Aim:The present ex vivo study aimed to evaluate the debris extrusion after instrumenting the root canals by three different files systems.Materials and Methods:Sixty extracted human mandibular premolars with single canals were selected and randomly divided into three groups (n = 20) for instrumentation with three different files. Group 1: WaveOne (primary) single reciprocating file (WO; Dentsply Maillefer, Ballaigues, Switzerland) (25/08), Group 2: Self-adjusting file (SAF; ReDent-Nova, Ra’anana, Israel) (1.5 mm), and Group 3: ProTaper NEXT X1 and X2 (PTN; Dentsply Tulsa Dental, Tulsa, OK) (25/06). Debris extruding by instrumentation were collected into pre-weighed Eppendorf tubes. These tubes were then stored in an incubator at 70°C for 5 days. The tubes were then weighed to obtain the final weight, with the extruded debris. Statistical analysis for the debris extruded apically was performed using one-way analysis of variance and post hoc Tukey's test.Results:The statistical analysis showed a significant difference between all the three groups tested (P < 0.01). The following post hoc Tukey's test confirmed that Group 2 (SAF) exhibited significantly least (P < 0.01) debris extrusion between the three groups tested.Conclusions:The SAF resulted in significantly less extrusion of debris when compared to reciprocating WO and rotary PTN.

In oval canals, the instrument used and the root filling material significantly affected the push-out values of root fillings. The highest value was recorded in oval root canals instrumented with the SAF System and filled with C-Point and BC sealer, whereas the lowest strength was noted in oval canals instrumented with WaveOne and filled with gutta-percha and AH Plus sealer.

Injury to anterior teeth is a common event. It requires a treatment approach that assures the complete biologic healing and functional restoration of the tooth or teeth involved. A cystic lesion, which is unable to heal nonsurgically, heals well with surgical intervention and use of mineral trioxide aggregate (MTA) as retrograde filling has been reported in literature. Another material with largely improved handling properties; Biodentine™ (Septodont, St. Maurdes Fossés, France) was introduced in 2011. It is a calcium silicate based material and manufacturers claim that it can be used for crown and root dentin repair treatment, repair of perforations or resorptions, apexification, and root end fillings. This article presents a case report of surgical management of a large cystic lesion using Biodentine™ as retrograde filling material which has not been reported in literature so far. Eighteen months radiographic follow-up exhibited completely healed cystic lesion.

Aims and Objectives:The principal goal of endodontics is the prevention of periapical infection. Acute and chronic apical periodontitis occur due to the persistence of pathogenic microorganisms such as Enterococcus faecalis and Candida albicans harboring the root canal systems of the teeth. The concept of the use of probiotics in addressing endodontic disease is new and has not been studied adequately. On the basis of the success of probiotics in periodontal treatment, this preliminary work was performed (a) to evaluate the antibacterial efficacy of probiotics against common endodontic pathogens, i.e. E. faecalis and C. albicans, and (b) to evaluate the potential use of probiotic therapy as an additive in endodontic treatment procedures.Materials and Methods:Two commercial probiotics were selected and evaluated based upon the numbers and concentration of organisms. Pathogenic test organisms were C. albicans (ATCC 10231) and E. faecalis (ATCC 29212). Phase 1 of the study was conducted by agar cup method test to evaluate the antibacterial activity of the selected probiotics against E. faecalis and C. albicans by measuring zones of inhibition (ZOI) in mm. Microorganisms from probiotic samples were isolated following manufacturer's instructions. Pathogenic organisms were set to a 0.1 McFarland standard challenge. Circular wells of 8 mm diameter were punched in each of the poured plates. Appropriately diluted test samples were added to the above-punched wells. The volume of the solution added to each well was 100 μl. The plates were incubated in an upright position at 37°C for 24 hours under aerobic conditions. Post incubation, ZOI was measured (mm). Phase 2 was conducted by mixing 9 ml of 30% poloxamer 407 and de Man, Rogosa and Sharpe (MRS) broth in a test tube with 500 μl of either E. faecalis or C. albicans set at an optical density (OD) of 0.252, together with 500 μl of test probiotic strain, set at a respective OD. Samples were then incubated at 37°C for 48 hours, followed by serial dilutions by 1 ml till 108. This was done to calculate colony forming units (CFU)/ml counts. Controls used were endodontic pathogens in 30% poloxamer with MRS broth without any probiotic group.Results:Probiotic groups showed inhibitory activity against E. faecalis by the agar cup method, whereas there was no effect on C. albicans. In the biofilm stage, both the test groups had an antibacterial effect on pathogenic organisms.Conclusion:This study suggests that probiotic organisms of the species Lactobacillus and Bifidobacterium are effective for preventing the growth of E. faecalis and C. albicans in vitro. Because probiotics are available in varied compositions and concentrations, further evaluation for their role in treating endodontic infection is suggested and warranted. In addition, the study suggested that poloxamer 407 could be utilized as an ideal delivery vehicle for probiotics for use as a potential endodontic intracanal medicament.

Aim:To compare the smear layer and debris removal in root canals instrumented with two different kinematic motions after ultrasonic and sonic irrigation activation.Materials and Methods:Eighty freshly extracted teeth were selected for the study and randomly divided the samples into two groups (n = 40) for instrumentation with either rotary ProTaper NEXT (PTN) or reciprocating WaveOne (WO) file systems. These (n = 40) were further divided into two groups (n = 20) where the final irrigant was activated using either Ultrasonics (Passive Ultrasonic Irrigation; PUI) or Sonics (EndoActivator; EA). Group 1: PTN + EA; Group 2: PTN + PUI; Group 3: WO + EA; and Group 4: WO + PUI. During instrumentation, a total of 4 ml of 5.25% NaOCl was used for irrigation. The final irrigation protocol included NaOCl and Smear Clear Solution. The samples were processed by scanning electron microscopic examination for debris and smear layer scoring, and statistical analysis was done.Results:The mean debris and smear layer score was less in the group instrumented by PTN with sonic activation of the irrigant.Conclusion:A combination of PTN instrumentation with sonic irrigation activation by EA is more effective in debris and smear layer removal in the groups tested.