Radiographic assessment of endodontic accidents at a Nigerian tertiary health institution: a one-year retrospective study

Introduction: Dental treatment can produce iatrogenic injury to the tooth with endodontic procedural errors occurring during the various stages of endodontic treatment. This study determined the prevalence and pattern of endodontic accidents in clinical practice at a tertiary health center in Nigeria. Methodology: This was a retrospective study of teeth treated with conventional hand-held file systems. Digital peri-apical working length, pre-obturation and post obturation radiographic images of teeth which received root canal treatment, were assessed for the presence or absence of errors. All errors present were recorded and data analysis was done using IBM SPSS version 22.0. Results: The prevalence of procedural errors was 31.3% with ledges being the most prevalent error followed by transportation while gouging was the least encountered error. Majority (83.8%) of the errors occurred during root canal instrumentation. A higher proportion of molars had errors compared to the other types of teeth with the prevalence of errors increasing from incisors to premolars and then to molar teeth. The mandibular molars were found to be most frequently involved in procedural errors. Conclusion: The prevalence of procedural errors seems high. Practitioners should show greater care during the canal preparation stage and to maintain the accuracy of the working length throughout the procedure, as errors which occur during canal preparation accounted for the vast majority of errors seen in this study. Special care should be taken when working on molars, which had a significantly higher error rate when compared to anterior teeth or premolars

Aberrant anatomy in endodontically treated teeth in a Nigerian Teaching Hospital

Objective: The anatomical features of teeth show wide morphological variations. These variations include coronal and radicular aberrations. They are thought to be influenced by age, gender, race and evaluation methods. Therefore, an in-depth knowledge of both normal and unusual dental morphology is vital in the practice of endodontics. The objective of the study was to investigate the incidence of aberrant root anatomy in endodontically treated teeth among adult patients attending the Endodontic unit of a tertiary hospital in Southern Nigeria. Methods: A retrospective review of all clinical records of adult patients who attended the Endodontic unit of the Department of Restorative Dentistry, University of Benin Teaching Hospital (UBTH) Edo State, Nigeria from January 2013 to January 2018 for root canal treatment (RCT). The demographic and clinical data were retrieved from the patients' records and analyzed using IBM SPSS version 20. Results: A total of 927 patients, comprising445 (48.0%) males and 482 (52.0%) females (a ratio of 1:1.1) underwent endodontic treatment during the study period. The age range of patients was 18-80 years. The total number of teeth treated was 1016. Aberrant root anatomy was observed in 161 (15.8%) of the studied sample. It was more frequently seen in mandibular 118 (29.9%) than maxillary 43 (6.9%) teeth. Aberrant root anatomy occurred most frequently in mandibular second molars 42 (38.9%) followed by the maxillary first molars 32 (38.1%). These aberrations were observed in the roots and canal numbers of treated teeth while the occurrence of aberrant anatomy was higher in females (9.9%) than males (5.9%). Conclusion: In this study, aberrant root anatomies were mostly observed in mandibular teeth and among female patients. Clinicians should be aware of the existence of wide variations in root form and canal morphology during endodontic procedures. The alertness is helped by the use of Dental operating microscopes or other magnification devices, multiple periapical radiographs with angular cone shift or other contemporary imaging modalities in revealing tooth anatomy that would otherwise be missed

Implantes endodónticos - Vitalium vs. Titanio Caso clínico con un seguimiento de 18 años / Endodontic implants-Vitallium vs. Titanium Clinical case with 18 years follow-up

Resumen Una de las primeras consideraciones en la Odontología moderna, es preservar y mantener los dientes naturales, por lo que se han buscado técnicas alternativas que permiten conservar los órganos dentales en boca, el mayor tiempo posible. Por esta razón, se presenta un caso clínico donde se logra salvar dos piezas dentales anteriores, que poseían una movilidad grado tres, posterior a un tratamiento ortodóntico que le habían mantenido al paciente por más de dos años. Este caso, se resolvió exitosamente por medio de dos implantes endodónticos: uno de vitalium y otro de titanio, dándole un seguimiento de más de 18 años. A continuación, se expone una técnica de manejo y colocación de estabilizadores endodónticos, tomando en consideración indicaciones y contraindicaciones.

Abstract One of the first and main considerations in modern odontology, is to preserve and maintain natural teeth, reason why alternative techniques have been searched, to preserve dental organs in mouth, as long as possible. That is why this article presents a clinical case where two frontal dental pieces, that had mobility in grade three were saved, after an orthodontic treatment -maintained for more than two years- was removed. The case was successfully solved through two endodontic implants made from vitallium and titanium, with a follow-up for more than 18 years. The following is an exposition of the procedure of endodontic stabilizers, considering indications and contraindications.

Retreatment Efficacy of Endodontic Bioceramic Sealers: A Review of the Literature / Eficacia del retratamiento de cementos endodónticos biocerámicos: Revisión de Literatura

Abstract The endodontic retreatment is a feasible solution when post-operative apical periodontitis persists or develops. The complete removal of the filling materials is important in order to ensure the unobstructed contact of the intracanal disinfectants with the microbes. As a new generation of bioceramic endodontic sealers has emerged, their removal efficacy from the root canal system during retreatment is a matter of concern among clinicians. The aim of this article is to provide a comprehensive review of the current literature on the retreatability of these novel obturating materials. A significant amount of bioceramic sealer remnants in the root canal walls was observed in all studies. Even though canal cleanliness could not be obtained at an ideal level, the re-establishment of the working length and patency can be considered manageable and comparable to other endodontic sealers.

Resumen El retratamiento endodóntico es una solución factible cuando la periodontitis apical post-operatoria persiste o se desarrolla. La eliminación completa de los materiales obturadores es importante para garantizar el contacto y acción de los desinfectantes e irrigantes endodónticos con los microorganismos persistentes. A medida que ha surgido una nueva generación de selladores endodónticos biocerámicos, su eficacia de eliminación del sistema de conductos radiculares durante el retratamiento es motivo de preocupación entre los profesionales. El objetivo de este artículo es proporcionar una revisión exhaustiva de la literatura actual sobre la influencia o posibles limitantes del uso de este tipo de cementos bioactivos durante el retratamiento endodóntico. Los estudios determinaron una cantidad significativa de restos de selladores biocerámicos en las paredes del conducto radicular. Aunque la limpieza del canal no se pudo obtener a un nivel "ideal", el restablecimiento de la longitud de trabajo y la permeabilidad se puede considerar manejable y comparable a otros selladores endodónticos.

Evaluation of Frontal Teeth Stabilization after Root Apex Resection among the Ukrainian Young People

Objective: To develop a protocol of improved stabilization of teeth after root apex resection among young people using endodonto-endoossal implants and assessing its effectiveness. Material and Methods: Thirty-six patients were previously selected and divided into Group 1 (without additional stabilization) and Group 2 (with additional stabilization). The efficacy of treatment in both clinical groups was estimated at 90, 180 and 360 days, respectively. The results were evaluated on the Miller scale in the Flesrar modification. Density of bone tissue was expressed in Hounsfield units. Results: The average mobility indices over 90 days indicate a significant lower mobility of teeth in patients in Group 2, where as an advanced method, the RTR with an additional filling of the bone marrow defect with an osteoplastic material was chosen as the method of treatment (+ 18.0 ± 0.21 U.M. 10.0 ± 0.8 µm, p<0.05). In Group 1, 90 and 180 days after surgery, the density of bone tissue in the defect area was 756.3 ± 2.45 HU and 880.1 ± 4.34 HU. In Group 2, these indices were insignificantly higher and amounted to 834.3 ± 4.35 HU and 880.4 ± 2.56 HU. After 360 days after treatment in the first clinical group the bone density index was 957.4 ± 2.45 HU, while in the second group - 1003.3 ± 4.38 HU. Conclusion: The mobility of teeth among patients on 90-th day corresponded to level 1, and on 360-th day corresponded to level 0, indicating the effectiveness of the proposed method. The biomechanical stabilization of the teeth was confirmed by the results of densitometry among patients of both groups, in particular, the recovery of bone density in the affected site was observed after 360 days.

Andodontic treatment: an analysis of demand by adult patients in a tertiary hospital in southern nigeria

Objective: An increase in dental awareness and need to maintain good oral health, in a growing population will necessitate an increased demand for root canal treatment (endodontic treatment). In emerging economies like Nigeria, the trend appears similar to what obtains in more developed economies where patients are keen on retaining their teeth. The objective was to determine the reasons for endodontic treatment and pattern of demand for treatment among adult patients attending the Endodontic unit of a tertiary hospital in Southern Nigeria. Methods: A retrospective review of all clinical records of adult patients who attended the Endodontic unit of the Department of Restorative Dentistry, University of Benin Teaching Hospital (UBTH) Edo State, Nigeria from January 2012 to December 2014 for root canal treatment (RCT). The demographic and clinical data were retrieved from the patients' records and analysed using SPSS version 20. Results: A total of 485 patients, comprising 226(46.6%) males and 259(53.4%) females (a ratio of 1:1.4) underwent endodontic treatment during the study period. The age range of patients was 18-68 years. In the studied population, the highest demand for endodontic treatment 219(45.2%) was among the 20-29 years' age range. The commonest indication for RCT was irreversible pulpitis (48.4%). The total number of teeth treated was 522. More posterior teeth 338(64.8%) were treated than anterior 184(35.2%). The mandibular first molar 96(18.4%) was the most frequently treated tooth. More maxillary teeth 332(63.6%) underwent RCT than mandibular teeth 190(36. 4%).Endodontic treatment was mostly completed in multiple visits 439(84.1%). A total of 279 (57.5%) patients had their treatments covered by the National Health Insurance Scheme (NHIS). Out of pocket payments accounted for 40.2% of patients who had endodontic treatment. Conclusion: There was a greater demand for root canal treatment among female and young adult patients. Most of the procedures were performed on maxillary teeth while the mandibular first molar was the most frequently treated tooth

Estabilizador Endodóntico en Fractura Complicada de Raíz en visita única / Endodontic Stabilizer in Complicated Root Fracture in a single visit

Introducción: La fractura complicada de raíz del tercio medio es una entidad compleja de pronóstico mayormente desfavorable y curso sintomático, donde el éxito clínico en no pocas oportunidades se convierte en una utopía, dado que la estabilidad en el afrontamiento de los bordes libres de los fragmentos fracturados es difícil de lograr. En este sentido el estabilizador edodóntico busca garantizar un anclaje bilateral satisfactorio, que posibilite unificar en una consulta los tiempos operatorios necesarios para un tratamiento exitoso. Objetivo: Describir la factibilidad del uso de un estabilizador endodóntico en el manejo de una fractura complicada de raíz del tercio medio en una visita. Presentación del caso: Paciente de 60 años, femenina que acude a consulta tras sufrir traumatismo dentoalveolar consistente con fractura complicada de raíz del tercio medio en 21; a los rayos X se observa ligero ensanchamiento periodontal y bordes discontinuos. Se realiza tratamiento edodóntico radical mediante la aplicación de un estabilizador intraconducto en la reducción de la fractura. Conclusiones: El uso de un estabilizador endodóntico en el manejo de una fractura complicada de raíz del tercio medio realizado en una sola visita es una alternativa factible de realizar en el tratamiento mediato e inmediato, ya que supone una rápida recuperación de las funciones buco-dentales del paciente(AU)

Introduction:The complicated fracture of the medium third of the root is a complex entity, particularly with an unfavorable prognosis and a symptomatic course in which the clinical success becomes a utopia in not just a few opportunities because the stability by confrontation of the free edges of the fractured fragments is difficult to achieve. In this respect, the endodontic stabilizer is used to guarantee a satisfactory bilateral anchorage that gives the possibility to unify, in a single visit, the necessary operation times for a successful treatment. Objective: To describe the feasibility of the use of an endodontic stabilizer in the management of a complicated fracture of the medium third of the root in a single visit. Case presentation: Female 60-year-old patient who comes to the consulting room after suffering from a consistent dentoalveolar trauma with a complicated fracture of the medium third of the root in tooth no.21; radiograph reveals a slight periodontal widening, and discontinuous edges. Radical endodontic treatment is performed with the placement of an intraductal stabilizer in the reduction of the fracture. Conclusions: The use of an endodontic stabilizer in the management of a complicated fracture of the medium third of the root in a single visit to the dentist is a feasible alternative in the mediate and immediate treatment seeing that it supposes a fast recovery of the bucco-dental functions of the patient(AU)

Testes pulpares: da "era do gelo" à "era tecnológica" / pulp tests: the \"Ice Age\" to the \"technological age\"

Os testes pulpares fazem parte dos exames mais utilizados para identificar a saúde da polpa dentária, e podem ser qualificados como: testes de sensibilidade (como os testes térmicos e elétricos) e testes de vitalidade (como a Fluxometria Laser Doppler e a Oximetria de pulso). Os testes de sensibilidade, apesar de serem os mais utilizados, apresentam limitações importantes, pois avaliam a resposta nervosa sensorial à aplicação de estímulos e apenas pressupõem a condição de vitalidade da polpa. Já os testes de vitalidade, que analisam o suprimento sanguíneo ou o tecido vascular, mesmo com algumas limitações, são mais objetivos e avaliam o real estado fisiológico da polpa. Este trabalho discute o panorama atual da utilização dos testes pulpares, revê os fatores condicionantes da avaliação da polpa, mostra as vantagens e dificuldades de ambos testes de sensibilidade e vitalidade, e analisa as perspectivas do uso da tecnologia no diagnóstico endodôntico...

Among the most commonly used exams to identify the health of dental pulp are the pulp tests, which can be qualified as sensitivity tests (such as thermal and electrical test) or vitality tests (such as Laser Doppler Flowmetry and Pulse Oximetry). Sensitivity tests, despite being the most widely used ones, have important limitations, since they assess the responses of sensory nerves to an applied stimulus and can only presuppose the pulp vitality. Vitality tests, which analyze the blood supply or the vascular tissue, even with some limitations, are more objectives and can assess the real physiological status of the pulp. This work discusses the current panorama of the use of pulp tests, and revises the determining factors of pulp evaluation, showing the advantages and difficulties of both tests, sensitivity and vitality, and analyzing the prospects for the usage of technology in endodontic diagnosis...

Measurement of cortical bone thickness in adults by cone-beam computerized tomography for orthodontic miniscrews placement / 华中科技大学学报（医学）（英德文版）

The purpose of this study was to investigate the cortical bone thickness of the inter-dental area of both jaws for orthodontic miniscrew placement. The cone-beam computerized tomography images of 32 non-orthodontic adults with normal occlusion were taken to measure the cortical bone thickness in both jaws. One-way analysis of variance (ANOVA) was used to analyze the differences in cortical bone thickness. Buccal cortical bone in the mandible was thicker than that in the maxilla. In the maxilla, cortical bone thickness was thicker in the buccal side than in the palatal side. Buccal cortical bone thickness in the mandible was thickest at the site distal to the first molar, and in the maxilla it was thickest at the site mesial to the first molar, while in the palatal side of maxilla it was thickest at the site mesial to the second premolar. The changing pattern of cortical bone thickness varies at different sites. In the buccal side of maxilla, the thinnest cortical bone thickness was found to be at 4 mm level from the alveolar crest, while the thickest was at 10 mm level (except for the site mesial to the first premolar). The buccal cortical bone thickness at the sites mesial or distal to the first molar in the mandible and palatal cortical bone thickness of maxilla tended to increase with increasing distance from the alveolar bone.

Implantes endodônticos intraósseos de NiTi

Introdução: os implantes endodônticos são considerados uma extensão metálica intraóssea radicular de um dente.São indicados especialmente para estabilizar elementos dentários. Assim sendo, são considerados um artifício final para aumentar de forma artificial o comprimento radicular com a finalidade que o dente afetado possa suportar seu próprio dinamismo e função. Objetivo: o objetivo desse relato de caso clínico é apresentar um tratamento conservador para estabilizar e criar condições restauráveis para dois incisivos inferiores, nos quais foram implantados dois estabilizadores endodônticos intraósseos de níquel-titânio confeccionados a partir de limas endodônticas com a finalidade de restabelecer sua função no sistema dentário

In vitro fracture resistance of glass-fiber and cast metal posts with different designs / Resistência à fratura de pinos de fibra de vidro e metálicos fundidos com diferentes configurações

PURPOSE: To evaluate the in vitro fracture resistance of roots with glass-fiber and metal dowels with different designs. METHODS: Fifty-endodontically treated maxillary central incisors were embedded in acrylic resin. Ten of them received only the coronary preparation, and the remaining forty were embedded (except for 4mm of the cervical area) after removing the clinical crowns. Specimens were divided into five groups (n=10): control (teeth with only coronary preparation), cylindrical cast dowel, conical cast dowel, cylindrical glass-fiber dowel and conical glass-fiber dowel. Specimens were subjected to an increasing compressive load (N) until fracture. RESULTS: ANOVA indicated significant difference (P<.05) among the groups, and the Tukey-Kramer´s test identified these differences. The control group (867±243 N) presented the highest values and was statistically similar to cylindrical glass-fiber dowel group (711±180 N). There is no significant difference among the metal dowel cylindrical (435±245 N) or conical (585±164 N) group and conical glass-fiber dowel (453±112 N). Cylindrical glass-fiber dowel (711±180 N) and conical cast dowel and core (585±164 N) groups had intermediate values and did not differ from each other. CONCLUSIONS: Cylindrical glass fiber dowels represent a viable alternative to the cast-metal dowel cylindrical or conical. Cylindrical glass fiber dowels also increase endodontically treated incisors' resistance to fracture.

OBJETIVO: Avaliou-se in vitro a resistência à fratura de raízes com pinos metálicos fundidos e de fibra de vidro, variando sua configuração geométrica. METODOLOGIA: Cinquenta incisivos centrais superiores tratados endodonticamente foram incluídos em resina acrílica. Dez receberam apenas preparo coronário (controle) e quarenta tiveram coroas seccionadas e raízes incluídas em resina (deixando 4 mm cervicais). Distribuiu-se os espécimes em 5 grupos: controle, pino metálico cilíndrico, metálico cônico, pino de fibra de vidro cilíndrico e cônico. Submeteram-se os corpos-de-prova a ensaio de compressão, até ocorrer a fratura. RESULTADOS: A ANOVA indicou diferença significante entre os grupos (P<.05) e no teste de Tukey-Kramer´s o controle (867±243 N) apresentou os maiores valores de resistência à fratura, sendo similar ao grupo do pino de fibra cilíndrico (711±180 N). Não houve diferença significante entre os pinos metálicos cilíndricos (435±245 N) ou cônicos (585±164 N) e os de fibra cônicos (453±112 N). Os grupos dos pinos de fibra cilíndricos (711±180 N) e pinos metálicos cônicos (585±164 N) apresentaram valores intermediários e não foram diferentes entre si. CONCLUSÃO: Pinos de fibra de vidro são uma alternativa viável ao pino metálico fundido cilíndrico e cônico. Os pinos de fibra cilíndricos aumentaram a resistência à fratura dos incisivos tratados endodonticamente.

Avaliação das tensões às estruturas de suporte, por meio do método fotoelástico, decorrentes das forças aplicadas sobre overdentures retidas em implantes com sistema de encaixe barra-clipe / Appraisal, by photoelastic method, of load transmission on support structures with overdentures retained in implants with bar-clip system

Introdução: O objetivo deste estudo é avaliar in vitro a transmissão de forças do sistema de retenção do tipo barra-clipe para overdenture, quando duas posições de implantes são simuladas, utilizando-se para isso as técnicas da análise fotoelástica. Métodos: Assim, duas mandíbulas fotoelásticas foram confeccionadas com dois implantes, posicionados na região interforaminal a 22mm de distância: modelo 1 - AFIP, modelo fotoelástico com implantes paralelos e orientados verticalmente; e modelo 2 - AFII, modelo fotoelástico com implantes angulados 10º em relação à linha média da mandíbula. Sobre os implantes foram instalados o sistema de retenção barra-clipe e uma prótese overdenture. Para simulação da mucosa oral, foi interposta, entre a prótese overdenture e a mandíbula fotoelástica, uma camada de 2mm de silicone. Cargas de 0,5; 1,0; 1,5; 2,0; e 3 bars foram aplicadas e as imagens analisadas. Resultados: Os resultados mostraram que não houve semelhança nas áreas de tensão entre os modelos de resina fotoelástica, quando avaliada a angulação dos implantes. Já o modelo1 AFIP apresentou maior concentração no ápice dos implantes e o modelo 2 AFII apresentou maior concentração na face mesial dos implantes. Conclusão: Considerando-se as limitações deste trabalho, concluiu-se que o método de análise fotoelástica é de grande valia para a obtenção de informação em relação à biomecânica referente a esse tipo de prótese e sistema de retenção.

Introduction: The main objective of this study is to appraise in vitro the load transmission in bar-clip retention system for overdenture when 2 implant position are simulated, using for this purpose the photoelastic analysis technique. Methods: Therefore, 2 photoelastic mandibles were manufactured with 2 implants each one, positioned in interforaminal region within 22 mm of distance: model 1 AFIP, photoelastic model with parallel and vertically oriented implants; and model 2 û AFII, photoelastic model with 10º angled implants in relation to mandible midline. A bar-clip retention system and an overdenture were fixed over both implants. To simulate oral mucosa were added a 2 mm silicon layer between overdenture prosthesis and photoelastic mandible. 0.5; 1.0; 1.5; 2.0 and 3.0 bars loads were applied and correspondent images were analyzed. Results: Results evidenced that: there is no similarity in loaded areas between photoelastic resin models, when the implant angle is appraised. Since in the model 1 - AFIP, the concentration area of tension was at implant apex and in the model 2 û AFII was at the distal face. Conclusion: Considering the limitations of this study, it was concluded that photoelastic analysis has a high potential value for obtaining information concerning the biomechanics of this kind of prosthesis and retention system.

Clinical management of mid-root fracture in maxillary central incisors: case reports / 国际口腔科学杂志·英文版

Management of mid-root fractures presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fracture fragments. This article presents two varied treatment options for mid-root fractures. A 15-year-old female reported an impact injury to the maxillary anterior teeth 2 days after its occurrence. Clinically, the maxillary left central incisor was palatally-extruded with a negative vitality response and radiographic evidence of an oblique fracture at the middle third of the root. An endodontic implant was employed which utilized an open technique and has been on follow-up for ten months. A 32-year-old male reported an injury, which resulted in a mobile maxillary right central incisor, three months after its occurrence. Through clinical and radiographic means, a discolored, extruded, and non-vital maxillary right central incisor with an oblique root fracture at the alveolar-crest level was observed. Exploratory surgery was performed; an apical barrier was created with a mineral trioxide aggregate and obturated with gutta percha. The fragments were stabilized with a fiber post and patient has been on follow-up for five months. Short-term follow-up for both of the cases showed promising results both clinically and radiographically.

Extirpación de canino retenido y estabilización dental mediante implantes endodónticos / Canin retaineds extirpation and dental stabilization with endodontic implants

El artículo reporta la extirpación de un canino retenido que originaba la reabsorción radicular de piezas dentarias antero superiores. El tratamiento fue realizado en el Centro Quirúrgico de la Clínica Especializada en Odontología de la Universidad San Martín de Porres, y consistió en la preparación biomecánica de los conductos radiculares de los dientes afectados, la remoción del canino retenido y la colocación de implantes trans endodónticos,obteniéndose un resultado funcional satisfactorio.

This report presents canin retaineds extirpation because it has caused radicular reabsortion on antero superior teeth and dental stabilization with endodontic implants. This procedure was performed in the Clinically Quirrgico Center of Specialized Dentistry, University of San Martín de Porres. The treatment consists of the root canal treatment of affected pieces, the removal of retained canin, and the transendodontic fixation. The case was resolved with acceptable functional results.

Endodontic applications of spiral computed tomography.

The variations in root canal morphology especially in multi-rooted teeth are a constant challenge for diagnosis and endodontic therapy. Complete knowledge of the root canal anatomy is mandatory because the non-treatment of any one canal may result in endodontic failures. Henceforth,the proper diagnosis and identification of the canals is a pre-requisite for successful endodontic therapy. This article intends to highlight the importance of Spiral Computed Tomography in the field of endodontics

Radiographic evaluation of endodontic treatment and radicular retainer quality

O propósito deste estudo foi avaliar radiograficamente a qualidade dos retentores intra-radiculares, região periapical e tratamentos endodônticos. Um total de 192 radiografias periapicais foram selecionadas da Clínica Odontológica do Centro Universitário do ParᖠCESUPA. De acordo com os critérios radiográficos, a qualidade foi categorizada como adequada ou inadequada. Os dados analisados por meio do teste estatístico X2 demonstraram que o tratamento endodôntico apresentou inadequado em 53.64 por cento; a região periapical foi inadequada em 34.89 por cento; os elementos reabilitadores presentes apresentaram adaptação cervical inadequada em 51.85 por centoe os retentores intra–radiculares foram executados inadequadamente em 58.33 por cento...

The purpose of this study was to evaluate the quality of the coronalrestoration, radicular retainer, periapical status and root fi llingsscored on radiographic basis of endodontically treated teeth. Atotal of 192 periapical radiographs were randomly selected from CESUPA´S Dental School patients. According to the radiographic criteria, the technical quality was categorized as ´adequate` or ´inadequate`. The data analyzed by statistical X2 test demonstratedthat 53.64 per cent had inadequate endodontic treatment; teeth with anadequate root fi lling were associated with a better periapical statusthan teeth with inadequate root fi lling (65.1 per cent vs. 34.89 per cent); teeth with adequate and inadequate coronal restorations were 48,14 per cent and 51.85 per cent, respectively. This difference was not statistically signifi cant and the rate of inadequate root canal post and core was 58.33 per cent.

Endodontic enigma : mandibular second premolar with three root canals: a case report.

Location and thorough instrumentation of all the canals in the root of a diseased tooth normally ensure success of the endodontic therapy. Present case was referred for endodontic therapy of mandibular second premolar. Clinical and radiographic examination revealed inadequate root canal filling. Three canals were located. Endodontic therapy was performed under aseptic conditions.

Biphasic resection of a mandibular molar

Teeth once designated obsolete for rehabilitation and deemed for extraction should be re-evaluated for salvaging two thirds or even one-third component of the individual teeth. In our part of the continent, financial restraints can affect the orthodox procedures of root amputation if the final restoration is not provided at an earlier date. This case report enlightens on a biphasic approach combining radisection and coronal resection of a tooth with an endodontic perforation, which is a procedure not normally executed for mandibular molars but was adopted after taking the socioeconomic status of the patient into consideration

Avulsão dentária: fatores que contribuem para o estabelecimento da reabsorção radicular externa / Dental avulsion: factors the can contribute to the establishment of the external root resorption

O presente estudo revisou os trabalhos da literatura que avaliaram os fatores que podem contribuir para o estabelecimento da reabsorção radicular externa em dentes avulsionados reimplantados. O processo de reparo pode ser influenciado pela reabsorção externa, representando a mais séria complicação e causa de perda dental pós-reimplante. A reabsorção é induzida, provavelmente, por lesões na camada de cementoblastos devido à anoxia ou remoção mecânica. Os fatores que exercem maior influência sobre as células do ligamento periodontal são o tempo extra-oral e o meio de estocagem, porém nenhum fator na cadeia de eventos desde a avulsão até a obturação final do canal deve ser ignorado se o sucesso no tratamento queira ser alcançado.

A six-year study of hydroxyapatite-coated root-form dental implants / Un estudio de seis años sobre implantes dentales de raíz con recubrimiento de hidroxiapatita

BACKGROUND: The effect of hydroxyapatite coating of dental implants is controversial. The long-term fate of hydroxyapatite-coated implants has been the subject of some criticism. PURPOSE: The aim of this retrospective study was to assess the clinical outcome of hydroxyapatite-coated cylindrical root-form endosseous Impladent dental implants (LASAK Ltd, Prague, Czech Republic) during a six-year course. METHODS: Three-hundred and ninety-one consecutively placed implants were used in 169 patients and followed for four to six years. Interval and cumulative success of implants and prostheses survival was tabulated. Marginal bone loss was measured RESULTS: Of the total number of implants, 98.5achieved initial osseointegration. The cumulative success was 98.3after one year, 97.0after three years, 92.8after five years and 90.4after six years. The prostheses survival at the end of the study was 100for fixed bridges totally supported by implants, 96.5for fixed bridges with combined implant and tooth support, 94.2for single crowns, 90.9for mandibular overdentures and 81.3for maxillary overdentures. Marginal bone loss averaged 2.4 +/- 0.8 mm at the end of five years. CONCLUSION: The success rate of the investigated hydroxyapatite-coated implants was comparable with the data presented in the literature and with the results of the similar implants without hydroxyapatite-coating. However, the marginal bone loss was of interest. Longer monitoring of the implants is necessary.

ANTECEDENTES: El efecto del recubrimiento de los implantes dentales con hidroxiapatita es un asunto controversial. El destino a largo plazo de los implantes recubiertos con hidroxiapatita ha sido objeto de críticas. PROPÓSITO: El objetivo de este estudio retrospectivo fue evaluar los resultados clínicos de los implantes dentales endo-óseos de raíz con recubrimiento de hidroxiapatita de la marca Impladent (LASAK Ltd., Praga, República Checa), durante el transcurso de seis años. MÉTODOS: Un número de 391 implantes colocados consecutivamente, fueron usados en 169 pacientes, y sujetos a seguimiento por un período de 4 a 6 años. Se tabuló el éxito de lo implantes – por intervalos y de forma cumulativa – así como la supervivencia de las prótesis. Se midió la pérdida de hueso marginal. RESULTADOS: El 98.5% de los implantes alcanzó óseo-integración en la fase inicial. El éxito cumulativo fue de 98.3% después de un año, 97.0% después de tres años, 92.8% luego de cinco años, y 90.4% tras seis años. La supervivencia de las prótesis al final del estudio fue de 100% para puentes fijos soportados totalmente por implantes, 96.5% para puentes fijos con combinación de soporte sobre dientes e implantes, 94.2% para coronas solas, 90.9% para sobredentaduras mandibulares, y 81.3% para sobredentaduras maxilares. La pérdida marginal de hueso tuvo un promedio de 2.4 ± 0.8 mm al final de los cinco años.CONCLUSIÓN: La tasa de éxito de los implantes recubiertos con HA investigados, resultó comparable a los datos presentados en la literatura, y a los resultados de implantes similares sin revestimiento de HA. Sin embargo, la pérdida marginal de hueso fue una alerta: se necesita monitorear los implantes por un período más largo de tiempo.