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Tewari, Rajendra Kumar
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Dentistry

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Effect of the Extent of Apical Enlargement on the Degree of Debridement of the Apical Third in Curved Root Canals Andrabi, Syed Mukhtar-Un-Nisar; Kumar, Ashok; Tewari, Rajendra Kumar; Mishra, Surendra Kumar; Iftekhar, Huma; Zia, Afaf
Journal of Dentistry Indonesia Vol. 25, No. 3
Publisher : UI Scholars Hub

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Objectives: The present study aimed to evaluate the influence of various apical instrumentation sizes and tapers on the degree of debridement of the apical third of curved root canals. Methods: We used 60 extracted human mandibular first molars with mesial root curvatures of 20° to 30°. In all teeth, access cavity preparation was performed, followed by coronal flaring with Gates Glidden drills #1–4 (Dentsply Maillefer). Specimen teeth were subsequently randomly divided into five groups (n = 12). Each group was enlarged to a particular apical size and taper as follows: no apical preparation done (group I, Control group); 25/.04 and 25/.06 (Group II); 30/.04 and 30/.06 (group III); 35/.04 (group IV); 40/.04 (group V). Specimens were rinsed with 17% EDTA and 3% NaOCl solutions. We used a scanning electron microscope to evaluate specimens’ degree of debridement. Retrieved data were analyzed using Kruskal–Wallis and Mann–Whitney U-tests (p < 0.05). Results: Acceptable debridement was observed in groups III, IV, and V. Additionally, debridement was significantly better in Groups IV and V than in group II. Conclusion: Apical preparation with <30/.04 size results in an unacceptable degree of debridement of the apical third.
Endodontic Management of An Unusual Mandibular First Molar with Six Canals: A Case Report and Systematic Review Ahmad, Sarah; Andrabi, Syed Mukhtar -Un- Nisar; Kumar, Ashok; Mishra, Surendra Kumar; Tewari, Rajendra Kumar
Journal of Dentistry Indonesia Vol. 29, No. 3
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The permanent mandibular first molar is frequently involved in conventional root canal treatment due to its function and position in the oral cavity. Additional root canals mandate accurate diagnosis and conservative management to prevent any procedural errors. The first independent middle mesial canal incidence was verified in mandibular molars in 1974, with a global incidence of 10.8–27.0%. Reporting of the middle distal canal in the endodontic literature is scarce, with an incidence of 0.2–3%. The present case report describes the endodontic management of an unusual permanent mandibular first molar with three canals in the mesial and distal roots, diagnosed with irreversible pulpitis and apical periodontitis. A dental operating microscope and multiple angulated radiographs were used to identify the unusual morphology, and this was confirmed with cone-beam computed tomography imaging. The access cavity was modified to a trapezoidal shape, and the pulp chamber was carefully explored following root dentinal maps to expose additional canals by ultrasonic troughing. Incorporating a dental operating microscope and cone-beam computed tomography imaging in routine endodontic cases facilitates a better understanding and visualization of the complex root canal anatomy, making even the management of endodontically challenging cases more predictable.
How to Manage FAN’S C Shape Canals along with S Shape Morphology in Indian Population: A Case Series and Narrative Review Lavanya, A; Tewari, Rajendra Kumar
Journal of Dentistry Indonesia Vol. 30, No. 2
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The C-shaped root canals offer greater negotiation, debridement, and obturation difficulty as they present with intercommunications, lateral canals, and reduced dentin thickness. Objective: This case series elaborates on the recognition that these varying configurations is important to enhance adequate cleaning, shaping, and sealing of the root canal. Case Reports: On clinical examination, all the teeth showed caries were nonresponsive to sensibility tests and toother diagnostic tests, suggestive of pulp necrosis with apical periodontitis. Conventional root canal treatment with different techniques and obturation systems have been used. This case series presents the successful management of various C-shaped configurations classified by Fan et al. and emphasizes the different treatment approaches for effective therapy. The cleaning and shaping process should always follow the canal anatomy to maintain the canal shape at the same point the primary and secondary curvatures and thin interconnections are negotiated, prepared, and sealed. Conclusion: The morphological variation existence and their different types and management should be known for improved healing and enhanced success of root canal treatment.
Esthetic Management of Maxillary Anteriors with Complicated and Uncomplicated Fractures Using Different Fragment Reattachment Approaches A, Lavanya; Tewari, Rajendra Kumar; Alam, Sharique
Journal of Dentistry Indonesia Vol. 31, No. 2
Publisher : UI Scholars Hub

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Appropriate management of anterior tooth fracture restores the function and aesthetics and provides a positive psychological impact for the patient. One of the most conservative approaches for such a restoration is reattachment; if a fracture fragment remains attached to the tooth and is available, as in young patients, immediate reporting helps preserve the vitality and long-term defense mechanism. Objective: This case report provides two cases with varied approaches for the management of complicated and uncomplicated crown fractures using reattachment procedures. Case report: During the clinical examination, the first case described the management of an uncomplicated fracture using the putty index technique. The second case report describes the management of a complicated fracture of the upper central incisor, which invades the biological width using flap elevation and fiber post-cementation. Conclusion: Fragment reattachment is a reliable, conservative, and immediate alternative technique having better retentive and aesthetic values. Tooth fragment reattachment provides dentists with a conservative approach for an aesthetically satisfactory tooth reconstruction.
Co-Authors A, Lavanya Afaf Zia, Afaf Ahmad, Sarah Alam, Sharique Andrabi, Syed Mukhtar -Un- Nisar Andrabi, Syed Mukhtar-Un-Nisar Iftekhar, Huma Kumar, Ashok Lavanya, A Mishra, Surendra Kumar