The mandibular first molar with three canals in the mesial root- a case report.

The dynamic concept of the root canal system, which describes a variable morphology of the multiple root canals which are inter-connected by anastomoses, has been established as the prevailing state in the mandibular molars. The aim of this case report was to describe the unusual root canal anatomy that was detected in the mandibular first molar during the routine endodontic treatment. The clinical and the radiographic examinations allowed the detection of the middle mesial root canal between the mesiobuccal and the mesiolingual root canals. This report highlights the importance of such examinations and the need to find and treat the additional canals, to achieve a successful endodontic treatment.

Effect of two different types of fibers on the fracture resistance of endodontically treated molars restored with composite resin.

PURPOSE: To compare the in vitro fracture resistance of endodontically treated molars with mesio-occluso-distal (MOD) cavities restored with two different types of fibers. MATERIALS AND METHODS: Sixty extracted human mandibular first molars were selected for the study and randomly assigned to six groups (n = 10). Group 1 served as the control. In groups 2 through 6, endodontic access and standard MOD cavities were prepared. Following root canal treatment, group 2 was left unrestored. In group 3, the teeth were restored with composite resin (Venus, Heraeus Kulzer). In group 4, flowable composite resin (Venus, Heraeus Kulzer) was used before restoring the teeth with composite resin. In group 5, leno-woven ultrahigh molecular weight polyethylene ribbon fiber (Ribbond) was inserted in the flowable resin in a buccal to lingual direction, and the teeth were then restored with composite resin. In group 6, translucent glass fiber (Vectris, Ivoclar) was adapted over the flowable resin in the bucco-lingual direction and restored with composite resin. The specimens were stored in 100% humidity at 37°C for 1 day. Compressive loading of the teeth was performed using a universal testing machine at a crosshead speed of 0.5 mm/min. The mean load necessary to fracture the samples was recorded in Newtons (N). Data were subjected to analysis of variance (ANOVA) and Duncan's post-hoc test, where significance was set at p < 0.001. RESULTS: The highest and the lowest mean fracture strengths were found in sound teeth (1598.8 N) and unrestored teeth (393.7 N), respectively. The mean load necessary to fracture the samples was 958.6 N in the polyethylene ribbon group (group 5), 913.2 N in the glass-fiber group (group 6), 699.7 N in teeth restored with flowable resin and composite (group 4), and 729.3 N in group 3 with composite resin alone. Statistical analysis showed significantly higher fracture resistance of both the fiber groups compared to composite resin alone (p < 0.001). CONCLUSION: Both polyethylene ribbon and glass fiber under MOD composite restorations significantly increased fracture strength with no statistical difference between the two groups. Therefore, both polyethylene- and glassfiber- reinforced composites can be used for access cavity restorations in teeth with weakened cusps.

Independent and confluent middle mesial root canals in mandibular first molars: a report of four cases.

Mandibular molars demonstrate considerable variations with respect to number of roots and root canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. This paper discusses the endodontic management of the rare anatomical complexity middle mesial canals in mandibular first molar and also serves to remind the clinicians that such anatomical variations should be taken into account during the endodontic treatment of the mandibular molars.

Evaluation of the antibacterial and physical properties of glass ionomer cements containing chlorhexidine and cetrimide: an in-vitro study.

BACKGROUND: Incorporation of antibacterial agents frequently results in changes in the physical properties of restorative materials. MATERIALS AND METHODS: This in-vitro study investigated the antibacterial and physical properties of Glass ionomer cement (GIC) with chlorhexidine and cetrimide, to determine the optimal concentration, for incorporation of these agents to obtain antibacterial GICs for use with the Atraumatic restorative treatment approach. This was assessed using the agar diffusion test. Chlorhexidine diacetate and cetrimide were added to Glass ionomer cement type-IX (GIC-FUJI IX) at 1 and 2% W/W ratio. The experimental GIC specimens were placed on agar plates inoculated with Lactobacillus casei, and the area of inhibition was calculated after 48 hours. RESULTS: All the experimental GICs exhibited inhibition of bacteria, but the sizes were dependent on the concentration of the antibacterial agent. Incorporation of chlorhexidine diacetate and cetrimide, at 2%, significantly decreased the compressive strength, and the setting time was extended a little by the addition of any concentration of chlorhexidine and cetrimide. CONCLUSIONS: The present study demonstrated that experimental GICs containing chlorhexidine diacetate and cetrimide were effective in inhibiting bacteria associated with caries, and incorporation of 1% cetrimide was optimal to give the appropriate antibacterial and physical properties.

Spiral CT diagnosis and endodontic management of an anatomically variant palatal root with two canals in a maxillary first molar.

This case report presents the endodontic management of an anatomically variant palatal root with 2 canals (Vertucci type II) in a maxillary first molar, which was confirmed with the help of spiral computed tomography (SCT). This serves to remind clinicians that such anatomic variations should be taken into account during the endodontic treatment of maxillary molars and highlights the invaluable aid of the SCT in accurate diagnosis and in negotiating the complex morphologic variations in root canals, thus enabling successful endodontic management.