Memoir~clinical cases

        At the time of tooth eruption, the root development is only 60-80% complete. If the pulp undergoes necrosis due to trauma or carious exposure, dentin formation ceases and root growth is arrested. The resultant immature root will have an apical opening that is very large. This is called an open apex, also referred to previously as a blunderbuss canal.      The walls of the canal with an immature root are thinner and more fragile (because of less mineralization) compared to a mature root. These walls may diverge, be parallel or converge slightly depending on the stage of root development. Open apex may also occur in mature teeth due to external resorption resulting from orthodontic treatment or periapical inflammation.   Problems with an open apex : 1.   larger apical diameter vs. smaller coronal canal diameter makes debridement difficult. 2.    lack of an apical stop makes obturation difficult. 3.   thin...

  In our clinical practise, we often assume a canine to have one root and one root canal. So was my assumption but my habit of critically evaluating the preoperative radiograph has helped to predict the presence of 2 root canals in the present case. On a literature search, I have realised that the occurrence of 2 canals is as high as 12% in some populations and it was about 3.2% in the Indian population. This made me realise how often we might be missing out on these extra canals which might later cause treatment failure.  On examining the preoperative radiograph 2 root canals were seen joining at the apex. It shows a typical Vertucci type II canal system. we went ahead with access opening which was made in a buccolingual direction similar to maxillary premolar. the simple logic here is that the canine roots are broader on the buccolingual direction and that facilitates extra canals. The canals were slowly negotiated with a 10 size K file and working length was determined and ...

All about bioceramics sealers Bioceramics are the class of ceramics used for repair and replacement of diseased and damaged parts of the musculoskeletal system History Calcium phosphate was first used as bioceramic restorative dental cement by LeGeros et al, 1982 .  The first documented use of bioceramic materials as a root canal sealer was by Krell and Wefel , 1984 Chohayeb et al.,1987 , evaluated the use of calcium phosphate as a root canal sealer in adult dog teeth. It made a more uniform and tighter adaptation to the dentinal walls as compared to guttapercha . Calcium phosphate cement has subsequently been used successfully in pulp capping, apical barrier formation, periapical defect repairs and bifurcation perforation repairs. Classification of bioceramic materials Mechanism of action  the following mechanisms have been suggested for calciumsilicate -based sealers : Diffusion     W.Zhang , 2009 Infiltration    R ....