This is a case of a patient with a buccal cutaneous sinus tract, originally misdiagnosed, with delayed healing and potential malpractice. An odontogenic cutaneous sinus tract is a pathologic canal that initiates in the oral cavity but opens externally at the cutaneous surface of the face or neck. It is frequently misdiagnosed, leading to inappropriate treatment. Once correct diagnosis is made, definitive treatment, through oral therapy to eliminate the source of infection, is simple and effective. This case was initially misdiagnosed as a sebaceous cyst and laceration of parotid gland. The case was correctly diagnosed through detailed examination and evaluation, using tracing and advanced imaging technology (cone beam imaging). Endodontic treatment was performed, which resulted in rapid resolution of the case, followed by dermatologic treatment with fractional laser to treat the scar formed.

Instrument separation during root canal therapy is inevitable in endodontics with several unfavorable clinical consequences. Therefore, examining the cyclic flexural fatigue resistance of commonly used rotary endodontic files is crucial. This study aimed to determine the cyclic flexural fatigue resistance of four nickel–titanium (NiTi) rotary files used as a single canal preparation technique: WaveOne, Reciproc, Protaper F2, and Unicone medium instruments. According to the manufacturer’s instructions, each file was rotated freely within a 1.3 mm deep and 1.3 mm wide V-shaped groove in a stainless-steel block with a 40° and 5 mm radius of curvature. Cyclic fatigue resistance was compared between the NiTi files by verifying the time needed to crack. The data were analyzed using one-way analysis of variance (ANOVA) followed by Scheffé post hoc with a significant level set at p < 0.05. Our results demonstrated that the WaveOne instrument had the highest cyclic flexural fatigue resistance among the tested groups (p ≤ 0.05), while Unicone had the lowest cyclic flexural fatigue resistance. This study concluded that WaveOne size 25/0.08 could illustrate a superior cyclic flexural fatigue resistance when instrumenting root canals with the lowest possibility to cause instrument separation.

OBJECTIVE: To examine the in vitro antimicrobial effect of a 20% Miswak extract against a mixture of Candida albicans (C. albicans) and Enterococcus faecalis (E. faecalis) using the dilution tube susceptibility test, which allows direct contact between the tested material and the microorganisms. METHODS: The study samples were collected and processed between August 2009 and January 2010 in the College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Each microorganism was obtained in a suspension and exposed to a 20% Miswak extract in plastic tissue culture clusters containing 24 wells. Six wells were used per group. The Miswak extract was incubated with the microorganisms for one, 6, and 24 hours. RESULTS: This in vitro study showed that Miswak extract was an effective antifungal and antibacterial agent at all tested experimental time periods, except one hour exposure of a 20% Miswak extract to E. faecalis and a mixture of E. faecalis and C. albicans, which was ineffective in inhibiting their growth. CONCLUSION: Twenty percent Miswak extract is an effective antifungal and antibacterial agent against C. albicans and E. faecalis.

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