Department Of Conservative Dentistry Research Articles

Frequency of Second Mesiobuccal Canal in Permanent Maxillary Molars: An Observational Study

Background: The success of root canal therapy in endodontics is heavily dependent on identifying a second mesiobuccal canal (MB2) in permanent maxillary molars. A comprehensive understanding of internal anatomy, particularly the recognition of MB2, is crucial for the effective treatment of this commonly encountered tooth. This study aimed to investigate the prevalence and occurrence of the second mesiobuccal canal in permanent maxillary first and second molars. Methods: This cross-sectional study that was conducted at the Department of Conservative Dentistry & Endodontics, Military Dental Centre Dhaka, Bangladesh from January 2018 to December 2018.  The analysis involved a total of 200 maxillary first molars and 200 maxillary second molars. In the initial phase for both groups, teeth were examined with the naked eye followed by microscopic assessment. Data analysis was conducted with MS Office tools. Results: In naked eye observation, the frequency of MB2 canals in the first molar teeth was found 64%, and in the second molar teeth it was found 56%. On the other hand, by microscopic assessment, the frequency of MB2 canals in the first molar teeth was found 96%, and in the second molar teeth, it was found 84%. Conclusion:  The occurrence of the second mesiobuccal canal (MB2) in permanent maxillary first molars is more common than in the second molars. Microscopic assessment proves to be more effective than naked eye assessment for detecting the presence of MB2 in both maxillary first and second molars. J Bangladesh Coll Phys Surg 2024; 42: 133-138

FUNCTIONAL CROWN LENGTHENING AS A PRE-RESTORATIVE PROCEDURE IN THE AESTHETIC ZONE

Introduction: Crown lengthening is a surgical procedure to increase the height of the clinical crown for aesthetic and restorative purposes, or combination. The indications include treatment of subgingival caries and altered passive eruption. Functional crown lengthening for restorative purposes in the esthetic zone should consider the concept of biologic width and the ideal proportion of the dentogingival complex. Case: A 39-year-old male patient was referred from the Department of Conservative Dentistry, RSGM UGM Prof. Soedomo to expose the maxillary anterior teeth crowns for full crown and veneer restorations. Clinical examination showed 11, 12, and 12 post root canal treatment with 3-4 mm remaining crowns. Teeth 13, 21, 22, and 23 appear short, excessive gingival display of 3 mm, with a diagnosis of altered passive eruption type 1B. Treatment: Functional crown lengthening was performed by gingivectomy followed by flap elevation, ostectomy, and osteoplasty. A fenestration was found at the apical of 22 and treated with regenerative procedure. Full crowns and veneers insertion was done 3 months after surgery. Crown lengthening as a pre-restorative procedure is a multidisciplinary treatment that considers the need for restoration by re-establishing the biologic width, to prevent inflammation and bone loss. In addition, adequate post- surgical tissue healing time prior to restoration is necessary to avoid gingival margin rebound and to assure long-term success of the restoration. Conclusionn : Functional crown lengthening as a pre-restorative procedure in the esthetic zone can gives satisfactory and stable results, with careful examination and correct surgical procedure.

Dental treatment of children with special healthcare needs: A retrospective study of 10 years of treatment.

Children with special healthcare needs (CSHCN) often face oral health challenges. This retrospective cross-sectional study at a university hospital aimed to determine CSHCN's medical spectrum, dental treatment needs, and mode of treatment: general anesthesia (GA) or outpatient dental care (ODC). Data from the Department of Conservative Dentistry, Heidelberg University Hospital, 2012-2022, were reviewed, considering age, gender, International Classification of Diseases-10 diagnoses, caries experience (dmft/DMFT), restorative parameters, and treatment under GA/ODC. For patients under GA, their American Society of Anesthesiologists (ASA) classification was considered. Descriptive statistics, Kruskal-Wallis test, Mann-Whitney U-test and logistic regression were utilized. Of 669 patients, congenital and chromosomal malformations (34.7%), diseases of the nervous system (19.1%), and mental and behavioral disorders (16.0%) were mainly diagnosed. Dentin caries prevalence was high at 79.1%, with treatments performed mainly under GA (51.4%). The odds of receiving treatment under GA decreased with patient age and increased with higher dmft/DMFT scores. Most under GA were classified as ASA 3 (51.7%), indicating high anesthesia risks. Children with special healthcare needs often have diseases that can lead to higher challenges related to cooperation. The high prevalence of dentin caries underscores the substantial need for dental treatments, which were consequently often performed under GA, despite the associated risks. These findings stress the need for trained dental professionals.

FREQUENCY OF SECOND MESIOBUCCAL CANAL IN PERMANENT MAXILLARY SECOND MOLARS AT A TERTIARY CARE CENTRE OF NEPAL

Background: The success of endodontic treatment relies on the precise identification of root canals followed by cleaning, shaping, and obturating the canals. Mesiobuccal root of maxillary second molar teeth present wide variations with regard to the number and type of root canals. The complexity of the root canal varies widely in different ethnic groups. The study aimed to determine the prevalence of second mesiobuccal canal (MB2 canal) in maxillary second molar. Methods: A descriptive cross-sectional study was conducted at Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa. A total of 100 permanent maxillary second molar undergoing endodontic treatments were studied. After access cavity preparation ultrasonic tips and magnification loupes were used to open the subpulpal groove in a direction from first mesiobuccal (MB1) canal towards the palatal canal to locate the second mesiobuccal (MB2) canal. Radiovisiography (RVG) was taken to confirm the presence of MB2 canals. Results: MB2 canals were detected in 52 teeth out of 100 teeth that were studied. It was found that the younger adult (18-35 years) tends to have a higher proportion of MB2 canals (65.6%) as compared to the middle-aged elderly (36-55years) in whom it could be identified only 33.4% of the time. Conclusions: Based on this study, it can be concluded that the prevalence of MB2 canal in mesiobuccal root of the permanent maxillary second molar is high.

Microleakage of Root Canal Sealed with Temporary Endodontic Sealing Materials

To measure the microleakage of different materials used as temporary endodontic sealing materials and to compare between them. Sixty sound human premolars extracted for orthodontic purpose, caries and cracks free were used. Teeth were divided into 6 groups depending on type of temporary materials (glass ionomer cement, zinc phosphate cement, amalgam, temporary filling "zinc oxide eugenol") for temporization and control groups (negative and positive). For each tooth, an access opening was done followed by instrumentation, irrigation and dryness. Then application of different temporary materials. Evaluation of marginal microleakag e (tooth – restoration interface) were done by using dye penetration test. The study was done in Department of Conservative Dentistry, College of Dentistry, University of Mosul. The results showed significant differences (p< 0.05) in marginal microleakage among groups tested. But there were no significant difference between buccal and lingual tooth restoration – interface for each group. Glass i onomer cement showed less microleakage at tooth – restoration interface when compared with other temporary filling mater ials which used in this study. Glass ionomer cement has sup erioer effect on reduction of microleakage when compared with other temporary filling,when used for temporization had more ability to reduce microleakage than zinc phosphate cement, amal gam and lastly temporary filling (zinc oxide eugenol).

Assessment of Distortion of Radiovisiographical Tooth Length Compared to Actual Tooth Length: In-vivo and In-vitro Study

Background: Determination of appropriate or exact working length measurement with radiovisiography (RVG) during root canal treatment (RCT) is an essential for the long-term success. As, there are several controversies with the distortion of RVG image in assessing the working tooth length (WTL) during RCT compared to actual tooth length (ATL). So, this study was aimed to assess the frequency of distortion of radiovisiographical tooth length (RTL) compared to actual tooth length (ATL). Methods: An analytical (in-vivo and in-vitro) study was conducted at Department of Conservative Dentistry and Endodontics, BSMMU. The patient indicated for extraction purpose of orthodontic treatment was considered as the study population. Human premolar teeth (n=20) were selected as study sample by purposive sampling technique which met the inclusion and exclusion criteria. The RTL measurements were carried out with RVG images before and after tooth extraction (in-vivo and in-vitro setting). Then the ATL measurements of extracted tooth samples were carried out with both Inch Architectural Scale Ruler and Endodontic Ruler individually three concordant times. Statistical analysis: The data was analyzed using T test and presented in frequency and percentages with tables. Results: For 95% of study samples, the differences from actual and radiovisiographical tooth length were <0.5 mm. Total 19 tooth samples (out of 20) showed acceptable level of coincidence except one sample showed non-acceptable level of coincidence. There was no sample revealed exact level of coincidence. There was a significant difference between the distortion category; yes (95%)/ no (5%) (P 0.001). The radiovisiological tooth lengths among all samples were same in both in-vivo and in-vitro setting. Study results also revealed the average distortion of RTL to ATL was 2.61±0.97 mm when RVG was done without using RVG sensor positioner. Conclusion: RVG tooth length images exhibited no distortion with the exact anatomical tooth lengths when the RTL was carried out with RVG sensor positioner. It’s recommended that to overcome the RVG image distortion, the RTL measurement ought to be carried out with RVG sensor positioner allowing RVG sensor/film parallel to long axis of tooth; RVG beam position perpendicular (900) to long axis of tooth.

Potential role of salivary vitamin D antimicrobial peptide LL-37 and interleukins in severity of dental caries: an exvivo study

IntroductionVitamin D performs various functions as a hormone by promoting calcium absorption but plays a major role in innate immunity,cell differentiation, cell maturation through its genomic effects via vitamin D receptor. The immune response also plays a major role in tooth surface and supporting structure destruction and playing a major factor in high caries formation. The inflammatory cytokines are released has proinflammatory cytokines and stimulate cells in disease process. Therefore, in the present study we have evaluated the association of salivary vitamin D, LL-37, interleukins 6 and 17A in various levels of severity of dental caries.MethodEthical approval was obtained (NU/CEC/2020/0339), 377 individuals reporting to department of conservative dentistry and endodontics, AB Shetty memorial institute of dental sciences were included based on inclusion criteria. The individuals were further divided into caries free(N = 105) and caries active(N = 272) based on their caries prevalence. The salivary were collected and evaluated for vitamin D, LL-37,IL-17A and IL-6.Results were statistically analysed with SPSS vs 22 (IBM Corp, USA). Normally distributed data were expressed as mean ± SD. Skewed data were expressed as median and interquartile range. To compare (mean) outcome measures between the two groups unpaired independent t-test was applied and for values in median IQR, Mann Whitney U test was used. All statistical analysis for P value were two-sided and significance was set to P ≤ 0.05.ResultsThe study showed that, the salivary vitamin D statistically decreased with increasing severity of caries which showed that vitamin D plays an important role in prevention of caries. Antimicrobial peptide LL-37 was higher in caries free group but was not statistically significant, salivary IL-6 level was higher in caries active group but intergroup comparison did not show significant difference. Salivary IL-17A did not show statistically significant between caries active and caries free group.ConclusionThe salivary levels of vitamin D may play a vital role in prevalence of dental caries and its severity which can be a underlying cause in presence of other etiological factors.

Evaluate Dental Students’ Knowledge, Attitudes, and Practices of Oral Radiology within the Department of Conservative Dentistry and Endodontics

Evaluate Dental Students’ Knowledge, Attitudes, and Practices of Oral Radiology within the Department of Conservative Dentistry and Endodontics

Prevalence of Dental Anomalies in Maxillary Lateral Incisors: An Institutional Cross-sectional Study from Karnataka

ntroduction: The majority of dental abnormalities are found in third molars, followed by permanent maxillary lateral incisors. The occurrence of these dental anomalies varies among different ethnic groups; hence, it is of prime importance for clinicians to know and understand the incidence of dental anomalies among the local population. Aim: To analyse the prevalence of dental anomalies in relation to permanent maxillary lateral incisors in the Karnataka region. Materials and Methods: A cross-sectional study was conducted in the Department of Conservative Dentistry and Endodontics of HKES’s S Nijalingappa Institute of Dental Science and Research, Kalaburgi, Karnataka, India from July 2022 to December 2022. A total of 1,116 subjects, aged between 15 and 50 years, were randomly screened. Each subject was clinically examined, and radiographs were taken for patients with dental anomalies. The five dental anomalies studied were congenitally missing permanent maxillary lateral incisors, peg laterals, dens in dente, talon’s cusp, and palato-gingival groove. Statistical analysis was performed using SPSS version 26. Descriptive statistics were estimated in terms of frequency and percentage. Results: A total of 43 subjects were found to have anomalies associated with the maxillary lateral incisor, including pegshaped laterals (1.25%-14), dens in dente (0.81%-09), congenitally missing (0.45%-05), talon’s cusp (0.27%-03), and palato-gingival groove (1.07%-12). Conclusion: Anomalies in permanent maxillary lateral incisors were noted in 3.85% of the Karnataka population.

Evaluation of Surface Roughness in Clear Silicon Fabricated Using Three Different Techniques: An In-vitro Study

Introduction: Anterior composite restorations present many aesthetic challenges for clinicians. Direct veneers provide chairside advantages such as evaluating tooth anatomy, shade selection, and correcting tooth morphology according to the patient’s desire. In today’s world, the use of digitalisation and 3D-printed models has grown. However, limitations of these are unknown and a research gap exists, with surface roughness being a major issue. Aim: To evaluate the surface roughness of clear silicon templates fabricated over 3D-printed models, blue inlay wax and dental stone. Materials and Methods: This in-vitro study utilised both quantitative and qualitative approaches. The study was conducted at the Department of Conservative Dentistry and Endodontics, Manubhai Patel Dental College and Hospital, Vadodara, Gujarat, India. The study was completed over three months. A total of 36 surfaces of clear silicone template (Exaclear) were obtained from two blocks each of 3D-printed model, blue inlay wax, and dental stone, measuring 30×10×10 mm. These blocks were divided into six units of 10×5 mm (N=36) and were divided into three groups: 1) 3D-printed model; 2) Blue inlay wax; 3) Dental stone. Surface roughness was evaluated using a surface roughness tester and Scanning Electron Microscope (SEM). Quantitative analysis of surface roughness was done using the surface roughness tester, and qualitative analysis was done using SEM. Statistical analysis was done using the posthoc Tukey Honest Significant Difference (HSD) test and statistical software SPSS Version 20.0. Results: The quantitative analysis showed the highest Roughness average (Ra) value mean±Standard Deviation (SD) for Group 1 (11.97±4.43 μm), followed by Group 3 (2.42±1.07 μm) and Group 2 (0.63±0.86 μm). SEM showed the presence of voids only in Group 1. Conclusion: Surface roughness of clear silicon template fabricated on wax surface is less as compared to templates fabricated on 3-D printed models.

Awareness of Patients Regarding Restorative and Endodontic Treatment during COVID-19: A Survey

Objective: The aim of the study was to assess the awareness of patients visiting the dental Outpatient Department of JSS Dental College Hospital regarding coronavirus symptoms and their willingness to get dental treatment done during this period. Materials and Methods: Five hundred and twenty-five patients in the age group of 25–65 years who reported to the department of conservative dentistry and endodontics during 6 months were assessed for coronavirus symptoms using a questionnaire of descriptive statistics and analysis. Results: Patients were willing to undergo treatment during the pandemic (97%). Conclusion: Irrespective of the coronavirus, patients seem to be keen to get either their restorative or endodontic treatment done, which shows that the patients are not completely aware of the spread of COVID-19 infection and awareness programs have to be conducted to educate people.

Demystifying the intricacies – a rare report of two cases of biradicular permanent mandibular lateral incisor and their endodontic management

Introduction and aim. One of the imperative reasons for endodontic failure is an extra or missed root and root canals. Permanent mandibular lateral incisors generally present as monoradicular tooth with one or two canals, but aberrancies in the form of extra root are also rarely seen. There is insufficiency in the literary work regarding the presence of an extra root in permanent mandibular lateral incisor. We hereby report two illustrious cases of biradicular permanent mandibular lateral incisors and their endodontic management and brief review regarding the case reports published so far regarding the existence of an extra root in permanent mandibular lateral incisor in the literature. Also, we intend to apprise the scientific documentation with the aforementioned. Description of the cases. Case 1. A twenty-two-year-old male patient of Indian origin was referred to endodontic clinic for intentional root canal therapy. Pre-operative radiograph revealed 32 exhibited aberrancy in the form of an extra root, with normal periodontal structures and bone architecture. Case 2. A sixty-two-year-old male patient came to the Department of Conservative Dentistry and Endodontics with the chief complaint of pain in the lower anterior tooth region. Radiographic examination revealed root caries on the mesial side and two roots with two canals with bifurcation at the level of middle third of root. Conclusion. Clinicians should be well prepared in advance for management of any anatomical aberrancy in their clinical practice by having a scrupulous knowledge of root canal system.

Prevalence of Caries with its Distribution by Age & Gender in Institutional Clinical Patients

Introduction: Consequence of dental caries is loose of healthy tooth structure which impacts negatively on aesthetics, function, self-esteem and quality of life of the patients. Different age groups and populations exhibit distinct caries prevalence rates, observations of which could provide a useful descriptive measure of caries susceptibility in tooth surfaces. Materials and Methods: In this study, patients attending the Department of Conservative Dentistry & Endodontics of Dhaka Dental College & Hospital, located in Mirpur-14 and Department of Conservative Dentistry & Endodontics of Sapporo Dental College & Hospital, located in Abdullahpur (North Dhaka City), Bangladesh, were examined between 2017 and 2019. The location of dental caries on the teeth surfaces was recorded as following surface: Occlusal , Mesio-occlusal, Disto-occlusal, Proximal and Cervical for statistical evaluation and comparison. Furthermore, the age and gender of the patients were recorded on the chart for each caries tooth.  Result: Female had higher incidence 86 (57%) of caries than males 64 (43%). Caries distribution was common in the maxillary jaw (53.38%) than in the mandibular jaw (46.62%). Among our study patient occlusoal surface caries was most commonly observed (43.4%). Then, the proximal surface caries was seen in 28.3% cases. Overall 71.7% prevalence of caries was in occlusal and proximal area. Where, prevalence of proximal and cervical surface caries was higher in maxillary tooth (18.9% and 4.82%) than mandibular tooth (9.3% and 2.6%) respectively.  Conclusion:  Female are more prevalent to dental caries than male. Occlusoal surface caries is most commonly observed, then, the proximal surface caries are commonly seen. Occlusal surface caries is more common in mandibular tooth than maxillary. Where, proximal and cervical surface caries was higher in maxillary tooth.   Medicine Today 2023 Vol.35(2): 78-82

A Comparative Evaluation of Postoperative Sensitivity Between Cention-N and Resin-Modified Glass Ionomer Cement in Class V Cavity: An In Vivo Study.

Aim This research aimed to assess and compare the postoperative sensitivity in class V cavity when restored with Cention-N and resin-modified glass ionomer cement (RMGIC). This study usedthe Schiff scale to assess sensitivity in the class V cavity. Materials and methods This was an in vivo study performed in the Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Sawangi Meghe, Maharashtra. Patients included in this study were randomly selected from regular outpatient departments diagnosed with class V cavities and referred for restorative treatment. These patients were segregated into Group A and Group B. Demographic information, detailed history of any medical condition, dental history, any allergy related to resins, and another group of drugs were recorded. The in vivo study involved 36 patients, 18 in each group, who presented at Sharad Pawar Dental College and Hospital. Inform consent was taken from all patients. The subjects' responses were evaluated using a Schiff analog scale to assess postoperative sensitivity to an air blast stimulus. Results The study included all 36 patients aged between 18 and 40 years. All 36 patients were segregated into two distinct groups. Two groups of 18 patients in each group were restored with Cention-N and RMGIC in groups A and B, respectively. It was determined that RMGIC exhibits a relatively higher incidence of postoperative sensitivity than Cention-N. It was determined that the difference was statistically relevant. Conclusion Considering the limitations of this study, it can be concluded that RMGIC shows more postoperative sensitivity than other groups on the first, second, and seventh days. Thus, it is concluded that Cention-N can be a superior alternative to RMGIC.

An Evaluation of the Effectiveness of Calcium Hydroxide as A Root Canal Sealer Constituent

A descriptive, comparative study was conducted in the Department of Conservative Dentistry and Endodontics, Dhaka Dental College Hospital, Bangladesh, from December 2014 to November 2015, to evaluate the effectiveness of calcium hydroxide as a root canal sealer constituent. A total of 60 patients were selected by purposive sampling technique. Patients were divided into two equal groups of 30: group-I had zinc-oxide eugenol [ZOE] cement as a root canal sealer, while group-II had calcium hydroxideor sealapex [Ca(OH)2] cement as a root canal sealer. Total number of teeth treated by single-visit root canal therapy. Out of 60 patients, 37(61.7%) patients were male. In ZOE group, the highest incidence was in age group 21-30 years, where as in Ca(OH)2 group, it was in 11-20 years. The mean age of the patients was 27.62±6.20 years in ZOE group and 25.0±6.14 years in Ca(OH)2 group. 21(70.0%) mentioned trauma as an etiological factor followed by caries 4(13.33%) in ZOE group, while 18(60.0%) patients mentioned trauma followed by caries 6(20.0%) in Ca(OH)2 group. In ZOE group, the incidence of pain was 23(76.67%), and in Ca(OH)2 group, 22(73.33%) reported pain. Periapical radiolucency follow-up findings were significantly better at 3-month and 6-month follow-ups in the Ca(OH)2 group. The difference inthe final outcome of effectiveness in both ZOE and Ca(OH)2 group in the management of periradicular pathosis was statistically not significant (P>0.05). The present study findings revealed that single-visit root canal therapy was equally effective in the management of endodontically involved teeth with periradicular pathosis. After 12 months, in follow-up with post-operative clinical and radiological evaluations, Ca(OH)2 sealer group showed better results than ZOE sealer group. However, in shorter follow-ups, Ca(OH)2 sealer group showed significantly better findings as compared to ZOE sealer groups.  
 CBMJ 2023 July: vol. 12 no. 02 P: 141-149

Comparison Of Inter-Appointment Pain Between Calcium Hydroxide Mixed With Normal Saline And Calcium Hydroxide Mixed With 2% Chlorhexidine During Root Canal Treatment

Introduction: Pain is one of the major and common symptoms a patient goes through during root canal treatment (RCT). Calcium hydroxide [Ca(OH)2] combined with normal saline (NS) is commonly used as an intracanal medicament against root canal pathogens, but combination of Ca (OH)2 with chlorhexidine (2% CHX) is not routinely used. Aim of this study is to compare the combination of Ca(OH)2 +NS and Ca(OH)2 +2% CHX to reduce the interappointment pain in RCT. Methods:  A comparative, prospective, qualitative study was conducted in the Department of Conservative Dentistry and Endodontics, KIST Medical College and Teaching Hospital from September 2022 to March 2023. Total of 60 patients aged 16-70 years were included in the study. Group I received Ca(OH)2+NS and group II received Ca(OH)2 +2% CHX. Pain score was recorded using visual analogue scale (VAS) from baseline to 6,12,24 and 48 hours. Results: The mean pain score after 6 hours for Group I was 0.93(±0.83) and Group II was 1.43 (±0.63); P=0.011. The mean pain score after 12 hours for Group I was 0.40(±0.56) and Group II was 0.90(±0.66); P=0.003. 24 hours, mean pain score for Group I was 0.27(±0.45) and Group II was 0.60(±0.56); P=0.014. Patients reported reduction of pain after 24 hours, with Ca(OH)2 +NS (Group I) than Ca(OH)2 +2% CHX (Group II). Conclusion: The combination of Ca(OH)2 +NS was more effective in reducing interappointment pain than Ca(OH)2 +2%CHX.

Reasons and Pattern of Demand for Root Canal Treatment Among Patients Attending A Tertiary Care Center of Madhesh Province: A Descriptive Cross-Sectional Study

Introduction: Root canal treatment (RCT) for permanent teeth involves the use of biologically acceptable chemical and mechanical treatment of the root canal system to promote healing and repair of the peri radicular tissues. The aim of the study was to analyze the reasons and pattern of demand for root canal treatment among patients attending a tertiary care center of Madhesh Province, Nepal.
 Materials and Methods: This was a descriptive cross-sectional study of patients who received root canal treatment in the Department of Conservative Dentistry and Endodontics, National Medical College, Birgunj, Nepal between September 2022 and February 2023.The demographic and clinical data of patients were recorded and statistical analysis was performed using SPSS version 24. Association between the variables was analyzed by Fischer exact tests. P-value<0.05 was considered as statistically significant.
 Results: 206 patients who received root canal treatment participated in this study. More mandibular teeth (53.9%) were root-treated compared to maxillary teeth (46.1%). The first molars constituted the most prevalent root-treated teeth (43.7%), followed by the second molars (26.7%) and the central incisors (10.7%). The most common chief complaint was pain (66%) and caries (75.7%) was the most frequently encountered pathology. The association of age category and dental arch with the type of root-treated teeth was statistically significant (p < 0.001 and p <0.004 respectively).
 Conclusion: Irreversible pulpitis caused by caries was the predominant indication for root canal treatment, with pain being the most common presenting complaint. The demand for treatment was higher in females and among patients within 21-40 years age category. More teeth from the mandibular arch were root-treated while the first molar was the most frequently treated tooth.

Patient's Knowledge and Perception of Endodontics Treatment: An Observational Study.

To assess public awareness regarding endodontic treatment and assess patients' knowledge regarding endodontic treatment. A questionnaire was prepared and given to 300 patients who had visited the Department of Conservative Dentistry and Endodontics between November 2021 and October 2022, after obtaining ethical clearance and consent from all the participants. The questionnaire included sociodemographic details and about their knowledge about endodontic treatment. The collected data were tabulated and analyzed. Data analysis was performed using methods of descriptive statistics like frequency and percentages. We found that most of the respondents had an average level of knowledge regarding endodontic treatment. We observed an improvement in knowledge and perception regarding endodontic treatment.

Internal Morphological Variability of Mandibular Premolars in North Indian Population

Aims: The current study aims to investigate the root canal morphology of root canals of mandibular premolar teeth via cone-beam computed tomography (CBCT) among a sample of the north Indian population.
 Study Design:  Retrospective observational study.
 Place and Duration of Study: Department of conservative dentistry and endodontics.
 Methodology: A total of 240 CBCT images were examined in the study. The Mandibular premolars were identified, and canal configurations were classified according to vertucci classification. Root canal configurations were investigated using a chi-square test.
 Results: Of the total 240 Mandibular premolars, vertucci type I was found in 86.66% in Mandibular first premolars followed by type v (8.33%) and type iv (5%). Vertucci type I was found in 96.6% in Mandibular second premolars followed by type v (1.66%), type iii (0.8%) and type viii (0.8%).
 Conclusion: The root morphology of Mandibular premolars in the north Indian population demonstrated a high degree of variability. However, the clinician should be aware about the possible anatomic variations of these teeth and their relationship with the adjacent anatomic structures while planning and performing endodontic, restorative, periodontal, and surgical procedures.

Incidence of Endodontic Failure Cases in the Department of Conservative Dentistry and Endodontics, DY Patil School of Dentistry, Navi Mumbai.

Endodontic and restorative treatment goal is to restore occlusion and normal function of a tooth and provide stability to the dental arch. Root canal bacterial infection and apical periodontitis profoundly impact the management and outcome of endodontic treatments. The crucial goal of nonsurgical root canal therapy (NSRCT) is the mechanical removal of infected tissues and the chemical killing of bacteria. The present study assessed the outcomes and factors associated with the failure of primary endodontic treatment. A total of 250 teeth from 219 patients (104 male and 146 female) were examined in the Conservative Dentistry and Endodontics department, who reported symptomatic root canal-treated teeth. Data through clinical examination and radiographic examination was recorded on a proforma designed for the study of each patient regarding endodontic failure. According to the type of tooth maximum number of teeth that were reported with failure are the molars (67.6%), followed by premolar (14.0%), incisor (12.8%), and lastly, canines (5.6%). Based on the location of affected teeth, the maximum teeth that presented with failed root canal treatment were from mandibular posteriors (51.2%), followed by maxillary posteriors (31.60%), maxillary anterior (13.2%), mandibular anterior (4.0%). Endodontic failures were mostly found in underfilled root canals and poorly sealed post-endodontic coronal restoration and strong association with peri-apical radiolucency.