ABSTRACT
É sabido que a cavidade oral é a porta de entrada para muitos microrganismos e que possui alguns gêneros de bactérias que quando se associam ou proliferam em excesso, com a falta de higienização correta, fatores ambientais e imunológicos podem causar danos em algumas partes dos dentes como no tecido pulpar e canais radiculares. Neste sentido, a endodontia tem sido capaz de tratar pessoas com problemas dentários em fases muito precoces como as medidas profiláticas até casos infeciosos que afetam a polpa dos dentes causando as lesões perirradiculares que são infecções causadas por microrganismos, Para tanto, é necessário que a odontologia ofereça transformações positivas por meio de técnicas que sejam mais previsíveis para os tratamentos. A literatura tem indicado o uso da laserterapia como técnica auxiliar para o tratamento endodôntico pelo seu potencial mínimo invasivo, preciso e eficaz em menor tempo de cura de patologias orais como as lesões perirradiculares. Este estudo pretendeu abordar a importância da laserterapia sobre as variáveis patológicas de pacientes com lesão perirradiculares. Para realiza-lo foi necessário buscar na literatura estudos que associem este tipo de tratamento e sua eficiência no tratamento desta patologia. Para realizar esta pesquisa foi necessário buscar dados na literatura que tratam sobre o tema para investigar o tempo indicado ao tratamento com a laserterapia bem como o estágio em que as lesões podem ser tratadas com auxílio deste método. Corroborando com o estudo apresentamos um caso clínico(AU)
It is known that the oral cavity is the gateway to many microorganisms and that it has some genera of bacteria that when they associate or proliferate in excess, with the lack of correct hygiene, environmental and immunological factors can cause damage in some parts of the teeth such as in pulp tissue and root canals. In this sense, endodontics has been able to treat people with dental problems at very early stages such as prophylactic measures to infectious cases that affect the pulp of teeth causing perirradicular lesions that are infections caused by microorganisms, therefore, it is necessary that dentistry offer positive transformations through techniques that are more predictable for treatments. The literature has indicated the use of laser therapy as an auxiliary technique for endodontic treatment for its minimal invasive, precise and effective potential in shorter time of cure of oral pathologies such as perirradicular lesions. This study aimed to address the importance of laser therapy on the pathological variables of patients with perirradicular lesions. To accomplish this, it was necessary to seek studies in the literature that associate this type of treatment and its efficiency in the treatment of this pathology. To carry out this research it was necessary to seek data in the literature that deal with the subject to investigate the time indicated for treatment with laser therapy as well as the stage at which lesions can be treated with the aid of this method. Corroborating the study, we present a clinical case(AU)
Subject(s)
Humans , Female , Middle Aged , Root Canal Therapy , Laser Therapy , Root Canal Filling Materials , Root Canal Preparation , Dental Pulp Cavity/injuries , Dental Pulp Diseases , Microbiota , Mouth/microbiologyABSTRACT
Introducción: Es un error común pensar que los dientes anteroinferiores, por lo general, tienen un solo conducto radicular con una sola raíz. Sin embargo, un estudio realizado por Vertucci et. al., (1974), mostraron una alta prevalencia (13%) de dos conductos radiculares en los dientes anteroinferiores, lo que estimuló más investigaciones. Objetivo: El propósito de este estudio fue determinar la prevalencia del segundo conducto radicular en los dientes anteroinferiores en una población nicaragüense, estos fueron detectados por medio de tomografía computadorizada (Cone Beam). Materiales y Métodos: En el estudio se analizaron 293 piezas dentales, de canino a canino de la arcada inferior. Para realizar el análisis se utilizó el software libre Radiant DICOM Viewer 2021.2.2, se realizaron cortes sagitales, axiales y coronales para ver la prevalencia del segundo conducto radicular. Resultados: De las 293 piezas dentarias analizadas se encontró que 259 presentaban un solo conducto que correspondía al 88.4% y 34 dientes presentaban dos conductos que correspondían al 11.6%. De acuerdo con el análisis tomográfico, se encontró que en los cortes axiales y sagitales fue donde se observó la presencia del segundo conducto. Con respecto a la presencia del segundo conducto de acuerdo al tercio del canal radicular se identificó que la mayoría se presentó en el tercio medio (52.94%), seguido por coronal (29.41%) y por último el tercio apical (17.65%). De acuerdo con la clasificación de Vertucci se encontró que se presenta un mayor porcentaje del tipo I con 88.40%, seguido por el tipo III con 4.44%, después el tipo V con 3.41%, y el tipo II con 2.39%. El de menor porcentaje fue el tipo VI con 1.37%, mientras que, en las piezas analizadas, no se encontraron los tipos IV, VII y VIII. Conclusión: Basados en los resultados obtenidos en este estudio, la prevalencia de un segundo conducto en dientes anteroinferiores fue de 11.6%.
Title The prevalence of a second root canal in mandibular anterior teeth using Cone Beam Computed Tomography. Abstract Introduction: It is a common misconception that the mandibular anterior teeth usually have a single root canal with a single root. However, a study by Vertucci et. al., (1974), showed a high prevalence (13%) of two root canals in the lower anterior teeth, which stimulated further investigations. Objective: The purpose of this study was to determine the prevalence of the second root canal in the mandibular anterior teeth in a Nicaraguan population, these were detected by means of computed tomography (Cone Beam). Materials and methods: In the study, 293 teeth were analyzed, from canine to canine of the mandibular teeth. To perform the analysis, the free software Radiant DICOM Viewer 2021.2.2 was used, sagittal, axial and coronal views were made to see the prevalence of the second root canal. Results: Of the 293 teeth analyzed, it was found that 259 had a single root canal corresponding to 88.4%, and 34 teeth had two root canals corresponding to 11.6%. According to the tomographic analysis, it was found that the presence of the second root canal was observed only in the axial and sagittal views. Regarding the presence of the second canal according to the third of the root canal, it was identified that the majority presented in the middle third (52.94%), followed by coronal (29.41%) and finally the apical third (17.65%). According to the Vertucci classification, it was found that there is a higher percentage of type I with 88.40%, followed by type III with 4.44%, then type V with 3.41%, and type II with 2.39%. The one with the lowest percentage was type VI with 1.37%, while in the pieces analyzed, types IV, VII and VIII were not found. Conclusion: Based on the results obtained in this study, the prevalence of a second root canal in lower anterior teeth was 11.6%.
Subject(s)
Animals , Cuspid/anatomy & histology , Dental Pulp Cavity/anatomy & histology , Cone-Beam Computed Tomography , NicaraguaABSTRACT
Abstract To investigate the root canal anatomy of permanent maxillary and mandibular canines in a Turkish subpopulation using cone beam computed tomography (CBCT). Retrospective CBCT data of 300 patients admitted to our clinic between 2016 and 2018 were screened and evaluated. A total of 235 patients, 100 males and 135 females, aged 14-76 years (mean age 37.27±13.40) were included in this study. A total of 191 (44,8%) maxillary canine teeth and 235 (55,2%) mandibular canine teeth were examined. The number of roots and root canal morphology according to Vertucci's classification, the presence of accessory canals, and the position of the apical foramen of the root were analyzed. The effect of gender and age on the incidence of root canal morphology was also investigated. The majority of the teeth had a Type I canal configuration in both maxillary canines (100%) and mandibular canines (92,8%). In the mandibular canines the other canal patterns found were Type III (6,8%), and Type II (0,4%). Apical foramen was centrally positioned in the majority of the teeth, 70,2% and 66,8% in maxillary and mandibular canines, respectively. The occurrence of two roots in mandibular canines was 3,8% and the root canal separation was found 53,8% and 46,2% in the middle and cervical third of the root, respectively. No significant statistical difference was observed effect of gender and age on the incidence of the root canal morphology and the position of the apical foramen. Due to the diverse morphology and the potential presence of a second canal for canine teeth among the Turkish subpopulation, dentists should perform endodontic treatments with greater care. CBCT is an accurate tool for the morphological assessment of the root canals.
Resumen Investigar la anatomía del conducto radicular de los caninos maxilares y mandibulares permanentes en una subpoblación turca utilizando la tomografía computarizada de haz cónico (CBCT). Se examinaron y evaluaron los datos CBCT retrospectivos de 300 pacientes ingresados en nuestra clínica entre 2016 y 2018. Un total de 235 pacientes, 100 hombres y 135 mujeres, de entre 14 y 76 años (edad media de 37,27±13,40) fueron incluidos en este estudio. Se examinaron un total de 191 (44,8%) dientes caninos maxilares y 235 (55,2%) dientes caninos mandibulares. Se analizó el número de raíces y la morfología del conducto radicular según la clasificación de Vertucci, la presencia de conductos accesorios y la posición del foramen apical de la raíz. También se investigó el efecto del sexo y la edad en la incidencia de la morfología del conducto radicular. La mayoría de los dientes tenían una configuración de conductos de tipo I tanto en los caninos maxilares (100%) como en los caninos mandibulares (92,8%). En los caninos mandibulares los otros patrones de conductos encontrados fueron el Tipo III (6,8%) y el Tipo II (0,4%). El foramen apical estaba situado en posición central en la mayoría de los dientes, 70,2% y 66,8% en los caninos maxilares y mandibulares, respectivamente. La ocurrencia de dos raíces en los caninos mandibulares es del 3,8% y la separación del conducto radicular se encontró en el tercio medio y cervical de la raíz en el 53,8% y el 46,2%, respectivamente. No se observó ninguna diferencia estadística significativa en el efecto del sexo y la edad sobre la incidencia de la morfología del conducto radicular y la posición del foramen apical. Debido a la diversa morfología y a la posible presencia de un segundo conducto en los dientes caninos entre la subpoblación turca, los odontólogos deberían realizar los tratamientos endodónticos con mayor cuidado. La CBCT es una herramienta precisa para la evaluación morfológica de los conductos radiculares.
Subject(s)
Humans , Dental Pulp Cavity/anatomy & histology , Cone-Beam Computed Tomography/instrumentation , Maxilla/anatomy & histology , Turkey , Mandibular CanalABSTRACT
Casos de fraturas dentárias oblíquas muitas vezes possuem um prognóstico desfavorável, geralmente com indicação da extração do elemento dental. O presente artigo visou relatar o tratamento do caso clínico de um paciente do sexo masculino, 12 anos, que compareceu à Unidade de Saúde Bucal do Hospital Universitário de Brasília com encaminhamento de extração do dente 12, apresentando fratura oblíqua que se estendia subgengivalmente na face vestibular. O trauma havia ocorrido há três anos e o paciente havia sido submetido a diversas intervenções endodônticas, apresentando no momento da consulta inicial por nossa equipe uma lesão periapical extensa. Após a realização da anamnese, exame clínico e radiográfico, foi adotada uma abordagem multidisciplinar conservadora com a manutenção do dente e a realização da enucleação da lesão periapical por meio de intervenção cirúrgica e posterior reabilitação. Em uma mesma sessão, foi realizada a obturação do conduto com cone de guta percha e cimento sealer 26 e a cirurgia parendodôntica juntamente com a apicoplastia. Uma semana após a intervenção cirúrgica foi realizada restauração classe IV com resina composta baseada no enceramento dos modelos de diagnóstico montados em articulador. Com base em uma avaliação criteriosa e multidisciplinar, foi possível adotar uma abordagem conservadora no caso em questão, com a manutenção e reabilitação de um dente permanente em um paciente jovem, evitando a indicação de exodontia(AU)
Cases of oblique dental fractures often have an unfavorable prognosis, usually with the indication of extraction of the dental element. The present article aimed to report the treatment of the clinical case of a 12-year-old male patient, who attended the Oral Health Unit of the Hospital Universitário de Brasília with a referral for extraction of tooth 7, presenting an oblique fracture that extended subgingivally on the labial surface. The trauma had occurred three years ago and the patient had undergone several endodontic interventions, presenting an extensive periapical lesion at the time of the initial consultation by our team. After anamnesis, clinical and radiographic examination, a conservative multidisciplinar approach was adopted with the maintenance of the tooth and the enucleation of the periapical lesion through surgical intervention and subsequente rehabilitation. In the same session, the conduit was filled with gutta-percha cone and sealer cement 26 and parendodontic surgery was performed together with apicoplasty. One week after the surgical intervention, class IV restoration was performed with composite resin based on the waxing of the diagnostic models mounted on an articulator. Based on a careful and multidisciplinary evaluation, it was possible to adopt a conservative approach in the case in question, with the maintenance and rehabilitation of a permanent tooth in a young patient, avoiding the indication of extraction(AU)
Subject(s)
Humans , Male , Child , Tooth Fractures/therapy , Dental Pulp Cavity/surgery , Dental Pulp Cavity/injuries , Periapical Abscess , Root Canal Therapy , Tooth Fractures , Tooth Fractures/surgery , Tooth Fractures/diagnosis , IncisorABSTRACT
Objetive: The aim of this study was to determine the prevalence, demographics, and root configuration of C-shaped canals of mandibular molars by means of cone beam computed tomography in the population of the Metropolitan Region, Chile. Material and Methods: 912 molars (456 first and 456 second molars) resulting from the analysis of 228 mandibular CT scans were evaluated. The root configuration was established by means of a panoramic reconstruction and axial tomographic sections, classifying the presence and type of canals through the analysis of five sections or cuts along the root. Data were statistically analyzed using a 5% confidence interval. Results: Of the 912 molars analyzed, 70 were classified as C-shaped canals (7.68%), corresponding to 58.33% of those molars that presented fused roots. 95.7% of this root canal configuration was observed in lower second molars, occurring more frequently in females (n=45, 64.29%). 45.65% of the cases that presented C-shaped canals were bilateral and the most frequent configuration was C3 (n=401, 66.63%) according to the Melton classification.Conclusion: The C-shaped canals of the mandibular molars in the studied population were observed mainly in second molars, showing a clear prevalence among females and a high percentage of bilaterality. The presence of fused roots significantly increases the possibility of finding this type of root configuration.
Objetivo: El objetivo del presente estudio fue determinar, por medio de tomografía computarizada de haz cónico, la prevalencia, demografía y configuración radicular de los conductos en forma de C de molares inferiores en la población de la Región Metropolitana, Chile. Material y Métodos: 912 molares (456 primeros y 456 segundos molares) resultantes del análisis de 228 tomografías mandibulares fueron evaluados. Mediante una reconstrucción panorámica y cortes tomográficos axiales se estableció la configuración radicular, clasificando la presencia y tipo de conducto por medio del análisis de 5 cortes a lo largo de la raíz. Los datos fueron analizados estadísticamente con un intervalo de confianza del 5%. Resultados: De los 912 molares analizados, 70 fueron clasificados como conductos en forma de C (7.68%), correspondiendo al 58.33% de aquellos molares que presentaron raíces fusionadas. El 95.7% de esta configuración de conductos fue observada en segundos molares inferiores, presentándose con mayor frecuencia en mujeres (n=45, 64.29%). El 45.65% de los casos que presentaron conductos en C se manifestaron bilateralmente y la configuración más frecuente observada fue la C3 (n=401, 66.63%) según la clasificación de Melton. Conclusión: Los conductos en forma de C de los molares mandibulares en la población estudiada fueron observados principalmente en segundos molares, marcando una clara predilección por el sexo femenino y un alto porcentaje de bilateralidad. La presencia de raíces fusionadas aumenta significativamente la posibilidad de encontrar este tipo de configuración radicular.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Dental Pulp Cavity/anatomy & histology , Mandible/anatomy & histology , Molar/anatomy & histology , Chile/epidemiology , Prevalence , Cross-Sectional Studies , Cone-Beam Computed TomographyABSTRACT
Introducción: La finalidad del tratamiento de conductos es conseguir la máxima desinfección, conformación y sellado tridimensional. Objetivo: Comparar la capacidad del sellado apical entre dos técnicas de obturación en conductos mesiales de molares inferiores con limas fracturadas en tercio apical. Material y métodos: Se utilizaron 60 raíces mesiales de molares inferiores, instrumentados con Protaper Universal, se desgastó 4 milímetros la parte activa del instrumento y se fracturó intencionalmente en tercio apical. Se formaron dos grupos de 30 raíces mesiales (n = 30) cada uno y se utilizaron dos técnicas de obturación: grupo 1: condensación lateral clásica y grupo 2: Obtura II. Las muestras se sumergieron en tubos de ensayo y en su interior contenían 5 mL de tinta china, se diafanizaron y observaron con un microscopio estereoscópico (LEICA, EZ4D) a 35x para medir la penetración de tinta china dentro del conducto radicular. Resultados: Se encontró una mayor microfiltración apical con suficiente evidencia estadística en el grupo de Obtura II comparado con el grupo de condensación lateral clásica (p < 0.002). Conclusiones: Ambos grupos presentaron microfiltración apical; sin embargo, en el grupo que se utilizó el sistema de obturación termoplastificada Obtura II se detectó mayor filtración apical comparada con el grupo de condensación lateral clásica (AU)
Introduction: The purpose of root canal treatment is to achieve maximum disinfection, shaping and three-dimensional sealing. Objective: To compare the apical sealing capacity between two obturation techniques in mesial canals of mandibular molars with broken files in the apical third. Material and methods: 60 mesial roots of lower molars were used, instrumented with Protaper Universal, the active part of the instrument was worn by 4 millimeters and it was intentionally broken in the apical third. Two groups of 30 mesial roots (n = 30) each were formed and two filling techniques were used: group 1: classic lateral condensation and group 2: Obtura II. The samples were immersed in test tubes and contained 5 mL of Chinese ink inside, they were clear and observed with a stereomicroscope (LEICA, EZ4D) at 35x to measure the penetration of Chinese ink into the root canal. Results: A higher apical microfiltration with sufficient statistical evidence was found in the Obtura II group compared to the classic lateral condensation group (p < 0.002). Conclusions: Both groups presented apical microfiltration, however, in the group that used the Obtura II thermoplastic obturation system, greater apical filtration was detected compared to the classic lateral condensation group (AU)
Subject(s)
Root Canal Obturation/methods , Dental High-Speed Equipment/adverse effects , Dental Leakage , In Vitro Techniques , Cross-Sectional Studies , Dental Restoration Failure , Dental Pulp Cavity/anatomy & histology , MolarABSTRACT
SUMMARY: An essential prerequisite to perform any dental procedure is a clear understanding and knowledge of dental anatomy and its possible variations. The root canal system is characterized for a complex morphology, which varies among populations, individuals in the same population and even in the same person. The aim of this study was to evaluate by CBCT the morphology, number, curvature, and length of roots of first and second maxillary premolars in a Mexican population. In this stud 1700 maxillary premolars were evaluated by CBCT scans of patients; the axial, sagittal and coronal sections were analyzed following the longitudinal axis of each tooth. As a result 51.60 % of the maxillary first premolars had a single root, 31.03 % had two roots, 16.29 % had root fusion, and 1.07 % had three roots. 22.3 % of the maxillary first premolars showed mesial curvature, 41.9 % had a distal curvature, and 35.7 % did not show any curvature; and the most prevalent configuration in maxillary first premolars was Type V. 88.9 % of the maxillary second premolars had a single root, 3.9 % had two roots, 6.9 % had root fusion, and 0.11 % had three roots; 37.59 % of the maxillary second premolars showed a mesial curvature and 62.40 % showed a distal curvature; and the most prevalent configuration in maxillary second premolars was Type I. The anatomy of the root canal system is extremely complex and has many anatomical configurations, these clinical situations must be considered previous to performing any endodontic treatment.
RESUMEN: Un requisito esencial previo a la realización de cualquier procedimiento dental es una clara comprensión y conocimiento de la anatomía dental y sus posibles variaciones. El sistema de canales radiculares se caracteriza por una morfología compleja, que varía entre poblaciones, individuos en una misma población e incluso en una misma persona. El objetivo de este estudio fue evaluar mediante CBCT la morfología, número, curvatura y longitud de raíces de primeros y segundos premolares maxilares en una población mexicana. En este estudio se evaluaron 1700 premolares maxilares mediante escaneos CBCT de pacientes; se analizaron los cortes axial, sagital y coronal siguiendo el eje longitudinal de cada diente. El 51,60 % de los primeros premolares maxilares tenían una sola raíz, el 31,03 % tenían dos raíces, el 16,29 % tenían fusión de raíces y el 1,07 % tenían tres raíces. El 22,3 % de los primeros premolares maxilares presentaban curvatura mesial, el 41,9 % presentaban curvatura distal y el 35,7 % no presentaban curvatura alguna; y la configuración más prevalente en primeros premolares maxilares fue el Tipo V. El 88,9 % de los segundos premolares maxilares tenían una sola raíz, el 3,9 % dos raíces, el 6,9 % fusión de raíces y el 0,11 % tres raíces; El 37,59 % de los segundos premolares maxilares presentaban curvatura mesial y el 62,40 % curvatura distal y la configuración más prevalente en segundos premolares maxilares fue el Tipo I. La anatomía del sistema de canales radiculares es extremadamente compleja y tiene muchas configuraciones anatómicas, estas situaciones clínicas deben ser consideradas antes de realizar cualquier tratamiento de endodoncia.
Subject(s)
Humans , Male , Female , Bicuspid/anatomy & histology , Bicuspid/diagnostic imaging , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Cone-Beam Computed Tomography , Prevalence , Anatomic Variation , MexicoABSTRACT
Este trabalho teve como objetivo apresentar um relato de caso clínico de uma restauração do tipo coroa endocrown cerâmica em um dente molar tratado endodonticamente. Paciente com 45 anos de idade, sexo feminino, procurou a clínica do Centro Universitário da Serra Gaúcha (FSG) relatando a necessidade de reabilitação protética no primeiro molar inferior do lado esquerdo. Com base no exame radiográfico e exame clínico foi constatado um primeiro molar inferior do lado esquerdo com tratamento endodôntico satisfatório, mas uma extensa destruição coronária. Após a aprovação da paciente e indicações para a utilização da técnica, optou-se pela confecção de uma coroa endocrown em cerâmica reforçada por dissilicato de lítio. Foi realizado o preparo do remanescente dentário, envolvendo a câmara pulpar, com ângulos arredondados e expulsivos e, após a moldagem do mesmo com silicone de adição, utilizando a técnica simultânea e duplo fio. O provisório foi realizado com resina quimicamente ativada na cor 62 e, na sessão seguinte a coroa endocrown foi ajustada e polida. Após receber o protocolo de condicionamento adequado da peça, a mesma foi cimentada com cimento autopolimerizável Multilink N. Pode-se concluir que a alternativa restauradora Endocrown é um tratamento conservador e favorável para dentes com extensa destruição coronária, permitindo adequada estética e função(AU)
This study aimed to present a clinical case report of an endocrown ceramic crown restoration in na endodontically treated molar tooth. A 45-year-old female patient sought the clinic at the Centro Universitário da Serra Gaúcha (FSG), reporting the need for prosthetic rehabilitation on the lower left first molar. Based on the radiographic and clinical examination, the first molar presented satisfactory endodontic treatment, but extensive coronary destruction. After the approval of the patient and indications for the use of the technique, it was decided to make an endocrown with reinforced ceramic by lithium disilicate. The remaining tooth was prepared, involving the pulp chamber, with rounded and expulsive angles and, after the impression with silicone using the simultaneous and double wire technique was taken. The provisional was made with chemically activated resin in color 62 and, in the following session, the endocrown crown was adjusted and polished. After receiving the proper conditioning protocol, it was lutted with Multilink N self-curing cement. It can be concluded that the Endocrown restorative alternative is a conservative and favorable treatment for teeth with extensive coronary destruction, allowing adequate aesthetics and function(AU)
Subject(s)
Humans , Female , Middle Aged , Ceramics , Tooth, Nonvital , Crowns , Molar , Dental Prosthesis , Dental Pulp Cavity , Prosthesis RetentionABSTRACT
El objetivo del presente estudio fue medir la curvatura vestíbulo-lingual de los conductos de las raíces mesiales de primeros molares inferiores en personas adultas del estado de Chihuahua, por medio de la técnica de tomografía computarizada de haz cónico (CBCT, por sus siglas en inglés) y usando el software de análisis 3D EndoTM (Dentsply/Sirona USA). Se llevó a cabo la medición por dos observadoras, empleando dos métodos diferentes, Schneider y 3D EndoTM (Dentsply/Sirona USA). Los resultados obtenidos tuvieron valores mayores a los 100 grados con la técnica 3D EndoTM y a los 20 grados con la técnica de Schneider. No se detectó una diferencia estadística significativa al comparar los diferentes conductos entre sí (AU)
The objective of the present study was to measure the vestibule-lingual curvature of the ducts of the mesial roots of lower first molars, of adults from the state of Chihuahua. Using the cone beam computed tomography (CBCT) technique and using the 3D analysis software EndoTM (Dentsply/Sirona USA). The measurement was carried out by two observers using two different methods, Schneider and 3D EndoTM (Dentsply/Sirona USA). The results obtained had values greater than 100 degrees with the 3D EndoTM technique and at 20 degrees with the Schneider technique. No statistically significant difference was detected when comparing the different ducts with each other (AU)
Subject(s)
Humans , Dental Pulp Cavity , Cone-Beam Computed Tomography , Molar , Software , Data Interpretation, Statistical , Imaging, Three-Dimensional , MexicoABSTRACT
O estudo revisou a literatura existente com o objetivo de comparar a percepção de uso, qualidade e tempo do preparo químico mecânico de canais radiculares realizado por estudantes de graduação em Odontologia com instrumentos de níquel-titânio (NiTi) e aço inoxidável. Para isso, as bases de dados eletrônicas PubMed, LILACS, Scopus, Embase,SciELOe CENTRALforam acessadas para verificar e selecionar estudos relacionados com a questão de pesquisa publicados até janeiro de 2021. Estudos laboratoriaisque compararam o uso de instrumentos de NiTi com aço inoxidável por alunos de graduação em Odontologia foram avaliados. Dois revisores independentemente selecionaram os estudos, coletaram os dados e analisaram o risco de viés.Dos 92 estudos potencialmente relevantes, 10 atenderam aos critérios de inclusão para análise de texto completo e, posteriormente, incluídos na revisão sistemática. O risco de viés foi considerado alto em todos os estudos. Instrumentos de NiTi apresentarammaior preferência e melhor percepção por estudantes de graduação em Odontologia, menor tempo e melhor qualidade do preparo químico mecânico, commenor ocorrência de acidentes como degraus, transporte e desvios de canal, apesar de estarem associados à maior ocorrência de fratura de instrumentos (AU).
This literature review aimed to compare undergraduate dental students' perceptions regarding the use of nickeltitanium (NiTi) and stainless steel instruments for the mechanical-chemical preparation of root canals, focusing on quality and time. PubMed, LILACS, Scopus, Embase, SciELO,and CENTRAL electronic databaseswere accessed to verify and select related studies published as of January 2021. Laboratory studies comparing the use of NiTi instruments with stainless steel instruments by undergraduate dental students were evaluated. Two reviewers independently selected the studies, collected the data, and analyzed the risk of bias. Out of the 92 potentially relevant studies, 10 met the inclusion criteria for a full-text analysis and were subsequently included in the systematic review. The risk of bias was considered high in all studies. Undergraduate dental students demonstrated a greater preference for and better perception of NiTi instruments. NiTi instruments also resulted in less time for and better qualityof the mechanical-chemical preparation. These were associated with a lower incidence of accidents, such as canal ledges, transportations, and deviations, as well as a higher incidence of instrument fractures (AU).
Subject(s)
Stainless Steel , Students, Dental , Root Canal Preparation/instrumentation , Dental Pulp Cavity/anatomy & histology , EndodonticsABSTRACT
Abstract Objective: To examine the cyclic fatigue resistance and surface topography of TruNatomy and ProTaper Gold nickel-titanium rotary files and evaluate the presence of alterations to surface topography following instrumentation in simulated curved canals. Material and Methods: Twenty-four nickel-titanium instruments, twelve each of TN and PTG file systems, were evaluated for cyclic fatigue resistance. The rotary files were rotated in a simulated root canal with standardized diameter, angle of curvature, and radius of curvature in a custom-made cyclic fatigue testing device until the instrument fracture occurred. The time to fracture for each instrument was recorded with a stopwatch; in seconds in each group. Fractured instruments were subjected to atomic force microscopy analysis measuring the average roughness and the root mean square values to investigate surface features of endodontic files. Mean values and standard deviation were calculated. Data were analyzed using the Mann-Whitney U test. Results: Time to fracture was marginally higher in PTG instruments than in the TN file systems. PTG files exhibited higher surface roughness when compared with TN files (p<0.05). Conclusion: TN file system had a higher cyclic fatigue resistance than PTG. Cyclic fatigue causing file breakage did affect the surface topography of the files. PTG files showed a higher surface porosity value than the TN files (AU).
Subject(s)
Titanium/chemistry , Microscopy, Atomic Force/instrumentation , Dental Alloys , Dental Instruments , Endodontics , Surface Properties , Statistics, Nonparametric , Dental Pulp Cavity , Hardness Tests , Nickel/chemistryABSTRACT
Objective: This study aimed to determine the push-out-bond-strength(PBS) of mineral trioxide aggregate (BIOMTA+) and calcium-enriched-mixture-cement (CEM) in retrograde cavities prepared using Er: YAG laser and stainless-steel bur. Material and Methods: The root canals of 60 extracted single-rooted human teeth were prepared, filled and their apical portion of 3-mm were resected using a diamond bur and randomly divided into four groups according to technique of retrograde preparation and filling material as follows(n=15): Group1: bur/ BIOMTA+ ,Group2: bur/ CEM, Group3: Er:YAG laser/ BIOMTA+, Group4: Er:YAG laser/ CEM. PBS test were performed to specimens and failure modes were evaluated. The data were statistically analyzed with ANOVA, Post-Hoc Tukey and t tests (p< 0.05). Results: CEM was exhibited higher than bond strength compared to BIOMTA+ in retrograde cavity prepared using laser (p= 0.021) and BIOMTA+ in retrograde cavity prepared using bur was exhibited higher than bond strength compared to in retrograde cavities prepared using laser (p= 0.024). Failure modes were dominantly cohesive in all groups tested and one representative specimen each failure mode was examined in SEM and the general characteristics of the failure modes were confirmed. Conclusion: With in the limitations of the present study, when used CEM, Er: YAG laser-assisted retrograde cavity preparation positively affected the bond strength values compared to BIO MTA+. Considering its optimal adhesion, the calcium-enriched-mixture-cement (CEM) might be a good option as a filling material in retrograde cavities in clinical use. (AU)
Objetivo: O objetivo deste estudo foi determinar a força de união (PBS) de cimento de agregado trióxido mineral (BIO MTA+) e cimento enriquecido com cálcio (CEM) em preparos cavitários retrógrados realizados com: Laser Er-YAG e brocas de aço inoxidável. Material e Métodos: Canais radiculares de 60 dentes unirradiculares extraídos foram preparados, preenchidos e 3 mm de suas porções apicais foram ressecadas usando uma broca diamantada e divididos randomicamente em quatro grupos de acordo com a técnica de preparação retrógrada e o material de preenchimento (n=15): Grupo 1: Broca/BIO MTA+, Grupo 2: Broca/CEM, Grupo 3: Laser Er-YAG/BIO MTA+, Grupo 4: Laser Er-YAG/CEM. O teste de PBS foi realizado para as amostras e os modelos de falha foram avaliados. Os dados foram analisados estatisticamente pelos testes de ANOVA, Post-Hoc Tukey e testes t (p< 0.05). Resultados: CEM apresentou maior força de união que BIO MTA+ em cavidades retrógradas preparadas com laser (p= 0.021) e BIO MTA+ em cavidades retrógradas preparadas com brocas apresentou maior força de união quando comparado à cavidades retrógradas preparadas com laser (p= 0.024). Os modelos de falha foram predominantemente coesos em todos os grupos testados e um espécime representativo de cada modelo de falha foi examinado em MEV e as características gerais dos modelos de falha foram confirmadas. Conclusão: Com as limitações do presente estudo, quando usou-se CEM, o preparo de cavidades retrógradas através de Laser Er-YAG afetou positivamente os valores da força de união quando comparados com BIO MTA+. Considerando sua ótima adesão, o cimento enriquecido com cálcio (CEM) pode ser uma boa opção como um material de preenchimento em cavidades retrógradas no uso clínico.
Subject(s)
Dental Cements , Dental Pulp Cavity , Lasers, Solid-StateABSTRACT
Objective: This study aimed to evaluate the prevalence of root fusion and the incidence of C-shaped canals in maxillary first molar (MFM) and maxillary second molar (MSM) teeth using cone-beam computed tomography. Material and Methods: In this study, a total of 1233 MFMs and 1406 MSMs from 802 patients were analyzed. First, the number of fused rooted teeth and the type of root fusion were determined. Subsequently, incidence and number of C-shaped canals were ascertained according to the type of fusion, location, position, and level of canal merging in teeth with fused roots. Six types were established according to the C-shape configurations observed. Presence of root fusion and the C-shaped canal according to gender, age, and tooth position were evaluated by chi-square test. Values with p< 0.05 were considered significant in statistical tests. Results: The incidence of fusion in the MFM and MSM teeth was 6.16% and 22.40%, respectively. Only three MFMs (0.24%) and 3.77% of the MSMs had C-shaped canals. While the incidence of fusion was higher in women (p< 0.05), the C shaped morphology was not affected by sex (p> 0.05). Individuals over the age of 50 years had a lower incidence of C-shaped canals (p< 0.05). Conclusion: C-shaped canal morphology was more commonly associated with complex types of root fusion involving three roots; 16.83% of MSMs with fused roots had C-shaped canals (AU).
Objetivo: o objetivo deste estudo foi avaliar a prevalência de fusão radicular e a incidência de canais em C nos dentes do primeiro molar superior (MFM) e do segundo molar superior (MSM) por meio da tomografia computadorizada de feixe cônico. Material e Métodos: Neste estudo, um total de 1233 MFMs e 1406 MSMs de 802 pacientes foram analisados. Primeiro, o número de dentes com raízes fundidas e o tipo de fusão radicular foram determinados. Posteriormente, a incidência e o número de canais em forma de C foram verificados de acordo com o tipo de fusão, localização, posição e nível de fusão do canal nos dentes com raízes fundidas. Seis tipos foram estabelecidos de acordo com as configurações em forma de C observadas. A presença de fusão radicular e do canal em C de acordo com sexo, idade e posição dentária foram avaliadas pelo teste do qui-quadrado. Valores com p <0,05 foram considerados significativos nos testes estatísticos. Resultados: A incidência de fusão nos dentes MFM e MSM foi de 6,16% e 22,40%, respectivamente. Apenas três MFMs (0,24%) e 3,77% dos MSMs tinham canais em forma de C. Enquanto a incidência de fusão foi maior em mulheres (p <0,05), a morfologia em forma de C não foi afetada pelo sexo (p> 0,05). Indivíduos com mais de 50 anos apresentaram menor incidência de canais em C (p <0,05). Conclusão: a morfologia do canal em forma de C foi mais comumente associada a tipos complexos de fusão radicular envolvendo três raízes; 16,83% dos HSH com raízes fundidas tinham canais em forma de C (AU).
Subject(s)
Humans , Tooth Root , Dental Pulp Cavity , Cone-Beam Computed Tomography , MolarABSTRACT
Pulp tissue may suffer calcification because of trauma, operative procedures or carious lesions. This paper aimed to report and discuss the guided endodontic access as an alternative treatment. A 52 years old female patient had severe root canal calcification of tooth #11 associated with a radiolucent periapical lesion. Firstly, the crown and metal post and core were removed. A digital impression and cone-beam computed tomography "CBCT" scans were performed and imported to implant planning software (SimPlant Version 11; Materialise Dental, Leuven, Belgium).The guided endodontic access template was designed to allow the drill to reach a distance of 2 mm short of the apical foramen, once printed, it was tested in the mouth to evaluate its insertion and stability in the dental arch. The calcified root canal was penetrated using the access drill rotating by a low-speed hand-piece (10,000 rpm) under saline solution irrigation through advancing movements. Then, the apical foramen was negotiated with C-Pilot files #10 and #15. The working length was measured using the iPex-II apex locator. The instrumentation was carried out with Reciproc R50 and 2.5% sodium hypochlorite. One week later, a full-ceramic crown preparation was performed, and polyvinyl siloxane impression was carried out. A total of three follow-up sessions were performed after one week, one and twelve months. Bone neoformation was observed in the site of the periapical lesion and the patient had no signs or symptoms of any discomfort. Therefore, guided endodontics is indicated for severe calcified root canals.(AU)
O tecido pulpar pode sofrer calcificação por trauma, procedimentos cirúrgicos ou como resposta a lesões cariosas. Este trabalho teve como objetivo relatar e discutir o acesso endodôntico guiado como opção de tratamento. Paciente do sexo feminino, 52 anos, com calcificação severa do canal radicular do dente 11 associada a lesão periapical radiolucida. Na primeira intervenção clínica, a coroa e o pino de metal foram removidos. Uma impressão digital e imagens de CBCT foram realizadas e importadas para o software de planejamento de implante (SimPlant Versão 11; Materialize Dental, Leuven, Bélgica) tentando projetar um modelo de acesso endodôntico guiado para permitir que a broca alcance uma distância de 2 mm antes do forame apical, uma vez impresso, foi testado na boca para avaliar sua inserção e estabilidade na arcada dentária. O canal radicular calcificado foi penetrado com broca de acesso girando por peça de mão de baixa velocidade (10.000 rpm) sob irrigação com solução salina por meio de movimentos de avanço. Em seguida, o forame apical foi negociado com as limas C-Pilot nº 10 e nº 15. O comprimento de trabalho foi determinado usando o localizador de ápice iPex-II. A instrumentação foi realizada com Reciproc R50 e hipoclorito de sódio 2,5%. Uma semana depois, foi realizado o preparo da coroa total em cerâmica e a moldagem com polivinilsiloxano. Um total de três sessões de acompanhamento foram realizadas após uma semana, um e doze meses. A neoformação óssea foi observada no local da lesão periapical e a paciente não apresentava sinais ou sintomas de qualquer desconforto. Portanto, o acesso endodôntico guiado é indicado para canais radiculares calcificados severamente.(AU)
Subject(s)
Humans , Female , Middle Aged , Tooth Calcification , Dental Pulp Cavity , EndodonticsABSTRACT
Auto-transplantation has been suggested to be a favourable treatment option in comparison to prosthodontic replacements. Studies have shown an average survival rate of 89.1% for auto-transplanted teeth. This article aims to report a successful third molar auto-transplantation, despite delayed endodontic treatment because of movement control order (MCO) imposition following COVID-19 out-break in Malaysia. A 22-year-old female patient's impacted lower left third molar (38) was used as a donor to replace her lower left second molar (37), which was deemed non-restorable due to caries and root resorption as a result of impinging pressure from the impacted adjacent third molar. Successful outcome and uneventful healing were achieved over a period of one year, despite delayed endodontic treatment following auto-transplantation. A favourable auto-transplant can be achieved despite delayed endodontic treatment post-transplantation, if the procedure is performed in a good aseptic environment and bacterial load is controlled at the site (AU)
O autotransplante tem sido sugerido como uma opção de tratamento favorável em comparação com as substituições protéticas. Estudos mostraram uma taxa de sobrevivência média de 89,1% para dentes autotransplantados. Este artigo tem como objetivo relatar um autotransplante de terceiro molar bem-sucedido, apesar do atraso no tratamento endodôntico devido à imposição da ordem de controle de movimento (MCO) após o surto de COVID-19 na Malásia. O terceiro molar inferior esquerdo impactado de uma paciente de 22 anos (38) foi usado como doador para substituir seu segundo molar inferior esquerdo (37), que foi considerado não restaurável devido à cárie e reabsorção radicular como resultado da pressão de impacto do terceiro molar adjacente impactado. Resultado bem sucedido e cicatrização sem intercorrências foram alcançados ao longo de um período de um ano, apesar do atraso no tratamento endodôntico após o autotransplante. Um autotransplante favorável pode ser alcançado apesar do atraso no tratamento endodôntico pós-transplante, se o procedimento for realizado em um ambiente asséptico e com carga bacteriana controlada no local.(AU)
Subject(s)
Humans , Female , Adult , Controlled Confinement , Dental Pulp , Dental Pulp Cavity , Endodontics , COVID-19 , Molar, ThirdABSTRACT
Objetivo: Presentar lineamientos basados en evidencia para el tratamiento de pulpas no vitales debidas a caries profundas o traumatismos en dientes primarios. Métodos: el Grupo de Trabajo de la Academia Americana de Odontología Pediátrica AAPD realizó una revisión sistemática/meta-análisis de estudios acerca de terapia para pulpa no vital en dientes primarios, producto de caries o trauma, usando el enfoque GRADE para determinar el nivel de certeza de la evidencia para recomendaciones clínicas. Resultados: La determinación de GRADE fue de elevada a muy baja. Al comparar dientes con o sin resorción radicular, el éxito de la pulpectomía fue mayor (p<0,001) en los que no presentaban resorción radicular antes del tratamiento. El éxito de las pulpototmías obturadas con ZO/yodoformo/HC EndoflasTM(Laboratorios Sanlor, Cali, Colombia) y ZOE (óxido de zinc con eugenol) no fue diferente al yodoformo(yodoformo + hidróxido de calcio, VitapexTM o MetapexTM) después de 18 meses (p= 0,55); sin embargo el éxito de ZO/iodoformo/HC y ZOE fue cercano al 90% mientras que el del yodoformo fue 71% o menor. El análisis de red demostró que ZO/iodoformo/HC y ZOE son mejores que yodoformo. ELRP fue mejor que pulpectomía (p<0,001) en dientes con resorción radicular previa al tratamiento, pero la pulpectomía fue superior si las raíces estaban íntegras (p= 0,09). La instrumentación de los conductos radiculares fue significativamente más rápida (p<0,001) que la instrumentación manual, pero la calidad de la obturación no presentó diferencia (p= 0,09) y ambas técnicas presentaron éxito similar. El análisis de red clasificó al ZO/iodoformo/HC como mejor, ZOE en segundo lugar, y yodoformo en último lugar a los 18 meses. La tasa de éxito no fue impactada por el método de obturación, método de determinación de la longitud radicular, tipo de diente, número de citas, agentes de irrigación, remoción de la capa de desechos dentinarios o momento/tipo de restauración definitiva. Conclusiones: La tasa de éxito a 18 meses para pulpectomías demuestran que ZO/iodoformo/HC y ZOE son superiores al yodoformo. Las indicaciones de ELRP están limitadas a dientes con resorción radicular y requiere la realización de un seguimiento cercano.
Objetivo: Apresentar uma orientação baseada em evidência para terapias pulpar não vitais de cárie profundas ou trauma em dentes deciduos. Métodos: Um grupo de trabalho da AAPD realizou uma revisão/análise sistemática para estudos não vitais de dentes deciduos resultantes de trauma ou cárie e utilizou a abordagem GRADE para avaliar o nível de certeza de evidência para recomendações clínicas. Resultados: O GRADE foi avaliado de nível alto à muito baixo. Comparando os dentes com/sem reabsorção radicular, o sucesso da pulpectomia foi melhor (p<0,001) naqueles sem reabsorção radicular pré-operatória. OZ/iodofórmio/HC (óxido de zinco + iodofórmio + hidróxido de cálcio; EndoflasTM) e OZE (óxido de zinco e eugenol) o sucesso da pulpectomia não diferiu do iodofórmio (iodofórmio + hidróxido de cálcio; VitapexTM, MetapexTM) (p= 0,55) após 18 meses; contudo, as taxas de sucesso de OZ/iodofórmio/HC e OZE permaneceram perto de 90% enquanto que o iodofórmio foi de 71% ou menos. As taxas de análise da rede mostraram que o OZ/iodofórmio/HC e OZE era melhor do que o iodofórmio. LERT foi melhor (p<0,001) do que a pulpectomia nos dentes com reabsorção radicular pré-operatória, mas os resultados da pulpectomia foram melhores (p= 0,.09) se as raízes estivessem intactas. A instrumentação rotatória dos canais radiculares foi significativamente mais rápida (p<0,001) do que manual, mas a qualidade do preenchimento não diferiu (p= 0.09) e ambos tiveram sucesso comparável. A análise de rede classificou OZ/iodofórmio/HC como o melhor, OZE segundo, e iodofórmio como o mais baixo aos 18 meses. As taxas de sucesso não foram influenciadas pelo método de obturação ou determinação do comprimento da raiz, tipo de dente, número de visitas, irrigantes, remoção da lama dentinária, ou tempo/tipo de restauração final. Conclusões: As taxas de sucesso da pulpectomia de 18 meses favoreceram pulpectomias com OZ/iodofórmio/HC e OZE sobre iodofórmio. O LERT demonstrou indicação limitada para dentes com raízes reabsorvidas e requer um acompanhamento assíduo.
Abstract: Purpose: To present an evidence-based guideline for non-vital pulp therapies due to deep caries or trauma in primary teeth. Methods: The authors, working with the American Academy of Pediatric Dentistry, conducted a systematic review/meta-analysis for studies on non-vital primary teeth resulting from trauma or caries and used the GRADE approach to assess level of certainty of evidence for clinical recommendations. Results: GRADE was assessed from high to very low. Comparing teeth with/without root resorption, pulpectomy success was better (P<0.001) in those without preoperative root resorption. Zinc oxide plus iodoform plus calcium hydroxide ([ZO/iodoform/CH]; EndoflasTM) and zinc oxide and eugenol (ZOE) pulpectomy success did not differ from iodoform (iodoform plus calcium hydroxide; VitapexTM, MetapexTM) (P=0.55) after 18-months; however, ZO/iodoform/CH and ZOE success rates remained near 90 percent while iodoform was 71 percent or less. Network analysis ratings showed ZO/iodoform/CH and ZOE better than iodoform. Lesion sterilization tissue repair (LSTR) was better (P<0.001) than pulpectomy in teeth with preoperative root resorption, but pulpectomy results were better (P=0.09) if roots were intact. Rotary instrumentation of root canals was significantly faster (P<0.001) than manual, but the quality of fill did not differ (P=0.09) and both had comparable success. Network analysis ranked ZO/iodoform/CH the best, ZOE second, and iodoform lowest at 18 months. Success rates were not impacted by method of obturation or root length determination, type of tooth, number of visits, irrigants, smear layer removal, or timing/type of final restoration. Conclusions: Pulpectomy 18-month success rates supported ZO/iodoform/CH and ZOE pulpectomy over iodoform.
Subject(s)
Humans , Tooth, Deciduous , Iodoformium , Dental Pulp Cavity , Smear Layer , Dental Caries , Dental Pulp , GRADE ApproachABSTRACT
OBJECTIVE@#To investigate the short-term clinical effect of lumbar nerve root canal injection under X-ray angiography in the treatment of sciatica.@*METHODS@#The clincal data of 78 patients with sciatica underwent lumbar nerve root canal injection under X-ray angiography from December 2017 to February 2020 was retrospectively analyzed. Including 31 males and 47 females, aged from 22 to 88 years old with a median of 65 years. There were 55 cases of lumbar disc herniation and 23 cases of lumbar spinal stenosis, the course of disease ranged from 1 to 8 weeks with a median of 3 weeks. There were 71 cases of single segment disc herniation or stenosis, including L3,4 of 5 cases, L4,5 of 61 cases, L5S1 of 5 cases, and 7 cases of multisegment herniation or stenosis. The pain visual analogue scale (VAS) was recorded and Macnab was used to evaluate the clinical effect.@*RESULTS@#All patients completed standardized treatment without serious adverse reactions. VAS were (3.21±0.76) scores immediately after treatment, (2.89±0.33) scores 1 hour after treatment, (1.80±0.27) scores 6 hours after treatment, (1.10±0.20) scores 24 hours after treatment, (2.53±0.35) scores 1 week after treatment and (4.27±0.36) scores 1 month after treatment. There were significant differences in VAS between before treatment(7.83±0.56) and each time period after treatment(P<0.05). According to Macnab low back pain evaluation standard, 42 cases were effective, 34 cases were markedly effective and 2 cases were ineffective within 24 hours after treatment, with an effective rate of 97.4%;38 cases were effective, 25 cases were markedly effective, 15 cases were ineffective within one week after treatment, the effective rate was 80.0%;32 cases were effective, 22 cases were markedly effective, 24 cases were ineffective within one month after treatment, the effective rate was 69.2%.@*CONCLUSION@#The short-term clinical effect of nerve root canal injection under X-ray radiography in the treatment of sciatica is good and it is an effective method to relieve sciatica.
Subject(s)
Adult , Aged , Aged, 80 and over , Angiography , Dental Pulp Cavity , Female , Humans , Intervertebral Disc Displacement/diagnostic imaging , Lumbar Vertebrae/diagnostic imaging , Male , Middle Aged , Retrospective Studies , Sciatica/drug therapy , Treatment Outcome , X-Rays , Young AdultABSTRACT
Abstract Objective: To evaluate root canal configuration and morphology of premolar teeth among Saudi subpopulations using cone beam computed tomography (CBCT). Material and Methods: In this retrospective cross-sectional study, CBCT images of 314 patients comprising 346 maxillary and 412 mandibular first premolar (FPM) teeth, 298 maxillary and 387 mandibular second premolar (SPM) teeth were analyzed to evaluate the number of roots, root canal morphology, and configuration based on the Vertucci's classification. The average intra-class correlation coefficient value was 0.931. Results: In the maxillary first premolar, 52.6% were two separate rooted and single rooted teeth, with one canal in 81.2% of the maxillary second premolar. Among the mandibular FPM, 96.6% of the teeth had one root and canal, and 97.9% of mandibular SPM had one root and canal. Type 1 canal configuration was seen as most common in all premolars. The number of roots in mandibular premolars did not reveal the difference among gender. Conclusion: Wide variations in root canal morphology and canal configuration system exists among maxillary and mandibular premolar teeth (AU).
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Bicuspid , Dental Pulp Cavity/anatomy & histology , Cone-Beam Computed Tomography , Saudi Arabia/epidemiology , Chi-Square Distribution , Cross-Sectional Studies/methods , Retrospective StudiesABSTRACT
Abstract Objective: To evaluate the periapical healing following root canal treatment in teeth with apical periodontitis (in vivo) and the cytotoxic potential of root canal sealers in vitro. Material and Methods: Apical periodontitis was induced in 60 dogs' teeth and root canals were filled with Sealapex (40 roots), EndoREZ (40 roots), intracanal dressing (20 roots), or left untreated (20 roots). After 30 and 90 days, histopathological analyses were made. In vitro, J774.1 macrophages were stimulated with root canal sealers extracts, cytotoxicity was assessed using lactate dehydrogenase assay, and qRT-PCR was used to analyze TNF-α gene expression. Results: In vivo, smaller apical periodontitis and lower inflammatory cell infiltrate were found in teeth treated with Sealapex compared to EndoREZ. In vitro, EndoREZ was cytotoxic and induced TNF-α gene expression by macrophages differently from Sealapex. Conclusion: Sealapex allowed improved tissue repair following root canal treatment in teeth with apical periodontitis compared to EndoREZ. Synthesis of TNF-α induced by LPS was enhanced by EndoREZ, whereas Sealapex prevented pro-inflammatory gene expression (AU).
Subject(s)
Animals , Dogs , Periapical Periodontitis , Root Canal Obturation , In Vitro Techniques , Dental Pulp Cavity , Endodontics , Analysis of VarianceABSTRACT
SUMMARY: The aim of this of this study was to evaluate the prevalence and morphology of radix entomolaris (RE) in the mandibular first molar (MFM) in a southern Chilean sub-population by cone-beam computed tomography (CBCT). Two hundred ten CBCT images of MFM were analysed. To detect the presence of RE, the observation and measurements were standardised, advancing 1 mm to apical from the floor of the pulp chamber to the most apical zone of the tooth. The data were analyzed using descriptive statistics, with a value of P < 0.05 being statistically significant. The prevalence of a third root in the permanent MFM was 5.7 % (12/210). The incidence of RE was the same in male patients (2.9 %) as in female patients (2.9 %) (p=0.324). The occurrence of an RE in the left MFM was 7.3 % (3/41 patients) for male patients and 4.5 % (3/66) for female patients (p=0.398). The right MFM in male patients had an incidence of 8.1 % (3/37) and 4.5 % (3/66) for female patients (p=0.340). When the presence of an RE was compared between the left (5.6 %) and right side (5.8 %), no statistically significant differences were found (p=0.998). The frequency of bilateral three-rooted MFM was 71.43 % (5/7) and 28.57 % (2/7) were unilateral. The prevalence of RE in MFM in a southern Chilean sub-population was 5.7 %. The occurrence was bilateral in the majority of cases and no significant differences were observed by sex or side. The commonest type of RE was Type 1 (83.3 %). The use of CBCT can improve the endodontic treatment outcome.
RESUMEN: El objetivo de este estudio fue evaluar la prevalencia y morfología de radix entomolaris (RE) en el primer mo- lar mandibular (MFM) en una subpoblación del sur de Chile mediante tomografía computarizada de haz cónico (CBCT). Se analizaron doscientas diez imágenes CBCT de MFM. Para detectar la presencia de OD se estandarizó la observación y las medidas, avanzando 1 mm apical desde el suelo de la cámara pulpar hasta la zona más apical del diente. Los datos fueron analizados mediante estadística descriptiva, siendo estadísticamente significativo un valor de P < 0,05. La prevalencia de una tercera raíz en el MFM permanente fue de 5,7 % (12/210). La incidencia de ER fue la misma en pacientes masculinos (2,9 %) que en pacientes femeninas (2,9 %) (p=0,324). La aparición de un ER en el MFM izquier- do fue del 7,3 % (3/41 pacientes) para los pacientes masculinos y del 4,5 % (3/66) para las pacientes femeninas (p=0,398). El MFM derecho en pacientes masculinos tuvo una incidencia de 8,1 % (3/ 37) y 4,5 % (3/66) para pacientes femeninos (p=0,340). Cuando se comparó la presencia de un OD entre el lado izquierdo (5,6 %) y derecho (5,8 %), no se encontraron diferencias estadísticamente significativas (p=0,998). La frecuencia de MFM de tres raíces bilaterales fue 71,43 % (5/7) y 28,57 % (2/7) fueron unilaterales. La prevalencia de RE en MFM en una subpoblación del sur de Chile fue de 5,7 %. La presentación fue bilateral en la mayoría de los casos y no se observaron diferencias significativas por sexo o lado. El tipo de ER más frecuente fue el tipo 1 (83,3 %). El uso de CBCT puede mejorar el resultado del tratamiento endodóntico.