Background: The number of voids within the root canal obturation is a relevant parameter to describe the quality of the technique, as well as to predict long-term prognosis. The aim of this study was to evaluate the quality of root canal obturation in curved root canals filled with Thermafil, GuttaCore, GuttaFusion and lateral compaction with AH Plus and EndoSequence BC sealer, by means of percentage of gutta-percha and sealer filled area. Methods: 200 curved canals of mandibular molars were divided in five groups (n = 40). Each specimen was evaluated at 3, 6 and 9 mm from the apex. A total of 600 samples were analyzed. Obturation was performed with either Thermafil (TH), GuttaCore (GC), GuttaFusion (GF) or lateral compaction (LC), using AH Plus as sealer. In another group EndoSequence BC sealer (BC) was used. Subgroups (n = 20) were made depending on the use of sonic activation during the placement of the sealer. The percentage of total obturation material was analyzed as an indirect measurement of percentage of voids. Results: GF showed a better performance at the apical level, while GC showed the higher percentage of total obturation at the coronal area. No differences were observed for the activation of sealers in any of the groups. Statistical analysis was performed by using two-way ANOVA. Statistical significance was set at CI: 95% (p < 0.05). Conclusions: Sonic activation of sealers did not show any benefit to avoid the presence of voids within obturation of curved canals. Following the manufacturer recommendations, we found that TH did not show benefits when applied to curved canals.

In general, mandibular canines have a single root and a single canal. The occurrence of two roots and two canals is a rare entity ranging from 1 to 5%. The anatomy of root canal morphology plays a decisive role in determining the conditions under which endodontic treatment can be performed effectively. Successful endodontic treatment comprises proper diagnosis, meticulous cleaning and shaping followed by three dimensional obturation. Failure to do so may lead to postoperative diseases, pain and further complications. This paper reports successful management of a mandibular canine with two roots and two canals. 45-year-old Nepalese women with a non-significant medical history presented with a chief complaint of pain in a lower left front tooth. The pain disturbed her sleep and lingered for several minutes even after removal of a thermal stimulus. Clinical examination and testing revealed generalized severe attrition with tenderness to percussion in the mandibular left canine. Electric pulp test for all the mandibular anteriors revealed almost no response in the mandibular left canine. Intraoral periapical radiographs in different angulations were taken which revealed two roots and two canals. A clinical diagnosis of chronic irreversible pulpitis with symptomatic apical periodontitis was made and root canal therapy was performed following the standard protocols. Although the prevalence of two roots and two canals in mandibular canine is very low, the clinician should always be mindful of variations in the number of roots and canals for proper management of such cases.

Background: A clinical trial was designed to evaluate bone regeneration in patients who received one of three retrosealants after apicoectomies in teeth with periapical lesions of endodontic origin to determine which is the best. Methods: Three retrosealants (EndoSequence, ProRoot MTA, Biodentine) were used following microsurgical apicoectomies in a prospective comparative randomized clinical trial in 74 patients who were selected from the endodontics department at the Universidad de Valparaiso, Chile. Clinical and CBCT evaluations were performed up to six months following the procedure. Results: There were no significant statistical differences in the bone regeneration among the three groups. The distribution of outcome was examined by the Kolmogorov-Smirnov test for normality. The Kruskal-Wallis test was used to examine differences among the three groups and pairwise comparisons were conducted by using Mann-Whitney tests. Conclusions: There were no significant differences in the healing of the periapical bone lesion between the three materials used in this investigation. Other studies with a larger number of cases and a longer follow-up time are recommended. Practical implications: Based on the results of this study, the clinician can choose any of the three retrofilling cements to seal the canals after an apicectomy.

J Conserv Dent, Official publication of Federation of Operative Dentistry (India)