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This case study explains and investigates a tooth fragment reattachment procedure used to repair crown fracture in anterior teeth. Such therapy provides for a more traditional approach towards traumatic coronal lesions while yet retaining aesthetics & function. The authors presented a clinical case scenario of a complicated crown fracture of a lateral incisor. This case is marked by trauma caused by a sports injury, which necessitated a variety of therapeutic options. We used a simple and conservative approach that did not require any tooth preparation. Adhesive reattachment is an uncomplicated technique for achieving greater aesthetic and functional results. According to our clinical experience, when both the tooth and the fractured fragment are intact, performing the technique of reattachment without tooth preparation is a predictable and a very efficient process. Reattachments techniques have outweighed resin composite restorations by resulting in better short as well as medium term outcome.

Objectives: The objective was to evaluate the efficacy of three machine-assisted irrigation systems in smear layer removal from apical one-third of the root canal system. Data Source: A comprehensive search of last 10 years was performed in the following systematic electronic database: PubMed/Medline and Scopus. Data Selection: We included in-vitro studies that compared Endoactivator, Endovac, and Passive ultrasonic irrigation system's clinical success of smear layer removal in apical one-third of the root canal systems. Data Synthesis: A total of 72 nonduplicated studies were retrieved in the systematic search. Seven studies included in the study assessed the success rate of smear layer removal in the apical third of the root canal system of three irrigation systems through scanning electron microscopic evaluation. These studies were classified as low risk of bias. The studies evaluating the scanning electronic microscopy of smear layer removal in the apical one-third of the root canal comparing the Endoactivator and Passive ultrasonic irrigation showed no statistical difference (P < 0.05). The studies evaluating the scanning electronic microscopy of smear layer removal in the apical one-third of the root canal comparing the Endoactivator and Endovac showed statistical difference (P > 0.05). Conclusion: Based on the findings, Endovac irrigation system was found to be effective in smear layer removal from apical one-third of the root canal system. Further in-vivo studies and clinical trials are required for more conclusive results.

Antibiotic resistance is considered a grievous danger to the well-being of common people owing to the growing trend of prescribing antibiotics. In reality, this threat is suitably referred to as a “ticking time bomb” necessitating quick interventions. Antibiotic resistance is not entirely recognized worldwide but is seen to affect poorer countries with inadequate and weaker healthcare systems. Regrettably, dentists still continue prescribing antibiotics to patients with an endodontic cause such as periapical abscesses & irreversible pulpitis, which requires only operative procedures. When we talk about the endodontic cause, antibiotics are prescribed widely systemically and locally as well. Intracanal medicaments, irrigant containing antibiotics, medicated sealer & medicated gutta percha comprises of the local mode of taking antibiotics, which enables dentist in aiming microorganisms in every single crook & bend of a root canal, which remains unreachable if done by usual RCT protocols. Instead of using Triple antibiotic paste in patients, to avoid antimicrobial resistance, calcium hydroxide can also be added. The fundamental base for substantial endodontic treatment comprises of complete debridement of the root canals which are infected along with drainage of hard and soft tissues. Even after achieving adequate debridement & drainage, the literature showed that prescribing antibiotics collaterally did not show any added therapeutic effect in preventing or resolving the signs & symptoms occurring during an endodontic infection. The objective of this current article is to comment about the over usage of antibiotics before and during endodontic management, its impact on antibiotic resistance, and crucial methods needed to prevent and manage the antibiotic abuse during endodontic treatment.