A clinical study was conducted to determine, first the incidence of pain after chemomechanical preparation of root canals, and second what clinical factors were associated with the incidence and degree of pain. Out ofthe 24.S patients in the study 140 (57 per cent) had no pain, 52 (21 per cent) had slight pain, 30 (15 per cent) had moderate pain and 17 (7 per cent) had severe pain. Statistical analysis showed a significantly higher incidence of pain after over-instrumentation of canals during preparation.

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This study demonstrates that endotoxins are present in carious lesions of symptomatic and asymptomatic teeth. The amount of endotoxin was significantly greater in the superficial compared to the deep layer of carious dentine. More endotoxins are present in caries of painful teeth compared with those without symptoms.

A rare case of dens invaginatus involving a non-carious mandibular lateral incisor with periapical periodontitis is reported. Invaginated teeth present technical difficulties in their clinical management because of their abnormal anatomy. In the present case, non-surgical root canal therapy was chosen. A one-year follow-up clinical and radiographic examination showed a non-symptomatic tooth with osseous healing proceeding.

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