ABSTRACT
Root perforations affect the prognosis of teeth. Inadequacy of the repair materials has been a contributing factor to the poor outcome of repair procedures. Mineral trioxide aggregate (MTA) is a new material that is being successfully used to repair perforations. The purpose of this study was to evaluate the success rate of root perforation repair using MTA. Pre-treatment and post treatment and at least 1 year follow-up radiographs were evaluated to determine the presence or absence of any pathologic changes adjacent to the perforation site. The result showed normal tissue architecture adjacent to the repair site at the recall visit. Teeth with existing lesions showed resolution of the lesion. Based on the result of this study, MTAprovides an effective seal of root perforations and improve the prognosis of perforated teeth that would otherwise be compromised.
ABSTRACT
En endodoncia la tomografía cone-beam (CBCT) permite el diagnóstico y planifi cación de tratamientos. Se presenta un caso en que se detectó una desviación del conducto radicular y perforación al instalar un poste, las cuales no fueron identifi cadas en la radiografía convencional. La tomografía cone-beam facilitó el diagnóstico y la defi nición del plan de tratamiento, el cual se realizó bajo microscopio y con ultrasonido para remover los materiales de obturación previos (gutapercha y poste). Las perforaciones iatrogénicas son causa de mal pronóstico en los tratamientos endodóncicos. El cone-beam es una herramienta que permite observar tridimensionalmente los conductos radiculares, lo que facilita el diagnóstico y tratamiento a seguir (AU)
Cone-beam (CBCT) tomography is more often used in endodontics, to improve diagnosis and treatment planifi cation. In the present study we were able to detect a deviation of the root canal and perforation during the colocation of a poste, which wasn't possible with conventional radiograph. The endodontic treatment was guided with cone-beam and was executed under microscope; help out with ultrasonic tips to remove the previous obturation materials (gutta-percha and post) to also detect the original tract and to clean and desinfect the original root canal. Iatrogenic perforations cause poor prognosis of the endodontic treatments. CBCT is a tool that allows observing three-dimensional the root canals; which facilitates the diagnosis and treatment planning (AU)
Subject(s)
Humans , Male , Adult , Cone-Beam Computed Tomography , Iatrogenic Disease , Root Canal Therapy , Tooth Root , Ultrasonic Therapy , Diagnostic Imaging , Mexico , Microscopy , Patient Care Planning , Prognosis , Root Canal Filling MaterialsABSTRACT
Las perforaciones radiculares son una complicación indeseada del tratamiento endodóntico que provoca la pérdida de la integridad de la raíz y posterior destrucción del tejido periodontal adyacente. Se presentó el caso de una adolescente con perforaciones radiculares de 21 y 22 como complicación de un tratamiento endodóntico previo con fístulas a nivel de la encía adherida y con factores de riesgo de mal pronóstico para el tratamiento conservador. Se realizó un tratamiento combinado: tratamiento pulpo radicular convencional y abordaje quirúrgico de las perforaciones. Estas fueron obturadas con amalgama de plata y en un segundo tiempo, para mejorar la estética de la restauración, se retiró la obturación de amalgama que interesaba el tercio cervical del diente sustituyéndola por un compómero. El resultado del tratamiento realizado, tanto desde el punto de vista estético, como funcional, fue exitoso y la paciente conservó los dientes después de un año de seguimiento.
Radicular perforations are undesired complications of endodontic treatment which causes the loss of integrity of the root and further destruction of the adjacent periodontal tissues. A teenager with root perforations at 21 and 22 levels as a complication of a previous endodontic treatment with fistulae to gingiva and risk factors of poor prognosis for conservative treatment as was reported. A combined treatment was performed: conventional endodontic treatment and surgical intervention of perforations. The perforations were sealed with silver amalgam and in a second time, to improve the aesthetics of the restoration, amalgam at cervical level was removed and filled with resin. The treatment was successful and after one year the patient preserved the teeth with good function and aesthetics.
ABSTRACT
Root perforation represents an undesirable complication that may lead to an unfavorable prognosis. The aims of this study were to characterize and to compare the presence of calcium oxide (CaO) on the chemical composition of materials used for root perforation therapy: gray and white mineral trioxide aggregate (MTA) and Portland cement (PC), gray MTA+5%CaO and gray MTA+10%CaO. The last two materials were analyzed to evaluate the increase of CaO in the final sample. CaO alone was used as a standard. Eighteen polyethylene tubes with an internal diameter of 3 mm and 3 mm in length were prepared, filled and then transferred to a chamber with 95% relative humidity and a temperature of 37ºC. The chemical compounds (particularly CaO) and the main components were analyzed by energy-dispersive X-ray microanalysis (EDX). EDX revealed the following concentrations of CaO: gray MTA: 59.28%, white MTA: 63.09%; PC: 72.51%; gray MTA+5%CaO: 63.48% and gray MTA+10%CaO: 67.55%. The tested materials presented different concentrations of CaO. Even with an increase of 5 and 10% CaO in gray MTA, the CaO levels found in the MTA samples were lower than those found in PC.
A perfuração do canal radicular representa uma complicação indesejável que sugere um prognóstico desfavorável. Os objetivos deste estudo foram caracterizar e comparar a presença de óxido de cálcio (CaO) na composição química de vários materiais utilizados no tratamento de perfurações radiculares. Foram analisados os materiais MTA cinza e branco, cimento Portland e na tentativa de se observar o aumento nos valores de CaO foram testados MTA cinza+5% de óxido de cálcio, MTA cinza+10% de óxido de cálcio e o CaO (padrão). Foram preparados 18 tubos de polietileno com diâmetro interno e comprimento de 3 mm. Estes foram preenchidos e depois transferidos para uma estufa com umidade relativa de 95% e temperatura de 37°C. Os compostos químicos (principalmente o óxido de cálcio) e os principais componentes foram avaliados por espectrometria de dispersão de raios-X (EDX). A análise por EDX revelou as seguintes concentrações de CaO: 59,28% no MTA cinza; 63,09% no MTA branco; 72,51% no cimento Portland; 63,48% no MTA cinza+5% de CaO; 67,55% no MTA cinza+10% de CaO. Os materiais testados apresentaram diferentes concentrações de CaO. Mesmo com o acréscimo de CaO nas concentrações de 5 e 10% ao MTA cinza, os valores de CaO foram inferiores aos observados no cimento Portland.