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1.
RFO UPF ; 27(1): 30-40, 08 ago. 2023. ilus, tag, graf
Article in English | LILACS, BBO | ID: biblio-1509382

ABSTRACT

Objective: to analyze, through literature review, the available literature on orthodontic treatment in traumatized permanent teeth. Methods: A literature search was performed in electronic databases (PubMed and SciELO) using the descriptors [tooth injuries] OR [injuries, teeth] OR [injury, teeth] OR [teeth injury] OR [injuries, tooth] OR [injury, tooth] OR [tooth injury] OR [teeth injuries] AND [orthodontics]. Observational studies and clinical trials were included, narrative reviews, laboratory and in vitro studies, case reports and series as well as articles that presented abstracts written in languages other than Portuguese, English and Spanish were excluded from the study. Two reviewers considered the eligibility, the risk of bias of the analyzed data and the qualitative synthesis of the studies included. A total of 1,322 references were found and 4 articles met all inclusion criteria and were included in the qualitative analysis. Some consequences like pulp necrosis and root resorption have been highlighted and trauma severity should be considered when orthodontically intervening in previously traumatized teeth. Final considerations: The traumatized teeth can be orthodontically treated as long as the time of tissue reorganization is respected, and the pull and periodontal conditions are followed up.(AU)


Objetivos: analisar, por meio de revisão de literatura, a respeito do tratamento ortodôntico em dentes permanentes traumatizados. Metodologia: Uma pesquisa bibliográfica foi realizada em bancos de dados eletrônicos (PubMed e SciELO) usando os descritores [tooth injuries] ou [injuries, teeth] ou [injury, teeth] ou [teeth injury] ou [injuries, tooth] ou [injury, tooth] ou [tooth injury] ou [teeth injuries] e [orthodontics]. Foram incluídos estudos observacionais e ensaios clínicos, revisões narrativas, estudos laboratoriais e in vitro, relatos de casos e séries, bem como artigos que apresentassem resumos redigidos em idiomas diferentes do português, inglês e espanhol foram excluídos do estudo. Dois revisores consideraram a elegibilidade, o risco de viés dos dados analisados e a síntese qualitativa dos estudos incluídos. Foram encontradas 1.322 referências e 4 artigos atenderam a todos os critérios de inclusão e foram incluídos na análise qualitativa. Algumas consequências como necrose pulpar e reabsorção radicular têm sido destacadas e a gravidade do trauma deve ser considerada na intervenção ortodôntica em dentes previamente traumatizados. Considerações finais: Os estudos incluídos nesta revisão sugerem que dentes traumatizados podem ser tratados ortodônticamente desde que respeitado o tempo de reorganização tecidual e acompanhadas as condições pulpares e periodontais.(AU)


Subject(s)
Humans , Tooth Movement Techniques/methods , Tooth Injuries/therapy , Dentition, Permanent , Root Resorption/etiology , Trauma Severity Indices , Dental Pulp Necrosis/etiology
2.
Rev. Odontol. Araçatuba (Impr.) ; 44(1): 9-16, jan.-abr. 2023. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1427810

ABSTRACT

As lesões dentárias traumáticas são um problema de saúde pública mundial, dentre as quais a fratura dentária é a de maior ocorrência, envolvendo principalmente os dentes anteriores. A abordagem de grandes fraturas anteriores é um desafio para cirurgiões dentistas de qualquer nível pois, além da função, afetam diretamente a estética do paciente, fazendo-se necessário um planejamento que envolva diferentes especialidades na odontologia. Objetivo: Relatar um caso clínico de reabilitação funcional e estética de fratura dentária nos incisivos centrais superiores envolvendo tratamento endodôntico, instalação de pino de fibra de vidro e restauração direta em resina composta. Relato de Caso: O paciente de 17 anos sofreu fratura nos incisivos centrais superiores causada por uma queda de bicicleta. Devido à busca tardia por tratamento o elemento 21 foi diagnosticado com necrose pulpar e, portanto, foi submetido à tratamento endodôntico pela Técnica Crown Down e reabilitação com pino de fibra de vidro Splendor-SAP. Posteriormente, os elementos 11 e 21 foram restaurados com facetas diretas em resina composta pela técnica incremental. Conclusão: A reabilitação com instalação de pino de fibra de vidro associada à técnica de estratificação incremental em resina composta se mostra como uma boa opção para reabilitação estética pois permite dar forma anatômica ao dente com riqueza de detalhes na estratificação da dentina e esmalte, além de máxima preservação da estrutura dental. Os resultados obtidos reforçam o sucesso estético e funcional com significativo impacto na qualidade de vida do paciente(AU)


Traumatic dental injuries are a worldwide public health problem, among which dental fractures are the most frequent, mainly involving the anterior teeth. The approach of large anterior fractures is a challenge for dental surgeons of any level because, in addition to function, they directly affect the patient's esthetics, requiring a plan that involves different specialties in dentistry. Objective: Report a clinical case of functional and aesthetic rehabilitation of dental fractures in maxillary central incisors involving endodontic treatment, installation of a fiberglass post and direct restoration in composite resin. Case Report: The 17-year-old patient suffered a fracture in the upper central incisors caused by a fall from a bicycle. Due to the late search for treatment, element 21 was diagnosed with pulp necrosis and, therefore, underwent endodontic treatment using the Crown Down Technique and rehabilitation with a Splendor-SAP fiberglass pin. Later, elements 11 and 21 were restored with direct veneers in composite resin using the incremental technique. Conclusion: Rehabilitation with the installation of a fiberglass post associated with the incremental layering technique in composite resin is a good option for aesthetic rehabilitation as it allows the anatomical shape of the tooth with rich details in the layering of dentin and enamel, in addition to maximum preservation of the tooth structure. The results obtained reinforce the aesthetic and functional success with a significant impact on the patient's quality of life(AU)


Subject(s)
Humans , Male , Adolescent , Tooth Injuries , Composite Resins , Dental Restoration, Permanent , Esthetics, Dental , Quality of Life , Root Canal Therapy , Dental Pulp Necrosis , Dental Veneers , Incisor
3.
Arq. ciências saúde UNIPAR ; 27(1): 418-433, Jan-Abr. 2023.
Article in Portuguese | LILACS | ID: biblio-1415098

ABSTRACT

Os traumatismos dentários representam um problema de saúde pública devido à alta prevalência e impacto psicossocial, sendo muito frequentes em crianças podendo resultar em necrose pulpar e culminar na rizogênese incompleta de dentes permanentes. Nestes casos de traumatismos em dentes permanentes com rizogênese incompleta e necrose pulpar, o tratamento mais indicado pela literatura é a apicificação, sendo um tratamento complexo e longo. Considerando a importância deste tema, o objetivo deste trabalho é relatar o caso de um paciente com traumatismo dental e necrose pulpar, que acarretou a interrupção do desenvolvimento completo e adequado do ápice dentário, sendo necessária a intervenção por meio da técnica de apicificação e o acompanhamento a longo prazo. O caso trata-se de uma menina em que um traumatismo dentário acarretou fratura de um incisivo central superior com formação radicular incompleta, comprometendo tanto a estética quanto a vitalidade do dente. Foi realizado o tratamento endodôntico com apicificação e posteriormente ao plug apical de MTA. O dente foi restaurado definitivamente com resina composta e realizado acompanhamento do paciente. Nas consultas de acompanhamento houve ausência de sintomatologia dolorosa e satisfação da paciente com a aparência atual. Sendo assim, a apicificação apresenta-se como uma ótima alternativa para dentes com rizogênese incompleta e necrose pulpar, embora longo houve uma melhora estética e satisfação do paciente.


Dental trauma represents a public health problem due to its high prevalence and psychosocial impact, being very frequent in children and can result in pulp necrosis and culminate in incomplete root formation of permanent teeth. In these cases of trauma to permanent teeth with incomplete root formation and pulp necrosis, the most indicated treatment in the literature is apexification, which is a complex and long treatment. Considering the importance of this topic, the objective of this work is to report the case of a patient with dental trauma and pulp necrosis, which caused the interruption of the complete and adequate development of the dental apex, requiring intervention through the apexification technique and follow-up. long-term. The case is about a girl in which a dental trauma resulted in a fracture of a maxillary central incisor with incomplete root formation, compromising both the esthetics and the vitality of the tooth. Endodontic treatment was performed with apexification and then apical MTA plug. The tooth was definitively restored with composite resin and the patient was followed up. In the follow- up consultations, there was no painful symptomatology and the patient was satisfied with her current appearance. Thus, the apexification presents itself as a great alternative for teeth with incomplete root formation and pulp necrosis, although in the long run there was an aesthetic improvement and patient satisfaction.


Los traumatismos dentales representan un problema de salud pública debido a su alta prevalencia e impacto psicosocial, siendo muy frecuentes en niños y pudiendo dar lugar a necrosis pulpar y culminar en la formación incompleta de la raíz de los dientes permanentes. En estos casos de traumatismos en dientes permanentes con formación radicular incompleta y necrosis pulpar, el tratamiento más indicado en la literatura es la apexificación, que es un tratamiento complejo y largo. Considerando la importancia de este tema, el objetivo de este trabajo es relatar el caso de una paciente con traumatismo dentario y necrosis pulpar, que causó la interrupción del desarrollo completo y adecuado del ápice dentario, requiriendo intervención a través de la técnica de apexificación y seguimiento. a largo plazo. Se trata de una niña en la que un traumatismo dental provocó la fractura de un incisivo central maxilar con formación radicular incompleta, comprometiendo tanto la estética como la vitalidad del diente. Se realizó tratamiento endodóntico con apexificación y posterior taponamiento apical con MTA. El diente fue restaurado definitivamente con resina compuesta y el paciente fue sometido a seguimiento. En las consultas de seguimiento, no había sintomatología dolorosa y la paciente estaba satisfecha con su aspecto actual. Así, la apexificación se presenta como una gran alternativa para dientes con formación radicular incompleta y necrosis pulpar, aunque a la larga se produjo una mejoría estética y satisfacción de la paciente.


Subject(s)
Humans , Female , Child , Dentition, Permanent , Endodontics/instrumentation , Wounds and Injuries/diagnosis , Patient Satisfaction , Composite Resins , Dental Pulp Necrosis/diagnosis , Dentists , Esthetics , Apexification/instrumentation , Regenerative Endodontics , Case Reports as Topic
4.
Rev. Fac. Odontol. (B.Aires) ; 38(90): 15-20, 2023. ilus
Article in Spanish | LILACS | ID: biblio-1553586

ABSTRACT

El diente evaginado (DE) es una anomalía del desa-rrollo que se define como un tubérculo o protube-rancia que se extiende desde la superficie oclusal del diente afectado. La fractura o desgaste de esta pro-longación, internamente compuesta por tejido pul-par, puede causar diversas enfermedades pulpares, como pulpitis, necrosis pulpar e incluso dar lugar a una periodontitis apical. En el presente caso clíni-co se muestra el tratamiento de DE en un segundo premolar superior izquierdo que presentaba como diagnóstico necrosis pulpar y absceso alveolar cró-nico. El tratamiento consistió en realizar la terapia endodóntica con técnica de apexificación empleando BiodentineTM (AU)


Dens evaginatus (DE) is a dental developmental defect defined as a tubercle or protuberance that extends from the occlusal surface of the affected tooth. Fracture or wear of this extension, internally composed of pulp tissue, can cause diverse pulp diseases, such as pulpitis, pulpal necrosis and it can even induce apical periodontitis.The following clinical case shows the treatment of DE in a maxillary left second premolar diagnosed with pulp necrosis and chronic alveolar abscess. The treatment of choice was endodontic therapy using BiodentineTM (AU)


Subject(s)
Humans , Male , Adult , Root Canal Filling Materials , Root Canal Therapy/methods , Dental Pulp Necrosis/therapy , Dens in Dente/pathology , Argentina , Schools, Dental
5.
Rev. Fac. Odontol. (B.Aires) ; 38(90): 45-50, 2023. ilus
Article in Spanish | LILACS | ID: biblio-1554019

ABSTRACT

Objetivo: se presenta el caso clínico de sinusitis de origen endodóntico, conocida como síndrome en-doantral, haciendo énfasis en la dificultad de diag-nóstico con radiografía periapical y la importancia de la tomografía computarizada. Caso clínico: una mujer de 32 años, con antecedentes de apretamiento dental nocturno y sinusitis recurrente, fue remitida para evaluación endodóntica. El examen clínico reve-ló sensibilidad a la percusión y palpación en la unidad dental. La radiografía periapical no indicó lesión en el diente 16 y la prueba de sensibilidad pulpar fue ne-gativa, además, la tomografía computarizada reveló una extensa lesión periapical y comunicación entre la raíz del diente 16 y el seno maxilar, confirmada por la pérdida de la continuidad de la imagen hiperdensa en el suelo del seno, lo que llevó al tratamiento endo-dóntico. El control de la infección dental resolvió la sinusitis, resaltando la importancia del diagnóstico preciso y el tratamiento en casos de sinusitis odon-togénica. Conclusión: este caso destaca el valor de la tomografía computarizada como herramienta diag-nóstica crucial en contextos clínicos complejos (AU)


Objective: the clinical case of sinusitis of endodontic origin, known as endoantral syndrome, is presented, emphasizing the difficulty of diagnosis with periapical radiography and the importance of computed tomography. Clinical case: a 32-year-old woman, with a history of tooth clenching and recurrent sinusitis, was referred for endodontic evaluation. The clinical examination revealed sensitivity to percussion and palpation in the dental unit. The periapical radiograph did not indicate a lesion in tooth 16 and the pulp sensitivity test was negative, in addition, the computed tomography revealed an extensive periapical lesion and communication between the root of tooth 16 and the maxillary sinus, confirmed by the loss of continuity of the hyperdense image in the sine floor, which led to endodontic treatment. Dental infection control resolved sinusitis, highlighting the importance of accurate diagnosis and treatment in cases of odontogenic sinusitis. Conclusion: this case highlights the value of computerized tomography as a crucial diagnostic tool in complex clinical contexts (AU)


Subject(s)
Humans , Female , Adult , Maxillary Sinusitis/etiology , Maxillary Sinusitis/diagnostic imaging , Dental Pulp Necrosis/complications , Cone-Beam Computed Tomography/methods , Focal Infection, Dental/complications , Periapical Periodontitis/complications , Root Canal Therapy/methods
6.
Pesqui. bras. odontopediatria clín. integr ; 23: e210196, 2023. tab, graf
Article in English | LILACS, BBO | ID: biblio-1448790

ABSTRACT

ABSTRACT Objective: To compare the pulp vitality of deciduous molars before and after selective caries removal (SCR) or nonselective caries removal to hard dentin (NSCR) over one year, using oxygen saturation percentage (%SaO2). Material and Methods: Deciduous molars with deep occlusal/proximal-occlusal caries lesions were randomized to SCR (n=22) or NSCR groups (n=22). After the caries removal, the teeth were protected with calcium hydroxide cement and restored with composite resin (Filtek Z250). The pulp condition diagnosis was evaluated at baseline, immediately after caries removal, and follow-up (7 days, 1-, 6- and 12-months) by %SaO2. Pulp exposure and pulp necrosis were primary outcomes, and %SaO2 was secondary. Results: Intraoperative pulp exposure occurred in four teeth of the NSCR group (18.2%) and one tooth of the SCR group (4.5%) (p>0.05). Two cases of pulp necrosis occurred in the NSCR group (10%). No difference in %SaO2 pulp was observed in the inter-and intragroup comparison over time (p>0.05). Conclusion: Advantageously, the %SaO2 minimizes preoperatory pulp vitality diagnosis subjectivity before SCR/ NSCR treatments. Furthermore, the pilot study results suggest the pulp response of deciduous molars, when evaluated by clinical, radiographic, and pulp %SaO2 seems not to differ between teeth treated with SCR or NSCR.


Subject(s)
Humans , Tooth, Deciduous , Dental Pulp Necrosis/therapy , Dental Caries/prevention & control , Molar , Oximetry/methods , Pilot Projects , Dental Pulp/injuries , Dental Pulp Test/methods , Oxygen Saturation
7.
Odontol. vital ; (37)dic. 2022.
Article in Spanish | LILACS, SaludCR | ID: biblio-1422179

ABSTRACT

Introducción: La fluorosis dental es una hipomineralización del esmalte producida como respuesta a la ingesta de fluor por un periodo prolongado durante la formación del esmaltado. Es una alteración irreversible, que clínicamente se caracteriza por la presencia de delgadas líneas blanquecinas distribuidas en el esmalte dental correspondientes a la disposición de las periquimatías, y en grados más avanzados de la enfermedad se odservan cambios en toda la superficie del esmaltado que adquiere un aspecto opaco, como de piedra caliza. En los niveles más severos de flurosis dental, la presencia de hipomineralización, y el aumento en la porosidad del esmalte dental propicia la pérdida de porciones importantes de su estructura, produciendo fracturas, por lo que se deteriora la apariencia y funcionalidad de los dientes afectados. (1) La OMS recomienda que el valor de referencia para el fluoruro en el agua potable es de 1,5 mg /1.(2) El flúor es un gas halógeno, el más electronegativo de los elementos de la tabla periódica, con número atómico 19, prácticamente no existe libre en la naturaleza, sino asociado a otros elementos como: calcio y sodio. La principal vía de incorporación del flúor en el organismo humano es la digestiva. Es absorbido rápidamente en la mucosa del intestino delgado y del estómago, por un simple fenómeno de difusión. Una en los tejidos, depositándose preferentemente en los tejidos duros; se elimina por todas las vías de excreción, principalmente por orina. La cantidad de flúor en el organismo es variable y depende de la ingestión, inhalación, absorción y eliminación, así como de las características de los compuestos. Generalmente se concentra en huesos, cartílagos, dientes y placa bacteriana. El depósito de flúor varía con la edad y la excreción. En los niños, el 50% se fija en huesos y dientes en formación; en adultos, se deposita básicamente en huesos. (3) Existen diversos métodos para su eliminación. En esta investigación se realizaron 18 procedimientos a pacientes de ambos sexos. La metodología fue dividir en dos grupos de 8 personas cada uno, en el cual se utilizó Antivet en el primer grupo y ácido clorhídrico al 18% en el segundo grupo. Los casos fueron seleccionados al azar y posteriormente se observaron los cambios clínicos con cada grupo. En el primer grupo de personas que utilizaron Antivet, se mostró que en casos severos de fluorosis no era un método tan eficaz, ya que no elimina por completo las manchas marrones, sin embargo, es un procedimiento muy bueno para uso clínico cuando los grados de fluorosis son menores. En el segundo grupo de personas que utilizaron ácido clorhídrico al 18% se demostró la eficacia del tratamiento en fluorosis de grados avanzados, donde el esmalte está más del 50% dañado, por lo que es un excelente método de tratamiento con el debido control en su manipulación. Objetivo: Saber diferenciar los tipos de materiales y conocer los diferentes métodos para eliminación de flúor así como mostrar la diferencia entre tratamientos. Metodología: El tipo de estudio es explicativo y con el cual se espera contribuir al desarrollo del conocimiento científico. Su realización supone el ánimo de contribuir al desarrollo del saber científico. Consistió en seleccionar 16 pacientes, masculinos y femenonos y de distintas edades de entre 15 y 40 años. Se dividieron al azar, en 2 grupos de 8 personas cada uno para tratarlos con 2 productos diferentes. El primer grupo fue tratado con ácido clorhídrico al 18% y el segundo grupo con la marca comercial Antivet. Resultado y conclusión: La fluorosis dental es causada por ingestas excesivas de flúor. El uso del ácido clorhídrico es corrosivo, su aroma es penetrante y los cuidados con el paciente son mayores, ya que un mal uso al tener contacto con piel o mucosa creará necrosis. El Antivet tiene desventajas de costo y disponibilidad, pero su ventaja es que brinda más seguridad en su manipulación.


Introduction: Dental fluorosis is a hypomineralization of the enamel produced due to fluoride intake for a prolonged time during enamel formation. It is an irreversible alteration, which is clinically characterized by the presence of thin whitish lines distributed in the dental enamel corresponding to the disposition of the perikymata. In more advanced degrees of the disease, changes are observed in the entire enamel surface, which acquires an opaque appearance, like limestone. In the most severe levels of dental fluorosis, the presence of hypomineralization and increased porosity of the dental enamel leads to the loss of essential portions of its structure, producing fractures, thus deteriorating the appearance and functionality of the affected teeth. (1) The WHO recommends that the reference value for fluoride in drinking water is 1.5 mg/l. (2) Fluoride is a halogen gas, the most electronegative of the periodic table elements, with atomic number 19. It practically does not exist free in nature but is associated with other elements such as calcium and sodium. The primary way of incorporating fluorine into the human organism is through the digestive system. It is rapidly absorbed in the mucosa of the small intestine and stomach by a simple phenomenon of diffusion. Once absorbed, fluoride passes into the blood and is distributed in the tissues, preferentially deposited in hard tissues; it is eliminated by all excretion routes, mainly by the urine. The amount of fluoride in the body is variable and depends on ingestion, inhalation, absorption, elimination, and the characteristics of the compounds. It is generally concentrated in bones, cartilage, teeth, and bacterial plaque. Fluoride deposition varies with age and excretion. In children, 50% is fixed in bones and teeth information; it is basically deposited in bones in adults. (3) There are various methods for its elimination. In this research, 18 procedures were performed on patients of both sexes. The methodology was divided into two groups of 8 persons each, in which Antivet was used in the first group and 18% hydrochloric acid in the second group. The cases were randomly selected, and subsequently, the clinical changes were observed in each group. In the first group of people who used Antivet, it was shown that in severe cases of fluorosis, it was not such an effective method since it does not completely eliminate the brown stains. However, it is a very effective method for clinical use when the degrees of fluorosis are lower. In the second group of people who used 18% hydrochloric acid, the effectiveness of the treatment was demonstrated in advanced degrees of fluorosis, where the enamel is more than 50% damaged, making it an excellent method of treatment with due control in its manipulation. Objective: To differentiate the types of materials and to know the different methods for fluoride elimination as well as to show the difference between treatments. Methodology: The type of study is explanatory, and it is expected to contribute to the development of scientific knowledge. It was carried out to contribute to the development of scientific knowledge. It consisted of selecting 16 patients of both sexes and of different ages between 15 and 40 years old. They were randomly divided into two groups of 8 persons, each to be treated with two different products. The first group was treated with 18% hydrochloric acid, and the second group with the comercial brand Antivet. Result and conclusion: Dental fluorosis is caused by excessive fluoride intake. Hydrochloric acid is corrosive, its aroma is penetrating, and the care with the patient is greater since a wrong use when in contact with skin or mucosa will create necrosis. Antivet has disadvantages of cost and availability, but its advantage is that it provides more safety in its handling.


Subject(s)
Humans , Adolescent , Adult , Dental Pulp Necrosis/drug therapy , Hydrochloric Acid/therapeutic use , Fluorosis, Dental/etiology
8.
Rev. Odontol. Araçatuba (Impr.) ; 43(3): 40-47, set.-dez. 2022. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1381100

ABSTRACT

Introdução: A revascularização pulpar é uma terapêutica que visa regenerar parte do complexo dentino pulpar, proporcionando a continuidade do desenvolvimento radicular, sanando a fragilidade e propensão a fratura que a apicificação apresentava. É um tratamento direcionado a dentes diagnosticados com rizogênese incompleta. Entretanto, a possibilidade de realização da técnica em dentes maduros tem sido alvo de pesquisas e estudo. Objetivo: O objetivo deste estudo, é apresentar através da revisão de literatura e caso clínico, os benefícios dos procedimentos endodônticos regenerativos (REPs), em dentes jovens e maduros, em relação à apicificação. Metodologia: O estudo é uma revisão de literatura, desenvolvida através de pesquisa exploratória e realizada uma abordagem qualitativa. Para a coleta de dados, foi aplicada a técnica de análise documental e revisão bibliográfica consultando PUBMED, Scielo, Google Acadêmico e monografias acadêmicas. O caso clínico foi realizado de acordo com o protocolo atualizado pela AAE em 2016. Discussão: A revascularização pulpar tem mostrado ser um tratamento promissor na endodontia, é preconizada a desinfecção e medicação intracanal, já que não pode haver instrumentação mecânica. Os agentes irrigadores devem ser bactericidas, bacteriostáticos e devem ter baixo teor de toxicidade, já a medicação intracanal deve ter papel inibidor em bactérias gram positivas e gram negativas. Conclusão: A apicificação mesmo com o uso de MTA, que não exige trocas excessivas de medicações, não sana as necessidades que um dente com rizogênese incompleta requer. Sendo assim, a revascularização foi eleita o tratamento de melhor prognóstico para dentes jovens e necrosados. O caso clínico demonstrou qualidade moderada, no tratamento regenerativo em um dente maduro com reabsorção externa, abrindo novas perspectivas para os (REPs)(AU)


Introduction: Pulp revascularization is a therapy that aims to regenerate part of the pulp dentin complex, providing continuity of root development, remedying the fragility and propensity to fracture that apexification presented. It is a treatment aimed at teeth diagnosed with incomplete rhizogenesis. However, the possibility of performing the technique on mature teeth has been the subject of research and study. Objective: The aim of this study is to present, through literature review and clinical case, the benefits of regenerative endodontic procedures (REPs), in young and mature teeth, in relation to apexification. Methodology: The study is a literature review, developed through exploratory research and carried out a qualitative approach. For data collection, the technique of document analysis and bibliographic review was applied, consulting PUBMED, Scielo, Academic Google and academic monographs. The clinical case was performed according to the protocol updated by the SEA in 2016. Discussion: Pulp revascularization has shown to be a promising treatment in endodontics, intracanal disinfection and medication is recommended, as there can be no mechanical instrumentation. Irrigating agents must be bactericidal, bacteriostatic and must have a low level of toxicity, whereas intracanal medication must have an inhibiting role in gram positive and gram negative bacteria. Conclusion: Apexification, even with the use of MTA, which does not require excessive medication changes, does not meet the needs that a tooth with incomplete rhizogenesis requires. Therefore, revascularization was chosen as the treatment with the best prognosis for young and necrotic teeth. The clinical case demonstrated moderate quality in regenerative treatment in a mature tooth with external resorption, opening new perspectives for (REPs)(AU)


Subject(s)
Humans , Female , Middle Aged , Root Canal Therapy , Dental Pulp Necrosis/therapy , Regenerative Endodontics , Dental Pulp Necrosis , Dental Pulp , Apexification
9.
J. res. dent ; 10(2): 16-20, apr.-jun2022.
Article in English | LILACS, BBO | ID: biblio-1395878

ABSTRACT

Internal inflammatory root resorption (IIRR) can occur as a serious complication of dental trauma which leads to progressive loss of the root structure. An early diagnosis could influence the therapeutic approach, but endodontic treatment becomes a challenge with a doubtful prognosis. The present report described an unusual clinical presentation of an IIRR with perforation resulting from a trauma four years previous. A 15-year-old female patient was presented to our service with pain in the maxillary incisor region. Intraoral radiography revealed a large radioloucent area compatible with IIRR, communicating with the periodontium in the middle third on the distal root face of the right central incisor. The root canal of the right central incisor was chemo-mechanically prepared. The calcium hydroxide (CH) intracanal medication was used and renewed periodically four times. The root canal was filled only in the cervical region to the level of resorption by the inverted gutta-percha cone technique. Clinically and radiographically, all follow-up examinations revealed an asymptomatic tooth, evidencing periapical tissue repair and new bone formation. The tooth remained asymptomatic 3 years afterwards. The present case report supports the idea of executing satisfactory intracanal decontamination by chemo-mechanical preparation, thus creating a favourable environment for tissue repair.


Subject(s)
Humans , Female , Root Canal Therapy , Dental Pulp Necrosis , Root Resorption , Calcium Hydroxide
10.
Rev. Fac. Odontol. (B.Aires) ; 37(85): 15-23, 2022. ilus
Article in Spanish | LILACS | ID: biblio-1397858

ABSTRACT

El Biodentine es un material biocerámico y bioacti-vo que puede emplearse como sustituto activo de la dentina. Entre sus numerosos usos se incorpora su utilización como sellador del coágulo en los procedi-mientos endodónticos regenerativos, logrando me-jores propiedades con respecto al Gold standard. Se presenta la resolución clínica y radiográfica de tres situaciones clínicas, mediante la aplicación del proto-colo de los procedimientos endodónticos regenerati-vos, en los que se utilizó Biodentine como alternativa para el sellado del coágulo a nivel cérvico-radicular, en la obturación a nivel del límite amelocementario (AU)


Biodentine is a bio-ceramic and bioactive material that can be used as an active substitute for dentin. Its many uses include its use as a clot sealer in regenerative endodontic procedures, achieving better properties compared to the Gold standard. The clinical and radiographic resolution of three clinical situations is presented, by applying the protocol of regenerative endodontic procedures, where Biodentine was used as an alternative for sealing the clot at the cervical-radicular level in the obturation at the level of the cementoenamel limit (AU)


Subject(s)
Humans , Male , Female , Child , Biocompatible Materials/therapeutic use , Dentin , Regenerative Endodontics , Argentina , Schools, Dental , Ceramics , Dental Care for Children/methods , Dental Pulp Necrosis/therapy
11.
Rev. odontopediatr. latinoam ; 12(1): 202542, 2022. ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1418978

ABSTRACT

Introducción:La revascularización pulpar es la terapia de primera elección para tratar al diente permanente inmaduro afectado por necrosis pulpar con periodontitis o absceso apical. Las evidencias indican que esta técnica induce la reparación de los tejidos dañados o perdidos, dentro y en la periferia, del conducto radicular. Durante los controles postoperatorios, el clínico dispone, fundamentalmente, de los hallazgos clínicos, radiográficos o imagenológicos, para interpretar y evaluar los resultados obtenidos con la terapia. Objetivo: Identificar los hallazgos clínicos, radiográficos e imagenológicos que determinan el éxito de la revascularización pulpar. Materiales y métodos: El desarrollo de la presente revisión narrativa se llevó a cabo mediante una estrategia de búsqueda en la base electrónica de datos y la consulta directa de portales web especializados. Además, se realizó una pesquisa en búsqueda de artículos primarios citados indiferentemente del año de publicación. Resultados: Fueron seleccionadas 25 publicaciones por su aporte y relevancia, de forma tal, que la presente revisión pueda cumplir con su objetivo. Conclusiones: Desde el punto de vista clínico, tanto para el control de los signos y síntomas de la infección como para inducir la reparación periapical, resulta una terapia exitosa. Ha demostrado que puede engrosar las paredes radiculares y estrechar el foramen apical a expensas de la deposición de un tejido mineralizado. Sin embargo, el alargamiento radicular sigue siendo un resultado incierto. La respuesta positiva a las pruebas de sensibilidad sugiere la existencia de un tejido vital en el interior del conducto radicular.


Introdução: A revascularização pulpar é a terapia de primeira escolha para o tratamento de dentes permanentes imaturos acometidos por necrose pulpar com periodontite ou abscesso apical. Evidências indicam que esta técnica induz o reparo de tecido danificado ou ausente dentro e ao redor do canal radicular. Durante os controles pós-operatórios, o clínico tem basicamente os achados clínicos, radiográficos ou de imagem para interpretar e avaliar os resultados obtidos com a terapia. Objetivo: Identificar os achados clínicos, radiográficos e de imagem que determinam o sucesso da revascularização pulpar. Materiais e métodos: O desenvolvimento desta revisão narrativa foi realizado por meio de uma estratégia de busca na base de dados eletrônica e consulta direta de portais especializados. Além disso, foi realizada uma busca em busca de artigos primários citados independente do ano de publicação. Resultados: 25 publicações foram selecionadas por sua contribuição e relevância, para que esta revisão possa cumprir seu objetivo. Conclusões: Do ponto de vista clínico, tanto para controlar os sinais e sintomas da infecção quanto para induzir o reparo periapical, é uma terapia de sucesso. Foi demonstrado que pode engrossar as paredes radiculares e estreitar o forame apical às custas da deposição de tecido mineralizado. No entanto, o alongamento da raiz continua sendo um resultado incerto. Uma resposta positiva aos testes de sensibilidade sugere a existência de tecido vital dentro do canal radicular.


Introduction: Pulpal revascularization is the first-choice therapy to treat immature permanent teeth affected by pulpal necrosis with periodontitis or apical abscess. Evidence indicates that this technique induces repair of damaged or missing tissue within and around the root canal. During the postoperative controls, the clinician basically has the clinical, radiographic or imaging findings to interpret and evaluate the results obtained with the therapy. Objective: To identify the clinical, radiographic and imaging findings that determine the success of pulpal revascularization. Materials and methods: The development of this narrative review was carried out through a search strategy in the electronic database and direct consultation of specialized web portals. In addition, a search was carried out in search of primary articles cited regardless of the year of publication. Results: 25 publications were selected for their contribution and relevance, so that this review can fulfill its objective. Conclusions: From the clinical point of view, both to control the signs and symptoms of the infection and to induce periapical repair, it is a successful therapy. It has been shown that it can thicken the root walls and narrow the apical foramen at the expense of the deposition of mineralized tissue. However, root elongation remains an uncertain outcome. A positive response to sensitivity tests suggests the existence of vital tissue within the root canal.


Subject(s)
Humans , Female , Pregnancy , Dental Pulp Necrosis , Dental Pulp Cavity , Periodontitis , Review Literature as Topic , Dentition, Permanent , Tooth Apex , Abscess
12.
Chinese Journal of Stomatology ; (12): 3-9, 2022.
Article in Chinese | WPRIM | ID: wpr-935822

ABSTRACT

Regenerative endodontic therapy is a tissue engineering based approach of treatment for endodontic disease. Its purpose is to achieve the regeneration of the pulp-dentin complex, thus to promote root development of the immature permanent tooth with necrotic pulp. Like other treatments based on tissue engineering techniques, the success of regenerative pulp therapy depends on such three elements as seed cells, scaffold materials and growth factors. Since its inception 20 years ago, there have been various terminologies in the literature, with similarities and differences in connotation. The present article summarizes and analyzes the term evolution, biological basis, clinical considerations and future scientific research directions of regenerative endodontics, in order to find out the unsolved scientific problems and to promote the development and standardization of this technique in clinical practice.


Subject(s)
Humans , Dental Pulp , Dental Pulp Necrosis , Regeneration , Regenerative Endodontics , Root Canal Therapy , Tissue Engineering
13.
Dent. press endod ; 11(3): 66-74, Sept-Dec.2021. Ilus
Article in English | LILACS | ID: biblio-1379506

ABSTRACT

Introdução: A presença de microrganismos é considerada a principal causa de insucesso da terapia endodôntica. Além disso, a anatomia interna dos dentes também representa um grande desafio para os endodontistas. Desse modo, lançar mão da tecnologia reduz tempo clínico e aumenta a chance de sucesso da terapia endodôntica. Objetivo: O objetivo do presente estudo foi relatar um caso clínico com a utilização de instrumentação mecanizada e o sistema Reci- proc Blue associados à terapia fotodinâmica. Descrição: Paciente do sexo feminino, melanoderma, compareceu à clínica escola de uma faculdade de Odontologia apresentando duas fístulas intrabucais ativas na região de fundo de vestíbulo próxima aos ápices dos dentes #12 e #22. Após os exames clínicos, radiográficos, testes de sensibilidade e rastreamento de fístulas, estabeleceu-se o diagnóstico de necrose pulpar, sugestível de abscesso apical crônico dos incisivos laterais superiores. Resultados: O tratamento endodôntico dos dois elementos dentários foi realizado em sessão única, utilizando o instrumento Reciproc Blue em movimento reciprocante associado à terapia fotodinâmica. Após 30 dias da conclusão dos tratamentos endodônticos e restauradores, os dentes apresentavam-se assintomáticos e com cicatrização das fístulas intrabucais. Conclusão: O uso do sistema Reciproc Blue associado à terapia fotodinâmica foi eficaz. Constatou-se o sucesso clínico e radiográfico da terapêutica aplicada, verificando-se o restabelecimento da região periapical, com regressão da lesão radiograficamente e ausência de sinais clínicos e sintomas de infecção do canal radicular. O acompanhamento por tempo prolongado é necessário para se avaliar o total reparo da lesão periapical (AU).


Introduction: The presence of microorganisms is considered the main cause of endodontic therapy failure. In addition, an internal anatomy also poses a major challenge for endodontists. In this way, avail a series of quick techniques and increase the chance of success. The reason of this study was to relate clinical cases, root canal treatment, using mechanized instrumentation with the system Reciproc Blue instrument, associated with photodynamic therapy. Case report: A female genetic patient, brown skin, presented at the school clinic of a dental school, with a major complaint of "blistering on the gum." At the clinical examination, the target dates are inside the mouth active in the selection bottom region near the apexes of the elements 12 and 22. Through clinical, radiographic, sensitivity and screening tests of fistulae, diagnosis and diagnosis of pulp necrosis, suggestive of chronic apex abscess of the incisors. Results: Endodontic treatment of the two dental elements was performed in a single session using the Reciproc Blue instrument in a reciprocating motion associated with photodynamic therapy. After 30 days of completion of endodontic and restorative treatments, one patient returned for evaluation and clinical follow-up. The new asymptomatic presentation and with a healing of the intrabucal fistulas. Conclusion: The system Reciproc Blue associated with photo-dynamic therapy was effective. It was verified the clinical and radiographic success of apicality, confirming the reestablishment of the apex region with regression of the radiographic lesion and the absence of clinical signs and signs of infection of the root canal. The patient is with the clinician and radiographic studies (AU).


Subject(s)
Humans , Photochemotherapy , Dental Pulp Necrosis , Periapical Abscess , Wound Healing , Dental Pulp Cavity
14.
Dent. press endod ; 11(3): 14-23, Sept-Dec.2021.
Article in English | LILACS | ID: biblio-1378576

ABSTRACT

A proposta da presente revisão de literatura foi estabelecer as evidências existentes sobre etiologia, sinais e sintomas, métodos de diagnóstico e tratamento de dentes gretados. Segundo a American Association of Endodontists (AAE), o termo dente gretado (DG) foi definido como uma fratura em um plano que quebra a continuidade do esmalte e da dentina, sem separação das partes, geralmente no sentido mesiodistal, passando pela superfície oclusal, podendo envolver uma ou ambas as cristas marginais. Essa fratura, por apresentar profundidade e direção desconhecidas, pode se estender até a polpa e/ou ligamento periodontal, levando a um quadro de pulpite reversível, pulpite irreversível, necrose pulpar ou, até mesmo, evoluir para uma fratura completa. Atualmente, os DGs estão relacionados à terceira maior causa de dentes perdidos, após cárie e doença periodontal. Estudos indicam uma falta de consenso entre profissionais sobre como tratar dentes gretados, uma questão clínica relevante, que precisa ser priorizada e esclarecida. Nesse contexto, essa revisão abordou a etiologia, sinais e sintomas, métodos de diagnósti- co e tratamento de dentes gretados (AU)


The purpose of this literature review is to examine the existing evidence regarding etiology, signs, symptoms, methods of diagnosis, and treatment of cracked teeth. According to the American Association of Endodontists (AAE), the term cracked tooth (CT) is defined as "a fracture in a plane that breaks the continuity of the enamel and dentin, without separation of the parts, usually in the mesiodistal direction, passing through the surface occlusal, which may involve one or both of the marginal ridges." Due to its unknown depth and direction, this fracture can extend to the pulp and periodontal ligament, leading to reversible pulpitis, irreversible pulpitis, pulp necrosis, or even progress to a complete fracture. Currently, cracked teeth are related to the third largest cause of missing teeth, after caries and periodontal disease. Studies indicate a lack of consensus among professionals about treating cracked teeth, a clinically relevant issue that needs to be prioritized and clarified. In this context, this review addressed the etiology, signs and symptoms, diagnostic methods, and treatment of cracked teeth (AU).


Subject(s)
Humans , Pulpitis , Dental Pulp Necrosis , Inlays , Specialization , Tooth
15.
Braz. j. oral sci ; 20: e213690, jan.-dez. 2021. ilus
Article in English | BBO, LILACS | ID: biblio-1281104

ABSTRACT

Aim: to develop a model for regenerative endodontics using newly-weaned Wistar rats immature molars with pulp necrosis to histologically describe the evolution of apical tissues following treatment with a bi-antibiotic paste, induced bloodclot formation and MTA. Methods: Ten 25-day-old female Wistar rats were divided into an initial control group (Ci) and two experimental groups in which pulp necrosis was experimentally induced on the left mandibular first molar by exposing the pulp chamber and leaving it open to the oral environment. One of the experimental groups was left untreated (E1) while the other was submitted to a protocol of regenerative endodontics 10 days thereafter (E2). Fifteen days after placement of a bi-antibiotic paste, bleeding was induced into the root canal space and MTA was placed upon. Animals were euthanized 30 days later. Right mandibular first molars served as an 80-day-old final control group (Cf). Each hemimandible was histologically processed to analyse parameters associated with root development. Statistical analysis was carried by means of ANOVA; p values below 0.05 were considered statistically significant. Results: baseline (i.e. 25-days old) mean root length and apical diameter of the distal root canal were 1.84±0.25 and 0.38±0.02mm respectively. Following the regenerative endodontic protocol, cells lining the walls of the root canal and significant increase to both length (2.37±0.22mm) and diameter (0.32±0.03 mm) were observed. Conclusions: newly-weaned Wistar rats serve as a suitable model to evaluate regenerative endodontic protocols. However, further research is needed in order to disclose the nature of the cells and/or cell mediators involved


Subject(s)
Animals , Rats , Root Canal Therapy , Dental Pulp Necrosis , Regenerative Endodontics , Anti-Bacterial Agents
16.
Rev. cir. traumatol. buco-maxilo-fac ; 21(4): 24-29, out.-dez. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1391265

ABSTRACT

Introdução: Traumatismos dentoalveolares acometem uma parcela considerável da população e ocorrem por diversas causas, como quedas, acidentes automobilísticos e agressões físicas. As lesões podem variar desde simples fraturas de esmalte até avulsão dental, estando associadas a danos de caráter estético, funcional, psicológico e social. Luxações intrusivas, que por lesionarem ao máximo os tecidos periodontais e pulpares, possuem um dos piores prognósticos, tendo como consequência a necrose pulpar na quase totalidade dos casos com rizogênese completa. Os possíveis tratamentos baseiam-se no desenvolvimento radicular e severidade da lesão, incluindo aguardar re-erupção espontânea, reposicionamento cirúrgico, tracionamento ortodôntico e exodontia do dente intruído. O presente estudo tem por finalidade relatar um caso clínico expondo o tratamento tardio da intrusão traumática grave do incisivo central superior permanente. Relato de caso: paciente do sexo feminino, 10 anos de idade, sofreu traumatismo bucofacial em 2009 e foi atendida na emergência, contudo nenhum atendimento odontológico foi realizado, somente no ano de 2011 procurou atendimento especializado na clínica odontológica da Universidade Estadual de Feira de Santana-BA. Considerações Finais: A conduta mais adequada frente a traumatismos dentoalveolares é atendimento de urgência, este tem por finalidade minimizar as sequelas causadas sempre no intuito de preservar o remanescente dentário e estruturas adjacentes... (AU)


Introduction: Dentoalveolar traumas affect a considerable portion of the population and occur due to several causes, such as falls, car accidents and physical aggressions. Lesions can range from simple enamel fractures to dental avulsion, and are associated with aesthetic, functional, psychological and social damage. Intrusive luxation, which, due to maximum damage to the periodontal and pulp tissues, have one of the worst prognoses and result in pulp necrosis in almost all cases of teeth with complete rhizogenesis. Possible treatments are based on root development and severity of lesion and include waiting for spontaneous re eruption, surgical repositioning, orthodontic traction and extraction of intruded tooth. The present study aims to report a clinical case exposing the late treatment of severe traumatic intrusion of the permanent upper central incisor. Case report: a 10-year-old female patient suffered a bucofacial trauma in 2009 and was attended to at an emergency service, however no dental care was provided, only in 2011 she sought specialized care at the dental clinic of the State University of Feira de Santana - BA. Final Considerations: The most appropriate conduct in the face of dentoalveolar traumatisms is urgent care, aiming to minimize sequelae to preserve the remaining tooth and adjacent structures... (AU)


Introducción: Los traumatismos dentoalveolares afectan a una parte considerable de la población y ocurren por diversas causas, como caídas, accidentes automovilísticos y agresiones físicas. Las lesiones pueden variar desde simples fracturas de esmalte hasta avulsión dentaria, estando asociadas con daños estéticos, funcionales, psicológicos y sociales. Las luxaciones intrusivas, que causan el máximo daño a los tejidos periodontales y pulpares, tienen uno de los peores pronósticos, resultando en necrosis pulpar en casi todos los casos con rizogénesis completa. Los posibles tratamientos se basan en el desarrollo de la raíz y la gravedad de la lesión, incluida la espera de una nueva erupción espontánea, el reposicionamiento quirúrgico, la tracción ortodóncica y la extracción del diente intruido. El presente estudio tiene como objetivo reportar un caso clínico que muestra el tratamiento tardío de la intrusión traumática severa del incisivo central maxilar permanente. Caso clínico: paciente de sexo femenino, 10 años, sufrió trauma orofacial en 2009 y fue atendida en urgencias, pero no se le brindó atención odontológica, solo en 2011 buscó atención especializada en la clínica odontológica de la Universidad Estadual de Feira de Santana - BA. Consideraciones finales: El abordaje más adecuado al trauma dentoalveolar es la atención de emergencia, que tiene como objetivo minimizar las secuelas ocasionadas, siempre con el fin de preservar el diente remanente y las estructuras adyacentes... (AU)


Subject(s)
Humans , Female , Child , Tooth Avulsion , Accidental Falls , Tooth Injuries , Dentition, Permanent , Dental Care , Dental Pulp Necrosis , Joint Dislocations , Maxilla
17.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 3-8, maio-ago. 2021. graf
Article in Portuguese | LILACS, BBO | ID: biblio-1252889

ABSTRACT

Dentes necrosados com rizogêneze incompleta representam um desafio para os endodontistas e odontopediatras, visto que as paredes radiculares desses dentes são mais finas, o que as tornam mais susceptíveis a fraturas. Durante muitos anos a técnica preconizada foi a apicificação que ainda é bastante utilizada. Nesta técnica são realizadas trocas constantes de medicação intracanal. O dente continua fragilizado e existe o risco do paciente não concluir o tratamento já que tal técnica demanda várias sessões clínicas. Com os avanços da ciência, surge a revascularização pulpar, trazendo vários beneficíos, entre os quais estão a continuidade apical e o ganho de espessura das paredes, além do benefício de conclusão do tratamento em uma ou duas sessões. Entretanto é necessária sua proservação que leva em média dois anos. O objetivo desta pesquisa foi avaliar o nível de conhecimento dos odontopediatras e endodontistas do município de Ilhéus-Bahia, frente a casos de necrose pulpar de dentes com formação radicular incompleta. O método e forma de análise de dados foram de um estudo observacional, transversal, realizado em consultórios do município de Ilhéus-BA que foram selecionados por amostragem aleatória. Os dados foram coletados por meio de um questionário contendo 10 questões de múltipla escolha sobre revascularização pulpar, especialização do profissional e tempo de formação. 20 profissionais aceitaram participar da pesquisa. Desses, 10% não sabiam ou nunca tinham ouvido falar sobre a revascularização pulpar. Conclui-se que ainda existem especialistas no Município de Ilhéus-BA que apresentam conhecimento insuficiente sobre a terapia endodôntica regenerativa, sendo que os mesmos deveriam ter conhecimento desta técnica já que são os profissionais que prestam o atendimento ao paciente jovem com dentes necrosados, reforçando a necessidade de elaboração de estratégia de conscientização e educação de saúde para habilitação e atualização dos mesmos(AU)


Necrotic teeth with incomplete rizogenesis representa challenge for endodontists and pediatric dentists, since the root walls of these teeth are thinner, which makes them more susceptible to fractures. For many years the recommended technique was apexification, which is still widely used. In this technique, constant changes of intracanal medication are performed. The tooth remains fragile and there is a risk that the patient will not complete the treatment as this technique requires several clinical sessions. With advances in science, pulp revascularization appears, bringing several benefits, among which are the apical continuity and the gain in thickness of the walls, in addition to the benefit of completing the treatment in one or two sessions. However, its preservation is necessary, which takes on average two years. The objective of this research was to evaluate the level of knowledge of pediatric dentists and endodontists in the municipality of Ilhéus-Bahia, in the face of cases of pulp necrosis of teeth with incomplete root formation. The method and form of data analysis were from an observational, cross-sectional study, carried out in offices in the municipality of Ilheus-BA that were selected by random sampling. Data were collected through a questionnaire containing 10 multiple-choice questions about pulp revascularization, professional specialization and training time. 20 professionals agreed to participate in the research. Of these, 10% did not know or had never heard of pulp revascularization. It is concluded that there are still specialists in the municipality of Ilhéus-BA who have insufficient knowledge about regenerative endodontic therapy, and they should have knowledge of this technique since they are the professionals who provide care to young patients with necrotic teeth, reinforcing the need to develop a health awareness and education strategy to enable and update them(AU)


Subject(s)
Humans , Male , Female , Dental Pulp Necrosis , Health Knowledge, Attitudes, Practice , Dental Pulp Necrosis/therapy , Knowledge , Dentists , Endodontists , Regenerative Endodontics
18.
Rev. Fac. Odontol. Porto Alegre (Online) ; 62(1): 129-150, jan.-jun. 2021.
Article in English | LILACS, BBO | ID: biblio-1451550

ABSTRACT

Introduction: The objective of this systematic review was to compare the apexification techniques of calcium hydroxide (Ca(OH)2), or mineral trioxide aggregate (MTA), with the pulp regeneration technique, using cohort studies, and non-randomized and randomized clinical trials. Methods: The methodology was based on electronic research in the following databases: PubMed, MEDLINE, Google Scholar, SciELO, and LILACS. In addition, a manual search was carried out using the references that were listed in the articles found. Results: A total of 403 potentially eligible studies were found, with seven being included in the inclusion criteria of this systematic review. The seven studies involved a total of 312 teeth. The minimum time of a follow-up period was 12 months. The irrigation solution most used was sodium hypochlorite, for both of the apexification and revascularization techniques. The medication commonly chosen in the apexification groups was Ca(OH)2, with antibiotic triple paste in the revascularization groups. The clinical rate of success in the groups treated with revascularization varied from 76% to 100%, while in the groups treated with apexification, it ranged from 68% to 100%. Only two studies reached a success rate equal to 100%. Conclusions: Variable levels of evidence were observed in relation to the treatments. However, it was confirmed that revascularization is an excellent option since its outcomes produced a greater gain of thickness and root length, besides developing a decrease in the apical foramen.


Introdução: O objetivo desta revisão sistemática foi comparar as técnicas de apexificação, com hidróxido de cálcio (Ca(OH)2) ou agregado trióxido mineral (MTA), com a técnica de regeneração pulpar, utilizando estudos coorte, ensaio clínico não randomizado e randomizado. Métodos: A metodologia foi baseada em pesquisa eletrônica nas seguintes bases de dados: PubMed, MEDLINE, Google Acadêmico, SciELO e LILACS. Além disso, foi realizada uma pesquisa manual utilizando as referências listadas nos artigos encontrados. Resultados: Foram encontrados 403 estudos potencialmente elegíveis, sendo sete incluídos nos critérios de inclusão desta revisão sistemática. Os sete estudos envolveram um total de 312 dentes. O tempo mínimo de um período de acompanhamento foi de 12 meses. A solução de irrigação mais utilizada foi o hipoclorito de sódio, para as técnicas de apexificação e revascularização. O medicamento comumente escolhido nos grupos de apexificação foi o Ca(OH)2, com pasta tripla antibiótica nos grupos de revascularização. A taxa clínica de sucesso nos grupos tratados com revascularização variou de 76% a 100%, enquanto nos grupos tratados com apexificação variou de 68% a 100%. Apenas dois estudos atingiram uma taxa de sucesso igual a 100%. Conclusões: Níveis variáveis de evidência foram observados em relação aos tratamentos. No entanto, confirmou-se que a revascularização é uma excelente opção, pois seus desfechos produzem maior ganho de espessura e comprimento radicular, além de diminuir o forame apical.


Subject(s)
Regeneration , Effectiveness , Dental Pulp , Apexification/methods , Calcium Hydroxide , Dental Pulp Necrosis , Pemetrexed , Regenerative Endodontics
19.
Biosci. j. (Online) ; 37: e37040, Jan.-Dec. 2021. ilus, graf, tab
Article in English | LILACS | ID: biblio-1359925

ABSTRACT

The dental pulp sensibility test is one of the main auxiliary resources for the diagnosis of pulp pathologies, and its accuracy is still debatable. This cross-sectional observational study evaluated the accuracy of the pulp sensibility test (PST) using cold spray (1,1,1,2-tetrafluoroethane) for the diagnosis of pulp diseases and determined the effect of individual and clinical variables on the reliability of this test. The paper was designed following the STROBE statement. Sixty patients with indications for primary endodontic treatment were selected and examined from August 2017 to July 2018. Data collection was performed through interviews, clinical/radiographic examinations and the PST. The results of the cold test, along with data on sex, age, the tooth type regarding the root number, and the presence of restorations and caries, as well as the recent consumption of analgesics, were recorded. The presence of bleeding within the pulp chamber was used as the gold standard to compare with the clinical diagnosis and to identify the true-positive, false-positive, true-negative, and false-negative responses. The accuracy of PST achieved in subgroups of individual and clinical variables was compared using the chi-square test with a significance level of 5% (p < 0.05). The PST with the use of cold spray showed a sensitivity of 0.88, a specificity of 1.00, a positive predictive value of 1.00, a negative predictive value of 0.86, and an accuracy of 0.93. The accuracy of the cold spray was not affected by individual or clinical variables. The PST with the use of cold spray is an accurate and reliable method for determining the diagnosis of pulp diseases, especially in cases of pulp vitality or irreversible pulpitis.


Subject(s)
Pulpitis/diagnosis , Dental Pulp Test , Dental Pulp Necrosis , Endodontics
20.
Chinese Journal of Stomatology ; (12): 840-848, 2021.
Article in Chinese | WPRIM | ID: wpr-921886

ABSTRACT

Pulpal and periapical diseases are the most prevalent dental conditions damaging the oral health of children in China. In view of China's national condition, the level of diagnosis and treatment for pulpal and periapical diseases of deciduous teeth is uneven and clinically there are inconsistent standards on the selection of operation methods for the endodontic treatment in deciduous teeth. Targeting these problems, the Society of Pediatric Dentistry, Chinese Stomatological Association organized experts from several famous universities and hospitals in China to carry out a panel discussion. The results of domestic and overseas researches and diagnosis and treatment experiences on dental pulp disease and periapical disease of deciduous teeth were also referred to. The present guideline was finally developed for the reference of dental clinicians.


Subject(s)
Child , Humans , Dental Care , Dental Pulp , Dental Pulp Necrosis , Periapical Diseases , Tooth, Deciduous
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