Objective: The complex root canal anatomy is inherently colonised by microbial flora. Endodontic treatment success is always related to adequate disinfection of the root canal space, which ultimately affects the treatment outcome. A thorough understanding of the external and internal root canal anatomy by using adequately imaging modalities is essential before planning any treatment. The aim of this study was to investigate the number and morphology of the root canals of maxillary and mandibular premolars in Chennai population. Material and Methods: Full-size cone-beam computed tomographic images were randomly collected from 100 patients, resulting in a total of 200 first and 200 second maxillary premolars as well as 200 first and 200 second mandibular premolars. All the eight premolars were analysed in single patients, who underwent cone-beam computed tomography scanning during pre-operative assessment (before implant surgery, orthodontic treatment, diagnosis of dental-alveolar trauma or difficult root canal treatment). Total number of roots and root canals, frequency and correlations between men and women were recorded and statistically analysed by using chi-square tests. The root canal configurations were rated according to the Vertucci’s classification. Results: In the maxillary first premolar group (n = 200), 36.3% had 1 root, 56.7% had 2 roots and 7.0% had 3 roots, with most exhibiting a type IV canal configuration. In the maxillary second premolar group (n = 200), 60% had 1 root, 29.8% had 2 roots and 10.2% had 3 roots, with the majority of single-rooted second premolars exhibiting a type I canal configuration. In the mandibular first premolar group (n = 200), 80.5% had 1 root, 9.8% had 2 roots and 5% had 3 roots. In the mandibular second premolar group (n=200), 90.1% had 1 root, 6.4% had 2 roots and 3.5 % had 3 roots, with most exhibiting a type I canal configuration. No statistical correlation was found between number of roots, gender and tooth position. Conclusion: This cone-beam computed tomographic study confirmed previous anatomical and morphological investigations. Therefore, the possibility of additional root canals should be considered when treating premolars. Keywords: Cone-beam computed tomography; Mandibular; Maxillary; Premolar; Root canal; Morphology.

Dental avulsion is considered as one of the most severe types of traumatic tooth injuries because it causes damage to several structures and results in the complete displacement of the tooth from its socket in the alveolar bone. The ideal situation is to replant the tooth immediately after avulsion because the extra oral time is an important determinant for the success of the treatment and for a good prognosis. The aim of this systematic review was to identify the recommended natural storage m to store and transport avulsed tooth based on the survival capacity of periodontal ligament cells.This paper reviews the different storage media that have been evaluated for avulsed teeth based on full-length research papers retrieved from PubMed/Medline, Lilacs, BBO and SciELO electronic databases using the key words 'storage medium', 'avulsion', 'tooth avulsion', 'replantation', 'tooth replantation', 'milk' and 'propolis'.Based on the application of inclusion and exclusion criteria, about 14 papers have been selected and critically reviewed with respect to the characteristics, efficacy and ease of access of the storage media. The review of this study shows and includes a wide array of wet storage media that have been evaluated in laboratory-based studies on PDL cells found on adult permanent teeth.Among the natural products other than milk, propolis, coconut water, green tea extract, egg white, green tea extract, Alovera gel, pomegranate juice, salvia officinalis followed by dragon blood sap (Croton Lechleri) were recommended based on the cell viability and its longevity. In an emergency, it is important for dentists to consider the circumstances of the accident, the location and suggest an appropriate transport media.

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Periapical surgery is the treatment of choice for a large periapical lesion with bone loss that occurs due to long standing untreated teeth affected by trauma, caries or in situations where there is an endodontic treatment failure. Failure of nonsurgical endodontic treatment may be due to peri radicular tissues incorporating with infections, foreign body response to filling materials, over instrumentation or over obturation which might have prevented complete periapical healing. We present here 2 case reports wherein, combination of platelet-rich fibrin (PRF) and the hydroxyapatite (HA) graft was used to achieve rapid healing of large periapical lesions, and the treatment outcome concluded that PRF and hydroxyapatite bone graft accelerated the wound healing and induced the rapid rate of bone formation, which was confirmed radiographically. Untreated non-vital teeth generally result in bone destruction in periapical region, which may occur due to the spread of infection following pulpal necrosis, trauma or failed endodontic treatment. Surgical intervention is essential when endodontic treatment has failed and retreatment is not possible. Periapical surgery, Apicoectomy or root end resection endodontic surgery is a safe and well documented treatment alternative when teeth with periapical pathosis are not responding to conventional endodontic treatment.1 Periapical surgery removes periapical pathosis resulting in optimal wound healing with regeneration of the bone and periodontal tissue.