Cone beam- computed tomography as an indispensable tool in the management of radiculous premolar: a case report

Background: Internal anatomy of maxillary first premolars is particularly multifaceted on account of the variation in number of roots and canal configuration. Maxillary first premolars with 3 roots are called as small molar or "radiculous" because of their similar anatomy to the maxillary first molars. The most demanding step in endodontic treatment is identification and proper access to pulp canals of certain teeth with atypical canal configurations. Methods of identification of such premolars can be by various aides. Case Presentation: The present case describes the application of Cone Beam-Computed Tomography in the diagnosis of extra root with extra canal in a three rooted maxillary right first premolar. Conclusions: Proper knowledge of the anatomical variations is a must for an endodontist to make a treatment successful. Utilizing the latest technology along with the traditional concepts can surely rule out the inaccuracy in the treatment involved in such cases.

An in vitro Comparison of Endodontic Medicaments Propolis and Calcium Hydroxide alone and in Combination with Ciprofloxacin and Moxifloxacin against Enterococcus Faecalis.

AIM: To evaluate and compare the antimicrobial properties of propolis and calcium hydroxide alone and in combination with ciprofloxacin and moxifloxacin against Enterococcus faecalis (E. Faecalis). MATERIALS AND METHODS: The laboratory study was carried out to test the effectiveness of propolis and calcium hydroxidealone as well as in combination with the established endodontic medicaments (moxifloxacin and ciprofloxacin). The various combinations were-group 1: propolis, group 2: calcium hydroxide, group 3: moxifloxacin, group 4: ciprofoxacin, group 5: propolis + moxifloxacin, group 6: propolis + Ciprofloxacin, group 7: calcium hydroxide + ciprofloxacin, group 8: calcium hydroxide + moxifloxacin. The efficacy of these medicaments was tested by checking for the zone of inhibition for the specific strain (ATCC 29212) of E. faecalis at different time intervals, i.e. 24, 48 and 72 hours. RESULTS: Mean zone of inhibition was maximum in group V (21.94 ± 4.26) followed by group VI (18.80 ± 1.93), group I (18.71 ± 4.26), group VIII (15.88 ± 2.59), group III (14.91 ± 1.00), group VII (14.57 ± 2.17), group IV (13.91 ± 1.00) and minimum in group II (12.89 ± 2.14). Mean zone of inhibition was found to be maximum at 72 hours and minimum at 24 hours. At all time intervals, the combination of Propalis with Moxifocacin showed the maximum antimicrobial efficacy. CONCLUSION: On the basis of the results of the present study, it can be concluded that propolis and calcium hydroxide show synergistic effect with moxifloxacin and ciprofloxacin against E. Faecalis. Propolis in combination with antibiotics and alone is more effective than calcium hydroxide. CLINICAL SIGNIFICANCE: Since propolis alone and in combination with antibiotics was observed to be more effective than calcium hydroxide, propolis can be considered as an intracanal medicament when compared to traditional calcium hydroxide.

A stereomicroscopic in- vitro study to investigate the root canal morphology of mandibular third molars using clearing technique

AIM: To analyse the root canal morphology of mandibular third molars using clearing technique. MATERIAL AND METHODS: Ninety permanent extracted mandibular third molar teeth were collected based on inclusion and exclusion criteria. Teeth were then decalcified and were made transparent Methylene Blue Dye was injected to color the pulp space. These teeth were then observed under sterio Microscope and root canal systems were identified according to Vertucci's Classification. RESULTS: The most common anatomical morphology found was having two roots. Overall type I Vertucci's configuration was the most common pattern of canals. Other canal patterns that were found included type II, III, IV and V. In this study no canal of type VI, VII or VIII were found. CONCLUSION: The morphological variations in root patterns and canal configuration of mandibular third molar should be given consideration for successful endodontic treatment.