Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment.

The aim of this study was to compare the compositions and cytotoxicity of white ProRoot MTA (white mineral trioxide aggregate) and 3 kinds of Portland cements. The elements, simple oxides and phase compositions of white MTA (WMTA), gray Portland cement (GPC), white Portland cement (WPC) and fast setting cement (FSC) were measured by inductively coupled plasma atomic emission spectrometry (ICP-AES), X-ray fluorescence spectrometry (XRF) and X-ray diffractometry (XRD). Agar diffusion test was carried out to evaluate the cytotoxicity of WMTA and 3 kinds of Portland cements.

The results showed that WMTA and WPC contained far less magnesium (Mg), iron (Fe), manganese (Mn), and zinc (Zn) than GPC and FSC. FSC contained far more aluminum oxide (Al₂O₃) than WMTA, GPC, and WPC. WMTA, GPC, WPC and FSC were composed of main phases, such as tricalcicium silicate (3CaO·SiO₂), dicalcium silicate (2CaO·SiO₂), tricalcium aluminate (3CaO·Al₂O₃), and tetracalcium aluminoferrite (4CaO·Al₂O₃·Fe₂O₃). The significance of the differences in cellular response between WMTA, GPC, WPC and FSC was statistically analyzed by Kruskal-Wallis Exact test with Bonferroni's correction. The result showed no statistically significant difference (p > 0.05).

WMTA, GPC, WPC and FSC showed similar compositions. However there were notable differences in the content of minor elements, such as aluminum (Al), magnesium, iron, manganese, and zinc. These differences might influence the physical properties of cements.

The properties of ideal root canal sealers include the ability of sealing the total root canal system and no toxic effects to periradicular tissues. Cytotoxicity test using cell culture is a common screening method for evaluation of the biocompatibility of root canal sealers. The purpose of this study was to investigate the cytotoxic effect of newly developed resin-based sealer (Adseal 1, 2, and 3) comparing with those commercial resin-based sealers (AH26 and AH Plus), ZOE-based sealers (Tubliseal EWT, Pulp Canal Sealer EWT) and calcium hydroxide based sealer (Sealapex). An indirect contact test of cytotoxicity by agar diffusion was performed according to the international standard ISO 10993-5. L929 fibroblast cells were incubated at 37℃ in humidified 5% CO₂-containing air atmosphere. The freshly mixed test materials were inserted into glass rings of internal diameter 5 mm and height 5 mm placed on the agar. After the 24 hrs incubation period, the decolorization zones around the test materials were assessed using an inverted microscope with a calibrated screen. A Decolorization Index was determined for each specimen. Adseal 1, 2, and 3 did not exert any cytotoxic effects, whereas AH26, AH Plus, Tubliseal EWT, Pulp Canal Sealer EWT, and Sealapex produced mild cytotoxicity.