RESUMO
Introduction:One of the most common dental procedures associated to vertical root fractures is the endodontic treatment with excessive dentin wall wear and another increasing risk factor is the use of intraradicular post. Objective: This study evaluated the resistance to fracture of the buccal and palatal roots of maxillary first premolars with endodontically treated canals and spaces for posts. Material and methods: Twenty two first permanent premolar roots (11 buccal and 11 palatal) composed the experimental sample. The canals were prepared with Protaper Universal® system until file F3 and then filled with gutta-percha cone F3 and endodontic sealer and received spaces for posts keeping 4 mm of filling at the apical third. The roots were subjected to compression test in a universal testing machine (Kratus). The roots were subjected to a progressive compression stress at a speed of 0.5 mm / min. A load cell of 200 kg was used. Results: Statistical analysis revealed significant differences between the strength values and resistance limit between groups (P<0.05), as analyzed by t Student test. The values of resistance to fracture of 0.44 kgf/mm2 for group 1 (buccal roots) and 0.31 kgf/mm2 for group 2 (palatal roots) were found. Conclusion: The resistance to fracture of the buccal roots was higher than that of palatal roots of first premolars submitted to biomechanical preparation and root preparation for intraradicular post.
RESUMO
O presente relato de caso tem como objetivo descrever e discutir o tratamento de um dente incisivo central superior direito tratado endodonticamente, com presença de reabsorção radicular apical e radiolucencia periapical. Ao exame clínico a paciente se encontrava com fístula na região apical da mucosa vestibular do referido dente. Ao exame por imagens a radiografia periapical e tomografia computadorizada conebeam, revelaram a presença de área radiolúcida no terço apical, dentro do canal radicular, inacessível aos procedimentos do preparo químico-mecânico tornado o retratamento endodôntico incerto. Dessa forma, a cirurgia perirradicular foi a terapêutica instituída, com a realização da apicectomia, retropreparo e retrobturação do canal radicular, com uso de insertos ultrassônicos apropriados e do Agregado Trióxido Mineral (MTA), respectivamente. Após dois anos de proservação pôde-se observar o controle da infecção endodôntica. O tratamento foi considerado um sucesso, visto que a paciente se encontrava assintomática, com ausência de fístula e com regressão completa da radiolucência periapical e neoformação ãssea. Pode-se concluir que a cirurgia perirradicular apresentou-se como um tratamento eficaz para a resolução do referido caso clínico, possibilitando um grau de desinfecção compatível com a cura perirradicular para o paciente... (AU)
This case report aims to describe and discuss the treatment of a right maxillary central incisor tooth, endodontically treated, with presence of an internal root resorption and periradicular radiolucency. On clinical examination the patient presented a sinus tract at the apical buccal mucosa of this tooth. The periapical radiograph and cone beam computed tomography detected the presence of radiolucent area inside root canal (apical third). This area showed to be inaccessible to adequate chemical-mechanical preparation, so, the endodontic retreatment would give an uncertain prognosis. Thus, the periradicular surgery was the indicated therapy for this case, including apicectomy, retropreparation and root canal retrofilling, with the use of appropriated ultrasonic inserts and Mineral trioxide aggregate (MTA), respectively. After two years of follow-up, the endodontic infection control was observed. The treatment was considered a success, as the patient was asymptomatic, with no sinus tract and with complete regression of periapical radiolucency and bone formation. It can be concluded that the periradicular surgery was an effective treatment for the patient, allowing a degree of disinfection compatible with periradicular cure... (AU)