Ectopic eruption is a deviation from the normal eruption pattern, making the tooth erupt out of its normal position, and possibly causing resorption of adjacent primary teeth. A wide range of etiological factors may be responsible for ectopic eruption of the teeth, so their management depends on the correction of the established etiological factor. The present case report describes an unusual case of ectopically erupted central incisor encased within an abnormally thickened labial frenum, which was treated by orthodontic repositioning of the ectopically erupting tooth after frenectomy.

Preservation of primary teeth is essential for the space maintenance till the eruption of permanent teeth. So, endodontic treatment is done for the same purpose. Various obturating materials have been introduced for the root canal filling of primary teeth but none could match all the ideal properties of the material. The main aim of the clinician should be to fill the root canal with material which could match maximum requirements of the ideal properties.

Successful root canal treatment depends on thorough cleaning & shaping and 3- dimensional fluid impervious obturation of tooth within the confines of canals. To achieve this objective  the apical constriction must be detected accurately during canal preparation and precise  control over  working length  during the  procedure must  be maintained.  There are  many methods  of working length determination including  radigraphs  and electronic method(apex locator). Introduction of apex locators  have definitely served  as an effective adjuvant  to radiographs. 

Clinicians are regularly confronted with different choices after failure of root canal treatment. In present scenario patient prefer to retain their original teeth thats why non-surgical retreatment should be the treatment of choice. The new generation of endodontic instruments, magnification, materials and  technology with the basic principles of endodontic retreatment have helped in retention of the patients natural tooth structure to form and function decreasing the need for extensively expensive prosthetic replacement in the area of implant dentistry. Surgical approach can be adopted in obstructed, calcified or non-negotiable canals.

A bstract Aims and objectives To comparatively evaluate the clinical efficacy of stepwise caries excavation with indirect pulp capping (IPC) in managing the young permanent teeth in pediatric patients who have deep carious lesions. Materials and methods Eighty-eight teeth (first/second permanent molars) were included and randomly divided into two groups: group I (stepwise caries excavation) and group II (IPC). For group I, i.e., stepwise caries excavation, in the initial visit, bulk caries removal was done from walls of the cavity, however, soft and infected dentin was left untouched on the pulpal floor. The final excavation was performed after 2 months. The dentin parameters like the color, the consistency, and the humidity of dentin were noted at the first and second visits. A final follow-up to assess the primary outcome, i.e., sustained pulp vitality, was done after 1 year. Results When both the groups were compared with each other using the Chi-squared test, a highly significant difference was found ( p < 0.05) between them. The success rate of stepwise caries excavation (97.3%) was found to be significantly greater than IPC (82.4%). After doing statistical analysis, a significant difference between stepwise excavation at baseline and at re-entry for parameters like the color, the consistency, and the humidity ( p < 0.05), where dentin was observed to be darker in color, harder in consistency, and drier to touch at re-entry was found. Conclusion Stepwise caries excavation was considered a safer technique than IPC for preserving the vitality of young permanent teeth. Also, the clinical changes recorded during the re-entry in the case of stepwise caries excavation technique indicated the arrest of the carious process. Clinical significance Pulp preservation is of utmost importance especially in the case of young permanent teeth which have open apex to aid in apexogenesis. Failure to do so in maintaining the vitality of pulp before root completion may lead to the unfavorable crown to root ratio resulting in thin dentinal walls which are prone to fracture. How to cite this article Manhas S, Pandit IK, Gugnani N, et al. Comparative Evaluation of the Efficacy of Stepwise Caries Excavation vs Indirect Pulp Capping in Preserving the Vitality of Deep Carious Lesions in Permanent Teeth of Pediatric Patients: An In Vivo Study. Int J Clin Pediatr Dent 2020;13(S-1):S92–S97.