Endodontic diagnostic dilemmas: thorough examination may preclude inappropriate treatment.

In situations where suspicious lesions of undetermined origins are encountered, it is important for clinicians to consider non-endodontic and perhaps non-odontogenic sources to properly diagnose the condition in order to provide appropriate treatment. Differential diagnoses may include cysts, anatomic variations, and neoplastic lesions. Diagnostic dilemmas and misperceptions can be prevented and ineffective treatment avoided by thoroughly reviewing the patient's medical and dental histories and employing a detailed clinical and radiographic examination. This article presents three cases that were referred to the authors' clinic for endodontic treatment but were ultimately diagnosed as non-endodontic in origin.

Symmetry of root and root canal morphology of maxillary and mandibular molars in a white population: a cone-beam computed tomography study in vivo.

INTRODUCTION: The aim of the present study was to use cone-beam computed tomography (CBCT) to analyze root canal anatomy and symmetry of maxillary and mandibular first and second molar teeth of a white population. METHODS: A total of 201 patients who required CBCT examinations as part of their dental diagnosis and treatment were enrolled in the present study. Overall, 596 healthy, untreated, well-developed maxillary and mandibular molar teeth (161 maxillary first molars, 157 maxillary second molars, 117 mandibular first molars, and 161 mandibular second molars) were examined by CBCT to establish the symmetry in root and canal anatomy between right and left sides in the same patient by evaluating the number of roots and root canals and the root canal configuration. RESULTS: Three separate roots with 3 separate canals was the normal anatomy of maxillary first and second molars. Most mandibular first and second molars had 2 separate roots, and the majority had 3 canals. In the present study, first molars, both maxillary and mandibular, exhibited greater asymmetry than the second molars. Maxillary first molars were found to be symmetrical in 71.1% of patients, whereas maxillary second molars were symmetrical in 79.6%. The remaining 28.9% and 20.4% of patients, respectively, showed asymmetry. Around 30% of the mandibular first molars and 20% of the mandibular second molars showed asymmetry. CONCLUSIONS: The results of the present study reported a percentage of symmetry that varied from 70%-81%. These variations in symmetry should be taken in high consideration when treating 2 opposite molars in the same patient, because their anatomy may be different in up to 30% of the cases.

Effective rotary nickel titanium file use: mastering the right touch.

Strategies for creating efficiency and safety in the clinical use of rotary nickel titanium instruments are presented with an emphasis on using the correct tactile touch.