Retratamientos endodónticos: una realidad que preocupa / Endodontic retreatment: a worrying reality

Las evaluaciones radiográficas de tratamientos endodón- ticos realizadas por graduados muestran un alto porcentaje de procedimientos incorrectos. Esta circunstancia lleva a la rea- lización de un elevado número de retratamientos ortógrados y retrógrados, con los inconvenientes y desventajas que conlle- va recurrir a una reintervención endodóntica. Es responsabili- dad de los profesionales, docentes y autoridades universitarias y gubernamentales revertir esta situación que afecta a la salud bucal de la sociedad. En el presente editorial se proponen di- ferentes alternativas para intentar modificar este preocupante panorama (AU)

Radiographic evaluations of endodontic treatments per- formed by graduates show a high percentage of incorrect procedures. This circumstance leads to the performance of a high number of orthograde and retrograde retreatments, with the inconveniences and disadvantages that entails resorting to an endodontic reintervention. It is the responsibility of pro- fessionals, teachers, university and government authorities to reverse this situation that affects the oral health of society. In this editorial, different alternatives are proposed to try to modify this worrying outlook (AU)

Application and thinking of cone beam computed tomography directing technology on teaching of dental microscope treatment to endodontic disease / 中华医学教育探索杂志

Endodontic treatment with the use of dental operating microscope is a difficult part in teaching. We have applied cone beam computed tomography (CBCT) guided technology for microendodontic training of dental students who are in their 5th year of the 7 year course to pursue their master's degree. The process of teaching is constituted of preoperative analysis, operation guided by CBCT, postoperative therapeutic evaluation. And the result of teaching quality is acquired by questionnaire. This method improved student's capacities of analysis and solution in intractable cases and greatly motivated students' participa-tion, as well as promoting their learning efficiency. The application of this technique in teaching process compensates the deficiency of traditional teaching method by shaking off the fetters of experience-dependent pattern in the endodontic microscope teaching, and is worth to be popularized in endodontic education.

Tratamiento conservador de un proceso expansivo tipo quístico con técnica mínimamente invasiva: caso clínico / Conservative treatment of an expansive processof cystic type with minimally invasive technique:clinical case

Los quistes son cavidades patológicas que adquieren importancia en el ámbito odontológico debido a la gran frecuencia en la que se encuentran en los maxilares y por el rol que el odontólogo presenta en su detección. Dentro de las lesiones tipo quísticas, mencionamos al quiste apical en bolsa donde existe una comunicación entre este y el conducto radicular, cuya curación puede lograrse a través de la terapia endodóntica. En el presente caso clínico se demostró cómo la pasta de hidróxido de calcio colocada en forma temporaria y en sucesivas sesiones en el interior de los conductos de los cuatro incisivos inferiores afectados por un gran proceso quístico, permitió la resolución paulatina hasta la erradicación completa del mismo. Se realizaron sucesivos controles clínicos y radiográficos mediante Rx periapicales, ortopantomografías y tomografías Cone Beam; dichos controles indicaron el momento oportuno de repetir el procedimiento de acuerdo a los resultados obtenidos en la disminución de las dimensiones del proceso quístico, optando por la terapia endodóntica definitiva a los 9 meses. Se destaca la eficacia de este tratamiento conservador, mínimamente invasivo, ante la presencia de ungran proceso quístico, con la finalidad de evitar las técnicas quirúrgicas, en pacientes comprometidos a las citas periódicas necesarias para lograr su erradicación.

The cysts are pathological cavities that acquire importance in the dental field due to the great frequency in which they are found in the jaws and the role that the dentist presents in their detection. Withincysts lesions cyst dental root in pocket can be mentioned, where there is a communication between itand the root canal, whose cure can be achieved through root canal therapy or endodontic therapy. In the present clinical case it was demonstrated how the calcium hydroxide paste placed temporarily andin successive sessions inside root canal of the four lower incisors affected by a large cystic process,allowed the gradual resolution until the complete eradication of it. Successive clinical and radiographic controls were carried out using periapical radiographs, orthopantomographies and Cone Beamtomography, these controls indicated the opportune moment to repeat the procedure according to theresults obtained in the reduction of the dimensions of the cystic process, opting for definitive endodontic therapy at nine months. The effectiveness of this conservative treatment is minimally invasive in the presence of a large cystic process, in order to avoid surgical techniques in patients committed to necessary periodic appointments to achieve eradication.

Survival of individual teeth after non-surgical endodontic treatment / 대한구강보건학회지

OBJECTIVES: The present study aimed to estimate the survival rate of teeth after non-surgical root canal treatment and to investigate the effect of income on the tooth survival rate. METHODS: The study included 1,414.668 endodontically treated teeth from 1,193.666 persons enrolled in the National Health Insurance Service in 2002. A survival analysis of the teeth was performed using the Kaplan-Meier method. The survival rates were calculated using a follow-up period of 11 years after the root canal treatment. RESULTS: In the present study, the 11-year cumulative survival rate of teeth after non-surgical endodontic treatments was 86.90%. The survival rates of teeth tended to decrease for the posterior teeth; the maxillary teeth showed a lower survival rate than that of the mandibular teeth. The teeth with the highest survival rates were the mandibular left lateral incisor, maxillary right incisor, mandibular right lateral incisor, and maxillary left central incisor, in that order. The lowest survival rates were shown by the mandibular second molar, maxillary second molar, maxillary first molar, and mandibular first molar, in that order. The survival rate of the first molar (#16, #26, #36, #46) was higher in the low-income group than in the high-income group (P<0.001). CONCLUSIONS: This study represents the outcome pattern of root canal treatment among South Korean individuals. These study findings can be used as comparative data for clinical decision making about endodontic treatment.

Resistencia a la fractura de dientes con debilitamiento radicular / Fracture resistance of teeth weakening with root

Dentro de los factores que afectan los dientes tratados endodónticamente y predisponen al fracaso se encuentran las paredes delgadas, raíces débiles incapacitadas para resistir fatiga causando fractura radicular y reduciendo la tasa de éxito. Un diente después del tratamiento endodóntico adecuado, debe tener buen pronóstico para reanudar su función y soportar una restauración capaz de resistir fuerzas de masticación y parafuncionales, y los ataques mecánicos y químicos del medio oral por un tiempo prolongado. Esta condición de raíces debilitadas se presenta en un gran porcentaje de población por lo tanto es pertinente tener en cuenta los parámetros clínicos para su rehabilitación constituyendo una alternativa reforzar la superficie radicular para mejorar la estabilidad y retención del retenedor, utilizando materiales con propiedades mecánicas optimas, estética y longevidad. El propósito de esta revisión, es adquirir un conocimiento de los parámetros clínicos a tener en cuenta en la rehabilitación de dientes debilitados radicularmente, para determinar cuál tratamiento constituye la mejor alternativa en cada situación específica, garantizando un pronóstico adecuado. Para la organización de la literatura fue necesario seleccionar temas como: pronostico de dientes tratados endodónticamente, alternativas de restauración, fractura radicular y posteriormente hacer énfasis en los últimos trabajos publicados sobre los avances tecnológicos que han permitido el desarrollo de materiales con mejores propiedades mecánicas que permiten la transmisión de esfuerzos de manera uniforme. La información se obtuvo de bases de datos como: Hinari, Sciencedirect, WileyInterscience, y de fuentes indexadas como: journal dental materials, journal prosteticdentristry, International Journal of Prosthodontics, QuintessenceInt, Journal Of Endodontics, Dental Traumatology.

Among the factors affecting endodontically treated teeth predisposed to failure are thin walls, weak roots unable to resist root fatigue causing root fracture and reducing the rate of success. A tooth after successful endodontic treatment should have a good prognosis to resume its function and support a restoration able to withstand chewing and parafunctional forces, as well as mechanical and chemical attacks in the oral environment for a prolonged time. This weakened condition of roots occurs in a large percentage of the population and therefore it is pertinent to consider the clinical parameters for their rehabilitation, with an alternative being to strengthen the root surface in order to improve stability and retention of the retainer, using materials that provide optimal mechanical properties, esthetics and longevity. The purpose of this review is to present concepts regarding clinical parameters that must be taken into account in the rehabilitation of weakened roots to determine which treatment is the best alternative in each specific situation, ensuring a good prognosis. Methodology: In order to organize the literature, it was necessary to select topics such as prognosis of endodontically treated teeth, alternative restoration, root fracture and then emphasize recent studies published on technological advances that have allowed the development of materials with better mechanical properties that allow uniform transmission of efforts uniformly. The information was obtained mainly from databases such as: Hinari, ScienceDirect, Wiley Interscience, and indexed sources such as Journal Dental Materials, Journal ProsteticDentristry, International Journal of Prosthodontics, Quintessence Int, Journal of Endodontics, Dent Traumatology.