Paraformaldehyde has been used in the past as a pulpotomy agent. However, it has a severe cytotoxic effect and may cause alveolar bone necrosis. Depulpin, a devitalizing agent containing 49% paraformaldehyde, is no longer used frequently due to its severe side effects. In the two cases described in the present study, Depulpin was used as a devitalizing agent during root canal treatment. It caused a gradual loss of sensibility in adjacent teeth, gingival necrosis, and osteomyelitis. This case report demonstrates the serious side effects of using a paraformaldehyde-containing paste as a devitalizing agent for pulp, particularly mandibular bone necrosis.

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Maxillary lateral incisors usually exhibit a single root with a single canal. However, maxillary lateral incisor teeth with unusual morphology of root canal system are frequently reported. These cases of variable root canal anatomy can be treated well by nonsurgical endodontic methods. A detailed description of root canal morphology is fundamental for successful endodontic treatment. Treatment using an operating microscope, radiographs from different angles, and cone-beam computerized tomography (CBCT) can produce more predictable endodontic outcomes.

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The aim of this study was to present a method for endodontic management of a maxillary first molar with unusual C-shaped morphology of the buccal root verified by cone-beam computed tomography (CBCT) images. This rare anatomical variation was confirmed using CBCT, and nonsurgical endodontic treatment was performed by meticulous evaluation of the pulpal floor. Posttreatment image revealed 3 independent canals in the buccal root obturated efficiently to the accepted lengths in all 3 canals. Our study describes a unique C-shaped variation of the root canal system in a maxillary first molar, involving the 3 buccal canals. In addition, our study highlights the usefulness of CBCT imaging for accurate diagnosis and management of this unusual canal morphology.

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There are increasing usage of Nickel-Titanium rotary files in modern clinical endodontic treatment because it is effective and faster than hand filing due to reduced step.

This study was conducted to evaluate the effect of canal preparations using 3 different rotary Nickel-Titanium files that has different cross sectional shape and taper on the maintenance of canal curvature. Simulated resin block were instrumented with Profile(Dentsply, USA), GT rotary files(Dentsply, USA), Hero 642(Micro-Mega, France), and Pro-Taper(Dentsply, USA).

The image of Pre-instrumentation and Post-instrumentation were acquired using digital camera and overspreaded in the computer. Then the total differences of canal diameter, deviation at the outer portion of curvature, deviation at the inner portion of curvature, movement of center of the canal and the centering ratio at the pre-determined level from the apex were measured.

Results were statistically analyzed by means of ANOVA, followed by Scheffe test at a significance level of 0.05.

The results were as follows;

1. Deviation at the outer portion of curvature, deviation at the inner portion of curvature were showed largest in Pro-Taper, so also did in the total differences of canal diameter(p<0.05).

2. All the groups showed movements of center. Profile combined with GT rotary files and Hero 642 has no difference but Pro-Taper showed the most deviation(p<0.05).

3. At the 1, 2, 3mm level from the apex movements of center directed toward the outer portion of curvature, but in 4, 5 mm level directed toward the inner portion of curvature(p<0.05).

As a results of this study, it could be concluded that combined use of other Nickel-Titanium rotary files is strongly recommended when use Pro-Taper file because it could be remove too much canal structure and also made more deviation of canal curvature than others.

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