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1.
Rev. cient. odontol ; 8(2): e015, mayo-ago. 2020. ilus, tab
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1118804

ABSTRACT

Objetivo: Comparar la resistencia de unión a la dentina del cemento sellador tipo Grossman (Grossdent) y Apexit Plus (Ivoclar Vivadent) después de la medicación intraconducto de hidróxido de calcio Ca(OH)2 con vehículos de paramonoclorofenol alcanforado (PMCFA) y de clorhexidina al 2% (CHX). Metodología: Estudio experimental in vitro. Se seleccionó una muestra de 44 dientes humanos monorradiculares y fueron divididos en 4 grupos con medicación intraconducto (n = 9) y 2 grupos control. Los dientes fueron desinfectados y los conductos radiculares instrumentados usando una técnica híbrida. Se medicaron dos grupos con hidróxido de calcio más PMCFA y dos grupos con hidróxido de calcio más CHX 2% durante dos semanas. De cada grupo con medicación uno fue obturado con cemento sellador endodóntico Grossman y el otro con Apexit Plus, mediante la técnica de compactación lateral. Los grupos control fueron obturados solo con los dos cementos anteriormente mencionados. Se cortaron las muestras en discos de 2 mm de espesor y fueron sometidas a prueba de empuje con una máquina de ensayo universal. Resultados: El valor de la media más alta lo obtuvo el grupo medicado con Ca(OH)2 más PMCFA y obturado con Apexit Plus (m 3,742 y DE 0,808), mientras que el valor más bajo lo presentó el grupo de Ca(OH)2 más PMCFA obturado con cemento Grossman (m 1,371 y DE 0,699), presentaron diferencias significativas (p < 0,001). Conclusión: La resistencia de unión a la dentina radicular se ve influenciada por la medicación intraconducto previa a la obturación endodóntica. (AU)


Objective: Compare the dentin bond strength of Grossman ́s sealer (Grossdent) and Apexit Plus sealer (IvoclarVivadent) after intra-canal medication of calcium hydroxide Ca(OH)2 associated with vehicles of camphorated parachlorophenol (CMPC) and chlorhexidine 2% (CHX). Methodology: This was an in vitro experimental study. A sample of 44 monoradicular human teeth were disinfected and divided into 4 groups of intra-canal medication (N= 9) and 2 control groups. The teeth were disinfected and root canals were instrumented using a hybrid technique. Two groups were medicated with Ca(OH)2 and CMPC and two groups with Ca(OH)2 and CHX 2% for two weeks. One group of each medication was filled with Grossman ́s sealer and the others with Apexit Plus sealer using the lateral compaction technique. The control groups were filled only with the two sealers mentioned previously. Samples were cut into 2 mm thick discs and placed on a push test with a universal testing machine. Results: The highest value of the means was obtained by the group medicated with Ca(OH)2 in association with CMPC and filled with Apexit Plus (m 3.742; SD 0.808), while the lowest value was presented by the group of Ca(OH)2 associated with CMPC, filled with Grossman ́s sealer (m 1,371; SD 0.699). Statistical differences were considered with p<0.001. Conclusion: Root dentin bond strength is influenced by intra-canal medication prior to endodontic filling. (AU)


Subject(s)
Humans , Pit and Fissure Sealants , Root Canal Therapy , Calcium Hydroxide/therapeutic use , Endodontics , Epidemiology, Experimental
2.
J. appl. oral sci ; 28: e20200217, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1134767

ABSTRACT

Abstract Objective Pulp revascularization is an effective treatment for immature necrotic teeth. Calcium hydroxide has been used in pulp revascularization as an intracanal medication due to its antimicrobial action and the non-exhibition of crown discoloration and cytotoxicity for stem cells from the apical papilla. Our study aimed to investigate the clinical success and quantitative radiographic changes of root development in immature traumatized teeth using calcium hydroxide plus 2% chlorhexidine gel as intracanal medication. Methodology In this retrospective study, 16 patients were treated with a standardized pulp revascularization protocol. Calcium hydroxide and 2% chlorhexidine gel were manipulated in a 1:1 (v/v) ratio and inserted into root canals with Lentulo spirals (Dentsply Maillefer, Baillaigues, Switzerland). Patients were followed up for a period from 9 to 36 months for the evaluation of clinical and radiological data. Radiographic measurements of root length, root width, apical diameter, and MTA placement from the apex were quantified using software ImageJ. Wilcoxon test and t-test were used, according to nonparametric or parametric data, respectively, for changes over time in root length, root width, and apical diameter. Results Fifteen teeth survived during the follow-up period (93.75%) and met the criteria for clinical success. Although the changes seem to be very small in many cases, significant increases in the average root length (14.28%, p<0.0001), root width (8.12%, p=0.0196), and decrease in apical diameter (48.37%, p=0.0007) were observed. MTA placement from the apex and age at the time of treatment was not significantly associated with the quantitative radiographic outcomes. Conclusions Pulp revascularization in traumatized immature teeth treated with calcium hydroxide plus 2% chlorhexidine gel as intracanal medication had high success and survival rates, showing periodontal healing and resolution of signs and symptoms. However, concerning the continued root development, the outcomes can still be considered unpredictable.


Subject(s)
Humans , Male , Female , Child , Adolescent , Root Canal Irrigants/therapeutic use , Calcium Hydroxide/therapeutic use , Chlorhexidine/therapeutic use , Dental Pulp/blood supply , Retrospective Studies , Treatment Outcome , Dental Pulp Necrosis/drug therapy , Tooth Apex
3.
Article in English | LILACS, BBO | ID: biblio-1135549

ABSTRACT

Abstract Objective: To examine the cytotoxicity of calcium hydroxide on human umbilical cord mesenchymal stem cells (HUCMSC) to understand the characteristics for use in regenerative dentistry procedures especially regenerative endodontics. Material and Methods: HUCMSC was isolated, cultured, and confirmed by flow cytometry. The biological characteristics, such as cell morphology, proliferation, and protein expression, were screened. To check the cytotoxicity, HUCMSC was cultured and divided into two groups, the control group (cultured in minimum essential medium (MEM) alpha) and calcium hydroxide group (cultured in MEM alpha and calcium hydroxide). Methyl-thiazole-tetrazolium (MTT) assay was done on different concentrations of calcium hydroxide (0.39 to 25 µg/mL) and the cells were observed and counted. One-way ANOVA test was used with a significance level set at 5%. Results: Flow cytometric analysis confirmed positive of CD73, CD90, CD105, negative of CD45 and CD34. A significant difference was found between the concentration of 6.25 and 3.125 µg/mL (p=0.004). There was no significant difference among 6.25, 12.5 and 25 µg/mL concentrations. There was also no significant difference among 0.39, 0.78, 1.56, and 3.125 µg/mL concentrations. Conclusion: Even though calcium hydroxide is a medicament of choice in clinical endodontics, it decreases the viability of HUCMSC. The lower the concentration of calcium hydroxide, the higher the viability of HUCMSC.


Subject(s)
Humans , Calcium Hydroxide/therapeutic use , Cell Survival , Stem Cell Research , Mesenchymal Stem Cells , Regenerative Endodontics , Umbilical Cord , Analysis of Variance , Indonesia/epidemiology
4.
Odontol. vital ; (30): 87-97, ene.-jun. 2019. graf
Article in Spanish | LILACS, SaludCR | ID: biblio-1091418

ABSTRACT

Resumen La revascularización amplía, hoy en día, el panorama de cómo recuperar un diente que se encuentra con un tercio de su formación radicular, producto de un evento de necrosis pulpar. El procedimiento indicado por la literatura implica una serie de pasos como el uso de pasta tri o biantibiótica o del hidróxido de calcio, para lograr mayor éxito en la técnica. Sin embargo, hay excepciones a la regla. Se describe un caso clínico, el cual incluyó una revascularización no planeada y a la cual, como consecuencia de los materiales utilizados, el diente respondió de excelente manera. Se modificaron las técnicas descritas en la literatura y se logró la formación radicular, demostrada a nivel radiográfico, aún en presencia de una fuerte infección, la cual se drenó por tejido extraoral, manifestando el alto grado de concentración bacteriana en la zona afectada. Como resultado, una vez más se muestra el potencial de regeneración, diferenciación y capacidad de respuesta de las células madre. El caso clínico tiene una evolución de 8 años.


Abstract Nowadays, revascularization gives us a wider panoramic in saving a tooth from pulp necrosis. The procedure involves a series of steps, including the use of antibiotic paste to increase the chance of success. However, some exceptions may apply to the rule. A clinical case is described, which -as a consequence of the use of specific materials- was transformed into a revascularization case. The revascularization technique was modified and a radicular formation was accomplished, as shown in the main X ray, even with a severe infection which was drained by extraoral tissue, demonstrating a higher level presence of bacteria in the affected area. As a result, this clinical case showed the potential of pulp regeneration and most importantly, the potential of stem cells and its differentiation and response capacity. The case has an evolution of eight years.


Subject(s)
Humans , Male , Child , Calcium Hydroxide/therapeutic use , Dental Pulp Cavity , Regenerative Endodontics , Regeneration , Molar/diagnostic imaging
5.
J. appl. oral sci ; 27: e20180030, 2019. tab, graf
Article in English | LILACS, BBO | ID: biblio-1002410

ABSTRACT

Abstract Objectives: To evaluate the effect of calcium hydroxide (CH) associated with two different vehicles as a capping material for pulp tissue in primary molars, compared with mineral trioxide aggregate (MTA). Methodology: Forty-five primary mandibular molars with dental caries were treated by conventional pulpotomy using one of the following materials: MTA only (MTA group), CH with saline (CH+saline group) and CH with polyethylene glycol (CH+PEG group) (15 teeth/group). Clinical and periapical radiographic examinations of the pulpotomized teeth were performed 3, 6, and 12 months after treatment. Data were tested by chi-squared analysis and a multiple comparison post-test. Results: The MTA group showed both clinical and radiographic treatment success in 14/14 teeth (100%), at all follow-up appointments. By clinical evaluation, no teeth in the CH+saline and CH+PEG groups had signs of mobility, fistula, swelling or inflammation of the surrounding gingival tissue. However, in the CH+saline group, radiographic analysis detected internal resorption in up to 9/15 teeth (67%), and inter-radicular bone resorption and furcation radiolucency in up to 5/15 teeth (36%), from 3 to 12 months of follow-up. In the CH+PEG group, 2/11 teeth (18%) had internal resorption and 1/11 teeth (9%) presented bone resorption and furcation radiolucency at all follow-up appointments. Conclusion: CH with PEG performed better than CH with saline as capping material for pulpotomy of primary teeth. However, both combinations yielded clinical and radiographic results inferior to those of MTA alone.


Subject(s)
Humans , Child, Preschool , Child , Oxides/therapeutic use , Pulpotomy/methods , Tooth, Deciduous/surgery , Calcium Hydroxide/therapeutic use , Silicates/therapeutic use , Calcium Compounds/therapeutic use , Aluminum Compounds/therapeutic use , Pulp Capping and Pulpectomy Agents/therapeutic use , Time Factors , Tooth, Deciduous/diagnostic imaging , Calcium Hydroxide/chemistry , Radiography, Dental , Prospective Studies , Follow-Up Studies , Treatment Outcome , Drug Combinations , Pulp Capping and Pulpectomy Agents/chemistry , Saline Solution/therapeutic use , Saline Solution/chemistry
6.
Braz. oral res. (Online) ; 33: e092, 2019. tab, graf
Article in English | LILACS | ID: biblio-1039296

ABSTRACT

Abstract This study evaluated the effect of antimicrobial photodynamic therapy (aPDT) on the endodontic treatment of apical periodontitis (AP). AP was induced in 48 premolars of 6 dogs. After biomechanical preparation, the teeth were divided into 4 groups: Calcium-Hydroxide (CH)/120d and CH/180d: root canals filled with CH-based dressing for 15 days before obturation; aPDT/120d and aPDT/180d: conditioning with phenothiazine photosensitizer (10 mg/mL) for 1 minute and irradiation with diode laser in the same session as obturation. Root filling was performed with AH Plus sealer. After the experimental periods, animals were euthanized and teeth were submitted for histology. HE staining was performed for descriptive analysis of the periapical region, measurement of apical periodontitis and for inflammatory cells, and blood vessels count. Immunohistochemistry was performed for osteopontin (OPN) and alkaline phosphatase (ALP). Data were analyzed statistically by two-way ANOVA and chi-square test (α = 5%). Teeth in Group CH/120d presented only a slightly enlarged periodontal ligament (PL) with advanced repair. Group aPDT/120d presented the PL moderately enlarged, with moderate inflammatory infiltrate and few collagen fibers. The same pattern was observed at 180 days. AP lesions in CH-treated groups were smaller than those in aPDT-treated groups (p < 0.001) with more blood vessels (p < 0.0001), regardless of the evaluation period, without significant differences in the number of inflammatory cells (p > 0.05). CH-treated groups showed significantly more intense immunostaining for ALP and OPN (p < 0.001) in both periods. Although aPDT stimulated angiogenesis and expression of bone formation markers, the two-session endodontic treatment with CH-based dressing promoted better apical periodontitis repair.


Subject(s)
Animals , Periapical Periodontitis/drug therapy , Photochemotherapy/methods , Root Canal Therapy/methods , Bone Cements/therapeutic use , Calcium Hydroxide/therapeutic use , Periapical Periodontitis/pathology , Time Factors , Bone Regeneration/drug effects , Immunohistochemistry , Reproducibility of Results , Treatment Outcome , Neovascularization, Physiologic/drug effects , Evaluation Study
7.
Braz. oral res. (Online) ; 33: e002, 2019. tab, graf
Article in English | LILACS | ID: biblio-989476

ABSTRACT

Abstract This study evaluated clinical and radiographic twelve-month outcomes of root canal treatments (CT) with smear layer removal, performed in primary teeth, using two different root canal filling materials. Pulpectomy was performed on 27 primary teeth with necrosis or irreversible pulpitis, caused by dental caries or trauma, in 23 children (2-7 years old). A single trained operator performed the CT in a single visit in cases without periapical or interradicular radiolucency (PIR) or in multiple visits in cases with PIR. Participants were selected based on specific inclusion and exclusion criteria, and randomly allocated into two groups: Group 1 (G1) - iodoform paste (iodoform + camphorated parachlorophenol + ointment comprising prednisolone acetate 5.0 mg and rifamycin 1.5 mg); Group 2 (G2) - Calen®/ZO paste. Treated teeth were restored with composite resin immediately after the root canal filling. The outcomes were evaluated clinically and radiographically according to specific criteria. Two blinded and standardized evaluators assessed the radiographic outcomes. We used descriptive analyses due to the small sample size. CTs were performed due to caries lesions in 70.4% of the cases and due to trauma in 29.6%. Only one tooth of G1 was unsuccessful; hence, pulpectomy performance in both groups was not influenced by the filling material, nor by any other analyzed variable. The level of the root canal filling was better in the Calen®/ZO group. The clinical and radiographic twelve-month outcomes indicated successful treatment, independently of the root filling material used.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Pulpectomy/methods , Root Canal Filling Materials/therapeutic use , Root Canal Therapy/methods , Zinc Oxide/therapeutic use , Calcium Hydroxide/therapeutic use , Hydrocarbons, Iodinated/therapeutic use , Ointments , Pulpitis/therapy , Pulpitis/diagnostic imaging , Tooth, Deciduous , Radiography, Dental , Reproducibility of Results , Treatment Outcome , Smear Layer/surgery , Tooth Injuries/therapy , Tooth Injuries/diagnostic imaging , Dental Caries/therapy , Dental Caries/diagnostic imaging
8.
Dent. press endod ; 8(1): 17-22, Apr-Jun. 2018. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-883674

ABSTRACT

Introdução: o tratamento de dentes jovens traumatizados requer atenção especial, devido à possível presença de ápice incompleto e paredes dentinárias delgadas, o que pode dificultar ou comprometer o tratamento endodôntico convencional. Faz-se necessária a realização de um procedimento para induzir a formação de uma barreira mineralizada, com o auxílio de materiais biocompatíveis, como o hidróxido de cálcio e o agregado trióxido mineral (MTA). Objetivo: relatar um caso clínico em que foi realizada apicificação, com tampão de MTA, em um incisivo lateral superior traumatizado. Conclusão: o uso de MTA como material obturador de dentes com ápice incompleto mostrou- se eficiente, pois permitiu resolução do caso com sucesso e a manutenção do dente na arcada, exercendo suas funções primárias quanto à estética e à mastigação.


Subject(s)
Humans , Female , Adult , Apexification/methods , Biocompatible Materials , Calcium Hydroxide/therapeutic use , Dental Pulp Capping , Root Canal Filling Materials
9.
Braz. oral res. (Online) ; 32(supl.1): e73, 2018.
Article in English | LILACS | ID: biblio-974476

ABSTRACT

Abstract: Root perforation results in the communication between root canal walls and periodontal space (external tooth surface). It is commonly caused by an operative procedural accident or pathological alteration (such as extensive dental caries, and external or internal inflammatory root resorption). Different factors may predispose to this communication, such as the presence of pulp stones, calcification, resorptions, tooth malposition (unusual inclination in the arch, tipping or rotation), an extra-coronal restoration or intracanal posts. The diagnosis of dental pulp and/or periapical tissue previous to root perforation is an important predictor of prognosis (including such issues as clinically healthy pulp, inflamed or infected pulp, primary or secondary infection, and presence or absence of intracanal post). Clinical and imaging exams are necessary to identify root perforation. Cone-beam computed tomography constitutes an important resource for the diagnosis and prognosis of this clinical condition. Clinical factors influencing the prognosis and healing of root perforations include its treatment timeline, extent and location. A small root perforation, sealed immediately and apical to the crest bone and epithelial attachment, presents with a better prognosis. The three most widely recommended materials to seal root perforations have been calcium hydroxide, mineral trioxide aggregate and calcium silicate cements. This review aimed to discuss contemporary therapeutic alternatives to treat root canal perforations. Accordingly, the essential aspects for repairing this deleterious tissue injury will be addressed, including its diagnosis, prognosis, and a discussion about the materials actually suggested to seal root canal perforation.


Subject(s)
Humans , Root Canal Filling Materials/therapeutic use , Dental Pulp Cavity/injuries , Dental Pulp Cavity/diagnostic imaging , Dental Pulp Diseases/therapy , Dental Pulp Diseases/diagnostic imaging , Oxides , Prognosis , Calcium Hydroxide/therapeutic use , Silicates/adverse effects , Calcium Compounds/therapeutic use , Aluminum Compounds/therapeutic use , Root Canal Preparation/adverse effects , Drug Combinations
10.
J. appl. oral sci ; 25(5): 465-476, Sept.-Oct. 2017. graf
Article in English | LILACS, BBO | ID: biblio-893653

ABSTRACT

Abstract Tissue repair is an essential process that reestablishes tissue integrity and regular function. Nevertheless, different therapeutic factors and clinical conditions may interfere in this process of periapical healing. This review aims to discuss the important therapeutic factors associated with the clinical protocol used during root canal treatment and to highlight the systemic conditions associated with the periapical healing process of endodontically treated teeth. The antibacterial strategies indicated in the conventional treatment of an inflamed and infected pulp and the modulation of the host's immune response may assist in tissue repair, if wound healing has been hindered by infection. Systemic conditions, such as diabetes mellitus and hypertension, can also inhibit wound healing. The success of root canal treatment is affected by the correct choice of clinical protocol. These factors are dependent on the sanitization process (instrumentation, irrigant solution, irrigating strategies, and intracanal dressing), the apical limit of the root canal preparation and obturation, and the quality of the sealer. The challenges affecting the healing process of endodontically treated teeth include control of the inflammation of pulp or infectious processes and simultaneous neutralization of unpredictable provocations to the periapical tissue. Along with these factors, one must understand the local and general clinical conditions (systemic health of the patient) that affect the outcome of root canal treatment prediction.


Subject(s)
Humans , Periapical Tissue/physiopathology , Root Canal Therapy/methods , Wound Healing/physiology , Tooth, Nonvital/physiopathology , Tooth, Nonvital/therapy , Periapical Periodontitis/therapy , Root Canal Filling Materials/therapeutic use , Root Canal Irrigants/therapeutic use , Bone Cements/therapeutic use , Calcium Hydroxide/therapeutic use , Treatment Outcome
11.
Rev. Salusvita (Online) ; 36(1): 99-121, 2017. ilus
Article in Portuguese | LILACS | ID: biblio-876190

ABSTRACT

Introdução: atualmente os produtos à base de hidróxido de cálcio são amplamente utilizados e difundidos na odontologia em várias situações clínicas, desde capeador em exposição pulpar à pulpotomias, em virtude de suas propriedades físicas, mecânicas, do baixo custo e de seu próprio mecanismo de ação, representando assim, o material mais próximo do ideal. Objetivo: descrever os conceitos, os fundamentos e a aplicação clínica do Hidróxido de Cálcio e do MTA, por meio de uma revisão da literatura. Material e Métodos: foi realizada uma revisão da literatura, por meio de busca bibliográfica nas seguintes bases de pesquisa online: Lilacs, Scielo, PubMED/Medline e Bireme, com uso dos descritores: hidróxido de cálcio (calcium hydroxide); hidróxido de cálcio e MTA (calcium hydroxide and MTA) e MTA, rastreando artigos relevantes publicados entre o período de 2010 a 2015. Resultados e Discussão: materiais a base de hidróxido de cálcio, são biocompatíveis e apresentam propriedades antimicrobianas, anti-inflamatórias, estimulantes da formação de dentina esclerosada, de tecido ósseo mineralizado além de proteger a polpa contra estímulos termoelétricos e tóxicos, provenientes de alguns materiais restauradores, mantendo assim, a integridade pulpar. São amplamente utilizados para: proteção pulpar, pulpotomias, cimentação protética, forramento cavitário, apicificação e em casos de reabsorção radicular. As formas de apresentação desses materiais pode ser produtos na forma de pó, ou na forma de pastas, autoativadas ou fotoativadas. O Agregado Trióxido Mineral (MTA) apresenta muitas propriedades coincidentes com o hidróxido de cálcio, mas uma das suas principais desvantagens é seu alto custo, o que inviabiliza o rotineiro na clínica, esse material é apresentado na forma de pó e líquido, o qual é composto apenas por água destilada. Conclusão: Diante das várias opções de produtos presentes no mercado, recomenda-se ao profissional a escolha do melhor material para cada caso, incluindo seguir protocolos adequados durante a aplicação dos materiais para alcançar resultados clínicos satisfatórios.


Introduction: products of calcium hydroxide are largely used in a variety of dental clinical condition due to its physical and mechanical properties and its low cost as well as its rationelle. In this contexto, it representes a material close to the ideal. Objective: to describe the concepts, fundamentals and clinical application of Calcium Hydroxide and MTA, through a review of the literature. Materials and Methods: a review of the literature was carried out by means of bibliographic search in the following online databases: Lilacs, Scielo, PubMED/Medline and Bireme, using the descriptors: calcium hydroxide; Calcium hydroxide and MTA, and MTA, tracking relevant articles published between the period 2010-2015. Results and Discussion: materials based on calcium hydroxide, are biocompatible and exhibit antimicrobial, anti-inflammatory, stimulating properties of the formation of sclerosed dentin, of mineralized bone tissue, besides protecting the pulp against thermoelectric and toxic stimuli from some restorative materials, thus maintaining pulp integrity. They are widely used for: pulp protection, pulpotomies, prosthetic cementation, cavity lining, apicification and in cases of root resorption. The forms of presentation of such materials may be products in the form of powder, or in the form of pastes, either self-activating or photoactivated. The Mineral Trioxide Aggregate (MTA) has many properties that coincide with calcium hydroxide, but one of its main disadvantages is its high cost, which makes the routine in the clinic unfeasible. This material is presented in the form of powder and liquid, which is Composed only of distilled water. Conclusion: in view of the various product options present in the market, the professional is advised to choose the best material for each case, including following appropriate protocols during the application of the materials to achieve satisfactory clinical results.


Subject(s)
Calcium Hydroxide/therapeutic use , Calcium Hydroxide/pharmacology , Endodontics/instrumentation , Biocompatible Materials , Review Literature as Topic , Dental Cements/analysis , Dental Pulp Capping
12.
Claves odontol ; 23(75): 65-79, 2017. ilus
Article in Spanish | LILACS | ID: biblio-972620

ABSTRACT

Los quistes son cavidades patológicas que adquieren importancia en el ámbito odontológico debido a la gran frecuencia en la que se encuentran en los maxilares y por el rol que el odontólogo presenta en su detección. Dentro de las lesiones tipo quísticas, mencionamos al quiste apical en bolsa donde existe una comunicación entre este y el conducto radicular, cuya curación puede lograrse a través de la terapia endodóntica. En el presente caso clínico se demostró cómo la pasta de hidróxido de calcio colocada en forma temporaria y en sucesivas sesiones en el interior de los conductos de los cuatro incisivos inferiores afectados por un gran proceso quístico, permitió la resolución paulatina hasta la erradicación completa del mismo. Se realizaron sucesivos controles clínicos y radiográficos mediante Rx periapicales, ortopantomografías y tomografías Cone Beam; dichos controles indicaron el momento oportuno de repetir el procedimiento de acuerdo a los resultados obtenidos en la disminución de las dimensiones del proceso quístico, optando por la terapia endodóntica definitiva a los 9 meses. Se destaca la eficacia de este tratamiento conservador, mínimamente invasivo, ante la presencia de ungran proceso quístico, con la finalidad de evitar las técnicas quirúrgicas, en pacientes comprometidos a las citas periódicas necesarias para lograr su erradicación.


The cysts are pathological cavities that acquire importance in the dental field due to the great frequency in which they are found in the jaws and the role that the dentist presents in their detection. Withincysts lesions cyst dental root in pocket can be mentioned, where there is a communication between itand the root canal, whose cure can be achieved through root canal therapy or endodontic therapy. In the present clinical case it was demonstrated how the calcium hydroxide paste placed temporarily andin successive sessions inside root canal of the four lower incisors affected by a large cystic process,allowed the gradual resolution until the complete eradication of it. Successive clinical and radiographic controls were carried out using periapical radiographs, orthopantomographies and Cone Beamtomography, these controls indicated the opportune moment to repeat the procedure according to theresults obtained in the reduction of the dimensions of the cystic process, opting for definitive endodontic therapy at nine months. The effectiveness of this conservative treatment is minimally invasive in the presence of a large cystic process, in order to avoid surgical techniques in patients committed to necessary periodic appointments to achieve eradication.


Subject(s)
Female , Humans , Adult , Jaw Cysts/therapy , Root Canal Therapy/methods , Calcium Hydroxide/therapeutic use , Radicular Cyst/therapy , Conservative Treatment , Radiography, Panoramic/methods , Cone-Beam Computed Tomography , Follow-Up Studies , Treatment Outcome
13.
Braz. oral res. (Online) ; 31: e101, 2017. tab, graf
Article in English | LILACS | ID: biblio-952124

ABSTRACT

Abstract: This study aimed to systematically review the literature to address the question regarding the influence of different materials in the clinical and radiographic success of indirect pulp treatment in primary teeth. A literature search was carried out for articles published prior to January 2017 in PubMed/MEDLINE, CENTRAL, Scopus, TRIP and ClinicalTrials databases; relevant articles included randomized clinical trials that compared materials used for indirect pulp treatment in primary teeth. Two reviewers independently selected the studies and extracted the data. The effects of each material on the outcome (clinical and radiographic failures) were analyzed using a mixed treatment comparisons meta-analysis. The ranking of treatments according to their probability of being the best choice was also calculated. From 1,088 potentially eligible studies, 11 were selected for full-text analysis, and 4 were included in the meta-analysis. In all papers, calcium hydroxide liner was used as the control group versus an adhesive system, resin-modified glass ionomer cement or placebo. The follow-up period ranged from 24 to 48 months, with dropout rates of 0-25.7%. The material type did not significantly affect the risk of failure of the indirect pulp treatment. However, calcium hydroxide presented a higher probability of failure. In conclusion, there is no scientific evidence showing the superiority of any material used for indirect pulp treatment in primary teeth.


Subject(s)
Humans , Tooth, Deciduous/drug effects , Calcium Hydroxide/therapeutic use , Dental Pulp/drug effects , Dental Pulp Capping/methods , Glass Ionomer Cements/therapeutic use , Gutta-Percha/therapeutic use , Tooth, Deciduous/diagnostic imaging , Radiography, Dental , Treatment Outcome , Publication Bias , Dental Caries/therapy
14.
Dent. press endod ; 6(1): 32-37, jan.-abr. 2016. ilus
Article in Portuguese | LILACS | ID: lil-786770

ABSTRACT

Introdução: o objetivo do presente trabalho é apresentar um método alternativo para inserção da pasta de hidróxido de cálcio na medicação intracanal, após o preparo químico-mecânico do sistema de canais radiculares. Métodos: a técnica consistiu no uso de seringas de plástico descartáveis de 1,2 mL (Ultradent) e pontas para irrigação/ aspiração (Capillary Tips - Ultradent). Para controle da profundidade do material a ser inserido, utilizou-se um stop de silicone na ponta da Capillary Tips, no comprimento de trabalho do canal radicular, previamente instrumentado. Em seguida, a lubrificação da seringa plástica e da ponta foi realizada com propilenoglicol. A manipulação do hidróxido de cálcio PA com propilenoglicol foi realizada utilizando-se uma espátula #24 sobre uma placa de vidro, até obter uma pasta de consistência fluída e homogênea. Para inserção da pasta de Ca(OH)2 dentro da seringa, utilizou-se a espátula de manipulação. Imediatamente após, a medicação intracanal pôde ser levada aos canais radiculares. Conclusão: a técnica de inserção de hidróxido de cálcio nos sistemas radiculares proposta apresentou resultados satisfatórios, previsibilidade clínica e facilidade na preparação.


Subject(s)
Endodontics , Calcium Hydroxide/therapeutic use , Propylene Glycol/therapeutic use , Root Canal Therapy
15.
Rev. Asoc. Odontol. Argent ; 104(1): 38-41, mar. 2016. ilus
Article in Spanish | LILACS | ID: lil-789833

ABSTRACT

Objetivo: diagnosticar y tratar la presencia de una fístula cutánea. Caso clínico: un paciente de sexo masculino, de 9 años de edad, consultó por una lesión cutánea en la zona mandibular del lado izquierdo. Concusiones: una fístula cutánea requiere un diagnóstico diferencial preciso, a fin de determinar su etiología y planificar el procedimiento endodóntico correcto. Como consecuencia de una mortificación pulpar, la presencia de bacterias dentro del conducto radicular puede generar una periodontitis perirradicular crónica de origen endodóntico.


Subject(s)
Humans , Male , Child , Periapical Diseases/complications , Cutaneous Fistula/diagnosis , Cutaneous Fistula/therapy , Diagnosis, Differential , Drainage , Cutaneous Fistula/microbiology , Calcium Hydroxide/therapeutic use , Root Canal Therapy
16.
Braz. oral res. (Online) ; 30(1): e93, 2016. graf
Article in English | LILACS | ID: biblio-952019

ABSTRACT

Abstract The aim of the present study was to evaluate the expression of transforming growth factor-β1 (TGF-β1) and osteonectin (ON) in pulp-like tissues developed by tissue engineering and to compare it with the expression of these proteins in pulps treated with Ca(OH)2 therapy. Tooth slices were obtained from non-carious human third molars under sterile procedures. The residual periodontal and pulp soft tissues were removed. Empty pulp spaces of the tooth slice were filled with sodium chloride particles (250-425 µm). PLLA solubilized in 5% chloroform was applied over the salt particles. The tooth slice/scaffold (TS/S) set was stored overnight and then rinsed thoroughly to wash out the salt. Scaffolds were previously sterilized with ethanol (100-70°) and washed with phosphate-buffered saline (PBS). TS/S was treated with 10% EDTA and seeded with dental pulp stem cells (DPSC). Then, TS/S was implanted into the dorsum of immunodeficient mice for 28 days. Human third molars previously treated with Ca(OH)2 for 90 days were also evaluated. Samples were prepared and submitted to histological and immunohistochemical (with anti-TGF-β1, 1:100 and anti-ON, 1:350) analyses. After 28 days, TS/S showed morphological characteristics similar to those observed in dental pulp treated with Ca(OH)2. Ca(OH)2-treated pulps showed the usual repaired pulp characteristics. In TS/S, newly formed tissues and pre-dentin was colored, which elucidated the expression of TGF-β1 and ON. Immunohistochemistry staining of Ca(OH)2-treated pulps showed the same expression patterns. The extracellular matrix displayed a fibrillar pattern under both conditions. Regenerative events in the pulp seem to follow a similar pattern of TGF-β1 and ON expression as the repair processes.


Subject(s)
Humans , Animals , Mice , Stem Cells/drug effects , Calcium Hydroxide/pharmacology , Osteonectin/analysis , Dental Pulp/drug effects , Transforming Growth Factor beta1/analysis , Time Factors , Calcium Hydroxide/therapeutic use , Immunohistochemistry , Osteonectin/drug effects , Cells, Cultured , Reproducibility of Results , Tissue Engineering/methods , Dental Pulp/cytology , Dentin/drug effects , Guided Tissue Regeneration/methods , Extracellular Matrix/drug effects , Transforming Growth Factor beta1/drug effects , Tissue Scaffolds , Odontoblasts/drug effects
17.
Odontol. pediatr. (Lima) ; 14(2): 150-157, jul.-dic.2015. ilus
Article in Spanish | LIPECS, LILACS, LIPECS | ID: lil-790539

ABSTRACT

Cuando una necrosis pulpar se instala en dientes jóvenes que aún no han completado el cierre apical o no han terminado el desarrollo radicular, la apexificacion es el tratamiento indicado, el cual induce la formación de una barrera calcificada que oblitere el orificio apical 0 que permita el desarrollo radicular completo. La mezcla del hidróxido de calcio Ca(OH)2 con suero fisiológico es la forma más deseable y sencilla de inducir la apexificacion con pronóstico exitoso. El caso clínico que se presenta es un paciente masculino de 10 años de edad, al cual se diagnostica necrosis pulpar en O.D.36, radiográficamente con zona radiohicida en ápices y furca, retracción pulpar y falta de cierre apical al cual se realiza el tratamiento de apexificacion con hidroxido de calcio, mostrando en el control radiográfico disminución de la lesión en furca y ápices, lográndose el cierre apical permitiendo el tratamiento de endodoncia con gutapercha y finalmente la rehabilitación con corona de acero cromo...


When a pulp necrosis it's established in young teeth that have not developed an apical seal or the incomplete development of the root, an apexitication is the election treatment, because it inducts the formation of a calcified barrier that obliterates the apical foramen or allows the complete radicular development. The mixture of Calcium Hydroxide with physiological serum is the most simple technique of inducting apexification. The case report presents a 10 year old male, with necrotic pulp in O.D 36, in the x-ray can be observed radiolucent zone in apex and furcation, pulp retraction and lack of apical seal; in this teeth apexification was performed with calcium hydroxide, and it shows a correct evolution in decrasing of lesion in furcation and seal in apex; that permits the obturation or radicular system and finally the rehabilitation with a steel crown...


Subject(s)
Humans , Male , Child , Apexification , Calcium Hydroxide/therapeutic use , Dental Pulp Necrosis/therapy
18.
Bol. Asoc. Argent. Odontol. Niños ; 44(1): 16-32, abr.-ago. 2015.
Article in Spanish | LILACS | ID: lil-776097

ABSTRACT

El mantenimiento de las piezas dentarias para desempeñar sus funciones en la alimentación, en la expresión oral, en el mantenimiento de espacios en las arcadas dentarias, en el estímulo para el crecimiento y desarrollo de los maxilares, entre otras acciones, ha sido considerado esencial para el logro de un desarrollo armónico. Por otro lado, y a pesar de los avances en la materia, la caries dental es la causa más frecuente de las patologías pulpares en los dientes primarios y constituye el principal motivo de su deterioro y/o su pérdida. Las características histo-patológicas de la pulpa dental, la brevedad de su ciclo vital, el tamaño relativo de las cámaras pulpares, favorecen el rápido compromiso pulpar y propician que el proceso infeccioso progrese rápidamente a la necrosis. Ello ha determinado y determina el desarrollo de numerosas técnicas y tratamientos, diferentes ofertas terapéuticas de las cuales ninguna ha alcanzado el consenso universal. Como establecen las Guías de Odontología Pediátrica sobre tratamientos pulpares en dientes primarios, la literatura dental en esta área ofrece escasa y pobre evidencia para sustentar las diferentes técnicas y constantemente señalan la necesidad de nuevos y rigurosos estudios que la avalen.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Tooth, Deciduous/pathology , Dental Pulp Diseases/therapy , Dental Pulp/anatomy & histology , Pulpectomy/methods , Pulpotomy/methods , Tooth, Deciduous/anatomy & histology , Tooth, Deciduous , Dental Pulp Exposure/therapy , Formocresols/therapeutic use , Calcium Hydroxide/therapeutic use , Root Canal Filling Materials/classification , Dental Pulp Necrosis/therapy , Practice Guideline , Dental Pulp Capping/methods , Pulpitis/therapy
19.
Dent. press endod ; 5(1): 68-72, jan.-abr. 2015. ilus
Article in Portuguese | LILACS | ID: lil-764831

ABSTRACT

Introdução: atualmente, o traumatismo dentário tem elevado bastante a necessidade de tratamento endodôntico em dentes com rizogenese incompleta e necrose pulpar. O tratamento desses dentes e um desafio para os endodontistas, pois apresentam características anatômicas e particularidades que dificultam os procedimentos necessários. Objetivo: o presente artigo descreve um caso clinico de tratamento de canal radicular, em um paciente jovem com o incisivo central superior esquerdo permanente apresentando rizogenese incompleta e necrose da polpa dentaria. Métodos: na primeira consulta, foi realizado exame clinico, radiografia periapical, abertura coronária, penetração desinfetante e odontometria. Após o esvaziamento do canal radicular, foi utilizada pasta de hidróxido de cálcio, paramonoclorofenol canforado e glicerina (HPG) como medicação intracanal, com o objetivo de fazer a desinfecção do canal radicular. Na segunda consulta, foi realizada a obturação do canal radicular utilizando-se a técnica imediata, quando foi introduzido o agregado trióxido mineral (MTA), para formação de um tampão apical e para promover um selamento apical adequado. Conclusão: após a radiografia final, constatou-se a completa obturação do canal radicular.


Subject(s)
Apexification , Dental Pulp Necrosis , Endodontics , Calcium Hydroxide/therapeutic use , Root Canal Obturation/methods , Root Canal Filling Materials , Root Canal Therapy , Tooth Root/abnormalities
20.
Rio de janeiro; s.n; 2015. 56 p. ilus.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1015204

ABSTRACT

O protocolo atual para o tratamento das reabsorções inflamatórias externas radiculares utiliza o hidróxido de cálcio como agente de desinfecção, como curativo de demora, em várias trocas sucessivas e por longo período de tempo. Além da necessidade de várias consultas para a substituição do hidróxido de cálcio, a sua permanência nos canais por longo período de tempo, provoca o enfraquecimento das estruturas dentárias. Portanto, modificação desta terapia seria aconselhável. Nesta investigação clínica, três pacientes portadores de reabsorção inflamatória externa radicular foram tratados com a terapia de revascularização, usualmente utilizada em dentes com necrose pulpar e ápices abertos. Os dentes foram tratados com o protocolo da terapia de revascularização que consiste na desinfecção do sistema de canais radiculares com pasta tri-antibiótica, com posterior preenchimento do canal com coagulo sanguíneo e selamento do canal com agregado trióxido mineral e resina adesiva. Foi observado durante a proservação a paralização do processo patológico com neoformação tecidual nas áreas radiolúcidas preexistentes. Foi detectada a redução da mobilidade dos elementos dentários tratados. Os três casos foram acompanhados por 30, 18 e 15 meses, respectivamente. Todos os elementos dentários permaneceram assintomáticos, mantidos com função e mobilidade fisiológica. A terapia utilizada no procedimento de revascularização mostrou-se eficiente no tratamento da reabsorção inflamatória externa radicular, reduzindo o número de consultas e aumentando a adesão dos pacientes.


The current external inflammatory root resorption treatment protocol, which uses calcium hydroxide dressing, usually comprises multiple and long-term applications. In addition to the need for multiple appointments for calcium hydroxide replacement, the long-term maintenance of this compound in the root canal weakens dental structures. A modification of this therapy would be advisable. In this clinical investigation, three patients with external inflammatory root resorption were submitted to revascularization therapy protocol usually used in teeth with necrotic pulp and open apices. The teeth were treated with revascularization therapy protocol, which consisted of disinfecting the root canal system with tri-antibiotic paste, filling it with blood clot, and sealing of the root canal with mineral trioxide aggregate and bonded resin restoration. During the follow up, the pathological process was arrested with tissue repair in preexisting radiolucent areas. Reduced mobility was observed in the treated teeth. The three cases were followed up for 30, 18, and 15 months, respectively. All teeth remained asymptomatic and retained function and physiological mobility. The therapy used in the revascularization procedure was efficient in the treatment of external inflammatory root resorption, reducing the number of appointments and increasing patient compliance.


Subject(s)
Humans , Male , Child , Root Resorption/therapy , Tooth Injuries , Drug Combinations , Glass Ionomer Cements/therapeutic use , Anti-Bacterial Agents/therapeutic use , Oxides/therapeutic use , Calcium Hydroxide/therapeutic use , Treatment Outcome , Silicates/therapeutic use , Calcium Compounds/therapeutic use , Aluminum Compounds/therapeutic use
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