Aim and objective: Chemosensitive disorders are being reported increasingly in coronavirus disease 2019 (COVID-19) patients. An attempt to document the incidence of this variation in the perception of taste, smell, salivation, and burning sensation in the mouth as well as mouth ulcerations in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Materials and methods: A single-institution short-term observational study was conducted on chemosensitive complaints like ageusia, anosmia, decreased salivation, oral ulcers, and burning sensation in the mouth, in patients diagnosed with COVID-19. Results: Among 201 patients, 25.9% of patients reported a loss of smell while 33.3% of patients reported alteration in taste. 27.9% of patients reported decreased salivation, while ulcer findings were only in 1.5% and burning sensation in 1% of the patients. Conclusion: Clinicians should suspect infection of SARS-CoV-2 in such patients, to avoid missing diagnosis or misdiagnosis of these patients which could lead to further transmission and spread of the disease. Clinical significance: Loss of smell and taste seems to be more common in COVID-19 patients as compared to other chemosensitive disorders like ulcers in the mouth or burning sensation or decreased salivation.

Aim: This study aimed to compare between patient's and clinician's interpretations of dental occlusion in eccentric mandibular positions when T-Scan III was used as a standard device. Materials and methods: Forty-three participants were trained to slide their jaw to the eccentric mandibular positions (right excursion, left excursion, and protrusion). The eccentric positions were determined at the edge-to-edge contact of anterior teeth in protrusion, the edge-to-edge contact opposing canines, and/or contact of buccal cusps of the opposing premolars in the working position. Contacting pairs of teeth were recorded based on the patient's perception, clinician's interpretation using traditional occlusal indicators, and a digital occlusal indicator; T-Scan III. Weighted kappa was used to determine the correlation of dental occlusion obtained from the patient's perception and clinician's interpretation compared to T-Scan III. Results: The highest correlation was in protrusion (substantial agreement; κ_ω = 0.661 for the patient group and 0.772 for clinician group) followed by left and right excursion (moderate agreement; the left excursion, κ_ω = 0.569 in both groups; the right excursion, κ_ω = 0.430 for the patient group and 0.545 for clinician group), respectively. Conclusion: In a clinical situation, the interpretation of dental occlusion in eccentric mandibular positions acquired from a clinician is more dependable than information from patients. Clinical significance: Dental occlusion evaluated by a clinician is more compatible with T-Scan III than that by patients.

Introduction: Tooth eruption is an important milestone of human growth and development. In the past few years, a delayed emergence of the deciduous tooth is observed. Anthropometric measurements are an important tool used to assess infants’ growth and development. Objective: To study the association of emergence time of first deciduous tooth with height, weight (Wt), and head circumference (HC) among infants of Kolar District. Materials and methods: An observational study comprising 154 infants between the age group of 5 and 12 months was considered. Infants with the presence of at least one emerging first deciduous tooth brought to the Hospital of Kolar district for routine vaccinations were examined. Data were collected for a period of 6 months. Infants were subjected to anthropometric measurements that comprised of HC, Wt, and length (Lt) recorded along with birth weight (BW) for further analysis. Statistical analysis was carried out using descriptive and inferential statistics using SPSS version 21. The student's t-test was used for assessment of statistical significance. Results: Of the 154 infants examined, tooth emergence (TE) age of lower central incisor (LCI) in females was 8.26 ± 1.81 months and males were 8.74 ± 1.20 months which was not very statistically significant, however, for upper central incisor (UCI) males showed an earlier age of TE. Infant's BW, HC, Wt, and Lt did not prove to be statistically significant for TE of LCI. Alternatively for UCI, HC and Wt were found to be inversely proportional to the age of TE. Conclusion: In general, the assessment of TE with anthropometric measurements carried out did not show any significant association with an infant's growth and development. However, there is scope for further studies with a larger sample size that can include additional parameters of assessing nutritional status.

Aim: To analyze and compare the cytomorphometric variations of oral exfoliated cells in normal healthy subjects, leukoplakia, and oral squamous cell carcinoma (OSCC) using LEICA DMLB2 research microscope. Materials and methods: Papanicolaou staining (PAP) was performed on the oral smears obtained from the study subjects. The study group consisted of normal healthy subjects (group I), leukoplakia (group II), and OSCC (group III). Photomicrographs of randomly selected 100 cells from each smear were captured at 40× magnification using a research microscope to obtain cell diameter (CD), nuclear diameter (ND), cellular area (CA), nuclear area (NA) and, nuclear-to-cytoplasmic (N/C) ratio. Descriptive and inferential statistics were used in the statistical analysis of the values obtained using one-way analysis of variance (ANOVA) and multiple comparison Tukey test. SPSS 22.0 version and GraphPad Prism 7.0 version software were used in the analysis, and the level of significance p < 0.05 was considered. Results: The results of this study demonstrated a statistically significant increase in ND, NA with a decrease in CD, CA, and altered N/C ratio in leukoplakia and OSCC when compared to normal healthy subjects. Conclusion: Oral exfoliative cytology using a commercially available toothbrush is a simple, non-invasive, relatively quick, and inexpensive technique that could be used in the screening of suspicious oral potentially malignant disorders (PMDs) and OSCC. Quantitative parameters, such as, morphometry, are reproducible and eliminate the observer bias as it is obtained by software analysis and hence improves the accurateness in the diagnosis. Clinical significance: Brush biopsy can also be used in any setup as well as a mass screening of dysplasias, PMDs, and early carcinomas in countries like India which holds the major core of the disease constraint.

Aim: The main aim of the present study was to calculate the total colonies of microorganisms around coated and non-coated silk sutures and to evaluate antibacterial efficacy around betadine-coated sutures in comparison to silk sutures. Materials and methods: The suture selected was 3-0 silk suture for the right side with a cutting needle and 3-0 silk suture dipped in betadine solution on the left side. The extraction on the right side and left side mandibular premolar teeth were done first and sutured with normal silk suture and betadine-coated suture, respectively, second visit, 2 mm of both the sutures were removed and sent for culture, the patient was recalled on the seventh day and the entire suture was removed and was sent for culture and the healing is recorded. On the third day, 2 mm of each stitch was sectioned, and on the seventh day, the entire stitch was removed, inoculated in 10 mL of sterile physiological saline, and vortexed for 5 minutes to release the microorganisms adhered to the suture material. The serially diluted suspension was seeded (spread plate method) with a different culture media. Following the incubation process, the colonies on each plate were counted per colony-forming units (cfu/mL). A paired t-test and independent t-test were done. A paired t-test is a statistical procedure used to determine the mean difference between two sets of observations is zero. Results: The surface of silk suture as well as betadine-coated sutures, was covered with a thick layer of plaque and debris. The average contaminated area was smaller on betadine-coated suture materials, which was removed on the third then on the seventh day there were statistically significant differences between silk and betadine-impregnated sutures. Substantial reductions in bacterial adherence were observed on betadine-coated sutures compared with silk suture material. Both the types of sutures silk and betadine-coated suture healing was uneventful, even though organisms were more in normal silk suture. Conclusion: The betadine-impregnated suture has a promising potential in preventing the colonization of pathogens around the extraction area. Betadine-impregnated suture material will reduce postoperative infection. Clinical significance: This study gives data to guide the selection of suture materials for contaminated wounds or wounds at risk for developing an infection. The bacterial adherence of suture materials should be considered by all practitioners while closing wounds or debriding infected wounds. Hence, betadine-impregnated suture material will reduce postoperative infection.

Aim: The aim of this study is to measure the cyclic fatigue resistance of TruNatomy (Dentsply Sirona, Maillefer, Ballaigues, Switzerland) instruments in single and double curvature canals and compare it with those of ProTaper Next and 2Shape. Materials and methods: Sixty NiTi rotary files were used in this study and distributed into three groups (n = 20 for each group). Group I: TruNatomy (size 26, taper 0.04), group II: ProTaper Next (size 25, taper 0.06), and group III: 2Shape (size 25, taper 0.06). Then, each group was subdivided into two subgroups (n = 10 for each subgroup) according to the curvature of the canals (single or double). Lengths of all the used files were 25 mm. The files were tested in custom-made artificial canals with a single curvature (60° curvature, 5-mm radius) and a double curvature (coronal curve: 60° curvature, 5-mm radius and apical curve: 70° curvature and 2-mm radius). Each file was operated in a continuous rotation movement until the file fractures. Time for file separation and length of fractured fragment were recorded. The number of cycles to failure of each file was calculated. Statistical analysis: Data were statistically analyzed using the Shapiro-Wilk test, one-way ANOVA, and the post hoc Tukey test. Results: The normal distribution of data was detected by the use of the Shapiro-Wilk test. The results of the ANOVA test revealed a significant difference in cyclic fatigue resistant among three groups of the tested files (p < 0.05). The post hoc Tukey test showed that in both single- and double-curved canals, the number of cycles to failure of the TruNatomy group was significantly higher than other groups (p < 0.05). No statistical difference in fragment length among the tested files in both curvatures (p > 0.05). Conclusion: In both curvatures, TruNatomy instruments were more resistant to cyclic fatigue than 2Shape and ProTaper Next instruments.

Aim: This pilot study aimed to evaluate the effectiveness of an oral probiotic, Lactobacillus reuteri DSM 17938 and L. reuteri ATCC PTA 5289 (ProDentis®, BioGaia), to avoid the recurrence of black stains (BS) in children and young adults. The purpose of this work is also to propose an oral hygiene protocol that could hinder or slow down the formation of these pigments. Materials and methods: Twenty patients aged between 8 years and 24 years with extrinsic pigmentations on one or more dental elements and with black lines attributable to chromogenic bacteria were divided into two groups randomly: the first (group I with 10 patients, test group) received a professional oral hygiene session and a therapy with a probiotic food supply containing L. reuteri for a duration of 2 months. The second group (group II with 10 patients, control group) received only a professional oral hygiene session. Data were collected using the Lobene modified index. Results: The mean Lobene index is lower in the test group compared to the control group after both 1 and 2 months from the beginning of the treatment. Conclusion: Black stain formation could be prevented by administering an L. reuteri-based probiotic food supply. Clinical significance: The use of probiotics is a relatively undeveloped strategy for the prevention and treatment of BS.

Aim: The present study aimed to assess the effect of various surface treatment options on surface roughness and flexural strength of the zirconia implant material. Materials and methods: This study included a total of 45 prefabricated samples of sintered zirconia disks. Grit papers of silicon carbide (240–1200 μm) were used to polish the sample surfaces and were then washed with water to clear any particles generated while polishing. These samples were segregated into three groups (15 samples in each group). Group I: control, group II: UV light-treated zirconia disks, group III: sandblasted and acid-etched (SLA)-treated zirconia disks. The surface characteristics of test samples post-surface treatment were evaluated with a scanning electron microscope (SEM). Post-surface treatment of all the three groups, surface roughness was analyzed with a digital optical profilometer. Flexural strength of zirconia samples was assessed using piston on a Universal load testing machine with the three-point bending test. Results: The highest surface roughness was recorded in SLA-treated zirconia group (0.524 ± 0.028) next by UV light-treated group (0.510 ± 0.132) and control group (0.466 ± 0.016). However, there was no statistically significant result seen between the groups. The highest flexural strength was found in the control group (596.21 ± 1.246) next by UV light-treated (488.45 ± 2.108) and SLA-treated zirconia group (424.67 ± 1.022). A statistically significant result was recorded between groups I and II, groups I and III (p < 0.001). Conclusion: The highest surface roughness was recorded in the SLA-treated zirconia group followed by the UV light-treated group and the control group. There was a statistically significant difference noted for flexural strength between the control group with the SLA group and the UV light-treated group. Clinical significance: The ongoing research in dentistry aims for enhancements in the bioactivity of zirconia implants so as to achieve improved healing and lowered morbidity. Now a days, zirconia is gradually emerging as an important material that might substitute the gold standard of the dental implant.

Aim: Anatomic variations based on ethnicity, gender, and age play a pivotal role in designing surgical techniques, although the majority of them are based on anthropometric data of the Caucasian population. The study aimed to assess the cortical thickness, width, and height of Indian mandibles using DentaScan; to determine their relationship with age and gender, and to focus on their surgical implications in the Indian population. Materials and methods: A prospective cross-sectional study conducted at the Department of Dentistry comprised of 100 DentaScans (males and females; 21–50 years) indicated for orthodontic therapy, impacted wisdom tooth surgery, and immediate dental implants. Subjects were equally divided into two age groups (21–35 and 36–50 years). DentaScan assessment of mandibular cortex, width, and height was conducted at symphysis, parasymphysis, and the body region. Student's t-test was used to derive comparisons between genders and age groups. p value ≤0.05 was considered statistically significant. Results: Thicker posterior cortices, wider mandibles, and greater height were found in males. Thicker symphysis was found in younger females. Older subjects demonstrated thicker upper third cortices at parasymphysis and body, and wider upper third mandibles anteriorly. Younger subjects displayed thicker lower third cortices at parasymphysis; wider lower third mandibles anteriorly and upper third posteriorly; and greater height at symphysis. Younger females and all males exhibit safer anterior and posterior sites, respectively. Older females with smaller mandibles require more careful treatment planning. Conclusion: Within the limitations of the study, it can be concluded that anthropometric differences in mandibular cortical bone are important decisive parameters that provide baseline data for designing a “gender- and age-specific” treatment plan for mandibular surgeries in the Indian population. Clinical significance: Considering the heterogeneity of mandible based on ethnicity, gender, and age; and since variations demand adaptation in surgical techniques, anthropometric baseline data of the Indian mandibular cortex serve as a useful reference guide for the surgeons and provide opportunities for standardized norms for designing a “gender- and age-specific” treatment plan for mandibular surgeries in Indian population.

Aim and objective: To assess the dental caries experience, oral hygiene status, and traumatic dental injuries (TDI) among the visually impaired in Jabalpur, Madhya Pradesh, India. Materials and methods: A descriptive cross-sectional study was conducted among 318 subjects. The questionnaire recorded the Decayed-Missing-Filled Tooth Index (DMFT), Oral Hygiene Index-Simplified [OHI(S)], and TDI. Discrete data were analyzed using Student's t-test and continuous data was analyzed using analysis of variance (ANOVA). A p value was set at 0.05 as significant. Results: The mean age of the study population was 13.9 ± 3.5 years. The caries prevalence was 69.2% with a caries experience of 1.23 ± 2.16. The OHI(S) score was 1.6 ± 1.0 and the prevalence of TDI was 27.6% in this population. Conclusion: Visually impaired subjects showed a higher dental caries experience, fair oral hygiene status, and extensive TDI. This study population lacked adequate knowledge concerning appropriate usage of oral hygiene aids, accurate brushing techniques, ill-effects of cariogenic diet, and lacked periodic dental visits. Clinical significance: Children and adults living with disabilities have fewer healthy teeth, more untreated tooth caries, and periodontal diseases compared to the general population. Yet, they have the same rights to good oral health and oral healthcare as the rest of the population. If the dental care needs of these populations have to be met then, there is a need for a refurbished dental curriculum emphasizing the training of the dental team to meet the needs of people with special needs.

Background: Mixed dentition arch analysis is an important criterion in determining an orthodontic treatment plan. The development of the Tanaka–Johnston (1974) and Moyers’ prediction (1973, 1998) was established on the Northern European population. However, the corroboration of ethnic tooth size variability suggests that prediction approaches based on a single ethnic sample may not be regarded as universal. Very few studies have been done for the Indian population. Aim and objective: The purpose of the study was done to evaluate the applicability of Tanaka–Johnston and Moyers’ mixed dentition analysis in the prediction of mesiodistal width of unerupted canines and premolars for North Indian children. Settings and design: This cross-sectional study was done on 200 participants (100 males and 100 females) in the Department of Pediatric Dentistry and Orthodontics in the North Indian population. Materials and methods: A sample of 200 North Indian population within the age group 12–15 years was randomly drawn. Mesiodistal widths of mandibular incisors and canine and premolars in both the arches were measured from the dental casts of the study participants. The sum of the actual mesiodistal widths of maxillary and mandibular canine-premolars segments was compared to those obtained from Tanaka–Johnston equations and Moyers’ prediction tables (35th to 85th percentile). Statistical analysis used: Inferential statistics were performed using unpaired and paired t-tests at a significance level of p < 0.05. Results: Moyers’ tables over-estimated the widths in maxilla and mandible of males and females at all probability levels (p < 0.001) except under-estimation in females mandibular arch only at 35% probability (p = 0.056) and at 35% and 50% probability in maxillary arch (p < 0.001 and p = 0.036, respectively). Tanaka and Johnston equations over-estimated the values in both the jaws of both the genders (p < 0.001). Conclusion: Tanaka–Johnston equations overestimated the values therefore less appropriate to be used in this population; however, Moyers’ prediction tables can be used but at different probability levels for both genders.

Aim and objective: The study aimed to assess the perception of undergraduate dental students toward online lectures during the coronavirus disease-2019 (COVID-19) lockdown period. Materials and methods: A questionnaire using a 3-point Likert scale was distributed to 400 undergraduate dental students of a dental institute. The survey form distribution and data collection were done using Google Forms. The data were entered into an excel spreadsheet and analyzed using SPSS version 15. Chi-square test and Fischer's exact test were applied to know the association of perception of undergraduate dental students toward online lectures with gender and their year of course. Results: A total of 356 students responded to the survey with a response rate of 89%. While the majority of students (77.8%) had a good experience in understanding online lectures, only 18% of students found online lectures to be more impactful than classroom lectures. Also, a statistically significant difference was found among students in a different year of the course (p = 0.04). Approximately 49% of the students with a higher number of males (69.6%) as compared to females (43.9%) felt that online lectures needed further improvement to support their learning (p = 0.001). While 58% of students preferred the inclusion of online lectures in future dental education, 76.4% of students said that they would prefer a combination of both online lectures and classroom lectures. Conclusion: Students had a positive response toward online lectures. However, based on the results, it can be concluded that the e-learning system needs further improvement to support students’ learning and it can only be considered as an adjunct to traditional classroom lectures. Clinical significance: The concept of online teaching was explored globally in view of the pandemic of COVID-19. The use of online lectures, webinars, and continuing dental education was very helpful and informative for dental students. The curriculum and teaching were possible even in lockdown, maintaining social distancing. Thus, this study helps to find out the perception and understanding of dental students toward online lectures and teaching during the COVID-19 pandemic.

Aim and objective: ErbB2 also referred to as CD340, HER2/neu belongs to the human epidermal growth factor receptor (EGFR) family. It is a cell surface receptor kinase involved in the regulation of important events like cell proliferation and differentiation. Phosphorylation of ErbB2 by their ligands causes activation of downstream signaling pathways like phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K)-Akt pathways. To evaluate the role of ErbB2 in odontogenic keratocysts (OKCs), dentigerous cyst (DC), and ameloblastoma by correlating the expression levels of ErbB2 with the biological behavior of the disease. Materials and methods: The present study comprises 10 histopathologically diagnosed FFPE samples, of OKC, DC, and ameloblastoma among odontogenic lesions. These cases were subjected to immunohistochemical staining with ErbB2 antibody. ASCO/CAP scoring criteria 2013 was employed for interpretation. Membranous reactivity was considered positive. Mann–Whitney U test was used for statistical analysis. Results: The ErbB2 expression levels in nine cases of OKC tissue showed significantly high expression, followed by eight cases of ameloblastoma, and five cases of a DC. All these odontogenic lesions showed positive for cell membrane staining. Conclusion: In the present study, HER2 is highly expressed in the majority of cases of OKC and ameloblastoma. However, further studies with a larger sample size have to be carried out along with other members of the ErbB2 family for definitive inference. Clinical significance: Increased expression of ErbB2 indicates neoplastic transformation.

Aim and objective: The aim and objective of this study was to estimate mast cell (MC) count in histopathological dysplasia grades in oral leukoplakia (OL) patients and in histopathological grades in oral squamous cell carcinoma (OSCC) patients and thereby determining their possible role in these lesions pathogenesis. Materials and methods: Forty histopathologically confirmed cases of OL and OSCC were taken. Sections of 4 microns thickness were taken from each paraffin block and stained with 1% standard toluidine blue stain for demonstrating MCs. Counting of MCs was done by 3 observers using a 10× eyepiece fitted with 1 cm² graticule and 40× objectives in 10 different fields in each slide. Results: It was found that the MC count was higher in OSCC than OL and control group and the difference was found to be statistically significant. (One way Analysis of Variance test) Also, the MC count increased from mild to severe dysplasia in OL patients, as well as from well to poorly differentiated grades in OSCC patients (p < 0.01). Conclusion: This study indicates that MC count was increased from mild to moderate to severe dysplasia of OL patients and also from well differentiated (WD) to moderately differentiated (MD) to poorly differentiated (PD) grades of OSCC patients. Clinical significance: MC count was increased in higher grades of epithelial dysplasia in OL patients and higher grades in OSCC patients.

Aim and objective: This study aimed to scrutinize sources and degree of stress in dental undergraduates in Asian Institute of Medicine, Science and Technology (AIMST) Dental Center during clinical years and correlating clinically with their oral hygiene. Materials and methods: A cross-sectional study was conducted among a total of 216 students including the third-, fourth-, and fifth-year dental students, and a modified version of the dental environment stress (DES) questionnaire was used to investigate the possible sources of stress during the clinical years. The results were evaluated using the statistical package for social sciences (SPSS) version 16. Basic descriptive statistics and Chi-square test were used to analyze and correlate the variables. A significant level was set at p < 0.05. Results: Total mean rank stress in terms of the academic year for the third year was 78.56, 125.6 in fourth, and 117.65 in the fifth year and was statistically higher for year 4 students. There is no statistical difference in the stress experienced by male and female undergraduate students. In response to the questionnaire pertaining to the source of stressors, an overall four-point Likert scale scoring of stress was marked as mild to moderate by the majority of the students. Pertaining to the level of oral hygiene to stress, statistical significance was noted with year 5 with a mean value higher for year 3 students. Conclusion: The overall findings of this investigation showed that dental students of AIMST University perceived comparatively mild-to-moderate levels of stress across the clinical study years. Clinical significance: Assessment of potential sources of stressors in the dental curriculum will point out the areas that need to be focused so that effective management can be instituted.

Aim and objective: This study aimed to investigate the association of oral health by body mass index (BMI) among schoolchildren of Kosovo. Materials and methods: A comparative-descriptive study was conducted using a sample of 270 children of age group 12–14 years, of both genders, who were selected from various schools along with Kosovo. A questionnaire was used to obtain information on children's demographic characteristics, oral hygiene practices, and dietary habits. Their parental education levels, family incomes, and leisure time activities were also obtained by questionnaire at recruitment. Clinical outcomes were assessed according to the Decayed/Missing/Filled Teeth (DMFT) index and the oral hygiene index-simplified (OHI-S). Adjusted for age, gender, height, and weight, BMI-age percentiles were calculated using the BMI Percentile Calculator for Child and Teen, and children were classified as underweight, normal, overweight, and obese considering age and sex. In the statistical analysis, differences between categorical variables were tested with the Chi-square test (χ²) and contingency tables. Results: Caries was present in 47.4% of children. A maximum number of caries affected children belonged to the healthy weight and obesity group, followed by overweight, and the least number was underweight (p < 0.003). We found a significant difference between DMFT (p < 0.02) and OHI-S values (p < 0.002) and BMI-age percentiles subgroups. Conclusion: The results show a difference in outcomes between DMFT and OHI-S values among BMI-age percentiles subgroups in schoolchildren. Children aged 12 years, from the obese category, had more cases with higher DMFT (significant difference p < 0.003), and also more cases with the high OHI-S value were detected among children from the obesity subgroup (p < 0.002). Clinical significance: Obesity, oral health, and dental caries have common risk determinants and require a comprehensive multidisciplinary approach to children by both medical and dental healthcare professionals.

Aim and objective: To present the endodontic treatment of maxillary right first molar with three roots and seven root canals diagnosed with cone-beam computed tomographic imaging and its successful management. Background: The anatomic complexities and variations of maxillary first molar reported vastly in the literature are constant challenges for successful endodontic therapy. Detection of all the root canals and their disinfection is important for proper healing and long-term survival of the tooth. CBCT imaging is being used extensively over the past two decades for the diagnosis of teeth with multiple root canals. The use of CBCT and various diagnostic tools for the successful management of a maxillary first molar with multiple root canals is discussed herein. Case description: This case report represents an unusual morphology of three roots and seven root canals in the maxillary first molar. A rare configuration of two mesiobuccal, two distobuccal, and three palatal root canals is reported. The diagnosis was done using multiple angulated radiographs and CBCT imaging. Nonsurgical endodontic treatment was performed followed by a full-coverage porcelain crown. Conclusion: Clinicians should always be mindful of various possible aberrations in the canal morphology of maxillary molars. This necessitates the use of various diagnostic tools like CBCT and dental operating microscope (DOM). The use of these aids led to successful diagnosis and treatment in the present case, thereby avoiding possible endodontic failure. Clinical significance: This case report along with the literature discusses and highlights the fact that maxillary first molars have the highest incidence of additional root canals. It also signifies the importance of CBCT and DOM as essential diagnostic tools in detecting the additional canals.