RESUMO
A calcificação do canal radicular é um processo que pode ocorrer posteriormente a um traumatismo dentário ou que pode se desenvolver lentamente em decorrência do envelhecimento dentário fisiológico. É caracterizada pela deposição de tecido duro tanto na câmara pulpar como no canal radicular. Essa condição pode ser diagnosticada através de radiografias periapicais e tomografia computadorizada. Em alguns casos, pode estar associada à necrose pulpar e presença de lesão periapical, e o tratamento pode ser considerado bastante complexo. Este relato de caso clínico aborda o tratamento endodôntico do elemento 21, sintomático, com obliteração do canal radicular e necrose pulpar como sequela de um traumatismo dentário. Após a realização de todos os exames, foi dado o diagnóstico de periodontite apical crônica, sendo proposto o tratamento endodôntico convencional. A maior dificuldade encontrada foi a localização da entrada do canal radicular. Inúmeras radiografias foram realizadas a fim de evitar desvios. Somente ao final do terço médio foi possível localizar a entrada do canal radicular e dar prosseguimento ao tratamento, utilizando a técnica coroa-ápice e medicação intracanal à base de hidróxido de cálcio durante as sessões. Foi possível realizar a obturação do canal radicular quando a paciente se mostrou assintomática. Obteve-se sucesso na realização da técnica, e, após a conclusão do caso, foi possível observar remissão dos sintomas. Após um período de acompanhamento de 6 meses e, posteriormente, de 3 anos, foi possível observar cicatrização dos tecidos periapicais
The calcification of the root canal is a process that may occur after a dental trauma or slowly develop due to physiological dental aging. It is characterized by hard tissue deposition on both the pulp chamber and the root canal. Periapical radiography and computed tomography can be used to diagnose this condition. In some cases, it may be associated with pulp necrosis and the presence of periapical injury, and the treatment may be considered to be quite complex. This case report addresses the endodontic treatment of the central incisor, symptomatic, with root canal obliteration and pulp necrosis as a sequela of dental trauma. After all the tests, chronic apical periodontitis was diagnosed, and conventional endodontic treatment was proposed. The most significant difficulty faced was when locating the root canal's entrance. Numerous radiographs were carried out to avoid deviations. The opening of the root canal could only be found at the end of the middle third, so treatment could proceed by using the crown- down technique and intracanal medication based on calcium hydroxide during the sessions. When the patient was asymptomatic, the root canal has been filled. The accomplishment of the technique was successful, and after finishing the case, there was remission of symptoms. After a six-month follow-up period and three years, the healing of the periapical tissues was observed.
RESUMO
Objective: This study aimed to analyze the influence of the instrumentation technique (hand or rotary), and apical enlargement on calcium hydroxide (CH) fillings in cur-ved canals. Materials and method: One hundred and ten simulated root canals were divided into eleven experi-mental groups (G). Canals were prepared with K-Flexofile hand instruments, using either crown-down (GCD 25, GCD 30 and GCD 35) or step-back (GSB 25, GSB 30 and GSB 35) techniques; and with rotary instruments, using either ProTaper (GPT F1 and GPT F2) or K3 (GK3 25, GK3 30 and GK3 35) systems. The apical diameter correspon-ded to 0.20 mm (GPT F1), 0.25 mm (GCD 25, GSB 25, GPT F2 and GK3 25), 0.30 mm (GCD 30, GSB 30, GK3 30), and 0.35 mm (GCD 35, GSB 35, GK3 35). A CH pas-te, previously colored with blue Indian ink, was injected into the canals using a special syringe. The four sides of the blocks with simulated canals were scanned and the images were transferred to the AutoCAD-2008 software, for assessing the amount (%) of filling in the apical 5 mm (ANOVA; Tukey?s Test; ?=0.05). Qualitative analysis was also performed regarding the presence or absence of voids (Chi-square Test; ?=0.05). Results: In GSB, there was significant difference between diameters 25 and 30. GSB showed lower amount of filling (P<0.05) than GK3, when the apical diameter corresponded to 0.30 mm. GCD showed lower amount of filling (P<0.05) than the other groups (SB, PT, and K3), when the apical diameter corresponded to 0.25 mm. No significant difference was detected when comparing the four sides of the blocks. Conclusion: Preparation technique and apical diameter had slight or no relevant influence on CH paste filling in simulated curved root canals. Statistical differences found in this study may be clinically irrelevant, since the amount of filling, regardless of preparation technique and apical diameter, was very close or equal to 100%.
RESUMO
Objetivo: O objetivo desse trabalho foi comparar a resis-tência ao deslocamento de quatro cimentos endodônti-cos utilizados para o selamento de retrocavidades (Por-tland, MTA, Super EBA® e Sealapex®) em dentina bovinae humana. Materiais e método: Quarenta raízes bovinase quarenta raízes distais de molares inferiores humanosforam apicetomizadas e cavidades retrógradas forampreparadas. As raízes foram divididas aleatoriamente emquatro grupos e preenchidas com os materiais retrobtu-radores testados. Após uma semana, as raízes foram sec-cionadas transversalmente e os slices foram submetidosao teste de push-out. Os padrões de falha foram analisa-dos em microscopia óptica (10×) e classificados como:adesiva, coesiva do cimento, coesiva da dentina e mista.Os dados foram analisados utilizando o teste de Kruskal--Wallis, Mann-Whitney e Dunn. Resultados: Os maioresvalores de resistência ao deslocamento foram obtidosem dentina bovina (P < 0,05). O cimento Portland eMTA apresentaram os maiores valores de resistência aodeslocamento quando comparados com Super EBA® eSealapex®. Falha coesiva de cimento foi predominanteindependentemente do cimento e do substrato. Conclu-são: Pode-se concluir que a resistência ao deslocamentodos materiais retrobturadores é dependente do tipo decimento utilizado e substrato analisado.
RESUMO
Objective: This study evaluated the influence of the instrumentation technique and apical preparation size on the filling capacity of a calcium hydroxide (CH)-based paste. Materials and Methods: Fifty simulated curved canals were prepared in acrylic blocks (five groups; n = 10 each). In three groups, the canals were preflared with Gates-Glidden drills and the apical stop was prepared with #25, 30 or 35 Flexofile files. In the other two groups, the canals were prepared with ProTaper rotary instruments and the apical stop was prepared with F1 and F2. A CH paste was injected into the canals using a special syringe. The four sides of the blocks were scanned with the root curvature to the mesial, buccal, distal and palatal faces. The amount (%) of filling in the total canal area and in the apical 5 mm was obtained [analysis of variance (ANOVA); Tukey's test; α = 0.05]. Qualitative analysis of apical filling was done (absence vs. presence of filling deficiencies) (chi-square test; α = 0.05). Results: There was no significant difference in canal filling among the groups at any block side. Presence of voids was associated with the simulated mesial and distal faces. Conclusions: An effective canal filling with the CH paste was not achieved in all cases. Canal filling failure occurred mostly in the apical third. Filling deficiencies can be better visualized in canals with mesial and distal root curvatures.