The complete and three-dimensional fluid tight seal of the root canal system is the final component of the endodontic triad. The long-standing and closest material which has fulfilled this criterion is gutta-percha (GP). Several materials have been tried and tested as an endodontic filling material, of which GP has been most extensively used for years and has established itself as a gold standard. In addition, it has proved itself successful with different techniques of obturation while maintaining its basic requisites. This article deals briefly with the history and evolution of GP, source, chemical composition, manufacturing, disinfection, cross-reactivity, and advancements in the material.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) the third leading cause of death in the world, represents an important public health challenge that is both preventable and treatable. According to Global Initiative for Chronic Obstructive Lung Disease (GOLD), Spirometric tests, Forced Expiratory Volume in first second (FEV1) less than 80% of the expected value and forced expiratory volume in first second to the forced vital capacity ratio (FEV1/FVC) less than 70% is the diagnostic criteria for COPD. In COPD smoking is the major risk factor and smoking affects the lipid profile of COPD patients. MATERIALS AND METHODS: Spirometric parameters including FEV1, FEV1/FVC ratio and lipid profile was studied in 100 cases of COPD patients admitted Government Fever Hospital, Guntur and 40 nonsmoker healthy subjects were selected as a control group. They were correlated using Pearson's correlation coefficient "r". RESULTS: Majority of the cases are males belonging to 50-60years age group and all of them are smokers. Majority of the patients had moderate airflow limitation (GOLD Stages II and III). The lipid profile in COPD patients showed significant elevation of LDL cholesterol levels when compared to controls (P<0.005). CONCLUSION: Spirometric parameters FEV1, FEV1/FVC ratio is important to diagnose as well as to assess the severity of the disease. Smoking is an important risk factor for COPD and smoking effects the lipid profile of COPD patients. There was no correlation between lipid profile and severity of COPD. INTRODUCTION: According to WHO, Chronic obstructive pulmonary disease (COPD) will be the third leading cause of death in the world by 2030, represents an important public health challenge that is both preventable and treatable. Globally the COPD burden is projected increase in coming decades because of continued exposure to COPD risk factors and aging of the population. (1) Inhaled cigarette smoke and noxious particles such as smoke from biomass fuels cause lung inflammation, a normal response that appears to be modified in patients who develop COPD. In COPD, smoking is the major risk factor and smoking affects the lipid profile of COPD patients. The plasma β-lipoprotein, cholesterol and triglycerides concentration are higher and HDL cholesterol is lower in smoker than in nonsmokers. (2) The clinical importance of hyperlipoproteinemia derives chiefly from the role of lipoproteins in atherogenesis. Abundant epidemiological evidence establishes the multi-factorial character of this disease and indicates that the effects of the multiple risk factors are at least additive. Hence an attempt was made to investigate the levels of total cholesterol (TCH), triglycerides (TG), low density lipoproteins (LDL), very low density lipoproteins (VLDL), high density lipoproteins (HDL) in COPD patients. Moreover, correlation of Forced Expiratory Volume in first second (FEV1) and FEV1/FVC ratio with lipid profile were carried out.

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Aim: The aim of this study was to compare push-out bond strength of root canal spaces filled with AH-Plus and BioRoot RCS after using different irrigants. Materials and Methods: Eighty single-rooted teeth were decoronated and endodontically treated by crown-down technique using ProTaper Universal rotary files progressively till F4 (40/0.06). Samples were divided into two groups according to the sealer ( n = 40): Group A = BioRoot RCS, Group B = AH Plus, further subdivided into four subgroups according to irrigation protocol ( n = 10): Group 1A, 1B – 0.9% saline, Group 2A, 2B – 5.25% NaOCl + 17% EDTA, Group 3A, 3B– 17% EDTA +2% chlorhexidine, and Group 4A, 4B – 17% EDTA + 3% green tea extract. Samples were obturated with sealers and prepared for push-out test with root slices of 2 mm thickness using universal testing machine. Data were statistically analyzed using two-way ANOVA, Bonferroni's post hoc analysis, and independent Student's t -test. Results: BioRoot RCS exhibited significantly higher push-out bond strength ( n < 0.001). The interaction between irrigants and sealer showed higher bond strength for BioRoot RCS when 17% EDTA+ green tea was used. Conclusion: Within the limitation of the study, it was concluded that bond strength of a sealer was influenced by the irrigants used.

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One of the most important steps in endodontic therapy is obtaining an adequate access to the root canal system. This ensures adequate instrumentation, irrigation, visibility, access and disinfection, making endodontic therapy more predictable. However, in the process of gaining a good convenience form, access cavities are being excessively widened, weakening the tooth to masticatory forces and increasing their chance of fracture. Clark and Khademi introduced evidence based new concepts of modern endodontic access designs which primary aims at preservation of tooth structure and increasing fracture resistance of the tooth. Several techniques of modern access designs have been proposed but they all correspond to one fundamental concept, bio-minimalism. This review aims to comprehensively summarize the principles of modern access cavity preparation as well as highlight the various techniques of modern access cavity designs.

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