Iftekhar, Huma
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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 Mandibular First Molar with Four Roots - A Rare Case Report with Clinical Management Guidelines Shahbaz, Shaikh; Iftekhar, Huma; Alam, Sharique; Shavez, Zehra
Journal of Dentistry Indonesia Vol. 29, No. 1
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Mandibular molar is usually two rooted with one mesial and one distal root. Additional roots are rare which requires accurate diagnosis and a methodical and scrupulous endodontic treatment. Objective: This paper aims to report the endodontic management of an unusual case of a mandibular permanent first molar with four roots (two mesial & two distal) and provide a clinical guideline to detect and manage these variant cases. Case report: A 15-year-old boy reported with a deep carious lesion in the lower left first molar (#36). The apical root contour of #36 on an intraoral periapical radiograph taken in different angulations suggested the presence of extra roots. A Spiral Computed Tomographic scan with multiplanar three-dimensional reconstructed images confirmed a fourrooted mandibular molar. Endodontic treatment of #36 was planned based on a diagnosis of pulpal necrosis with symptomatic apical periodontitis. The pulp chamber floor was assiduously explored along the developmental root fusion line (DRFL) to guide a trapezoidal access cavity and expose two mesial and two distal orifices. Conclusion: The present case report highlights the successful endodontic treatment of an atypical four rooted mandibular first molar by following a systematic approach from diagnosis to its clinical management.