Acute odontogenic maxillary sinusitis treated endodontically ­ two case reports and 15-day CBCT outcome

Patients presented acute recurrences from Otorhinolaryngology treatments with unilateral symptoms compatible with maxillary sinusitis with a dental origin (MSDO). Cone beam computed tomography (CBCT) showed sinus extensive membrane thickening that was not visible at periapical exam associated to the maxillary molar infection in both cases. Respiratory structures assessment was possible using a 6-inches field of view CBCT. Non-surgical endodontic treatment (case 1) performed and retreatment (case 2) showed a fast symptoms relief. Recall examination after 15 days revealed healthy soft tissues with normal periodontal probing and no dental mobility. In addition, 15-day CBCTs revealed initial maxillary sinus membrane recovery after the endodontic approaches in the reported cases. No additional medical intervention nor antibiotics administration were necessary in these MSDO cases management. Long-term follow-up in such cases is advisable to exclude other potential dental or respiratory issues. Diagnose and follow-up using CBCT presented significant sinus membrane thick reduction with no symptom's recurrence after the endodontic treatment

Canal transportation in simulated root canals instrumented with one progressive taper and two constant taper nickel-titanium rotary systems

This study investigated the occurrence of canal transportation in the apical third of simulated root canals instrumented with progressive and constant taper shaft designed rotary instruments. Thirty simulated resin canals were prepared with progressive taper (ProTaper Universal) and constant taper (Hero 642 and K3) Ni-Ti rotary systems, with 10 canals per group. The pre and post-instrumentation images of the canals were superimposed and the composite images were analyzed with Image Pro Plus 5.0 software. Centering ability of the instruments was assessed by subtracting the amount of resin removed at the inner wall from that removed at the outer wall. Total amount (in mm) of resin removed was recorded by adding the amount of resin removed at the inner and outer walls, comparing the pre and post-preparation images. Data were analyzed statistically by Kruskal Wallis and Median tests (α=5%). There was statistically significant difference (p<0.05) among the groups. ProTaper produced the greatest canal transportation in the apical third. In conclusion, canal transportation occurred in all groups; the constant taper rotary instruments (Hero 642 and K3) presented greater centering ability towards the original canal curve and caused less canal transportation than the progressive taper instruments (ProTaper).

Este estudo investigou a ocorrência do transporte do canal no terço apical de canais simulados preparados com instrumentos rotatórios de conicidade progressiva e constante. Trinta canais simulados em blocos de resina foram preparados com sistemas rotatórios de Ni-Ti de conicidade progressiva (ProTaper Universal) e de conicidade constante (Hero 642 e K3), com 10 canais simulados por grupo. As imagens pré e pós-operatórias dos canais foram superpostas e analisadas com o Programa Image Pro Plus 5.0. A capacidade de manter a centralização do canal foi avaliada pela subtração da quantidade de resina removida da parede interna daquela removida na parede externa. A quantidade total de resina (em mm) removida foi obtida por meio da soma da resina removida das paredes internas e externas do canal, comparando as imagens pré e pós-operatórias. Os dados foram analisados estatisticamente pelo teste de Kruskal Wallis e Teste das medianas (α=5%). Houve diferença estatisticamente significativa (p<0.05) entre os grupos. O Sistema ProTaper produziu o maior transporte do canal no terço apical. Em conclusão, o transporte do canal ocorreu em todos os grupos; os intrumentos rotatórios de conicidade constante (Hero 642 e k3) apresentaram uma grande capacidade de manter o canal centrado e causaram menos transporte do canal do que os instrumentos de conicidade progressiva (ProTaper).