Objective: To investigate the anatomic symmetry of maxillary and mandibular posteriors in Indian subpopulation using cone beam computed tomography (CBCT). Materials and Methods: CBCT images of 246 patients that had at least one noncarious, posterior tooth free of restorations in each quadrant were enrolled for retrospective analysis. A total of 3015 teeth (811 maxillary premolars, 845 mandibular premolars, 738 maxillary molars, and 621 mandibular molars) were analyzed for number of roots and root canals, canal morphology and anatomic symmetry, and concurrent types between the maxilla and mandible. Results: There was no difference in the percentage of symmetry for maxillary first (81.5%) and second (81.5%) premolars. Mandibular second premolars (98.3%) exhibited greater symmetry than mandibular first premolars (96.1%). First molars (77.5% and 82.1%) showed greater symmetry than second molars (70.8% and 78.6%), in both maxillary and mandibular arches, respectively. The most common anatomy observed were: maxillary first premolars – 2 roots with 2 canals, maxillary second premolars – 1 root with 2 canals, mandibular first and second premolars – 1 root with 1 canal, maxillary first and second molars – 3 roots with 4 canals, and mandibular first and second molars – 2 roots with 3 canals. When compared with any other teeth, maximum asymmetry was observed in maxillary second molar (29.2%). Conclusion: The percentage of symmetry observed in the present study varied from 70% to 98% with least percentage of symmetry in maxillary second molars. These data should alert the clinicians while treating homonymous teeth of the same patient.

Context: Sodium hypochlorite is the most commonly used irrigant but it has disadvantage like high cytotoxicity. So there is a need to find an alternative to 5.25% Sodium hypochlorite against microorganism Enterococcus faecalis and Candida albicans. Literature has shown that these 5 extracts namely Terminalia chebula, Myristica frangrans, Aloe barbadensis, Curcuma longa and Azadaricta indica has good properties which can be used as a potential endodontic irrigant. Aims: To evaluate the antimicrobial efficacy of various herbal extracts namely Curcuma longa (CL), Azadiracta indica (AI), Aloe barbadensis (AV), Myristica fragrans (MF) and Terminalia chebula (TC) as endodontic irrigant against Enterococcus faecalis and Candida albicans using real-time quantitative polymerase chain reaction (qPCR). Materials and Methods: Eighty-four teeth were extracted and suspended with Enterococcus faecalis and Candida albicans. A preliminary study was first performed to determine the minimum inhibitory concentration of extracts. The irrigating groups were divided into five herbal groups and 2 control groups. After irrigating the teeth the remaining microbial load was determined using qPCR. Statistical Analysis Used: Statistical analysis was performed using Oneway Anova/Kruskal-Wallis test with post-hoc Tukey's HSD and was statistically significant ( P < 0.05). Results: It was shown that Neem was highly efficient to 5.25% NaOCl in reducing Enterococcus faecalis and Candida albicans within the root canals when compared with other extracts. Conclusions: Neem leaf extract has a significant antimicrobial efficacy against Enterococcus faecalis and Candida albicans compared to 5.25% sodium hypochlorite.

Context: Evaluation of microhardness of root dentin provides indirect information on the change in mineral content of root dentin thereby providing useful information on the bonding quality of resin-based root canal sealers. Aims: This study evaluated the effect of 17% EDTA, MTAD, and 18% HEBP solutions on the microhardness of human root canal dentin using the Vickers microhardness test. Materials and Methods: Forty human single-rooted teeth were decoronated at the cementoenamel junction and sectioned longitudinally into buccal and lingual segments. Eighty specimens were divided into four groups (n=20). Group I was treated with distilled water (control), groups II, III, and IV were treated with 1.3% NaOCl as a working solution for 20 minutes followed by 17% EDTA, MTAD, and 18% HEBP respectively. The surface hardness of the root dentin was determined in each specimen with a Vicker's hardness tester. The values were statistically analyzed using the one-way ANOVA and post hoc Tukey multiple comparison tests. Results: There was a statistical significant difference among all the groups (one-way ANOVA; P<0.001). Among the experimental groups, HEBP showed the highest dentin microhardness (53.74 MPa, P<0.001). Least microhardness was found with MTAD (42.85 MPa, P<0.001). Conclusions: HEBP as a final rinse appears to be a promising irrigation protocol with less impact on the mineral content of root dentin.

Aim: Several factors influence the condition of the periapical tissues associated with root filled teeth. The primary objective of this study was to retrospectively evaluate the extent and speed of bone healing of large periapical lesions associated with nonsurgical root canal treatment or retreatment. The secondary objective was to analyse the relationship between the time to complete healing when analysed using cone beam computed tomography (CBCT) and other possible predictors that affect healing.Methodology: Seventy‐nine patients were treated during the years 2013–2020 with large periapical lesions of endodontic origin (10–15 mm) as observed on intraoral periapical radiographs (IOPAR) were included. IOPAR and CBCT were available before treatment and during the follow‐up (IOPAR every 6 months and CBCT every 12 months). The volume of periapical lesions was calculated by OsiriX Lite software. Variables such as initial volume of the lesion, age, gender, type of treatment or type of root canal filling were compared to identify the differences between healed and unhealed lesions. Pearson's Chi‐square test was used for categorical variables, the t‐test for age and the Wilcoxon test for initial volume of the lesion. The association between time to healing and the variables was assessed using univariate analysis and multivariate analysis. The Wilcoxon test was used to observe the association of healing time with categorical variables and the correlation index was measured with the quantitative variables.Results: Of the 79 cases analysed, 60 lesions (76%) were completely healed as verified by CBCT in a mean healing time of 19 months, of which 60% healed fully between 12 and 18 months. Increase in age of patient and larger initial volume of the lesion were associated with a significantly longer healing time (p < .001). Gender, filling material and type of treatment did not have a significant effect on the healing process (p > .05).Conclusions: Clinicians should be aware that periapical lesions in older patients and larger areas of bone loss take longer to heal. CBCT monitoring of large periapical lesions is critical and it can help clinicians in the decision‐making process.