepared up to size 30 corresponding to finishing file F3, and Group 3: prepared up to size 50 corresponding to finishing file F5. After the filling of the root canals, the teeth were isolated and immersed in a dye solution, then cut longitudinally, photographed, and the dye penetration were calculated using a computer software. RESULTS: Comparison of the three different apical preparation sizes showed no statistically significant differences regarding the apical microleakage. CONCLUSION: The most important value of the dye penetration was observed in the group with the largest apical diameter.
ABSTRACT
It is very rare (2%-6% cases) for a mandibular canine to have two root canals and the incidence of finding two roots with two root canals in a mandibular canine that too bilaterally is almost negligible. This case report discusses the presence and multidisciplinary management of such rarest configuration in both mandibular canines of a female patient. This case shows the importance of recognition of anatomical variations in successful accomplishment of root canal treatment.
ABSTRACT
Background and Objectives: Surfaces of composite restorations are adversely affected upon bleaching and topical fluoride application. Such a procedure is normally carried out in the presence of restorations already serving in a different oral environment, although previous in vitro studies only considered the freshly-prepared composite specimens for assessment. The current study accordingly aimed to evaluate both the surface hardness and roughness of aged composite restoratives following their successive exposure to bleaching and topical fluoride preparations. Materials and Methods: Disc specimens were prepared from micro-hybrid, nano-filled, flowable and bulk-fill resin composites (groups 1-4, n = 60 each). All specimens were subjected to artificial aging before their intermittent exposure to surface treatment with: none (control), bleach or topical fluoride (subgroups 1-3, n = 20). All surface treatments were interrupted with two periods of 5000 thermal cycles. Specimens' surfaces were then tested for both surface hardness (Vickers hardness number (VHN), n = 10) and roughness (Ra, n = 10). The collected VHNs and Ras were statistically analyzed using two-way ANOVA and Tukey's comparisons at α = 0.05 to confirm the significance of differences between subgroups. Results: None of the tested composites showed differences in surface hardness and roughness between the bleached and the non-treated specimens (p > 0.05), but the bleached flowable composite specimens only were rougher than their control (p < 0.000126). In comparison to the control, fluoride treatment not only reduced the surface hardness of both micro-hybrid (p = 0.000129) and flowable (p = 0.0029) composites, but also increased the surface roughness of all tested composites (p < 0.05). Conclusion: Aged composite restoratives provide minimal surface alterations on successive bleaching and fluoride applications. Flowable resin composite is the most affected by such procedures. Although bleaching seems safe for other types of composites, the successive fluoride application could deteriorate the aged surfaces of the tested resin composites.
