ABSTRACT
Intentional replantation has been used as an alternative treatment modality to tooth extraction and prosthetic replacement when conventional endodontic treatment modalities are unfeasible or contraindicated. This case report presents a successful case of intentional replantation for the mandibular first molar with an endodontic mishap. An endodontic instrument was separated in the apical third of the root canal and extended beyond its mesiobuccal root apex. Intentional replantation served as a means to remove the separated instrument. The periodontal ligament (PDL) cells were kept viable throughout the endodontic treatment using a distinctive technique, wherein a preoperative impression is used for continuous wetting with saline. Platelet-rich fibrin (PRF) was shredded and placed in the alveolar socket to enhance PDL cell reattachment and prevent ankylosis. The 2-year successful follow-up reinforced that intentional replantation can be a viable option for removal of separated instruments that lie beyond the root apex. The use of these techniques to keep PDL cells viable and the use of PRF can aid in prevention of ankylosis.
ABSTRACT
CONTEXT AND AIMS: The purpose of this study was to compare and evaluate the shaping ability of ProTaper (PT) and Self-Adjusting File (SAF) system using cone-beam computed tomography (CBCT) to assess their performance in oval-shaped root canals. MATERIALS AND METHODS: Sixty-two mandibular premolars with single oval canals were divided into two experimental groups (n = 31) according to the systems used: Group I - PT and Group II - SAF. Canals were evaluated before and after instrumentation using CBCT to assess centering ratio and canal transportation at three levels. Data were statistically analyzed using one-way analysis of variance, post hoc Tukey's test, and t-test. RESULTS: The SAF showed better centering ability and lesser canal transportation than the PT only in the buccolingual plane at 6 and 9 mm levels. The shaping ability of the PT was best in the apical third in both the planes. The SAF had statistically significant better centering and lesser canal transportation in the buccolingual as compared to the mesiodistal plane at the middle and coronal levels. CONCLUSIONS: The SAF produced significantly less transportation and remained centered than the PT at the middle and coronal levels in the buccolingual plane of oval canals. In the mesiodistal plane, the performance of both the systems was parallel.
