The study aimed to assess occlusal reduction's effect on postoperative pain in multiple-visit root canal treatment. This randomized control trial was conducted at the Operative Dentistry & Endodontics Department, Baqai Dental College Karachi, from January 2021 to January 2022. A total of 110 patients fulfilling the inclusion criteria were included in the study. The patient was divided into two groups, Group A, occlusal reduction (OR) and Group B, no occlusal reduction (NOR). In group A, all occlusal contacts on the functional and non-functional cuspsand the marginal ridges were reduced by 1 mm by a diamond bur in a high-speed handpiece and confirmed with articulating paper. No occlusal reduction was performed in group B patients. Patients were recalled after 24 hours and 7 days, and their pain level was recorded on VAS; at the same appointment, the root canal was completed, and the tooth was restored permanently. Pain level on the 7th day was taken as the study's primary endpoint. The meanage of patients was 37.41±10.635, with a minimum age of 19 and a maximum of 59 years old. Female patients were 56% and 44%, male. There were two study groups' OR 50% and NOR 50%. The tooth type included were 40% anterior and 60% posterior. Group A patients had reduced pain levels after 24 hours, with a significant difference of P=0.014 compared to group B patients. After 7 days of treatment, no significant difference was found in postoperative pain between both groups with P=0.533. Thus, it can be concluded from the study that the occlusive reduction may not be effective in reducing pain at the 7th postoperative days of multiple visit root canal treatment. Although a significant difference in pain levels was identified after 24 hours of therapy, patients in the occlusion reduction group reported less discomfort than those in the control group.

Objective: To determine the frequency of two canals in mandibular central incisors using a radiographic technique in a sample representing Karachi Pakistan. Study Design: Cross-sectional in Vitro study. Setting: Hamdard University Dental Hospital. Period: January, 2022 to July, 2022. Material & Methods: According to inclusion criteria 187 extracted mandibular central incisors were collected, flushed under running tap water. 10% formalin was used as storage media afterwards. The attached periodontal tissues and calculus remaining after extraction were removed using a 1/2 Gracey Curette. Number 2 round bur was used in a high speed hand piece to initiate access chamber opening of the pulp chamber. Irrigation was done with 2.5% sodium hypochlorite to make the pulp chamber clearly visible. Detection and negotiation of second canal were performed by using Dental Operating Microscope. No. 15 K-files were introduced into the main canals. Two peri-apical radiographs were exposed at different angulations using DIGORA OPTIME for confirmation. Data was analyzed by using SPSS version 23. Results: Mean age of the patients included in the study were 37.12±12.81 years. According to gender distribution there were 101 (54%) males and 86 (46%) females. Outcome concludes that in mandibular central incisors frequency of two canals was 28.3 %. Conclusion: Presence of two canals in mandibular central incisors among Pakistani population in our study was 28.3%. When endodontic therapy is commenced on these teeth, dentist must consider the possibility of existence of second canal and exercise caution.

Background and Objective: Despite a plethora of studies conducted to date, researchers continue to investigate the best sealer and obturation technique combinations. The aim of this study is to compare the apical seal provided by two bioceramic sealers (Endoseal and Endosequence) with that provided by a calcium hydroxide sealer (Sealapex), and to evaluate the effect of different obturation techniques (cold lateral condensation, continuous wave compaction and single cone) on the apical seal under a stereomicroscope. Materials and Methods: A total of 110 single-rooted mandibular premolar teeth were decoronated, cleaned and shaped using the Endosequence filing system to tip size 30/0.04 taper. Canals were irrigated with 5.25% NaOCl and 17% EDTA. The samples were randomly divided into 11 groups (9 experimental and 2 control groups) according to the designated sealer and technique. Samples were stored in an incubator for 7 days at 37 °C under 100% humidity. Samples were coated with nail varnish except for apical 2 mm and vertically placed in 0.2% rhodamine B dye solution for 48 h. Samples were split longitudinally and viewed under a stereomicroscope at 40× magnification. Results: Insignificant results were obtained between obturation techniques (p = 0.499) whereas statistically significant results were attained based on the type of endodontic sealer (p < 0.001). The overall lowest mean apical microleakage and best sealing ability was demonstrated by Sealapex (2.59 ± 1.20 mm) and amongst techniques by continuous wave compaction (3.90 ± 2.51 mm). Conclusions: Endosequence produced the best apical seal with the continuous wave compaction technique, whereas Endoseal did so with the bioceramic-coated single-cone technique. For the Sealapex sealer, the most effective apical seal was observed using cold lateral condensation. The quality and effectiveness of apical seal differed with the type of endodontic sealer and obturation technique used, and vice versa.