Radicectomy of radix entomolaris: An alternative treatment approach for persistent periapical lesion assisted by cone-beam computed tomography and operating microscope.

Every clinician as well as patient would prefer to sustain their natural teeth in all situations. For a badly mutilated terminal abutment, molar treatment options are limited, but loss of posterior tooth can lead to several unwanted sequelae. A guiding principle should be to preserve what is present. If complete preservation is not possible, the most conservative treatment should follow in every clinical situation. Radisectomy is one such conservative surgical treatment approach that allows resection of one or more affected roots of tooth at the level of furcation and preserves the remaining roots and the complete crown structure, thereby maintaining the occlusal harmony. Hereby, we are presenting a case report on radicectomy of distobuccal root of a mandibular third molar with persistent periradicular pathosis, with the assistance of microscope and cone-beam computed tomography.

Evaluation of Bond Durability, Surface Morphology, and Remineralization at the Adhesive Interface with Dentin Bonding Agents Modified with Silica-doped Nanohydroxyapatite.

Objectives: To compare and evaluate the bond durability, surface morphology, and remineralization of the adhesive layer with newer adhesive systems modified with novel bioactive nanoparticles. Methodology: Bonding agents evaluated in this study include (a) Conventional dentin bonding agent (CN-DBA) (b) Nanohydroxyapatite (nanoHAP) incorporated dentin bonding agent (NH DBA); (c) Silica doped nanohydroxyapatite (Si nanoHAP) incorporated dentin bonding agent (Si NH DBA). A total of 104 human dentin discs (5 mm × 5 mm × 2 mm) were sectioned. Elemental analysis (Ca/P ratio) and surface morphology of the adhesive layer with different dentin adhesives were evaluated under scanning electron microscopy with energy-dispersive X-ray analysis after speculated storage time of 1 day and 6 months. Microshear bond strength of adhesive restorations with different dentin adhesives was evaluated under universal testing machine and fractographic analysis under scanning electron microscope after speculated storage time of 1 day and 6 months. The results were analyzed using analysis of variance and post hoc analysis. Results: Si-NH-DBA showed highest mean microshear bond strength for both 1 day and 6 months, which was significantly higher compared to conventional nanofilled dentin bonding agent (CN-DBA) and NH-DBA. Si-NH-DBA group showed only 10% reduction in bond strength after 6 months, which was less compared to that of other groups. Similarly, Si-NH-DBA showed higher remineralization with stellate-shaped crystals at the adhesive layer after 6 months with hydrolytic resistant hybrid layer, compared to CN-DBA and NH-DBA. Conclusion: Silica-doped nanohydroxyapatite proved its efficiency on bond stability, remineralization, and hydrolytic resistance when incorporated into dentin bonding agents because of its bioactivity and carbonate-containing apatite-forming ability.