Context:Biomineralization is a process which leads to the formation of an interfacial layer with tag-like structures at the cement-dentin interface. It is due to interaction of mineral trioxide aggregate (MTA) and Portland cement with dentin in phosphate-buffered solution (PBS). This study is aimed to evaluate the effect of influence of biomineralization process on push-out bond strength of ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK, USA), MTA Branco (Angelus Soluc¸o˜es Odontolo´gicas, Londrina, PR, Brazil) and calcium phosphate cement (BioGraft CPC).Aim:The aim of this study was to evaluate the effect of biomineralization process on the push-out strength of ProRoot MTA, MTA Branco, and CPC after mixing with 0.2% chlorhexidine gluconate solution (0.2% CHX) and 2% lidocaine solution (2% LA) on the bond strength of MTA-dentin.Materials and Methods:Dentin discs with uniform cavities were restored with ProRoot MTA, MTA Branco, and calcium phosphate cement after mixing with 0.2% CHX solution and 2% lidocaine solution. The samples were uniformly distributed into two groups. Experimental group being immersed in PBS solution and control group being immersed in saline for 2 months. Instron testing machine (Model 4444; Instron Corp., Canton, MA, USA) was used to determine the bond strength.Statistical Analysis Used:A two-way analysis of variance and post hoc analysis by Bonferroni test.Results:All samples immersed in experimental group displayed a significantly greater resistance to displacement than that observed for the samples in control group (P < 0.05). MTAs displayed a significantly greater resistance to displacement than calcium phosphate cements.Conclusion:The main conclusion of this study was that the push-out bond strength of the cements, mainly the MTA groups, was positively influenced by the biomineralization process.

CHX appears to be a good alternative to replace distilled water, as a solution to be mixed with MTA.

Root resorption is largely pathologic and known to be initiated by several factors, including pulpal necrosis, trauma, periodontal treatment, orthodontic treatment, and bleaching agents. Incorrect diagnosis can lead to improper management and tooth loss. The treatment should involve the complete suppression of all the resorptive factors and the reconstruction of the defect using a suitable restorative material. The resorptive defect is often detected by the routine radiographic examination. A characteristic radiopaque line generally separates the image of the lesion from that of the root canal because the pulp remains protected by a thin layer of predentin until late in the process. Histopathologically, the lesions contain fibrovascular tissue with resorbing clastic cells adjacent to the dentin surface. Advanced lesions may also display fibro-osseous characteristics with deposition of ectopic bone-like calcifications. This case report presents extensive root resorption in the maxillary left lateral incisor and left canine in a 35-year-old patient. The defect was identified during the routine radiographic examination. The patient revealed a history of trauma 15 years back. Following the examination, the teeth were found to be vital and associated with the moderately deep periodontal pocket in the interdental region. The teeth were managed endodontically, and the resorption defect was restored with a biocompatible material after surgically elevating a flap. Periodontal management was also performed simultaneously by the surgical debridement of the area. Six-month postoperative radiograph revealed an arrest of the resorption and healing of the periodontal defect. Hence, an interdisciplinary management involving endodontic as well as periodontal treatment was performed that helped in saving the teeth with poor prognosis.

Gingival fenestrations are relatively rare phenomenon which results from exposure of tooth due to loss of the overlying bone and gingiva. If left untreated such lesions may act as a source of infection by providing a nidus for bacteria. This case report describes one such case of mucosal fenestration that was managed well using an interdisciplinary approach which included endodontic retreatment, periapical surgery with regenerative approach in the first stage. After 6 months second stage surgery was performed using connective tissue graft. At one year follow up, complete closure of the mucosal defect was found with substantial bone regeneration.