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1.
Rev. Asoc. Odontol. Argent ; 111(3): 1111211, sept.-dic. 2023. ilus, tab
Article in Spanish | LILACS | ID: biblio-1554315

ABSTRACT

Objetivos: Identificar y determinar la prevalencia de cristales de colesterol (CRCo) en granulomas perirradiculares de origen endodóntico y el tipo de reacción que provocan en los tejidos circundantes. Material y métodos: Se estudiaron con microscopía óptica 75 preparados histológicos de archivo pertenecientes a lesiones perirradiculares humanas correspondientes a piezas dentarias que habían recibido un tratamiento endodóntico pre- vio y que, según los informes que acompañaban las muestras, habían sido obtenidas mediante una apicectomía. Del total, 68 muestras fueron diagnosticadas como granulomas, mientras que los 7 restantes se diagnosticaron como quistes inflamato- rios y fueron descartadas. Resultados: 39 granulomas pertenecían a pacientes de sexo femenino con presencia de CRCo en el 58,97% de los ca- sos. Los 29 granulomas restantes pertenecían al sexo mascu- lino y presentaron CRCo en un 41,37%. La mayor proporción de CRCo fue hallada en granulomas pertenecientes a pacien- tes mayores de 62 años. Los CRCo se observaron rodeados de macrófagos y células gigantes multinucleadas, provocando una reacción a cuerpo extraño. También se observaron células espumosas en áreas circundantes. Conclusiones: La presencia de CRCo en granulomas perirradiculares de origen endodóntico provoca una reacción a cuerpo extraño que puede interferir con el proceso de re- paración posendodóntico especialmente en pacientes de edad avanzada (AU)


Aim: Identify and determine the prevalence of cholester- ol crystals (CRCo) in periradicular granulomas of endodontic origin and the type of reaction they produce in the surround- ing tissues. Material and methods: 75 archival histological preparations were studied with optical microscopy. They be- longed to human periradicular lesions corresponding to teeth that had received a previous endodontic treatment and that, according to the reports accompanying the samples, had been obtained by an apicoectomy. Of the total, 68 samples were diagnosed as granulomas, while the remaining 7 were diag- nosed as inflammatory cysts and were discarded. Results: 39 granulomas corresponded to female patients in which the presence of CRCo was observed in 58.97% of the cases. The remaining 29 granulomas were from male patients and showed CRCo in 41.37% of the cases. The highest pro- portion of CRCo was found in patients over 62 years of age. The CRCo were surrounded by macrophages and multinucle- ated giant cells causing a foreign body reaction. Foam cells were also observed in the surrounding areas. Conclusions: The presence of CRCo in periradicular granulomas of endodontic origin could be a factor interfering with periapical healing after conventional endodontic thera- py, especially in elderly patients (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Periapical Granuloma/pathology , Root Canal Therapy/adverse effects , Foreign Bodies/etiology , Apicoectomy/methods , Biopsy/methods , Histological Techniques/methods , Age Factors
2.
Rev. Ateneo Argent. Odontol ; 66(1): 26-33, 2022.
Article in Spanish | LILACS | ID: biblio-1380245

ABSTRACT

Los quistes periapicales o radiculares representan una de las patologías periapicales más frecuentes dentro del grupo de las lesiones quísticas de los maxilares. Son el resultado de la extensión de proce- sos inflamatorios-infecciosos. Su diagnóstico sigue siendo un desafío para el profesional odontológico, quien debe diferenciarlo de otros procesos inflama- torios periapicales. El objetivo del presente artículo es presentar, apoyado en una revisión de la literatura, el caso clínico de un paciente masculino de 38 años de edad que se presentó a la consulta por leve tume- facción indolora en zona anterosuperior del maxilar. A la inspección se observó borramiento de la región del surco vestibular a nivel de piezas dentarias 1.1, 1.2 y 1.3, de color rojizo con crepitación de la tabla ósea vestibular a la palpación. La tomografía de haz cónico mostró lesión osteolítica, extendida desde zona apical de la pieza dentaria 1.4 hasta zona del elemento dentario 1.1. Se realizó la extirpación de la lesión y api- cectomía. El estudio histológico corroboró el diagnós- tico presuntivo de quiste periapical. Los controles a distancia mostraron buena evolución del tratamiento. Se concluyó en la importancia de realizar un correcto diagnóstico clínico e imagenológico para la selección de un adecuado tratamiento según el caso (AU)


Periapical or radicular cysts represent one of the most frequent periapical pathologies within the group of cystic lesions of the jaws. They are the result of the spread of inflammatory-infectious processes. Its diagnosis continues to be a challenge for the dentist, who must differentiate it from other periapical inflammatory processes. The objective of this article is to present, supported by a review of the literature, the clinical case of a 38-year-old male patient who presented to the consultation due to mild painless swelling in the anterosuperior maxilla. Upon inspection, effacement of the vestibular sulcus region was observed at the level of teeth 1.1, 1.2 and 1.3, reddish in color with crepitation of the buccal bone table on palpation. Cone beam tomography showed an osteolytic lesion that extended from the apical area of tooth 1.4 to area of tooth 1.1. Excision of the lesion and apicoectomy were performed. The histological study corroborated the presumptive diagnosis of periapical cyst. Remote controls showed a good evolution of the treatment. It was concluded on the importance of carrying out a correct clinical and imaging diagnosis for the selection of an adequate treatment according to the case (AU)


Subject(s)
Humans , Female , Adult , Radicular Cyst/surgery , Radicular Cyst/diagnostic imaging , Apicoectomy/methods , Biopsy/methods , Oral Surgical Procedures , Cone-Beam Computed Tomography
3.
Rev. Fac. Odontol. (B.Aires) ; 36(83): 13-20, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1342365

ABSTRACT

La microcirugía endodóntica (MCE) es una alternativa al tratamiento no quirúrgico de la periodontitis apical persistente. Por su evolución junto a los avances tecnológicos, la incorporación de la tomografía computarizada de haz cónico (CBCT), la tecnología de impresión tridimensional (3D) y las guías quirúrgicas diseñadas con software asistido por computadora, han permitido implementar la planificación digital llevada a cabo en el acto quirúrgico. El objetivo de este informe es describir un caso clínico de MCE guiada, con un protocolo de diseño digital y el uso de una guía quirúrgica impresa en resina biocompatible, diseñada con precisión de acuerdo con las mediciones de CBCT preoperatorias. Se diseñó un kit de trefinas con "sleeves" (Neokings) para realizar la osteotomía y resección de los últimos 3 mm apicales direccionados por la guía quirúrgica. La tabla cortical intacta se recuperó y se utilizó como injerto junto con plasma rico en fibrina. La guía de cirugía apical permite al profesional lograr ubicar con precisión los tejidos objetivos de la cirugía y acortar el tiempo del procedimiento. Un control CBCT inmediato mostró la planificación exacta en 3D del sitio quirúrgico (AU)


Subject(s)
Humans , Female , Adult , Apicoectomy/methods , Periapical Periodontitis , Microsurgery , Osteotomy , Patient Care Planning , Argentina , Plasma , Schools, Dental , Clinical Protocols , Cone-Beam Computed Tomography , Printing, Three-Dimensional
4.
Journal of Peking University(Health Sciences) ; (6): 905-910, 2018.
Article in Chinese | WPRIM | ID: wpr-941722

ABSTRACT

OBJECTIVE@#To establish an apicoectomy guide template design and manufacturing method, based on multi-source data fusion, computer aided design (CAD) and fused deposition modeling (FDM). The feasibility of the guide template was preliminary evaluated by the in vitro model experiment.@*METHODS@#An extracted upper anterior tooth, after root canal treatment, was optical scanned, after which the extracted upper anterior tooth was poured in an apicoectomy plaster model. Cone-beam computed tomography (CBCT) scanning of the apicoectomy plaster model was performed, after which optical scanning of the plaster model for apical resection surgery was carried out. All of the relevant CBCT and optical scanning data of the extracted upper anterior tooth and the apicoectomy plaster model were introduced into the Geomagic Studio 2012 software. The multi-source data fusion technology was used to virtually simulate the three-dimensional positional relationship of the extracted tooth, the dentition, the alveolar bone and the gingival, based on which, the three-dimensional design of the apicoectomy guide template was completed in the Geomagic Studio 2012 software. With the technology of fused deposition modeling, the apical resection surgical guide template was three-dimensionally printed with the material of polylactic acid (PLA). Under the guidance of the surgical guide template, the root apical resection was performed on the plaster model. After the apicoectomy, the extracted upper anterior tooth was taken off from the apicoectomy plaster model and then was given the optical scanning. The apical resection length and angle were calculated by the function of distance measurement and angle measurement, and the results were compared with the preset values.@*RESULTS@#The length of the apical resection was 2.88 mm along the direction of the long axis of the tooth, which was 0.12 mm lower than the preset 3 mm. The included angle between the apical resection plane and the long axis of the tooth was 77.9°, 12.1° lower than the preset 90°.@*CONCLUSION@#This study successfully established a digital design and production method of apicoectomy guide template by combing the multi-source data fusion, CAD and FDM technology. The design route and the production method are feasible. The study will provide a technology and methodology reference for the development of domestic special software for the digital design of apicoectomy guide template.


Subject(s)
Apicoectomy/methods , Computer-Aided Design , Cone-Beam Computed Tomography , Printing, Three-Dimensional , Software
5.
Acta cir. bras ; 31(6): 422-427, graf
Article in English | LILACS | ID: lil-785019

ABSTRACT

ABSTRACT PURPOSE: To evaluate the clinical applicability of Pozzolana Biologic Silva cement (PBS(r)) in endodontic surgery. METHODS: Persistent apical periodontitis was diagnosed in 30 teeth of 12 patients by cone-beam computed tomography (CT). All patients had 2 or 4 affected teeth and underwent endodontic surgery with root-end filling. Patients with 2 affected teeth had one tooth (control) treated with mineral trioxide aggregate (MTA-Angelus(r)) as a root-end filling material, and the other tooth treated with PBS (experiment). When the patient had four affected teeth, two of them were treated with MTA and two with PBS. Six months after surgery, all patients were assessed by CT scan. Between-group comparisons of measurements were performed using the Wilcoxon test. RESULTS: Periradicular tissue regeneration was observed in all cases. Significant within-group differences in long axes of the lesion were found in the bucco-palatal direction (PBS group, p=0.0012; MTA group, p=0.024) and coronal-apical direction (PBS group, p=0.0007; MTA group, p=0.0015) between pre- and postoperative measurements. CONCLUSIONS: Pozzolana Biologic Silva cement can be used in the treatment of persistent periradicular lesions. The clinical use of PBS as a root-end filling material may be an alternative to MTA. PBS has additives, which provide enhanced strength.


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Young Adult , Oxides/therapeutic use , Periapical Periodontitis/surgery , Biocompatible Materials/therapeutic use , Calcium Compounds/therapeutic use , Aluminum Compounds/therapeutic use , Dental Cements/therapeutic use , Apicoectomy/methods , Periapical Periodontitis/diagnostic imaging , Postoperative Period , Regeneration/physiology , Tooth Root/surgery , Tooth Root/diagnostic imaging , Prospective Studies , Drug Combinations , Cone-Beam Computed Tomography
6.
Rev. Asoc. Odontol. Argent ; 103(1): 29-34, mar.2015. ilus
Article in Spanish | LILACS | ID: lil-758495

ABSTRACT

destacar la importancia del retratamiento y de la cirugía perirradicular en el campo endodóntico, a fin de mantener la estética y la función del órgano dental. Casos clínicos: se presentan 6 casos: 3 de retratamientos realizados por la vía coronaria convencional y 3 de tratamientos en los que se empleó la cirugía perirradicular. En todos los casos, se obtuvo la curación del área perirradicular afectada, por medio de diferentes procedimientos. Conclusión: el retratamiento endodóntico y la cirugía perirradicular, dentro de la diversidad de procedimientos, son terapéuticas que colaboran con el mantenimiento de la integridad de la arcada dentaria...


Subject(s)
Humans , Male , Female , Apicoectomy/methods , Periapical Diseases/surgery , Retrograde Obturation , Retreatment/methods , Treatment Outcome , Cuspid , Dental Restoration Failure , Incisor , Molar , Tooth Extraction
7.
Claves odontol ; 21(72): 9-16, jul. 2014. tab, graf
Article in Spanish | LILACS | ID: lil-726056

ABSTRACT

Con el propósito de estudiar in vitro la capacidad de sellado en sentido corono-apical de tres técnicas de obturación canalicular (condensación lateral con conos de gutapercha + sellador de Grossman, cono único de gutapercha + sellador de Grossman y cono único de gutapercha + cemento de ionómero vítreo), en dientes apicectomizados de conductos de corte transversal achatado, se utilizó un método bacteriológico que permitió comprobar el grado de permeabilidad de bacterias conocidas (Proteus mirabilis y Streptococcus salivarius) a través de las obturaciones realizadas. Los resultados permitieron establecer que ninguna de las técnicas estudiadas resultó totalmente efectiva, tanto a la valoración inmediata como a distancia, apreciándose una marcada tendencia al aumento de la permeabilidad a la microfiltración bacteriana en las muestras conservadas (p<0,02). Resulta evidente, según esta experiencia, que la anatomía del conducto radicular condiciona la calidad de la obturación en aquellos dientes que deben ser apicectomizados


Subject(s)
Humans , Apicoectomy/methods , Bacterial Adhesion , Dental Leakage/diagnosis , In Vitro Techniques , Root Canal Obturation/methods , Culture Media , Glass Ionomer Cements/chemistry , Evaluation Study , Gutta-Percha/chemistry , Proteus mirabilis/isolation & purification , Data Interpretation, Statistical , Streptococcus/isolation & purification
8.
Rev. Assoc. Paul. Cir. Dent ; 67(4): 262-267, out.-dez. 2013. ilus
Article in Portuguese | LILACS, BBO | ID: lil-707531

ABSTRACT

Apesar do alto índice de sucesso do tratamento endodôntico de dentes com periodontites apicais, o insucesso pode ocorrer. Estes insucessos podem ser tratados através do retratamento endodôntico convencional, exodontia ou em algumas situações clínicas, através da microcirurgia endodôntica. Com índices de sucesso acima de 90%, a microcirurgia endodôntica é uma alternativa terapêutica a ser considerada para a manutenção estética e funcional de dentes portadores de insucessos endodônticos.


Although the high success rate of endodontic treatments of teeth with apical periodontitís, failures can occur. These clinical cases can be treated by conventional endodontic retreatment, or extraction and in some clinical situations, through endodontic microsurgery. With a success rate above 90%, the endodontic microsurgery is a good therapy to be considered in order to maintain these teeth in function.


Subject(s)
Humans , Female , Middle Aged , Apicoectomy/methods , Endodontics , Microsurgery/methods , Periapical Periodontitis/surgery
9.
Full dent. sci ; 4(16): 633-636, out. 2013. ilus
Article in Portuguese | LILACS, BBO | ID: lil-695739

ABSTRACT

O objetivo deste relato de caso foi apresentar uma alternativa de tratamento após a ocorrência de um insucesso no tratamento endodôntico. O exame radiográfico mostrou o segundo molar mandibular direito tratado endodonticamente de forma satisfatória com a presença de um instrumento fraturado no terço apical e em contato direto com os tecidos periapicais. Em vista do espaço interoclusal limitado do paciente e a oposição de se submeter a uma cirurgia apical, foi sugerido o reimplante intencional como uma alternativa de tratamento. O procedimento consistiu na extração do dente de forma atraumática seguidamente remoção do fragmento, apicectomia, retro-obturação com MTA e, finalmente, reimplantação no alvéolo. Os exames periódicos foram feitos aos 15 dias, 6 meses, 12 meses e 5 anos. Na última visita, pôde-se observar sucesso clínico e radiográfico com base no teste de mobilidade, nenhuma sintomatologia dolorosa relatada, profundidade de sondagem normal, ausência de reabsorção radicular (inflamatória ou por substituição) e integridade óssea alveolar. O trabalho mostrou que reimplante intencional pode ser indicado corretamente como último recurso de tratamento para os casos em que a terapia endodôntica conservadora e técnica cirúrgica não podem ser executadas.


The objective of this case report was to present an alternative treatment to manage an endodontic failure. The radiographic examination showed the with presence of a fractured instrument in contact with the periapical tissues on the second right molar endodontically treated. Due to the limited interocclusal space and patientÆs opposition to undergo an apical surgery, the intentional replantation was suggested as an alternative treatment. The procedure consisted in atraumatic tooth extraction, followed by the removal of the fragment; apicoectomy, retro-obturation with MTA; and finally reimplantation. Patient returned for radiographic and clinical examination after 15 days, 6 months, 12 months, and 5 years. On the last visit, clinical and radiographic success was observed considering mobility test normal probing depth, alveolar bone integrity as well as the absence of painful symptoms root resorption (inflammatory or by substitution). The work showed that intentional reimplantation can be indicated properly as a last resort treatment for cases in which conservative endodontic therapy and surgical technique cannot be performed.


Subject(s)
Humans , Female , Adult , Apicoectomy/methods , Apicoectomy , Radiography, Dental/methods , Radiography, Dental , Tooth Replantation/methods , Tooth Replantation , Retreatment/methods , Retreatment , Endodontics/methods
10.
Braz. dent. j ; 24(2): 107-110, Mar-Apr/2013. graf
Article in English | LILACS | ID: lil-675667

ABSTRACT

Despite the excellent properties of mineral trioxide aggregate (MTA), the condensation technique may have some influence in its sealing ability. The purpose of this study was to compare the sealing ability of sonic and ultrasonic setting of MTA. Thirty-four extracted human teeth had their canals prepared and filled with Sealapex sealer and gutta-percha using the active lateral condensation technique. The teeth were rendered waterproof and apicoectomy performed at 3 mm from the apex. Root-end cavities (3.0 mm deep and 1.4 mm diameter) were prepared with diamond ultrasonic tips. The root-end cavities were filled with Pro-Root MTA® with ultrasonic vibration, sonic vibration or no vibration. The positive control group did not receive any material while the negative control group was totally rendered waterproof. After material set, the specimens were immersed in Rodhamine B for 24 h, under vacuum in the first 15 min, then washed, dried and split longitudinally for evaluating the infiltration at the dentin/material interface. Data were analyzed using ANOVA and Tukey's tests at 5% significance level. Sonic vibration promoted the lowest infiltration values (p<0.05). It was concluded that sonic vibration could be considered an efficient aid to improve the sealing ability of MTA when used as root-end filling material.


Resumo O objetivo deste estudo foi avaliar in vitro, a influência da vibração sônica e ultrassônica no selamento marginal proporcionado pelo MTA. Trinta e quatro dentes humanos tiveram seus canais radiculares instrumentados e obturados com cimento Sealapex® pela técnica da condensação lateral ativa. Os dentes foram impermeabilizados e seccionados os 3 mm apicais. Retrocavidades (3 mm de profundidade e 1,4 mm de diâmetro) foram preparadas com pontas ultrassônicas diamantadas. As retrocavidades foram preenchidas com Pro-Root MTA® com auxílio da vibração ultrassônica, com auxílio da vibração sônica e sem vibração alguma. O grupo controle positivo não recebeu material retrobturador, enquanto que o negativo foi totalmente impermeabilizado. Após a presa do material, os espécimes foram mergulhados em Rodamina B por 15 min em vácuo, permanecendo nesta solução por mais 24 h. Em seguida, foram lavados, secados e clivados longitudinalmente para avaliação da infiltração do corante na interface dentina/material retrobturador. Os dados foram analisados utilizando a análise de variância e o teste de Tukey (p<0,05). Observou-se que apenas a vibração sônica foi diferente apresentando os menores índices de infiltração. Pode-se concluir que vibração sônica contribui com a melhora da capacidade de selamento marginal proporcionado pelo MTA quando empregado como material retrobturador. .


Subject(s)
Humans , Aluminum Compounds/therapeutic use , Calcium Compounds/therapeutic use , Dental Bonding , Oxides/therapeutic use , Retrograde Obturation/methods , Root Canal Filling Materials/therapeutic use , Silicates/therapeutic use , Apicoectomy/methods , Calcium Hydroxide/therapeutic use , Drug Combinations , Dentin/ultrastructure , Diamond/chemistry , Fluorescent Dyes , Gutta-Percha/therapeutic use , Rhodamines , Root Canal Preparation/instrumentation , Root Canal Preparation/methods , Sonication , Surface Properties , Salicylates/therapeutic use , Time Factors , Ultrasonics/instrumentation , Vibration
11.
Article in English | IMSEAR | ID: sea-140114

ABSTRACT

Unicystic ameloblastoma (UA) is known as a distinct entity which has a less aggressive behavior when compared with conventional ameloblastoma. In this report, we have presented two cases of UAs, (of which one case showed a more aggressive behavior with mural invasion into the adjacent tissues and granular cell differentiation), both of which were successfully managed with enucleation following marsupialization. We aim to highlight how this method can be used for the successful management of such cases, rather than following more aggressive approaches. In both the cases, marsupialization was done for the UA lesions initially and follow-ups were maintained. When the tumor size had regressed on radiographic follow up, an enucleation procedure with ostectomy of the margins was carried out. Special importance was also given to the endodontic treatment of the teeth involved in the area of the lesion. The patients were free of the condition and did not show any signs of recurrence on radiographic follow-ups even after 30 months of the final procedure. Granular variant of UA is quite rare and had been considered to be more aggressive. Marsupialization of UA is an alternative treatment option of resection even for more aggressive variants, as long as the histological behavior of the lesion was carefully evaluated and strict radiographic follow-up is maintained.


Subject(s)
Adolescent , Ameloblastoma/surgery , Apicoectomy/methods , Biopsy , Bone Transplantation/methods , Decompression, Surgical/methods , Female , Follow-Up Studies , Humans , Male , Mandibular Neoplasms/surgery , Middle Aged , Osteotomy/methods , Root Canal Therapy/methods , Tooth, Impacted/surgery
12.
Rev. odontol. Univ. Cid. São Paulo (Online) ; 22(1): 39-49, jan.-abr. 2010.
Article in Portuguese | LILACS, BBO | ID: biblio-858480

ABSTRACT

A evolução da tecnologia e de pesquisas científicas trouxe novas possibilidades para o cirurgião-dentista aprimorar sua terapêutica e maximizar resultados favoráveis perante diversas patologias. A Endodontia vem se firmando como especialidade de alto índice de sucesso, porém o fracasso ainda existe, principalmente nos casos de retratamento com lesão e obturação insatisfatória e em cirurgias apicais envolvendo infecções refratárias. Após revisão da literatura, observa-se que vários autores, ao longo dos anos, discutem a indicação e a técnica cirúrgica, que envolve diretamente a apicectomia, o retropreparo, o tratamento da superfície apical ressectada, a obturação retrógrada, o material retrobturador e a microinfiltração que esse material possa apresentar. O uso de ultrassom no corte do ápice e a possibilidade de se utilizar a irradiação laser no retropreparo, visando uma profunda desinfecção e possível diminuição da permeabilidade dentinária, chamaram a atenção da comunidade científica, gerando uma onda de estudos direcionados nesse sentido. Pode-se observar uma grande variedade de resultados e propostas quando do manejo do ápice durante a cirurgia apical, assim como contradições referentes à indicação cirúrgica.


The evolution of technology and scientific research has brought new possibilities for the dental professionals to improve their therapy and maximize favorable results against various pathologies. Endodontic therapy shows a high rate of success, but failure still exists, especially in cases of retreatment with lesion and unsatisfactory obturation and in apical surgery involving refractory infections. After reviewing the literature, it is observed that many authors over the years discussed the indications and surgical technique of this kind of procedure, which directly involves the apicoectomy, retrofilling cavity preparation, the refinement of apical ressected surface, retrograde filling, the retrofilling material microleakage. The use of ultrasound in the apex ressection and the possibility of using the laser irradiation in retrofilling cavity preparation, seeking a thorough disinfection and possible reduction of dentin permeability, drew attention of the scientific community, generating a wave of studies about this topics. A wide variety of results and proposals is discussed when the management of the apex is during in an apical surgery, and contradictions regarding to the surgical indication.


Subject(s)
Apicoectomy/methods , Endodontics/methods , Lasers , Ultrasonics/methods
13.
Braz. dent. j ; 21(5): 416-419, 2010. ilus, tab
Article in English | LILACS | ID: lil-568986

ABSTRACT

This in vitro study evaluated the effect of different apicoectomy angles, instruments used in root-end preparation, and dental materials used in retrofilling on apical sealing. Root ends were resected at 45 or 90 degrees in 80 single-rooted teeth. For each type of apicoectomy, root-end cavities were prepared with either a round carbide #2 bur or an S12/90D ultrasonic tip. The root-end cavities in each subgroup (apicoectomy + root-end preparation) were filled with silver amalgam without zinc (Am) or with gray mineral trioxide aggregate -Angelus (MTA), and the specimens were immediately immersed in 0.2 percent rhodamine B for 24 h. Sealing was evaluated based on the dyed cross-sectional dentin area. Data were analyzed statistically by the Kruskal-Wallis test at 5 percent significance level. No group showed complete sealing of root-end areas. The only significant factor affecting microleakage was dental material, with MTA exhibiting less leakage.


Este estudo in vitro avaliou o efeito de diferentes ângulos de apicectomia, instrumentos utilizados na retrocavitação e materiais odontológicos usados na retrobturação sobre selamento apical. Oitenta dentes unirradiculares, tratados endodonticamente, foram apicectomizados. Quarenta raízes tiveram seu ápice radicular seccionado com angulação de 45º e a outra metade com angulação de 90º. Para cada tipo de apicectomia realizou-se retrocavidades com broca esférica carbide nº 2 ou com retroponta ultra-sônica S12/90D. Cada subgrupo (apicectomia/retrocavidade) foi retrobturado com MTA ou amálgama, sendo os espécimes imediatamente imersos no corante Rodamina B a 0,2 por cento por 24 h. O selamento apical foi avaliado com base na área transversal de dentina corada ao redor da retrobturação. Os dados foram submetidos á análise estatística utilizando os testes de Kruskal-Wallis e Mann-Whitney. Nenhum grupo foi capaz de selar totalmente a região apical. O tipo de material utilizado na retrobturação foi o único fator que mostrou significativa diferença no selamento apical em relação à infiltração de corante.


Subject(s)
Humans , Aluminum Compounds/chemistry , Apicoectomy/methods , Calcium Compounds/chemistry , Dental Bonding , Dental Amalgam/chemistry , Dental Leakage/classification , Fluorescent Dyes , Oxides/chemistry , Retrograde Obturation/methods , Root Canal Filling Materials/chemistry , Silicates/chemistry , Drug Combinations , Dental Pulp Cavity/ultrastructure , Dentin/ultrastructure , Equipment Design , Gutta-Percha/chemistry , Image Processing, Computer-Assisted/methods , Materials Testing , Retrograde Obturation/instrumentation , Rhodamines , Root Canal Preparation/instrumentation , Root Canal Preparation/methods , Time Factors , Ultrasonic Therapy/instrumentation
14.
J. appl. oral sci ; 17(6): 596-599, Nov.-Dec. 2009. ilus, tab
Article in English | LILACS | ID: lil-534426

ABSTRACT

OBJECTIVES: CO2, Er:YAG and Nd:YAG lasers have been used in endodontic surgery. This in vitro study evaluated 1 percent Rhodamine B dye penetration using computer-assisted morphometry (ImageTool Software®) of 108 endodontically treated human permanent canines. MATERIAL AND METHODS: Teeth were divided into 9 groups according to the technique used: A: 90-degree apicoectomy with bur, root-end cavity preparation with ultrasound and filled with MTA; B: 90-degree apicoectomy with bur, root-end cavity prepared with ultrasound and filled with MTA, and treatment of apical surface with CO2 laser (1 W, CW/CW); C: 90-degree apicoectomy with bur, and treatment of apical surface with Nd:YAG laser (150 mJ, 10 Hz); D: 90-degree apicoectomy with bur, and treatment of apical surface with CO2 laser,(1 W, CW/CW); E: apicoectomy with Er:YAG laser (400 mJ, 10 Hz), root-end cavity prepared with ultrasound and filled with MTA; F: apicoectomy with Er:YAG laser (400 mJ, 10 Hz) and treatment of apical surface with Nd:YAG laser (150 mJ, 10Hz); G: apicoectomy with CO2 laser (5W, CW/SP), root-end cavity prepared with ultrasound and filled with MTA; H: irradiation of apical end with CO2 laser (1 W, CW/CW); I: irradiation of apical end with Nd:YAG laser (150 mJ, 10 Hz). RESULTS: Dye penetration was found in all specimens at different rates, the lowest penetration occurring in groups C (16.20 percent), B (17.24 percent) and F (17.84 percent). CONCLUSIONS: Groups B, C and F represent the best technical sequences to perform endodontic surgery.


Subject(s)
Humans , Apicoectomy/methods , Laser Therapy/methods , Lasers, Gas/therapeutic use , Lasers, Solid-State/therapeutic use , Tooth Apex/pathology , Aluminum Compounds/therapeutic use , Apicoectomy/instrumentation , Calcium Compounds/therapeutic use , Cuspid/pathology , Cuspid/surgery , Drug Combinations , Dental Leakage/classification , Dentin/pathology , Fluorescent Dyes , Image Processing, Computer-Assisted , Oxides/therapeutic use , Retrograde Obturation/methods , Rhodamines , Root Canal Filling Materials/therapeutic use , Root Canal Preparation/instrumentation , Root Canal Preparation/methods , Silicates/therapeutic use , Ultrasonic Therapy/methods
15.
Rev. Clín. Ortod. Dent. Press ; 8(4): 48-53, ago.-set. 2009.
Article in Portuguese | LILACS, BBO | ID: lil-541943

ABSTRACT

Os caninos superiores apresentam um longo período de desenvolvimento intraósseo e um longo caminho de irrupção até a cavidade bucal. Eles são os últimos dentes a entrar no arco dentário e o seu extenso tempo de rizogênese aumenta a possibilidade de ocorrência de irrupção ectópica e impacção. A exposição cirúrgica associada a aparelhos ortodônticos para tracionamento, e/ou as extrações dentárias, são as principais formas de tratamento dos caninos impactados. Entretanto, as extrações devem ser limitadas aos casos de dentes anquilosados, com rebsorção radicular interna ou externa, alterações patológicas e caninos localizados de tal forma que sua movimetação comprometa os dentes adjacentes. Nos casos de supeita de anquilose apical e/ou dilaceração radicular apical, a cirurgia de apicotomia representa uma alternativa de tratamento. Nesse artigo são apresentados dois casos clínicos, em que a técnica de apicotomia foi realizada para viabilizar o tracionamento e o correto posicionamento dos caninos.


Subject(s)
Humans , Male , Female , Adult , Apicoectomy/methods , Cuspid/surgery , Tooth, Impacted/surgery , Tensile Strength
16.
Braz. j. oral sci ; 8(3): 141-144, July-Sept. 2009. ilus, tab
Article in English | LILACS, BBO | ID: lil-563322

ABSTRACT

Aim: This ex vivo study compared, under scanning electron microscopy (SEM), the marginal adaptation ofroot canal obturation with either ResilonTM or gutta-percha cones following root-end resection. Methods:Thirty human single-rooted teeth with fully formed apices were collected and decoronated. The root canalswere instrumented up to a size 45 taper .04 and obturated with laterally condensed gutta-percha (Group 1;n=15) or ResilonTM (Group 2; n=15). AH Plus sealer was used in both groups. After 48-h storage in saline, theapical 3 mm of each root were resected with a water-cooled high-speed plain fissure #170L carbide bur.Epoxy resin replicas of the resected root ends were examined by SEM. The total area of apical gap in eachreplica was measured using UTHSCSA ImageTool software. Data were analyzed statistically by the Mann-Whitney U-test (á=5%). Results: The mean area of apical gap in groups 1 and 2 was 0.0042 mm2 and 0.0015mm2, respectively, with no statistically significant difference (P = 0.83). Conclusions: The type of materialdid not influence at the apical adaptation of root canal obturation after apicoectomy, and the misfit may berelated to anatomic factors.


Subject(s)
Humans , Apicoectomy/methods , Dental Marginal Adaptation , Gutta-Percha/chemistry , Root Canal Filling Materials/chemistry , Root Canal Obturation/methods , Microscopy, Electron, Scanning , Acrylic Resins/chemistry , Data Interpretation, Statistical
17.
JBE, J. Bras. Endod ; 5(20): 361-365, mar.-jun.2005. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-851837

ABSTRACT

Avaliou-se a capacidade seladora de alguns materiais utilizados em obturações retrógradas, por meio da infiltração marginal de corante.Foram utilizados 34 incisivos centrais superiores humanos extraídos com raízes íntegras, cujos canais foram preparados biomecanicamente e obturados. Após 48 horas, realizou-se a apicectomia e confeccionou-se as cavidades retrógradas por meio de pontas ultra-sônicas. Após a impermeabilização das superficies externas das raízes, as mesmas foram divididas aleatoriamente em três grupos de 10, de acordo com os materiais retrobturadores, ou seja, o ProRoot-MTA, o MTA-Angelus e um cimento experimental (MBP-c). Após a retrobturação, as raízes foram imersas em solução aquosa de rhodamine B a 0,2 por cento por 48 horas. A impermeabilização externa foi removida e, então, realizou-se o desgaste longitudinal da face mesial radicular com disco de carburundum, expondo-se à retrobturação.


Subject(s)
Humans , Apicoectomy/methods , Dental Cements/chemistry , Dental Leakage/diagnosis , Root Canal Filling Materials , Retrograde Obturation/methods , In Vitro Techniques , Data Interpretation, Statistical , Statistics, Nonparametric
18.
Braz. oral res ; 23(1): 23-30, 2009. ilus
Article in English | LILACS | ID: lil-514638

ABSTRACT

This prospective clinical study aimed to evaluate the benefits of the endoscope as an aid to root-end management, and to assess the treatment outcome during 2 years following surgery. Forty-three endodontic surgical procedures in 30 patients were performed with the aid of an endoscope and followed for a period of 2 years. Radiographic criteria and clinical evaluation were used to assess the outcome. All cases were evaluated in terms of healing and functionality. 91.1% and 90.7% of the teeth evaluated after 1 and 2 years, respectively, were classified as successful. We found no statistically significant differences for both healing and functionality between the 1- and 2-year evaluations. No difference related to tooth type or tooth location was found at the 2-year follow-up. Fisher's exact test was used to statistically assess the difference between successful and unsuccessful cases for each of the variables considered. The endoscope can be an aid for endodontic surgical procedures in terms of both periapical healing and functionality up to 2 years follow-up.


Subject(s)
Adult , Female , Humans , Male , Apicoectomy/methods , Endoscopy , Microsurgery/methods , Wound Healing/physiology , Follow-Up Studies , Prospective Studies , Treatment Outcome
19.
Rev. odonto ciênc ; 22(56): 160-165, abr.-jun. 2007. ilus, tab
Article in Portuguese | LILACS, BBO | ID: lil-472484

ABSTRACT

A apicectomia com retrobturação apical é uma alternativa cirúrgica para tratamento de lesões apicais persistentes ou quando ocorre insucesso em terapia endodôntica convencional. Existe na literatura, um grande número de estudos sobre as técnicas para ressecções apicais, retrocavitações e materiais retrobturadores. Nesse estudo foram utilizados 10 dentes humanos unirradiculares tratados endodonticamente, apicetomizados, retrocavitados e retrobturados com um cimento de ionômero de vidro (Fuji Ortho LC®). O objetivo desse estudo foi verificar se o material testado preenchia as condições necessárias para ser utilizado como retrobturador. Os resultados revelaram que o Fuji ORTHO LC® é um material com propriedades suficientes para promover selamento adequado do conduto radicular quando usado em retrobturações apicais.


Subject(s)
Humans , Apicoectomy/methods , Glass Ionomer Cements/therapeutic use , Dental Leakage , Retrograde Obturation
20.
JBE j. bras. endodontia ; 5(20): 361-365, mar.-jun. 2005. ilus
Article in Portuguese | LILACS, BBO | ID: lil-521911

ABSTRACT

Avaliou-se a capacidade seladora de alguns materiais utilizados em obturações retrógradas, por meio da infiltração marginal de corante.Foram utilizados 34 incisivos centrais superiores humanos extraídos com raízes íntegras, cujos canais foram preparados biomecanicamente e obturados. Após 48 horas, realizou-se a apicectomia e confeccionou-se as cavidades retrógradas por meio de pontas ultra-sônicas. Após a impermeabilização das superficies externas das raízes, as mesmas foram divididas aleatoriamente em três grupos de 10, de acordo com os materiais retrobturadores, ou seja, o ProRoot-MTA, o MTA-Angelus e um cimento experimental (MBP-c). Após a retrobturação, as raízes foram imersas em solução aquosa de rhodamine B a 0,2% por 48 horas. A impermeabilização externa foi removida e, então, realizou-se o desgaste longitudinal da face mesial radicular com disco de carburundum, expondo-se à retrobturação.


Subject(s)
Humans , Apicoectomy/methods , Dental Cements/chemistry , In Vitro Techniques , Dental Leakage/diagnosis , Root Canal Filling Materials , Retrograde Obturation/methods , Data Interpretation, Statistical , Statistics, Nonparametric
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