The objectives of root canal treatment are elimination of microorganisms, removal of pulpal remnants, removal of debris, and shaping of the root canal system so that it may be obturated. The most important step in endodontic therapy is canal preparation which can be achieved by accurate working length determination. Working length determines the extent of placing the instruments into the canal, it affects the degree of pain and discomfort which the patient will experience post treatment and it plays an important role in the success of the treatment if placed within correct limits. The cementodentinal junction, where the pulp tissue changes into the apical tissue, is the ideal physiologic apical limit of WL because at this point healing is supposed to be optimal, and the wound to the periapical tissues is minimal.The apical constriction is however, histological and is impossible to locate clinically or radiographically. There are several methods of determining working length which include radiographical methods, digital tactile sense, apical periodontal sensitivity, paper point method and electronic apex locators. The requirements of an ideal method for determining working length include rapid location of the apical constriction in all pulpal conditions, easy measurement, rapid periodic monitoring and confirmation, patient and clinician comfort, minimal radiation to the patient; ease of use in special patients; and cost effectiveness. To achieve the highest degree of accuracy in working length determination, a combination of several methods should be used. This article reviews the different methods to determine WL and their clinical implications. KEY WORDS Working Length, Apex Locator, Radiographic Method.

Ameloblastoma is a benign odontogenic tumor of epithelial origin. It is locally aggressive with unlimited growth capacity and has a high potential for malignant transformation as well as metastasis. Ameloblastoma has no established preventive measures although majority of patients are between ages 30 and 60 years. Among all types of ameloblastomas, multicystic ameloblastoma is believed to be a locally aggressive lesion that has the tendency for recurrence. In this report we present a case of a large multicystic ameloblastoma in the right parasymphysis-body region of the mandible in a 31-year-old man. The large lesion was diagnosed with the help of cone beam computed tomography and was successfully managed by hemi mandibulectomy with simultaneous reconstruction. The need for extending the surgical margins beyond the radiographic extension to prevent recurrence is highlighted.

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The undesirable discoloration or pitting of teeth due to fluorosis or developmental defects like amelogenesis imperfecta or enamel hypoplasia pose a challenge to the clinician to cater to the aesthetic requirements of patients. Fluorosis had been reported way back in 1901. There are treatment options depending upon individual cases as follows: microabrasion / macroabrasion, bleaching, composite restoration, veneers or full crowns. For the aesthetic enhancement of stains associated with mild to moderate fluorosis enamel microabrasion is the preferred treatment. This technique involves removal of entrapped stains by rubbing of slurry containing HCl acid and an abrasive agent on the stained enamel surface. But if the depth of the defect is more then microabrasion can be done in conjunction with bleaching or bonded restorations can be done to achieve optimal aesthetics. Casein phospopeptide - Amorphous calcium phosphate (CPP – ACP) can be topically applied after microabrasion which enhances remineralisation and prevents post-operative sensitivity. The present paper illustrates the management of mild to moderate dental fluorosis by microabrasion to remove stains on the enamel surface followed by remineralisation using CPP - ACP paste. An unaesthetic smile has psychological impact especially on young patients and lowers their confidence.1 Discoloration of the young permanent anterior teeth is mostly seen due to varying developmental defects. This could be due to extrinsic aetiology such as those caused by coffee, tea, red wine and tobacco or due to intrinsic aetiology. The intrinsic stains may be due to pre-eruptive or post-eruptive causes.2 Pre-eruptive causes of intrinsic stains include dentinogenesis imperfecta and fluorosis, whereas post-eruptive causes of intrinsic stains include tetracycline dentine staining or due to injuries.3 The excessive and chronic ingestion of fluoride during amelogenesis leads to fluorosis which can be skeletal or dental depending upon the intake.4,5 Dental fluorosis is characterized by white opaque flecks on teeth or yellow to brown discolorations with pitting on the enamel surface.6,7 The enamel microabrasion is an effective and non-invasive procedure for removing the stains limited to outer enamel layer.7,8 It uses a rubber cup along with abrasive materials and chemical solutions.9,10 Currently, many products are commercially available for enamel microabrasion such as Prema Compound (Premier Dental Products, Norristown, PA, USA) containing 15 % HCl and Opalustre (Ultradent, South Jordan, UT, USA) containing 6.6 % HCl and silicon carbide.7 (Table 1) Since these products are expensive, the prototype paste containing 18 % HCl and pumice, as described by Croll in 1986 is most commonly used in clinical practice.8

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