ABSTRACT
La apicectomía consiste en la amputación de la fracción apical de la raíz de un diente lesionado y se considera la última opción terapéutica para mantener el diente afectado en boca. Con el objetivo de dilucidar el potencial terapéutico de la técnica quirúrgica, en el presente estudio presentamos el reporte de caso de un paciente con cuadro de hiperestesia asociada al nervio alveolar inferior debido a sobreobturación de la raíz mesial de un primer molar inferior izquierdo. Para resolver el caso realizamos apicectomía mediante abordaje convencional acompañado de medicación empírica enfocada a resolver cuadros de parestesia asociada al procedimiento. Durante los controles posteriores al procedimiento quirúrgico se pesquisa ausencia de parestesia y sintomatología dolorosa, por lo que consideramos la apicectomía como una buena opción de tratamiento en casos de sobreobturación apical que no pueden solucionarse mediante tratamiento no quirúrgico.
Apicoectomy consists of the amputation of the apical fraction of the root of an injured tooth and is considered the last therapeutic option to keep the affected tooth in the mouth. With the aim of elucidating the therapeutic potential of the surgical technique, in this study we present the case report of a patient with hyperesthesia associated with the inferior alveolar nerve due to overfilling of the mesial root of a left lower first molar. To solve the case we performed apicoectomy by conventional approach accompanied by empirical medication focused on resolving paresthesia associated to the procedure. During the controls after the surgical procedure we found absence of paresthesia and painful symptomatology, so we consider apicoectomy as a good treatment option in cases of apical overfilling that cannot be solved by non-surgical treatment.
ABSTRACT
The filling material should be restricted to the root canal, and not extend to the periradicular tissues. Overextension occurs when there is an overflow of gutta-percha and sealer, whereas overfilling refers to the overflow only of sealer beyond the apical foramen. Both may cause several negative clinical consequences. Nevertheless, an accurate diagnosis of where they occurred cannot always be performed by conventional radiographic examination, because of the two-dimensional aspect of the image. This paper describes a clinical case of labiomandibular paraesthesia after overfilling into the mandibular canal (MC), as diagnosed by cone-beam computed tomography (CBCT), later used to perform the treatment planning. A 34-year-old Caucasian female patient sought a private dental clinic complaining of pain in the right mandibular posterior region. After taking the anamnesis and performing clinical and radiographic exams, the patient was diagnosed with pulp necrosis in the second right mandibular molar, and underwent root canal treatment. The final radiography showed overextension or overfilling, probably into the MC. About 2 hours after the procedure, the patient reported paraesthesia of her lower right lip and chin. A CBCT confirmed a small overfilling into the MC. For this reason, vitamin B12 was prescribed as the first treatment option. After 7 days, the patient reported a significant decrease in paraesthesia, and was completely normal after 15 days. This case report shows that CBCT is an effective radiographic diagnostic tool that can be used as an alternative in clinical cases of labiomandibular paraesthesia caused by overextension or overfilling (AU)
O material obturador deve preencher todo o canal sem extravasar para os tecidos perirradiculares. O extravasamento de guta-percha e cimento além do forame apical, denomina-se sobrextensão, enquanto o termo sobreobturação refere-se ao extravasamento de cimento endodôntico. Ambos podem causar consequências clínicas negativas, porém um preciso diagnóstico nem sempre é logrado somente a partir do exame radiográfico convencional em razão de sua natureza bidimensional. O presente relato descreve um caso clínico de parestesia de lábio inferior e mento após o extravasamento de cimento obturador para o canal mandibular (CM), diagnosticado por meio da tomografia computadorizada de feixe cônico (TCFC), também utilizada para o planejamento do tratamento. Paciente do gênero feminino, 34 anos, leucoderma, procurou atendimento odontológico particular queixando-se de dor odontogênica na região posterior direita da mandíbula. Finalizados a anamnese e o exame clínico-radiográfico, diagnosticou-se a necrose pulpar do segundo molar inferior direito, ulteriormente submetido ao tratamento endodôntico. A radiografia final evidenciou provável extravasamento de material obturador para o interior do CM. Aproximadamente 2 horas após, a paciente relatou parestesia no lábio inferior direito e no queixo, e a TCFC confirmou a presença de pequena quantidade de cimento obturador no CM. Por conseguinte, a prescrição de vitamina B12 foi o tratamento de escolha. Decorridos 7 dias, a paciente referiu significativa diminuição da parestesia e após 15 dias os padrões de normalidade estavam completamente restabelecidos. O presente relato de caso demonstra que a TCFC é uma ferramenta de diagnóstico potencialmente empregada em casos de parestesia labiomandibular causada por sobrextensão ou sobreobturação (AU)
Subject(s)
Humans , Female , Adult , Paresthesia , Endodontics , Cone-Beam Computed TomographyABSTRACT
Context: A study was done to assess the average distances of root apices of mandibular first molar, second molar, and second premolar to inferior alveolar nerve canal (IANC), among males and females in central India. Materials and Methods: High‑resolution full‑volume cone‑beam computed tomography (CBCT) scans were obtained from the radiology database at the Sri Aurobindo College of Dentistry, Indore. After scrutinizing the database, CBCT of 40 males and 40 females that conformed to the inclusion and exclusion criteria were selected for the study. Results: All the data were analyzed using SPSS, Version 16. Descriptive statistics of the variables and measurements are presented using Students t‑test (paired and unpaired), and correlation between age was tabled by Karl Pearson’s correlation coefficient method. Conclusion: For the second premolar, the average distance to the IANC was 0.88–13.03 mm for males and 0.00–5.49 mm for females. The average distance of IANC to the mesial root apex of first molar was 1.46–13.23 mm for males and 0.93–8.03 mm for females. For the second molar, the average distance was 1.31–14.71 mm for males and 0.00–6.91 mm for females (values on left side were shorter as compared to right side). In the overall population, only second molar exhibited significant difference in the distance from root apex to IANC when compared bilaterally. In addition to gender differences, age‑related differences were found to be significant for the first molar on left side and second molar on the right side of the population (P < 0.05).
ABSTRACT
Laparoscopic adjustable gastric banding (LAGB) is a restrictive procedure which has a low morbidity and mortality rate in the immediate postoperative period along with a good weight loss. It is necessary for weight loss to adjust gastric band with calibration. Sometimes, patients performed LAGB experienced vomiting, regurgitation, and epigastric discomfort by over-filling. But to the contrary, we may meet patients who do not feel early satiety in the face of over-filling. We report here, the case of a 24-year-old woman with a failure of adjusting gastric band despite of over-filling, and unbuckled band, treated via removal of unbuckled band. Surgical band removal and change, or conversion to other procedures should be considered when unbuckled gastric band are encountered.
Subject(s)
Female , Humans , Young Adult , Calibration , Mortality , Postoperative Period , Vomiting , Weight LossABSTRACT
Endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve (IAN). We report a case of disabling dysesthesia and paresthesia of a 70-year-old man after endodontic treatment of his mandibular left third molar that caused leakage of root canal filling material into the mandibular canal. After radiographic evaluation, extraction of the third molar and distal osteotomy, a surgical exploration was performed and followed by removal of the material and decompression of the IAN. The patient reported an improvement in sensation and immediate disappearance of dysesthesia already from the first postoperative day.