Selamento de perfuração radicular com cimento de ionômero de vidro: caso clínico / Sealing of root perforation with glass ionomer cement: a case report

Apesar do desenvolvimento da terapia endodôntica, complicações adversas podem surgir durante o tratamento, resultando em prognóstico duvidoso; a perfuração radicular situa-se entre essas complicações. As perfurações radiculares localizadas nos diferentes terços do canal radicular estão relacionadas às negligências nas etapas operatórias do tratamento endodôntico, principalmente a não observância das particularidades anatômicas dos diferentes grupos dentais. Diversos materiais têm sido indicados e utilizados para selar as perfurações endodônticas, entre eles o hidróxido de dentináricálcio, o amálgama de prata, o agregado trióxido mineral (MTA), a hidroxiapatita e o cimento de ionômero de vidro. Este trabalho tem por objetivo descrever a situação clínica de um 2º pré-molar superior no qual se constatou por meio da radiografia periapical que o mesmo possuía obturação de canal satisfatória, porém com a presença de uma perfuração lateral a nível cervical da raiz. Inicialmente o tratamento envolveu a curetagem e selamento da área perfurada com cimento de ionômero de vidro modificado por resina seguido da reconstrução coronal com resina composta. Após avaliações de 1 e 2 anos, observou-se uma evolução clínica e radiográfica favorável, o que permite concluir que é possível aumentar a longevidade do elemento dental em boca não obstante a presença de uma perfuração radicular...

Despite the development of endodontic therapy, adverse complications can arise during treatment, resulting in a questionable prognosis; root perforation is one such complication. Root perforations located along different thirds of the root canal are associated with practitioner error during the operative stages of endodontic treatment, particularly with failure to observe the anatomic singularities of different tooth types. Various materials have been suggested and used to repair root canal perforations, including calcium hydroxide, silver amalgam, mineral trioxide aggregate (MTA), hydroxyapatite, and glass ionomer cement. This report describes the clinical management of a maxillary second premolar in which periapical radiography showed satisfactory canal obturation, but with a lateral root perforation present at the cervical level. Initial treatment involved curettage and sealing of the perforated area with resin-modified glass ionomer cement, followed by composite-resin reconstruction of the crown. There was favorable clinical and radiographic progression at 1- and 2-year follow-up. We thus conclude that tooth longevity can be prolonged even in the presence of a root perforation...

Occurrence of aggressive periodontitis in patients at a dental school in southern Brazil.

Aggressive periodontitis is a rare, severe and rapidly progressing periodontal disease. Early diagnosis is of utmost importance for establishing treatment in order to stop periodontal destruction and prevent tooth loss. The aim of this study is to describe the occurrence of aggressive periodontitis in patients at a Dental School in Brazil by means of a cross-sectional study. First, records from patients aged 15-36 years were consecutively scrutinized. Patients should not have systemic diseases. The search went up to 383 valid records. By means of periapical radiographs, the distance between the cement-enamel junction and the bone crest was measured. Records in which there was severe bone loss or periodontal destruction incompatible with the age of the patient were selected. Patients with bone loss > or = 3mm were called to answer a questionnaire and undergo periodontal examination, in order to confirm or dismiss the diagnosis of aggressive periodontitis. From a total 383 records, 55.1% (211) were female and 44.9% (172) were male. In 3.9% (15) of the records, presumed diagnosis was aggressive periodontitis, and 12 out of those 15 eligible patients (80%) came in for clinical examination and confirmation or dismissal of the diagnosis. Aggressive periodontitis was diagnosed in 7 patients, corresponding to 1.8% of the total. Of these, 4 (1% of the total) presented generalized aggressive periodontitis and 3 (0.8% of the total) presented localized aggressive periodontitis. In 5 patients (1.3%) chronic periodontitis was diagnosed. It may be concluded, within the limits of the study, that aggressive periodontitis at this Dental School is compatible with world prevalence values, suggesting the need for periodontal diagnosis as from adolescence, considering the possible damage caused by this disease.

Occurrence of aggressive periodontitis in patients at a dental school in southern Brazil. / Occurrence of aggressive periodontitis in patients at a dental school in southern Brazil.

Aggressive periodontitis is a rare, severe and rapidly progressing periodontal disease. Early diagnosis is of utmost importance for establishing treatment in order to stop periodontal destruction and prevent tooth loss. The aim of this study is to describe the occurrence of aggressive periodontitis in patients at a Dental School in Brazil by means of a cross-sectional study. First, records from patients aged 15-36 years were consecutively scrutinized. Patients should not have systemic diseases. The search went up to 383 valid records. By means of periapical radiographs, the distance between the cement-enamel junction and the bone crest was measured. Records in which there was severe bone loss or periodontal destruction incompatible with the age of the patient were selected. Patients with bone loss > or = 3mm were called to answer a questionnaire and undergo periodontal examination, in order to confirm or dismiss the diagnosis of aggressive periodontitis. From a total 383 records, 55.1

(211) were female and 44.9

(172) were male. In 3.9

(15) of the records, presumed diagnosis was aggressive periodontitis, and 12 out of those 15 eligible patients (80

) came in for clinical examination and confirmation or dismissal of the diagnosis. Aggressive periodontitis was diagnosed in 7 patients, corresponding to 1.8

of the total. Of these, 4 (1

of the total) presented generalized aggressive periodontitis and 3 (0.8

of the total) presented localized aggressive periodontitis. In 5 patients (1.3

) chronic periodontitis was diagnosed. It may be concluded, within the limits of the study, that aggressive periodontitis at this Dental School is compatible with world prevalence values, suggesting the need for periodontal diagnosis as from adolescence, considering the possible damage caused by this disease.