Mandibular molar teeth with acute irreversible pulpitis pose challenges in single visit root canal treatment – (i) success of local anaesthesia and (ii) post‐operative pain. One hundred and twenty‐six patients with pain associated with carious mandibular molar teeth were enrolled. All patients were administered 10 mg of ketorolac tromethamine prior to local anaesthesia. Local anesthetics used were 2% lignocaine with 1:80 000 adrenaline and 4% articaine with 1:100 000 adrenaline. Three irrigation solutions were used – saline, 3% sodium hypochlorite and dexamethasone. Mean intra‐operative pain scores for the lignocaine and articaine groups were 4.33 (±2.58) and 4.22 (±2.88), respectively. There was a statistically significant difference (P = 0.000) in post‐operative pain incidence between the lignocaine and articaine groups with 16.7% (10 patients) and 49.2% (29 patients), respectively. Pre‐operative ketorolac tromethamine was not effective in reducing the intra‐operative pain incidence. However, it was effective in controlling post‐operative pain with lignocaine anesthetic group.

Present study evaluated the efficacy of laser activation to control intra- and post-operative pain in single-visit root treatment for mandibular molar teeth with acute irreversible pulpitis following 2% lignocaine inferior alveolar nerve block. Ninety-eight patients presenting with pain were randomly divided into two anesthetic groups. Group-I inferior alveolar nerve block plus buccal infiltration and intra-ligamentary injections, Group-II inferior alveolar nerve block followed by laser irradiation focused directly on the pulp tissue. Intra- and post-operative pain intensities were assessed on a 10-point scale.The mean intra-operative pain scores in group-I was 6.62 ± 1.6 and in group-II before and after laser irradiation pain scores was 6.94 ± 2.1 and 1.3 ± 2.04, respectively. Post-operative pain scores at 24-hrs in the laser group were significantly higher. Laser irradiation applied directly on pulp tissue for control of intra-operative pain was effective, thereby negating the need for additional local anesthesia.Clinical relevanceLaser activation was effective method to control intra-operative pain in irreversibly inflamed pulp.Laser irradiation did not cause adverse post-operative pain.

The purpose of this case report is to highlight the importance of cone-beam computed tomography, magnification, thermoplastic gutta-percha obturation, trichloroacetic acid, and bioactive endodontic cement usage in diagnosis and efficient management of invasive cervical resorption (ICR). Patients with predisposing factors associated with ICR, especially trauma of maxillary incisors, need close periodic monitoring to prevent the progression of the resorptive activity and initiate early management.

Objectives: To determine the influence of TF adaptive motion on fatigue resistance and efficacy of gutta-percha removal by retreatment files. Materials and methods:A total of 180 extracted single rooted natural human lower premolar teeth were used. Root canal preparations were completed using Mtwo files and obturated using a thermoplastic technique. The teeth were randomly divided into six groups. Three different retreatment file systems (D race, ProTaper universal retreatment, and TF adaptive files) employed with two different rotary motion of continuous and TF adaptive motion. Efficacy of gutta-percha removal was estimated using radiograph and retreatment files were assessed for deformation or fracture using an operating microscope (1.6x and 2.5x magnification). Data were analyzed using analysis of variance (ANOVA) and Chi-square tests (p < 0.05) in Statistical Package for the Social Sciences (SPSS) version 23.0.Results: ProTaper retreatment files took significantly less time to reach working length. ProTaper retreatment files were able to delete gutta-percha from more number of samples. Both D race and TF adaptive files exhibited fracture. Conclusion:TF adaptive motion did not improve the performance of the retreatment files.

This article aims to present about the restorative strategies to be adopted for the management of root canal-treated traumatized maxillary incisors incorporating the contemporary minimal invasive options. Each root canal-treated tooth poses a unique challenge to be addressed in an individual manner. This presentation highlights the restorative assessment and technique to be adopted for restoring the root canal-treated maxillary incisor.