Introduction: Abnormal root canal morphologies of third molars can be diagnostically and technically challenging during root canal treatment. Aim:The aim of this retrospective study was to investigate the root and canal morphology of mandibular third molars in Central India population by using Cone Beam Computed Tomography (CBCT) analysis. Materials and Methods:CBCT images of 171 mandibular third molars were observed and data regarding number of roots, number of canals, Vertucci's classification in each root, prevalence of C shaped canal, gender and topographical relation of morphology in mandibular third molar was statistically evaluated.

The present case highlights the endodontic management of a maxillary second molar with three roots and seven canals. Root canal treatment was performed for the maxillary second molar diagnosed with symptomatic irreversible pulpitis. During the procedure under magnification, extra canals were detected in the mesiobuccal root. Cone-beam computed tomography (CBCT) evaluation confirmed four canals in the mesiobuccal root with Vertucci's Type XXI (4-1) pattern. The distobuccal root exhibited two canals with Vertucci's Type III (1-2-1) configuration. The palatal canal was single and large. A 4 year follow-up revealed satisfactory clinical and radiographic findings. Magnification and CBCT allow us to explore possible anatomic variations with insights to tackle such situations clinically.

The present research study assessed the cell viability and cytotoxic effect of mineral tri-oxide aggregate (MTA), Tetric N-Bond Universal bonding agent, Theracal PT (pulpotomy treatment), and platelet-rich fibrin (PRF) as pulp capping agents on human dental pulp stem cells (hDPSCs). The cells were isolated from the pulp tissue of an extracted healthy permanent third molar. After four passages in Dulbecco’s Modified Eagle’s Medium, the primary cells were employed for the investigation. The test materials and untreated cells (negative control) were subjected to an Methylthiazol-diphenyl-tetrazolium (MTT) cytotoxicity assay and assessed at 24-, 48-, and 72-h intervals. The Wilcoxon matched-paired t-test and Kruskal–Wallis analysis of variance (ANOVA) test were applied (p < 0.05). PRF imparted the highest cell viability at 48 h (p < 0.001), followed by MTA, Theracal PT, and Tetric N-Bond. Similarly, PRF had the highest potential to enhance cell proliferation and differentiation (p < 0.001), followed by Theracal PT, MTA, and the bonding agent at the end of 24 h and 72 h, respectively. Finally, PRF sustained the viability of human primary dental pulp stem cells more effectively than Theracal PT and MTA; however, the application of a Tetric N-Bond as a pulp capping agent was ineffective.

Objectives This study aimed to investigate the efficacy of ionic and non-ionic-based contrast media ( in vitro study) and the combinatorial effect of chitosan-based endo-radiopaque solution (CERS) ( in vivo study) for visualization of the root canal anatomy. Materials and Methods In vitr o study (120 teeth): The root canal of maxillary premolars and molars ( in vitro group 1 and 2 respectively, n = 60 each) were analyzed using 4 different contrast media (subgroups: Omnipaque 350, Iopamidol, Xenetix 350, and Urografin 76; n = 15 each) in combination with 5.25% sodium hypochlorite (NaOCl). Based on the results of the in vitro study, in vivo study (80 teeth) was done to compare Xenetix 350 + 5.25% NaOCl with CERS ( in vivo group 1 and 2 respectively, n = 40 each) on maxillary and mandibular premolars and molars. Two endodontists used radiovisiography to assess the depth of ingress and identify the aberrant root anatomy after access cavity preparation, and after initial cleaning and shaping of canals. Kruskal-Wallis test was used for in vitro comparison ( p < 0.05), and Wilcoxon signed-rank test and Mann-Whitney U test for in vivo analysis ( p < 0.01). Results In vitro study, Xenetix 350 + 5.25% NaOCl facilitated a significant higher visualization ( p < 0.05). For in vivo study, CERS had a statistically significant depth of ingress ( p < 0.01), and was efficient in identifying the aberrant root canal anatomy of premolars and molars. Conclusions CERS facilitates better visualization of the root canal anatomy of human premolars and molars.

This article describes an unusual location of the orifices and roots in a permanent mandibular second molar with symptomatic irreversible pulpitis and symptomatic apical periodontitis. During its micro-endodontic management, the cone-beam computed tomography evaluation revealed a rare variant of a three-rooted permanent mandibular second molar with four canals. The single buccal root had two canals with Vertucci's Type II pattern and a lingual root dividing into two with a single canal in each root, respectively. Interestingly, the concerned tooth had normal occlusal morphology and alignment in the arch. A follow-up of 9 months after the completion of endodontic therapy exhibited satisfactory clinical and radiographic findings.