This study addresses the efficacy of an automated decontamination protocol using the germicide ‘tetra acetyl ethylene diamine (TAED) perborate’ (Farmec SpA, Italy). The germicide TAED perborate protocol is used in the Castellini Dental Units fitted with an Autosteril unit (an automated device that can cycle 0.26% TAED perborate solution and sterile water for cleaning the water system between patients and overnight). Prior to testing the Autosteril and the 0.26% TAED perborate protocol on the Logos Jr Dental Unit (Castellini SpA, Italy), TAED perborate was used on a dental unit water system simulation device.

A dental unit water system simulation device equipped with four dental unit water systems and with naturally grown and mature biofilm contamination was used in this study (three treatment units and one control). One treatment group used a simulated 5 minutes contact with TAED perborate and sterile water for irrigation; the second used a simulated 5 minutes contact with TAED perborate and 2 ppm ClO₂ for irrigation; the third used a simulated 5 minutes contact with TAED perborate and municipal water for irrigation. The control group used municipal water for irrigation with no cleaning/disinfection protocols. This protocol was repeated for 30 cycles. Laser scanning confocal microscopy (LSCM) was used to study the effects on natural and mature biofilms, and R2A agar used to quantify heterotrophic plate counts in the effluent irrigant. Antimicrobial efficacy was evaluated by challenging TAED perborate with microbes and spores (M. smegmatis and B. subtilis). Deleterious effects of the germicide were evaluated on metal and nonmetal parts of dental unit water systems. Heterotrophic plate counts using R2A agar and LSCM of the lines were conducted to assess biofilm and microbial control.

Baseline water samples showed mean contamination >5.6 log₁₀ cfu/ml. After initial cleaning, all three groups maintained mean contamination levels of less than 1.1 (SD <0.3) log₁₀ cfu/ml. LSCM of baseline samples was positive for live biofilm in all groups. At the end of the study, viable biofilm was only present in the control. In the microbial challenge test, all vegetative organisms were killed within 30 seconds of contact, while spores were killed within 5 minutes. Corrosion was seen in metals used in US-manufactured dental unit materials, while not observed in those used in the Castellini Logos Jr dental unit.

In this study, the TAED perborate protocol was effective in biofilm control and control of dental treatment water contamination. Use of sterile water or 2 ppm ClO₂ along with TAED treatment also controlled planktonic contamination effectively.

Environmental biofilms contaminate dental unit water systems over time and affect the quality of dental treatment water. Contaminants include environmental biofilms, microbes, including gram-negative rods and endotoxins in high doses that are not of acceptable quality for treating patients. There are many germicidal protocols for treating this contamination and one such is the prescribed use of TAED perborate used in conjunction with sterile water for irrigation in the autosteril device, an integral component of the Castellini dental units for between patient decontamination of dental unit water systems. This study was conducted on an automated simulation dental unit water system to test the TAED perborate protocol's efficacy on naturally grown, mature environmental biofilms, it's efficacy on microbes and spores and it's effects on materials used in dental unit water systems. This translational research addresses both microbial control and material effects of TAED perborate in studying efficacy and possible deleterious effects and simulated use in dentistry. Currently, this antimicrobial use protocol is followed worldwide in the Castellini dental units that are used in day-to-day dental patient care.

Puttaiah R, Svoboda KKH, Lin SM, Montebugnoli L, Dolci G, Spratt D, Siebert J. Evaluation of an Automated Dental Unit Water System's Contamination Control Protocol. J Contemp Dent Pract 2012;13(1):1-10.

The aim of periodontal surgery is complete regeneration. The present study was designed to evaluate and compare clinically soft tissue changes in form of probing pocket depth, gingival shrinkage, attachment level and hard tissue changes in form of horizontal and vertical bone level using resorbable membranes.

Twelve subjects with bilateral class 2 furcation defects were selected. After initial phase one treatment, open debridement was performed in control site while freezedried dura mater allograft was used in experimental site. Soft and hard tissue parameters were registered intrasurgically. Nine months reentry ensured better understanding and evaluation of the final outcome of the study.

Guided tissue regeneration is a predictable treatment modality for class 2 furcation defect. There was statistically significant reduction in pocket depth as compared to control (p < 0.01). There is statistically significant increase in periodontal attachment level within control and experimental sites showed better results (p < 0.01). For hard tissue parameter, significant defect fill resulted in experimental group, while in control group, less significant defect fill was found in horizontal direction and nonsignificant defect fill was found in vertical direction.

The results showed statistically significant improvement in soft and hard tissue parameters and less gingival shrinkage in experimental sites compared to control site.

The use of FDDMA in furcation defects helps us to achieve predictable results. This cross-linked collagen membrane has better handling properties and ease of procurement as well as economic viability making it a logical material to be used in regenerative surgeries.

Patel S, Kubavat A, Ruparelia B, Agarwal A, Panda A. Comparative Evaluation of Guided Tissue Regeneration with use of Collagen-based Barrier Freeze-Dried Dura Mater Allograft for Mandibular Class 2 Furcation Defects (A Comparative Controlled Clinical Study). J Contemp Dent Pract 2012;13(1):11-15.

The aim was to evaluate the effects of Oral-B (OB), Listerine (LN) and Rembrandt Plus (RM) mouthrinses on microleakage of composite resin restorations bonded with two adhesive systems after bleaching with 10% carbamide peroxide.

A total of 60 Cl V cavities were prepared on human premolars. The occlusal and gingival margins were placed 1 mm occlusal to and apical to CEJ respectively. The teeth were randomly divided into two groups based on the adhesive system used: Excite (EX) and Clearfil SE Bond (CSE) groups. After composite resin restoration of cavities, thermocycling and bleaching with 10% carbamide peroxide for 2 hours daily for 14 days, the teeth in each adhesive group were further subdivided into three subgroups and were immersed for 12 hours in the three OB, RM and LN mouthrinses. The teeth were then placed in 2% basic fuschin for 24 hours. After dissecting the teeth, microleakage was evaluated under a stereomicroscope at 16×. Data was analyzed with multifactor ANOVA and Bonferroni test at p < 0.05.

Microleakage with EX was significantly higher than that with CSE (p = 0.009). Microleakage at gingival margins was significantly higher than that at occlusal margins (p = 0.15). Microleakage with OB was higher than that with LN (p = 0.02). However, there were no significant differences in microleakage between LN and RM (p = 1) and between RM and OB (p = 0.15). In addition, with the EX adhesive system, microleakage with OB was higher than that with LN and RM (p = 0.02).

In the present study, microleakage of composite resin restorations was influenced by the type of the adhesive system, mouthrinse type and the location of the cavity margin.

Use of some mouthrinses, such as OB after bleaching can increase postrestoration microleakage of resin composite restorations bonded with etch-and-rinse adhesive systems.

Ajami AA, Bahari M, Oskoee SS, Kimyai S, Kahnamoui MA, Rikhtegaran S, Ghaffarian R. Effect of Three Different Mouthrinses on Microleakage of Composite Resin Restorations with Two Adhesive Systems after Bleaching with 10% Carbamide Peroxide. J Contemp Dent Pract 2012;13(1):16-22.

The purpose of this study was to evaluate the effect of smear layer on apical seal of endodontically treated teeth.

Sixty freshly extracted human maxillary central incisor teeth were selected and were randomly divided into two experimental groups. Group A of 25 teeth and group B of 25 teeth and a control group of 10 teeth. Cleaning and shaping of the root canals were performed using endodontic K-files up to no. 50 size file in step-back technique. During the process, in root canals of group A, 17% EDTA (ethylenediaminetetraacetic acid) followed by 3% NaOCl (sodium hypochlorite) was used as root canal irrigant.

In group B, MTAD (mixture tetracycline citric acid and detergent) was used as a root canal irrigant.

In control group, saline was used as root canal irrigant. The root surfaces were then coated with nail polish of both experimental groups and control group. The samples were then immersed in India ink dye for 1 week at 37°C.

The statistical analysis of the results showed that the apical leakage was significantly more in teeth, where smear layer was not removed.

The removal of smear layer improves the longterm apical seal and success of endodontically treated teeth.

The development and maintenance of apical seal is desirable and considered to be a major prerequisite to improve the outcome of root canal treatment.

Nischith KG, Srikumar GPV, Razvi S, Chandra RV. Effect of Smear Layer on the Apical Seal of Endodontically Treated Teeth: An ex vivo Study. J Contemp Dent Pract 2012;13(1):23-26.

To compare the apical seal of lateral condensation technique, thermafil and one-step by using this model.

A two-chamber bacterial microleakage model using E. faecalis as microbial marker was used for evaluation of the leakage. Bacterial penetration was monitored over a 60-day period. Leakage was recorded when turbidity was observed in the lower chamber.

After comparing the bacterial penetration values, total penetration was observed 45% in lateral condensation technique, 80% in thermafil and 75% in one-step. There was no significant difference between groups after 60 days; however, the microleakage in lateral condensation group was seen later than one-step and thermafil.

Thermafil and one-step obturator can be advocated as effective obturation techniques for achieving predictable success in endodontic therapy.

Thermafil and one-step obturator are suitable devices for obturation.

Bakhtiar H, Heidari N, Mehrvarzfar P, Ghazvini K, Habibi M, Jafarzadeh H, Dastmalchi N. In vitro Comparative Study of the Microbial Leakage of One-step, Thermafil and Lateral Condensation Techniques. J Contemp Dent Pract 2012;13(1):27-30.

The purpose of this study was to evaluate and compare the maximum reproducibility with minimum variation of natural head position using two methods, i.e. the mirror method and the fluid level device method.

The study included two sets of 40 lateral cephalograms taken using two methods of obtaining natural head position: (1) The mirror method and (2) fluid level device method, with a time interval of 2 months.

Inclusion criteria

• Subjects were randomly selected aged between 18 to 26 years

Exclusion criteria

• History of orthodontic treatment

• Any history of respiratory tract problem or chronic mouth breathing

• Any congenital deformity

• History of traumatically-induced deformity

• History of myofacial pain syndrome

• Any previous history of head and neck surgery.

The result showed that both the methods for obtaining natural head position—the mirror method and fluid level device method were comparable, but maximum reproducibility was more with the fluid level device as shown by the Dahlberg's coefficient and Bland-Altman plot. The minimum variance was seen with the fluid level device method as shown by Precision and Pearson correlation.

The mirror method and the fluid level device method used for obtaining natural head position were comparable without any significance, and the fluid level device method was more reproducible and showed less variance when compared to mirror method for obtaining natural head position.

Fluid level device method was more reproducible and shows less variance when compared to mirror method for obtaining natural head position.

Khan AR, Rajesh RNG, Dinesh MR, Sanjay N, Girish KS, Venkataraghavan K. Comparison of Reproducibility of Natural Head Position using Two Methods. J Contemp Dent Pract 2012;13(1):31-39.

To evaluate four different techniques of caries excavation in primary teeth in terms of efficacy, efficiency and pain experienced during the procedure.

Sample of 120 teeth from children aged 5 to 9 years were equally divided into 4 groups – Air rotor (group A), Carisolv (group B), Papacarie (group C) and Er:YAG laser (group D). Visual and tactile criteria along with DIAGNOdent pen value was used to evaluate efficacy. Time was recorded to determine efficiency and FLACC scale was used to assess the pain experienced.

Air rotor and laser were more effective and efficient method whereas laser and CMCR methods were more comfortable methods.

Laser irradiation and CMCR methods are comparable to conventional methods in terms of effectiveness and are less painful methods.

Newer techniques of CMCR and laser irradiation of dentinal caries are minimally invasive methods and are less painful and thus should be more frequently employed in pediatric dentistry.

Bohari MR, Chunawalla YK, Ahmed BMN. Clinical Evaluation of Caries Removal in Primary Teeth using Conventional, Chemomechanical and Laser Technique: An in vivo Study. J Contemp Dent Pract 2012;13(1):40-47.

To compare and evaluate few physical properties of epoxy resin, resin-modified gypsum and conventional type-IV gypsum die material.

In the present study, dimensional accuracy, surface detail reproduction and transverse strength of three die materials like epoxy resin (Diemet-E), resin-modified gypsum (Synarock) and conventional type-IV gypsum (Ultrarock) are analyzed. For dimensional accuracy, master die (Bailey's die) is used and calibrations were made with digital microscope. For surface detail reproduction and transverse strength, rectangular stainless steel master die (Duke's die) was used and calibrations were made with Toolmaker's microscope and Instron universal testing machine respectively. One-way analysis of variance (ANOVA) was performed on the means and standard deviation for groups of each test.

The results of the study showed statistically significant difference among these materials in dimensional accuracy, surface detail reproduction and transverse strength.

Epoxy resin exhibited superiority in dimensional accuracy, surface detail reproduction and transverse strength and is nearest to the standards of accurate die material.

Gujjarlapudi MC, Reddy SV, Madineni PK, Ealla KKR, Nunna VN, Manne SD. Comparative Evaluation of Few Physical Properties of Epoxy Resin, Resin- Modified Gypsum and Conventional Type IV Gypsum Die Materials: An in vitro Study. J Contemp Dent Pract 2012;13(1): 48-54.

To attain alliance between the oral hygiene practices with prevalence of tooth abrasion among urban and rural adult population of Central India. To plan dental care services in inaccessible areas and to suggest appropriate remedial measures to prevent this avertable and self-inflicted injury of teeth in this cross-sectional study.

A sum of 1045 adult residents both from Urban (529) and rural (516) parts of Bhopal district (Central India) was selected on a random basis. The multistage sampling technique was adopted to ascertain the sample size. In urban area the study population consisted of 240 males, 289 females and 201 males and 315 females in rural area respectively. All residents above 18 years of age from the Bhopal district were included in cross-sectional study. Assessment form comprises of questionnaire and general information on oral hygiene practices, dietary habits and medical history. Abrasion was assessed using diagnostic criteria recommended by Smith and Knight (modified). Chi- square test was used to test associations between categorical variables at 5% level of significance. Regression analysis attempted to define for risk factors causing abrasion. Literature on the prevalence of abrasion is very sparse, so attempt is made to correlate the etiological factors and recommend to prevent tooth wear.

Investigation of this cross-sectional study was aggregate of 1045 residences. Result shows high prevalence of abrasion 70.2%. Higher prevalence concomitant with diffident habits related to oral hygiene maintenance was recorded more among rural (76.9%) when compared to urban dwellers (63.7%). Presence of abrasion verifies statistical significance in relation to age, ruralurban difference and variations in habit of oral hygiene care. Stated in the present study, avertable and self-inflicted is toothabrasion, recurrently resulted by the reprehensible brushing method and common use of indigenous material for the maintenance of oral hygiene.

Shows significant liaisons with the presence of abrasions in relation to Urban and rural dwelling, age, material used and mode of brushing and duration of brushing. Indigenous and course material causes high amount of enamel wear and with the advancement in age abrasion tend to increase. Prevalence of abrasion does not show any gender predilection. Cultural believes, lifestyle and transition reflects in deviating presence of abrasion in populations.

Yadav NS, Saxena V, Reddy R, Deshpande N, Deshpande A, Kovvuru SK. Alliance of Oral Hygiene Practices and Abrasion Among Urban and Rural Residents of Central India. J Contemp Dent Pract 2012;13(1): 55-60.

The aim of this in vitro study was to evaluate and compare the shear bond strength of teeth reattached with sixth generation dentin bonding agent: Xeno III and microhybrid resin composite: Esthet-X, using three different techniques: (1) Simple reattachment, (2) overcontour and (3) internal dentinal groove.

A total of 70 human maxillary central incisors were selected and divided into four groups as follows. Group I: Control group comprised of 10 samples. Group II: Simple reattachment, group III: Overcontour and group IV: Internal dentinal groove. Groups II, III and IV comprised of 20 samples each. The teeth in three study groups were sectioned using a diamond disk and the fragment was reattached with Esthet-X and Xeno III using three different techniques. Specimens were stored in tap water for 24 hours and shear bond strength was determined using universal testing machine using a knifeedge chisel (0.5 mm in cross-section) at a crosshead speed of 1 mm/minute.

The results of this study showed following mean value of fracture strength in Kgf: Group I: Control—27.71; group II: Simple reattachment—9.78; group III: Overcontour—24.41; group IV: Internal dentinal groove—23.83.

The overcontour technique had the highest strength recovery while the simple reattachment had the lowest.

The overcontour technique provided strength recovery almost similar to intact teeth emphasizing that tooth preparation influenced fracture resistance.

Srilatha, Joshi S, Chhasatia N, Rani PJ, Mathur E. Reattachment of Fractured Anterior Teeth— Determining Fracture Strength using Different Techniques: An in vitro Study. J Contemp Dent Pract 2012; 13(1):61-65.

Shah P, Gugwad SC, Bhat C, Lodaya R. Effect of Three Different Core Materials on the Fracture Resistance of Endodontically Treated Deciduous Mandibular Second Molars: An in vitro Study. J Contemp Dent Pract 2012;13(1):66-70.

Many essential oils have been advocated for use in complementary medicine for bacterial and fungal infections. However, few of the many claims of therapeutic efficacy have been validated adequately by either in vitro testing or in vivo clinical trials.

To study the antibacterial activity of nine commercially available essential oils against Streptococcus mutans in vitro and to compare the antibacterial activity between each material.

Nine pure essential oils; wintergreen oil, lime oil, cinnamon oil, spearmint oil, peppermint oil, lemongrass oil, cedarwood oil, clove oil and eucalyptus oil were selected for the study. Streptococcus mutans was inoculated at 37°C and seeded on blood agar medium. Agar well diffusion assay was used to measure antibacterial activity. Zone of inhibition was measured around the filter paper in millimeters with vernier caliper.

Cinnamon oil showed highest activity against Streptococcus mutans followed by lemongrass oil and cedarwood oil. Wintergreen oil, lime oil, peppermint oil and spearmint oil showed no antibacterial activity.

Cinnamon oil, lemongrass oil, cedarwood oil, clove oil and eucalyptus oil exhibit antibacterial property against S. mutans.

The use of these essential oils against S. mutans can be a viable alternative to other antibacterial agents as these are an effective module used in the control of both bacteria and yeasts responsible for oral infections.

Chaudhari LKD, Jawale BA, Sharma S, Sharma H, Mounesh Kumar CD, Kulkarni PA. Antimicrobial Activity of Commercially Available Essential Oils Against Streptococcus mutans. J Contemp Dent Pract 2012;13(1):71-74.

The study was aimed at esthetic and functional results as well as patient tolerance after reconstruction with reconstruction plate. The follow-up ranged from 1 to 4 years.

A retrospective study of 36 patients who had mandibular reconstruction with AO/ASIF stainless steel reconstruction plates after oncologic resection was evaluated. The indications and postoperative outcomes were studied.

At the end of study, 24 of 36 patients (67%) still had the plate in place. Around three (8%) plates were fractured. Nine (25%) plates got exposed leading to surgical intervention. Surgical results were satisfying, particularly when looking at delayed healing or long-term tolerance. Esthetic (79% rated results as good or acceptable) and functional results of this reconstruction were satisfying.

We conclude by saying that reconstruction plate provides a solution for safe and rapid mandibular reconstruction for patients with poor prognosis or poor condition. This method also preserves the possibility of secondary reconstruction.

The reconstruction plate may be a good clinical choice for safe and rapid mandibular reconstruction.

Harsha G, Reddy SGK, Talasila S, Salaam SA, Srinivasulu M, Reddy VS. Mandibular Reconstruction using AO/ASIF Stainless Steel Reconstruction Plate: A Retrospective Study of 36 Cases. J Contemp Dent Pract 2012;13(1):75-79.

Taneja VK, Kumar GA, Farishta S, Minocha RC, Baiju G, Gopal D. An Assessment of Skeletal Craniofacial Asymmetry in South Indian Population. J Contemp Dent Pract 2012;13(1):80-84.

Transversal slicing system (TSS) of Planmeca PM 2002 CC is a tomographic technique which enables us to take cross-sectional views of jaws. Tomographic imaging modalities are commonly applied to acquire cross-sectional images of the jaws for preimplant assessment of bone. Among the available tomographic imaging modalities, panoramic radiography is the most accessible imaging system.

Study was conducted using 25 mandibles, out of these five were used for linear dimensional accuracy measurement and the rest 20 were utilized to study the details within the mandible. Study was aimed to evaluate dimensional stability in the images using different parameters, such as determination of direction of slice, determination of horizontal and vertical magnification, angular distortion, threedimensional distortion and determination of details.

For the direction of slice and for determination of horizontal and vertical magnification change in + 5° to – 5° was in acceptable limit. In determination of details, it was found that there was great discrepancy in readings given by nonradiologist which offset the mean value which was attributed to lack of training for interpretation of the observers.

99% of the readings were in the clinically acceptable limits.

The easy availability, use of routine equipment, the low cost, low radiation dose for cross-sectional radiography make the TSS most preferred modality.

Kumar MA, Mody B, Nair GKR, Surender LR, Gopal SS, Prasad RVKA. Dimensional Accuracy and Details of the Panoramic Cross-sectional Tomographic Images: An in vitro Study. J Contemp Dent Pract 2012;13(1):85-97.

To evaluate the linear dimensional accuracy of the elastomeric impressions using various impression techniques using different combinations of viscosities of impression materials.

Crown preparation was done in a dentulous acrylic resin denture base model with six natural teeth embedded into it was made to represent the dentulous maxillary arch. A total of 55 impressions were obtained and poured in die stone using various impression techniques with different combinations of viscosities of impression materials.

Among the six techniques used, the heavy body light body two-step technique using custom tray showed the least distortion which was closely followed by the putty wash two-step technique with 2 mm spacer using stock tray.

The study revealed that the heavy body light body two-step technique with custom tray provided the best results.

Dimensional accuracy of impressions is very much required for precisely fitting of prosthesis. This study may be helpfull to select the technique and materials as per clinical requirement of accuracy of impressions.

Singh K, Sahoo S, Prasad KD, Goel M, Singh A. Effect of Different Impression Techniques on the Dimensional Accuracy of Impressions using Various Elastomeric Impression Materials: An in vitro Study. J Contemp Dent Pract 2012;13(1):98-106.

Sharma S, Vijayaraghavan V, Tandon P, Kumar DRV, Sharma H, Rao Y. Dental Education: Current Scenario and Future Trends. J Contemp Dent Pract 2012;13(1):107-110.

To recognize a line of treatment for scleredema of Buschke in an adolescent.

Scleredema of Buschke is an uncommon disorder characterized by induration of the skin, which includes a non pitting hardening of the skin around the neck, shoulders, and trunk sometimes the face. Three variants are recognized. The histopathologic features of scleredema are characterized by thickened collagen bundles within the reticular dermis that are separated by mucin containing fenestrations. No consistent treatment modality is currently followed.

The present case report describes scleredema of Buschke in a 10-year-old female child reported with stiffness of facial skin and difficulty in opening the mouth. The patient was treated with antibiotics and vitamin supplements and there was drastic improvement with decrease in skin stiffness and increase in mouth opening. The stiffness of facial muscles decreased and mouth opening increased.

Multiple treatment modalities for scleredema have been used. In the present case, high-dose antibiotic therapy was used with good prognosis.

High-dose antibiotic therapy can be used for treatment of dermatologic disorders with reasonably good prognosis.

Rani JD, Patil SG, Murthy STS, Koshy AV, Nagpal D, Gupta S. Juvenile Scleredema of Buschke. J Contemp Dent Pract 2012;13(1):111-114.

To present a case of expansive focal cemento-osseous dysplasia and emphasize the importance of differential diagnosis.

Cemento-osseous dysplasia is categorized into three subtypes on the basis of the clinical and radiographic features: Periapical, focal and florid. The focal type exhibits a single site of involvement in any tooth-bearing or edentulous area of the jaws. These lesions are usually asymptomatic; therefore, they are frequently diagnosed incidentally during routine radiographic examinations. Lesions are usually benign, show limited growth, and do not require further surgical intervention, but periodic follow-up is recommended because occasionally, this type of dysplasia progresses into florid osseous dysplasia and simple bone cysts are formed.

A 24-year-old female patient was referred to our clinic for swelling in the left edentulous mandibular premolarmolar region and felt discomfort when she wore her prosthetics. She had no pain, tenderness or paresthesia. Clinical examination showed that the swelling in the posterior mandible that was firm, nonfluctuant and covered by normal mucosa. On panoramic radiography and computed tomography, a welldefined lesion of approximately 1.5 cm in diameter of mixed density was observed.

The swelling increased slightly in size over 2 years making it difficult to use prosthetics and, therefore, the lesion was totally excised under local anesthesia, and surgical specimens were submitted for histopathological examination. The histopathological diagnosis was focal cemento-osseous dysplasia.

In the present case, because of the increasing size of the swelling making it difficult to use prosthetics, young age of the patient and localization of the lesion, in the initial examination, cemento-ossifying fibroma was suspected, and the lesion was excised surgically; the histopathological diagnosis confirmed it as focal cemento-osseous dysplasia.

We present a case of expansive focal cemento-osseous dysplasia. Differential diagnosis is essential because ossifying fibroma is a real neoplastic entity.

Uzun Bulut E, Acikgoz A, Ozan B, Zengin AZ, Gunhan O. Expansive Focal Cemento-Osseous Dysplasia. J Contemp Dent Pract 2012;13(1):115-118.

This study describes a clinical case of type III dens invaginatus with an extensive periradicular lesion treated successfully.

Dens invaginatus is a maldevelopment of the dental germ which occurs as a result of the invagination of the enamel organ. These cases may present difficulties with respect to its diagnosis and treatment because of canal morphology. The success of endodontic therapy requires a knowledge of dental anatomy and its anomalies.

A 17-year-old female patient is reported presenting right maxillary lateral incisor (tooth no. 7) classified as type III dens invaginatus with necrotic pulp and presence of an extensive radiolucid lesion. Endodontic treatment was recommended for tooth. However, intracanal exudate was present, suggesting a resistant infection. Enucleation of the lesion was performed as a complementary approach. The root canal obturation was carried out by the gutta-percha thermoplastification technique with root canal sealer, followed by restoration of the tooth. Healing of the lesion with hard tissue formation was confirmed at follow-up.

A combination of endodontic and surgical treatments were fundamental to the maintenance of the tooth. The treatment was considered successful.

Root canal therapy of dens invaginatus should be based on a thorough clinical and radiographic evaluation. The knowledge of classification and anatomical variations of teeth with dens invaginatus are of great importance for correct treatment.

de Souza Falcão L, de Freitas PS, de Oliveira Marreiro R, Garrido ÂDB. Management of Dens Invaginatus Type III with Large Periradicular Lesion. J Contemp Dent Pract 2012;13(1):119-124.

Garoushi S, Lassila L, Vallittu PK. Single Visit Replacement of Maxillary Canine using Fiber-reinforced Composite Resin. J Contemp Dent Pract 2012;13(1):125-129.

Developmental anomalies can occur in any tooth and supplementary premolars are no exception. The complexity of such teeth has to be considered for planning endodontic treatment to increase the chances of success.

Vora J, Meena N, Mehta D, Murthy CS. Endodontic Management of Maxillary Supplementary Premolar using Cone-Beam Computed Tomography. J Contemp Dent Pract 2012;13(1):130-135.