Impact of Pericervical Dentin on Fracture Resistance of Endodontically Treated Posterior Permanent Teeth: A Systematic Review and Meta-analysis.

OBJECTIVE: The main aim of this present systematic review is to evaluate if the preservation of pericervical dentin (PCD) increases the fracture resistance of endodontically treated permanent posterior teeth. MATERIALS AND METHODS: Two independent reviewers conducted a comprehensive review of all published studies from 2007 (1/1/2007) to 2023 (31/5/23) since the concept of PCD first appeared in the literature in 2007. Searches were conducted in multiple electronic database engines: PubMed, Scopus, EBSCO (Dentistry and oral health sciences), Web of Sciences (WOS), Cochrane, Google Scholar and Open Grey, Ovid and Shodhganga, in addition to cross-references and hand search. Articles were chosen according to a certain inclusion and exclusion criteria, which, in brief, are laboratory-based studies published in English that assess the impact of PCD on fracture resistance of endodontically treated permanent posterior teeth. Using domains, such as sample size, sample dimensions, and control group as quality assessment criteria, evaluated the selected articles and classified them according to their risk of bias into low, moderate, and high. A meta-analysis was conducted using random effects modeling at a significance level of p < 0.05. RESULTS: A total of studies 6,043 were retrieved from 10 different electronic search databases and hand searches, but only 12 laboratory-based studies were selected after removing duplicates and applying the eligibility criteria. Of the included 12 studies, nine studies showed low risk of bias and three studies showed moderate risk of bias. Two studies showed related data for meta-analysis, the difference observed between the two studies is statistically non-significant. CONCLUSION: Based on the results of the study, there is evidence to support that PCD preservation offers fracture resistance to the endodontically treated posterior teeth. CLINICAL SIGNIFICANCE: The practice of conservative cavity preparation and avoiding the usage of instruments with high taper increases the fracture resistance of the tooth by retaining the PCD. How to cite this article: Haridoss S, Rajendran M, Swaminathan K, et al. Impact of Pericervical Dentin on Fracture Resistance of Endodontically Treated Posterior Permanent Teeth: A Systematic Review and Meta-analysis. J Contemp Dent Pract 2024;25(4):372-385.

Bleaching techniques in primary teeth: a systematic review.

OBJECTIVE: Discolouration of primary teeth, often attributed to trauma and pulpal infection, is a prevalent concern that can significantly impact the esthetics and self-esteem of children. To address this issue, bleaching techniques have emerged as a viable treatment option. This systematic review aims to provide a comprehensive summary of the effectiveness of bleaching agents in managing discoloured primary teeth. METHODS: Two reviewers independently conducted an electronic database search using PubMed, EMBASE, LILACS, CINAHL via EBSCO, Scopus, and Web of Science until September 26,2023. In vitro studies and case reports that assessed the quantifiable success were included. The present review utilized Distiller SR software for data extraction. The protocol of this study was registered in PROSPERO (International Prospective Register of Systematic Reviews) (CRD42022329831). The quality of studies was analysed with Cochrane tool and the JBI checklist. RESULTS: The search retrieved 1845 references of which 14 studies were included for qualitative analysis. There were 8 in vitro studies and 6 case reports included in this systematic review. There were 299 teeth samples in the in vitro studies and 18 teeth were assessed in the case reports. All the 18 teeth (6 case reports) showed considerable shade improvement within 7-14 days. However, only 3 teeth were followed up for a period of 12-24 months. Substantial shade improvement was also observed in samples in the in vitro studies. CONCLUSION: This systematic review has comprehensively examined the various bleaching agents and methods for the management of discoloured primary teeth. However, it is crucial to recognize that the available evidence is from case reports and is insufficient to make a clinical recommendation.

Comparison of conventional preparation with modified access preparation on fracture resistance of primary molars - A finite element analysis.

Objective: To investigate the influence of Conventional Straight (CS) line and Modified Straight (MS) line access preparations with various restorative materials on the fracture resistance of primary molars using Finite Element Analysis (FEA). Methodology: Three FEA models for each of the primary molars were divided into Group I- Intact tooth model; Group II- Model with CS outline and Group III- Model with MS outline. Based on the restorative material used, Group II and III were further subdivided into subgroup 1- GIC restoration, subgroup 2 - composite resin with GIC base and subgroup 3- Stainless Steel Crown (SSC). Each model was subjected to 5 different force loads directed at the occlusal surface. Maximal von Mises (VM) stresses calculated from stress distribution patterns. Result: The maximum displacement, in all the models of primary molars were seen in GIC restored models in molars with both CS and MS access whereas the minimal displacement was seen in the SSC restored molars of MS group. Conclusion: In primary maxillary second molar and mandibular first and second molar with intact marginal ridges, the fracture resistance of tooth with MS outline restored with GIC base followed by Composite resin was comparable with the tooth restored with SSC and CS outline. Clinical outcome: Based on the results of this FEA analysis, composite restorations with MS outline would be appropriate for endodontically treated primary molars that have intact margins.

Mechanical Properties and Clinical Success of Intracanal Posts in Primary Maxillary Anterior Teeth: A Systematic Review and Meta-analysis.

Background: Intracanal posts are commonly used to restore lost permanent/primary tooth structure and the smile of the patient. Aim: This systematic review aims to evaluate the clinical success of intracanal posts used in primary maxillary anterior teeth and compare their mechanical properties. Methods: An extensive literature search was performed using Medline via PubMed, Embase via embase.com, LILACS, CINAHL via EBSCO, Cochrane Oral Health Group Specialized Register, Scopus, and Web of Science until December 2021 and was updated till December 2022. In vivo and in vitro studies in the English language that assessed clinical success and mechanical properties were included. Distiller SR software was used for everything from title screening to data extraction. Results: A total of 30 studies were analyzed, including 11 in vivo and 19 in vitro studies. Four studies were included in a meta-analysis, and all 30 studies qualified for qualitative analysis. The meta-analysis showed that fiber posts are clinically superior to composite resin posts (CRPs) (p = 0.02). No significant difference was observed between the fracture resistance of CRPs and no posts (p = 0.73). Most of the included studies showed a high risk of bias. Conclusion: Conclusive evidence about the effectiveness of various intracanal posts cannot be established. This is due to the limited number of clinical trials and included studies of low to moderate quality with a high risk of bias. To validate the use of posts in primary maxillary anterior teeth, further research, including randomized controlled trials (RCTs) of higher quality, is required. Clinical significance: The use of intracanal posts in primary teeth is a commonly used treatment modality among pediatric dentists. However, the quality of the evidence to support its use is low. This systematic review provides a comprehensive summary of the current literature and highlights the need for further research. Results were interpreted with caution, as the evidence supporting the use of intracanal posts in primary teeth is limited. How to cite this article: Shanmugam Y, Raghu A, Muthu MS, et al. Mechanical Properties and Clinical Success of Intracanal Posts in Primary Maxillary Anterior Teeth: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023;16(S-3):S293-S305.

Shaping Properties and Outcomes of Nickel-Titanium Reciprocation Systems in Primary Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies.

The aim of this systematic review was to investigate the shaping properties and outcomes of reciprocating instruments in primary teeth. A search was conducted across various electronic databases such as PubMed, Scopus, EBSCO (dentistry and oral health sciences), LILACS, Cochrane, Google Scholar (first 100 hits), Open Grey, Ovid, and Shodhganga. Two authors independently performed data extraction and quality assessment of the selected articles using Rayyan software. A total of 12 studies were included. All 12 included studies qualified for qualitative analysis and five for meta-analysis. The meta-analysis revealed there was no statistical significance between rotary and reciprocating instruments concerning instrumentation time and canal transportation. The rotary and reciprocating instruments showed better shaping outcomes than hand instruments. Randomized controlled trials are required with adequate quality to perform a meta-analysis to provide better and more substantial evidence to use reciprocating instruments.

Transportation and Centering Ability of Kedo-S Pediatric and Mtwo Instruments in Primary Teeth: A Cone-beam ComputedTomography Study.

Background: Cleaning and debriding the canals and preserving the shape of the canal without deformation is the primary goals of pulpectomy. Transportation is a critical endodontic iatrogenic fault that could cause a catastrophe. This study evaluated the canal centering ability and canal transportation caused by Kedo-S pediatric and Mtwo instruments, using a cone-beam computed tomography (CBCT). Materials and methods: This in vitro study was performed on distal roots of 50 primary mandibular first molars. The teeth were scanned using CBCT and randomly divided into two groups. The canals were then prepared using either Kedo-S or Mtwo files (n = 25). The instrumented canals were rescanned. The scanned volumes were sectioned at 2, 4, and 6 mm from cementoenamel junction (CEJ). Canal transportation (CT) and instrument centering ability were estimated and compared in both groups. Results: The mean values for two study groups were compared. T -test was used to determine theP value. The Levene's test was used to test the significance between two groups. The two groups showed similar results in terms of transportation and centering ability (P > 0.05). Conclusion: Kedo-S pediatric and Mtwo instruments demonstrated similar canal centering ability and CTs. How to cite this article: Haridoss S, Rakkesh KM, Swaminathan K. Transportation and Centering Ability of Kedo-S Pediatric and Mtwo Instruments in Primary Teeth: A Cone-beam Computed Tomography Study. Int J Clin Pediatr Dent 2022;15(S-1):S30-S34.

Computed Tomographic Assessment of Remaining Dentin and Risk of Perforation after Kedo-S and Mtwo Rotary Instrumentation in Root Canals of Primary Teeth: An In Vitro Study.

Background: Root canal cleaning is a key step in the endodontic treatment of the primary molars. An innovative generation of endodontic instruments has been devised with the aim of emerging better procedures. The objective of the study is to assess the preparation of time, the risk of lateral perforation, and the removal of dentin from Kedo-S and Mtwo rotary instruments on primary teeth. Study design: This is an in vitro experimental study comparing the two groups. Materials and methods: A total of 50 extracted mandibular primary first molars are collected, divided randomly into two groups of 25 teeth each. Group I: Kedo-S Pediatric rotary file, Group II: Mtwo rotary file. Distal canal is standardized for evaluation and teeth are sectioned at the CEJ. The teeth were instrumented according to manufacturer's guideline. Both the groups are scanned before and after instrumentation of the canal using cone-beam computed tomography (CBCT) and values are evaluated. Results: Compared with Mtwo files, Kedo-S files need less instrumentation time and limited lateral perforation. No statistical differences were reported between the instrumentation of Kedo-S and Mtwo with regard to the amount of dentin removed. Conclusion: In pediatric endodontics, Kedo-S pediatric rotary file can be considered an effective alternative to traditional rotary files because it requires less instrumentation time and preserves dentin thickness. How to cite this article: Swaminathan K, Rakkesh KM, Haridoss S. Computed Tomographic Assessment of Remaining Dentin and Risk of Perforation after Kedo-S and Mtwo Rotary Instrumentation in Root Canals of Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(S-1):S87-S91.

Dental Caries Experience among Children and Adolescents with Cleft Lip and/or Palate: An Umbrella Review.

Aim and objective: To assess the systematic reviews and meta-analyses investigating the dental caries experience in children with cleft lip and/or palate (CL/P). Study design and methodology: A systematic search was carried out from MEDLINE Via PubMed, JBI Database of Systematic Reviews and Implementation Reports, EMBASE, OVID, Cochrane Database of Systematic Review, and Epistemonikos databases. Two independent reviewers carried out the collection and analysis of the study data. Methodological quality was assessed by ROBIS (Risk of bias assessment in systematic review) tool. Review results: An initial search of electronic databases yielded a total of 25 relevant reviews, of which only three systematic reviews were taken into consideration for qualitative synthesis. The total number of unique primary studies among the three included systematic reviews were 25, of which overlap of the studies was calculated using citation matrix. The corrected covered area (CCA) was estimated to be 0.26. Based on the ROBIS tool, only one systematic review reported with low risk of bias. Conclusion: Individuals with CL/P report more decayed, missing, or filled teeth/surfaces than those without CL/P in primary, mixed, and permanent dentition. Future studies should focus on the factors which could modify the caries risk of an individual with CL/P. Clinical significance: This umbrella review offers a more reliable and balanced view regarding the dental caries experience among individuals with cleft lip and/or palate. This paper also highlights the important role of pediatric dentist in multidisciplinary health care team in implementing first dental visit and anticipatory guidance to consider early diagnosis and specific preventive interventions for Early Childhood Caries (ECC) in individuals with CL/P. How to cite this article: Abirami S, Panchanadikar NT, Muthu MS, et al. Dental Caries Experience among Children and Adolescents with Cleft Lip and/or Palate: An Umbrella Review. Int J Clin Pediatr Dent 2022;15(S-2):S261-S268.

Comparison of viscosities of human breast milk versus infant milk formulae with and without addition of sweetening agents.

Context: Early childhood caries is a major health problem affecting children worldwide. Although incorrect feeding practices hold a prime position in the etiology, there are gaps in the literature pertaining to the physical properties of milk. Aim: To assess the viscosity of human breast milk (HBM) versus infant milk formulae, with and without the addition of sweetening agents. Materials and Methods: All commercially available infant milk formulae (60 samples) and breast milk from 30 donor mothers were assessed for viscosity using Brookfield DV2T viscometer. The study period was from April 2019 to August 2019. Viscosity of infant milk formulae sweetened with sugar, honey, and brown sugar was further investigated and compared with that of HBM. Statistical Analysis: Inter-group and intra-group mean viscosity was compared using independent t-test and repeated-measures ANOVA. Results: Viscosity of HBM ranged from 18.36 centipoise (cP) to 91.30 cP, the mean viscosity being 45.7 cP. Viscosity values varied for each formula group, the least being as low as 5.1 cP and the highest being 89.3 cP. The mean viscosities of each group were in the range of 33 to 49 cP. Conclusions: HBM was found to have a tendency toward higher viscosity than most of the infant milk formulae. Also, varied viscosity values were obtained when commonly used sweetening agents were added to infant milk formulae. Greater viscosity of HBM might increase its adherence to enamel surface leading to prolonged demineralization and potentially altering the caries risk, needs to be investigated further.

Solitary Median Maxillary Central Incisor Syndrome: A Case Report.

Aim: This report intends to present a case of solitary median maxillary central incisor syndrome (SMMCI) and its multidisciplinary team approach for diagnosis of other associated anomalies, with special emphasis on their management. Background: Solitary median maxillary central incisor syndrome is a unique developmental condition characterized by only maxillary central incisor and a series of developmental defects, appearing as a syndrome. The appearance of a single incisor may take place due to the union of two incisor teeth or the absence of tooth germs. The mechanism of the fusion is still uncertain. Case description: A 9-year-old female child reported with a chief complaint of pain in the right lower back tooth for the past 10 days. The presence of a single maxillary central incisor was an incidental finding. Then a detailed history and multidisciplinary evaluations revealed the diagnosis of SMMCI syndrome. Conclusion: The effort in diagnosing and managing this syndrome had a strong impact on the child's life of which the parent was highly motivated and got a better understanding of associated problems of overall development. Clinical significance: In SMMCI syndrome, the patient requires a multidisciplinary health team in order to improve their quality of life. It is of greater importance to diagnose the syndrome and treatment of these median line deformities. How to cite this article: Balasubramanian S, Haridoss S, Swaminathan K. Solitary Median Maxillary Central Incisor Syndrome: A Case Report. Int J Clin Pediatr Dent 2022;15(4):458-461.

Impact of Pediatric Dentistry Residents Posted in Pediatrics Department: A Retrospective Assessment of 6 Years.

AIM: To measure the influence of rotatory pediatrics postings for dental residents on the outpatient census of the pediatric dentistry department. The secondary aims were to assess the change in trend toward the number of preschool children visiting the department before and after the initiation of pediatrics posting and also to find the percentage of children affected with caries among children visiting the pediatricians. MATERIALS AND METHODS: Retrospectively, the census of the pediatric dentistry department was calculated from 2010 to 2016. The number of preschool children who visited the pediatric dentistry department during this period was determined. From the pediatrics posting records, the dental status of the children, the number screened, the number referred, and the number reported to dentistry following referral were tabulated. Descriptive statistics and Chi-square tests were performed. RESULTS: After the initiation of pediatrics postings for residents, the outpatient census has increased by 26%. There was a significant increase in the number of preschool children visiting the pediatric dentist. About 57.09% of children screened in the pediatrics department had dental disease. CONCLUSION: There is an increase in the patient flow of the pediatric dentistry department with a greater number of preschool children visiting the pediatric dentist after initiation of the pediatrics postings for residents. More than half the children visiting pediatricians had dental disease requiring professional care. CLINICAL SIGNIFICANCE: Pediatrics postings for residents can be used in teaching centers as an opportunity to spread awareness and increase the number of preschool children visiting pediatric dentists, thereby increasing prevention and early intervention of early childhood caries. HOW TO CITE THIS ARTICLE: Mohan A, Muthu MS, Ramachandran P, et al. Impact of Pediatric Dentistry Residents Posted in Pediatrics Department: A Retrospective Assessment of 6 Years. Int J Clin Pediatr Dent 2021;14(1):84-87.

Correlation Between Body Mass Index and Dental Caries Among Three- to 12-Year-Old Schoolchildren in India: A Cross-Sectional Study.

INTRODUCTION:  Diet is a deeply ingrained element of a person's life. Children's dietary habits are a significant contributor to obesity and dental caries. Dental caries during childhood continues to be a significant public health concern, while childhood obesity is increasingly being cited as a major public health problem. This study aimed to assess the correlation between body mass index (BMI) and dental caries in children aged three to 12 years who attended both government and private schools in Chennai, Tamil Nadu, India. MATERIALS AND METHODS:  We conducted a cross-sectional review of 2200 children aged three to 12 years with clinically recorded dental caries. The World Health Organization diagnostic criteria for BMI percentile was used to evaluate and record dental caries clinically. The Mann-Whitney and the Kruskal-Wallis tests were used for univariate comparisons. RESULTS:  Mean values between the overweight category and underweight category revealed no significant differences. CONCLUSION:  We found no association between BMI-for-age and dental caries in children in both primary and mixed dentition. This relationship should be investigated further by longitudinal studies.

Do Oral Health Educational Programmes for Expectant Mothers Prevent Early Childhood Caries? - Systematic Review.

PURPOSE: To summarise the evidence for the efficacy of oral health educational programmes provided to expectant mothers for preventing Early Childhood Caries (ECC) and to determine the most effective intervention programme. MATERIALS AND METHODS: The search strategy included clinical trials in the Cochrane Oral Health Group's Trials Register, PubMed, Science Direct, Google Scholar, LILACS and ClinicalKey (up to 26 August 2013) in English. Reference lists of identified randomised controlled trials (RCTs) and review articles were also hand searched. Studies were selected according to predefined inclusion and exclusion criteria. RESULTS: The search identified 392 studies, only four of which were included. Risk ratios (RR) were calculated. The quality of the evidence was assessed by the GRADE approach. Results showed statistically significant decreases in caries incidence (RR = 0.18, 95% CI [from 0.06 to 0.52]) in one study. Meta-analysis could not be performed. CONCLUSION: Oral health educational programmes for expectant mothers may have a positive impact in preventing ECC, although the evidence is weak.

The effects of changes in glutathione levels through exogenous agents on intracellular cysteine content and protein adduct formation in chronic alcohol-treated VL17A cells.

Alcohol-mediated liver injury is associated with changes in the level of the major cellular antioxidant glutathione (GSH). It is interesting to investigate if the changes in intracellular GSH level through exogenous agents affect the intracellular cysteine content and the protein adduct formation indicative of oxidative insult in chronic alcohol treated liver cells. In VL-17A cells treated with 2 mM N-acetyl cysteine (NAC) or 0.1 mM ursodeoxycholic acid (UDCA) plus 100 mM ethanol, an increase in cysteine concentration which was accompanied by decreases in hydroxynonenal (HNE) and glutathionylated protein adducts were observed. Pretreatment of 100 mM ethanol treated VL-17A cells with 0.4 mM buthionine sulfoximine (BSO) or 1 mM diethyl maleate (DEM) had opposite effects. Thus, altered GSH level through exogenous agents may either potentiate or ameliorate chronic alcohol-mediated protein adduct formation and change the cysteine level in chronic alcohol treated VL-17A cells. The gene expression of non-treated and ethanol-treated hepatocytes in 2 microarray datasets was also compared to locate differentially expressed genes involved in cysteine metabolism. The study demonstrates that increased protein adducts formation and changes in cysteine concentration occur under chronic alcohol condition in liver cells which may increase alcohol-mediated oxidative injury.

Prevalence and pattern of early childhood caries in a rural South Indian population evaluated by ICDAS with suggestions for enhancement of ICDAS software tool.

BACKGROUND: Early Childhood Caries (ECC) continues to be the most common public health issue in developing countries. AIM: The purpose of this study was to assess the prevalence of ECC in 0- to 3-year-old children from rural areas of South India, using the ICDAS. DESIGN: A cross-sectional study was carried out with 1486 children aged 0-3 years in South India. Two calibrated examiners performed the oral examinations using International Caries Detection and Assessment System (ICDAS) criteria. Data analysis involved the use of the new ICDAS epidemiological software tool. RESULTS: Prevalence of ECC in studied child population was 40.6%. Among the 604 children with ECC, only non-cavitated teeth were present in 314 children, and only cavitated teeth were present in 84 children. The remaining 206 children had both cavitated and non-cavitated teeth. Interesting lesion behavior was observed in 27 children, who had enamel lesions in mandibular canines only, in an otherwise sound dentition. On examining the teeth surfaces affected (n = 102,274), 50.3% had non-cavitated surfaces and 49.7% had cavitated surfaces. CONCLUSIONS: The results demonstrate the high prevalence of ECC in this population and the need to consider early diagnosis and specific preventive interventions. The authors of this study have also addressed their views about the use of ICDAS software tool.

Alleviating Thoracotomy Pain With Intercostal Liposomal Bupivacaine: A Case Report.

Thoracotomy pain is common after chest surgery and may result from injury to the lung pleura, intercostal muscles, costovertebral joint, or intercostal nerves. Inappropriately controlled postoperative pain can hinder recovery and increase the risk of complications such as infection, atelectasis, blood clots, and development of post-thoracotomy pain syndrome. A number of treatment options for acute pain are available, most of which require systemic medications or indwelling catheters that may be contraindicated in patients on anticoagulants. We present the case of a patient with post-thoracotomy pain that effectively was treated with an ultrasound-guided nerve block with liposomal bupivacaine. The patient experienced pain relief without adverse event. Liposomal bupivacaine may be considered a potential treatment option for patients with severe acute post-thoracotomy pain in whom other modalities have not worked or are contraindicated. LEVEL OF EVIDENCE: N/A.

GSH protects against oxidative stress and toxicity in VL-17A cells exposed to high glucose.

PURPOSE: The deficiency of glutathione (GSH) has been linked to several diseases. The study investigated the role of GSH as a protective factor against hyperglycemia-mediated injury in VL-17A cells treated with 50 mM glucose. METHODS: The cell viability and different oxidative stress parameters including glyoxalase I activity were measured. RESULTS: GSH supplementation with 2 mM N-acetyl cysteine (NAC) or 0.1 mM ursodeoxycholic acid (UDCA) increased the viability, GSH level and the GSH-dependent glyoxalase I activity in 50 mM glucose-treated VL-17A cells. Further, pretreatment of 50 mM glucose-treated VL-17A cells with NAC or UDCA decreased oxidative stress (levels of reactive oxygen species and protein carbonylation), apoptosis (caspase 3 activity and annexin V-propidium iodide positive cells) and glutathionylated protein formation, a measure of oxidative stress. GSH depletion with 0.4 mM buthionine sulfoximine (BSO) or 1 mM diethyl maleate (DEM) potentiated the decrease in viability, glyoxalase I activity and increase in oxidative stress and apoptosis, with decreased GSH levels in 50 mM glucose-treated VL-17A cells. CONCLUSION: Thus, changes in GSH levels with exogenous agents such as NAC, UDCA, BSO or DEM modulate hyperglycemia-mediated injury in a cell model of VL-17A liver cells.

Evaluation of canal transportation and centering ability of K 3 (0.02%) and K 3 (0.04%) with hand K files in primary teeth using spiral computed tomography.

BACKGROUND: One of the objectives of root canal preparation is to clean and shape the root canal system while maintaining the original configuration. Therefore, it is important to keep the instruments centered to provide a correct enlargement, without excessive weakening of the root structure. AIM: The aim of the study was to compare canal transportation and centering ability of K 3 (0.02% taper) and K 3 (0.04% taper) with stainless steel hand K files in primary teeth using a spiral computed tomography (SCT) scan. MATERIALS AND METHODS: A total of 75 extracted mandibular primary second molars was collected. Canals were divided randomly into three groups of 25 teeth each. Group I: K 3 files (0.02% taper), Group II: K 3 (0.04% taper), and Group III: Stainless steel hand K files. Three regions from apical, mid-root, and coronal levels of the canal were recorded. All the teeth were scanned before and after instrumentation by using SCT. RESULTS: K 3 (0.02% taper) showed less canal transportation and a better centering ratio than K 3 (0.04% taper) and stainless steel hand K files. STATISTICAL ANALYSIS: The mean values were compared between different study groups and the P-value was calculated by using Kruskal-Wallis one-way ANOVA. The Mann-Whitney U-test followed by the Bonferroni correction method was employed to identify the significant groups at the 5% level. CONCLUSION: K 3 (0.02% taper) shaped root canals without significant shaping errors when compared to K 3 (0.04% taper) and stainless steel hand K files in primary teeth.

Single-rooted primary first mandibular molar.

Morphological variations like single-rooted molar in primary dentition are scarce. Understanding the root canal anatomy and variations is necessary for successful root canal therapy. The purpose of the present article is to report successful endodontic treatment of primary left mandibular first molar with an abnormal morphology of a single root. This case report highlights the importance of knowledge and its applications in the management of anomalous anatomic variants which play a crucial role in the success of endodontic treatment.