Repair of a Perforation Defect With Calcium Silicate-Based Cement Using an Internal Matrix.

This case report describes the nonsurgical endodontic management of a distolingual floor perforation in a mandibular first molar using an internal matrix and mineral trioxide aggregate (MTA) cement. The pulp chamber was properly cleaned, and after placement of a synthetic collagen material that served as a barrier at the level of furcation, MTA was used to repair the perforation defect. Root canal treatment was completed and the tooth was restored with a composite restoration followed by a porcelain-fused-to-metal crown.

Diagnosis, Evaluation, and Endodontic Management of Rare Four-Rooted Mandibular Second Molar Using CBCT.

When endodontically diagnosing and evaluating the morphology and anatomy of roots and root canals, especially in multirooted teeth, clinicians must exercise extremely keen vision and give careful attention to minute details. Fundamental knowledge of the most common anatomic characteristics and the possible variations of these characteristics is necessary to provide successful endodontic therapy. While all mandibular molars have significant variations in roots and root canal configuration, mandibular second molars perhaps present the biggest challenge. This article highlights the endodontic management of a mandibular second molar with four roots (two mesial and two distal) with one canal in each root and the cone-beam computed tomography (CBCT) evaluation of the tooth, along with orifice location assessment using developmental root fusion lines.

Endodontic management of a maxillary first molar with three roots and seven root canals with the aid of cone-beam computed tomography.

Variation in root canal morphology, especially in maxillary first molar presents a constant challenge for a clinician in their detection and management. This case report describes the successful root canal treatment of a three rooted right maxillary first molar presenting with three canals each in the mesiobuccal and distobuccal roots and one canal in the palatal root. The clinical detection of this morphologic aberration was made using a dental operating microscope, and the canal configuration was established after correlating and computing the clinical, radiographic and cone-beam computed tomography (CBCT) scan findings. CBCT images confirmed the configuration of the canals in the mesiobuccal and distobuccal roots to be Al-Qudah and Awawdeh type (3-2) and type (3-2-1), respectively, whereas the palatal root had a Vertucci type I canal pattern. This report reaffirms the importance of careful examination of the floor of the pulp chamber with a dental operating microscope and the use of multiangled preoperative radiographs along with advanced diagnostic aids such as CBCT in identification and successful management of aberrant canal morphologies.

Asymmetry in mesial root number and morphology in mandibular second molars: a case report.

Ambiguity in the root morphology of the mandibular second molars is quite common. The most common root canal configuration is 2 roots and 3 canals, nonetheless other possibilities may still exist. The presence of accessory roots is an interesting example of anatomic root variation. While the presence of radix entomolaris or radix paramolaris is regarded as a typical clinical finding of a three-rooted mandibular second permanent molar, the occurrence of an additional mesial root is rather uncommon and represents a possibility of deviation from the regular norms. This case report describes successful endodontic management of a three-rooted mandibular second molar presenting with an unusual accessory mesial root, which was identified with the aid of multiangled radiographs and cone-beam computed tomography imaging. This article also discusses the prevalence, etiology, morphological variations, clinical approach to diagnosis, and significance of supernumerary roots in contemporary clinical dentistry.

Langerhans cells and their role in oral mucosal diseases.

Dendritic cells are arguably the most potent antigen-presenting cells and may be the only cells capable of initiating the adaptive immune response. The epithelial residents of dendritic cells are Langerhans cells, which serve as the "sentinels" of the mucosa, altering the immune system not only to pathogen entry but also of tolerance to self antigen and commensal microbes. Oral mucosal Langerhans cells are capable of engaging and internalizing a wide variety of pathogens and have been found responsive to nickel in patients with nickel allergies, oral Candida species, oral lichen planus, lichenoid drug eruptions, graft versus host diseases, periodontal diseases median rhomboid glossitis, human immunodeficiency virus infection, hairy leukoplakia of the tongue, and oral squamous cell carcinoma. Review focuses on the role of antigen-presenting cells in particular Langerhans cells to better understand the mechanisms underlying immune responses. In this review, comprehensive detail about mucosal diseases has been compiled using the PubMed database and through textbooks.

Bilateral supplemental maxillary central incisors: a case report.

Hyperdontia is a developmental anomaly that is hypothesized to arise from multiple causes. Supernumerary teeth may remain embedded in the alveolar bone or can erupt into the oral cavity. When such teeth remain embedded, they may cause disturbances to developing teeth. Erupted supernumerary teeth can cause aesthetic or functional problems, especially when situated in the maxillary anterior region. Before a definitive diagnosis and treatment plan can be developed, it is essential to clinically and radiographically enumerate and identify supernumerary teeth. Supplemental central incisors are rare and bilateral cases are even rarer: only five cases have been reported in the literature to date. We describe a case of bilateral supplemental maxillary central incisors and discuss the management of supernumerary teeth.