Aim: This study explores the reasons behind patients’ preferences for dental college hospitals or private clinics, aiming to optimize dental healthcare delivery and enhance patient satisfaction by understanding the motivations driving their choices and the implications for dental care provision. Materials and methods: This cross-sectional self-developed questionnaire study was done in Madurai among 200 participants who previously had dental visits either in dental college hospital or private dental clinics. The questionnaire comprised a total of 34 questions categorized under four subheadings. The printed questionnaire was handed over to the participants and the participants were instructed to carefully read and truthfully respond to the questions. The collected data were subjected to statistical analysis by using IBM SPSS Software version 23. Chi-square test is used. Results: Among the total respondents, 62% preferred dental college hospitals, and 38% opted for private dental clinics. Overall satisfaction was high (94.4%), with the majority (59.1%) from dental colleges. Dental colleges were noted for quality care, friendly dentist approach, sufficient time spent by the dentist, receiving clear treatment explanations and being involved in decision-making while private clinics were rated higher for cleanliness, earlier appointment dates and shorter waiting times. Conclusion: Each dental setting has its own unique advantages and disadvantages. Understanding patient preferences and improving service delivery can help both dental college hospitals and private clinics better meet diverse patient needs. Clinical significance: The study shows that patients prefer dental college hospitals for expertise and comprehensive care, and private clinics for personalized care and shorter wait times. Understanding these preferences helps optimize resource allocation, patient care, and scheduling. Policymakers can improve accessibility by developing infrastructure in underserved areas. Ongoing research and community engagement are crucial for refining service delivery to meet diverse patient needs.

The treatment options for trauma vary depending on the severity of the traumatic injury. A young patient suffering from such an injury might experience emotional trauma as a result of functional and esthetic causes. This case report describes the clinical management of two complicated crown-root fracture cases. A 23-year-old male patient came with a complaint of broken teeth in the upper front tooth region, with a history of road traffic accident (RTA). On intraoral examination, there was an Ellis class 3 fracture in 11, 12, and 21. So the diagnosis was made to be fractured teeth in 11,12, and 21. The patient has been treated with cast post in 11, fiber post placement and composite core buildup in 12, and 180° rotation in 21 and placement of metal-ceramic crowns in all three teeth. The patient has been followed up for a period of 1 year, and he is totally asymptomatic. A 17-year-old male patient came to the department with a missing tooth in relation to 22. IOPA has revealed the presence of root in 22, suggesting complete crown fracture in 22. So the treatment plan has been formulated to carry out surgical extrusion of 22 and restored with cast post and crown. Addressing the traumatic injury at the right time, with proper diagnosis and following a systematic approach might benefit the patient.

Sinus tracts caused by endodontic infections can cause lot of pain and are difficult to treat. This case report presents a patient who was diagnosed with traumatic pulp necrosis and extensive inflammatory apical periodontitis in tooth #31. An endodontic treatment was initiated, and the working length was determined by using an apex locator. During irrigation of the root canal with saline, the irrigant was found to be squirting out of the extraoral lesion, confirming the diagnosis of a sinus tract. Chlorhexidine was preferred as an irrigant during the instrumentation procedure to avoid the risk of apical extrusion. The canal was then obturated using the lateral condensation method. The patient was followed up for 4 years, and cone beam computed tomography scans revealed no recurrence of the lesion. This case report highlights the importance of correct diagnosis and prompt management of endodontic infections to prevent the recurrence of sinus tracts and associated complications.

Aim: The objective of this article is to present clinical cases with challenging anatomies in which root canals were instrumented with the ProTaper Ultimate system (Dentsply Sirona) and filled with AH Plus bioceramic endodontic cement (Dentsply Sirona), targeting different diagnoses and clinical situations. Background: The use of mechanized nickel-titanium (NiTi) systems allows for a more efficient, fast, and safe biomechanical preparation, as they are instruments with greater flexibility and resistance to cyclic fatigue when compared to conventional NiTi files. Case description: A report of five clinical cases was presented, with a significant degree of complexity, where we opted to use the new Dentsply Sirona ProTaper Ultimate mechanized system for biomechanical preparation. Conclusion: The system used for biomechanical preparation and the endodontic filling cement provided speed, comfort, and safety in the effective resolution of root canal treatments with complex anatomy. Clinical importance: This system has a technological advantage that provides the operator with greater security and a good clinical prognosis regarding the instrumentation of the root canal system in complex cases. However, more studies are needed to evaluate its clinical performance compared to other systems available on the market.

Calcification of root (calcific metamorphosis) is usually seen as a reaction of pulp to trauma. There are multiple factors that decide the degree of calcification. It may be seen partially or entirely in the canal. Treatment of calcified tooth is a challenge to dentists. The following case report describes access, negotiation, and successful rehabilitation of the maxillary left central incisor with diffuse mid-root calcification using ultrasonic tips under magnification in 11. A male patient of age 23 years reported to the Department of Conservative Dentistry and Endodontics at Sri Ramakrishna Dental College and Hospital with a chief complaint of pain in the upper left front tooth for the past 1 month. The history of presenting illness revealed that the patient experienced pain in a previously root canal-treated tooth. On clinical examination, the maxillary left central incisor was discolored. Cone-beam computed tomography (CBCT) images revealed oblique radio-opacity that was evident in the canal at the junction of the apical and middle third of the root with the widening of periodontal ligament space in the apical third of the root. The radiographic diagnosis was given as calcified root canal with apical periodontitis in 11. The final diagnosis was given as root canal-treated tooth with symptomatic apical periodontitis with calcified root canal in relation to 11. The treatment plan was root canal treatment and negotiation of the calcified barrier using magnification and ultrasonic tips in relation to 11.