Abstract:Objective: This study was designed to compare the level of apical microleakage of root canal sealers; Acroseal, AH Plus, Endoflas FS and Endomethasone N, with laterally condensed gutta percha by level of apical dye penetration. Materials and Methods: Freshly extracted sixty permanent maxillary anterior teeth were divided randomly into four groups. Shaping and cleaning of teeth was done followed by obturation with gutta percha and four different root canal sealers. Samples were immersed in 2% methylene blue dye solution in individual dappen dish and stored in the solution for 30 days. The roots were split longitudinally with a chisel in two halves and observed under stereomicroscope. Apical microleakage measured from the apex to the most coronal extent of dye penetration. Results: Minimum microleakage was observed with AH Plus with mean value 2.140 mm, standard deviation 0.817. The maximum microleakage was observed with Endomethasone N with mean value 3.858 mm, standard deviation 1.840. There was no statistically significant difference in microleakage between Acroseal, AH Plus, and Endoflas FS. Endomethasone N showed highest level of microleakage than other three groups under the test condition, which was statistically significant. Conclusion: The microleakage was the lowest for the AH Plus and increased in the following order, Endoflas FS, Acroseal, Endomethasone N.

Dens evaginatus is an uncommon developmental anomaly of human dentition characterized by the presence of tubercle on the occlusal surface of mandibular premolars and lingual surface of anterior teeth. Due to occlusal trauma this tubercle tends to fracture thus exposing the pathway to the pulp chamber of teeth. This case report is about the presentation of dens evaginatus in mandibular premolars bilaterally; among them tooth 44 was associated with chronic apical periodontitis. Fractured tubercle of three premolars was sealed with composite resin. Root canal treatment was performed with tooth 44. Routine endodontic treatment did not result in remission of infection. Therefore, culture and sensitivity tests were performed to identify the cause and modify treatment plan accordingly. Triple antibiotic paste was used as an intracanal medicament to disinfect the root canal that resulted in remission of infection.

Background & Objectives:Dentin hypersensitivity and pain following tooth preparation of vital teeth occurs with a highly variable prevalence often leading to constant pain requiring endodontic therapy. The study was conducted with objective to evaluate the impact of remaining dentin thickness, coronal pulp size, tooth wear on dentin hypersensitivity following tooth preparation.Materials & Methods:Total 138 permanent vital teeth for abutment of fixed partial prosthesis were included in the study. Tooth wear measured using ‘exact tooth wear index’ and level of sensitivity to stimuli was recorded using a numerical rating scale. Following tooth preparation radiograph using paralleling technique were used for measurement of remaining dentin thickness and pulp chamber.Results:The multiple linear regression predictor model summary and overall fit statistics indicated a high degree of correlation (R = 0.661, 0.889, 0.839 for anterior, premolar and molar teeth respectively). The total variation for pain could be explained in 43.7% (anterior), 79.1% (premolar), and 70.4% (molar) by the independent variables and there was a significant linear relationship between the variables in the model (p < .001).Conclusion:This study investigated few possible variables that may be taken into consideration before referring the vital abutment tooth for intentional root canal therapy so that every attempt can be made to avoid pulp amputation.

Background & Objectives: Tooth wear (attrition, abrasion, erosion, and abfraction) is perceived globally as ever increasing problem. Several outcome of the tooth wear are hypersensitivity, esthetic problems, functional impairment, annoyance to the patient, and fracture of the tooth. Among these, the measurable and more commonly reported outcome is hypersensitivity to stimuli. Although dentin hypersensitivity is a common clinical condition and is generally reported by the patient after experiencing a sharp, short pain caused by one of the several different external stimuli, it is often inadequately understood. None of the scientific literature available till date attempted to establish the relationship between tooth wear and dentin hypersensitivity which could be a key factor in monitoring those patients.  The aim of the study was to estimate the association between severity of teeth wear and sensitivity in the patients with reported dentinal hypersensitivity.Materials & Methods: Fifty patients with dentin hypersensitivity were investigated for tooth wear. Tooth wear measured using exact tooth wear index and level of sensitivity to stimuli was recorded using a numerical rating scale. Results: Enamel wear at cervical region of teeth showed a positive correlation (p=.010), similarly, dentin wear at cervical region of teeth showed positive correlation and significant association (p<.001) with dentinal hypersensitivity.Conclusion: The observation supports a significant association between severities of tooth surface wear and dentinal hypersensitivity.

This report describes the cases autopsied at B. P. Koirala Institute of Health Sciences-Nepal, during the period of two years in which the treatment provided falls below the accepted standard practice causing the death of the patient. Postmortem examination provides an opportunity to find out the actual cause of death in which the cause of death is suspicious. Sometimes the cause of death found through postmortem examination is different from the clinical cause of death. The autopsy finding on the cause of death will help doctors even to think about unusual conditions that lead to death and hence apply preventive measures for those unusual conditions. The cause of medical error is not always due to the doctor's mistake, but sometimes also due to the obsolete hospital protocol. The autopsy reporting of medical errors can be used to identify lacunae in hospital protocols, problem-prone clinical processes and suggest interventions that may reduce negligence.