The dynamics of periapical lesions in endodontically treated teeth that are left without intervention: a longitudinal study.

INTRODUCTION: The long-term dynamics of periapical lesions in endodontically treated teeth is not fully elucidated, thus presenting a clinical dilemma regarding the need for an intervention. The aim of the study was to retrospectively evaluate the long-term dynamics of periapical lesions that were left without intervention in endodontically treated teeth. METHODS: Periapical status surveys of patients treated in a public dental clinic were retrospectively evaluated for the presence of periapical lesions in endodontically treated coronally restored teeth. The dynamics of the included periapical lesions was evaluated based on the periapical index (PAI) score changes between 2 consecutive periapical surveys of at least a 4-year interval. The influence of various factors on lesion dynamics was statistically evaluated. RESULTS: The study cohort consisted of 74 patients with a total of 200 endodontically treated teeth having periapical lesions that fulfilled the inclusion criteria. Fifty-seven (28.5%) lesions remained unchanged, 103 (51.5%) lesions worsened (PAI score increased), and 40 (20%) lesions improved (PAI score decreased). Poor root canal filling and poor restoration were found to adversely affect the long-term dynamics of the periapical lesions (P < .05). Age, sex, and the presence of a post had no statistically significant influence on lesion dynamics (P > .05). CONCLUSIONS: Poor root canal filling and poor restoration may adversely affect the long-term dynamics of periapical lesions that are left without intervention in endodontically treated teeth. Therefore, in cases of poor root canal filling or poor restoration, further intervention may be indicated.

Discuss that the coronal seal is more important than the apical seal for endodontic success.

One of the main principles for successful root canal treatment is the prevention of microorganisms and toxins from the oral flora penetrating through the root canal system into the periapical tissues (1). This is achieved by obturating the root canal system completely, including the coronal and apical ends. Inadequate obturation of the root canal system has been found to be the most frequent cause of failure after endodontic treatment (2). A number of studies have indicated that leakage, whether from a coronal or apical direction, adversely affects the success of root canal treatment (3-7). The significance of the coronal seal has been increasingly recognized in the dental literature (4, 5, 8, 9) and in more recent times, it has been suggested that apical leakage may not be the most important factor leading to the failure of endodontic treatment--but that coronal leakage is far more likely to be the major determinant of clinical success or failure (10). This paper will discuss aspects of: endodontic success and failure; the use of leakage studies to assess the quality of the seal; the significance of both apical and coronal leakage; followed by a review of the literature.

Influence of coronal restorations on the periapical health of endodontically treated teeth.

The purpose of the study was to evaluate a possible relationship between the quality of the coronal restoration, the root canal obturation and the periapical status of endodontically treated teeth. Full mouth series of radiographs from randomly selected patient charts at the Dental Faculty, University of Oslo were examined. A total of 1001 endodontically treated teeth restored with a permanent restoration were evaluated independently by two examiners. According to a predetermined set of radiographic criteria, the technical quality of the root filling of each tooth was scored as either good (GE) or poor (PE), and the technical quality of the coronal restoration was scored as good (GR) or poor (PR). The root and the surrounding structures were then evaluated and according to the periradicular findings, the treatment was categorized as success or failure. The success rate for all endodontically treated teeth was 67.4% (n = 1001). Teeth with root canal posts had a success rate of 70.7% (n = 527) and teeth without posts had a success rate of 63.6% (n = 472). The two groups with technically good endodontics had the highest success rates. In combination with technically good restorations the success rate was 81% (GE + GR, 81%) and combined with technically poor restorations the success rate was 71% (GE + PR, 71%). The two groups with technically poor endodontics combined with either good restorations or poor restorations had significantly lower success rates (PE + GR, 56% and PE + PR, 57%). The technical quality of the endodontic treatment as judged radiographically was significantly more important than the technical quality of the coronal restoration when the periapical status of endodontically treated teeth was evaluated.

Obturaçäo de canais laterais em funçäo da técnica e do local da condensaçäo / Filling of the lateral canals: effect of the technique and site of condensation

Analisou-se a possibilidade de obturar canais laterais utilizando a técnica clássica e a de controle biológico e variando-se o local da condensaçäo lateral. Em 40 dentes humanos confeccionou-se canais laterais. Nesses dentes, após o preparo do canal principal, realizou-se pela técnica clássica e pela técnica de controle biológico, variando-se o local da condensaçäo, ou seja, ao lado do canal lateral ou ao lado oposto. A condensaçäo efetuada ao lado oposto do canal lateral propiciou maior preenchimento desses canais sem contudo haver diferença entre a técnica clássica e a biológica controlada. Quando a condensaçäo foi efetuada no lado do canal lateral, a técnica clássica propiciou um maior preenchimento destes

ESTUDIO DEL EFECTO RESIDUAL SOBRE MICROORGANISMOS DE DIFERENTES PASTAS, UTILIZADAS PARA "OBTURACION DE CONDUCTOS RADICULARES", DE DIENTES DECIDUOS

La pasta en base al formocresolan, in vitro resultó la más eficaz para controlar el desarrollo de los gérmenes(exepto sobre los B. subtilis)l, La pasta compuesta por el Iodoformo+agua, resultó la menos potente contra la vida microbiana encontrada en los conductos radiculares, y estudiada in vitro, Las pastas mostraron ser más efectivas sobre los microorganismos en el segundo día, A partir del décimo quinto día el efecto de las pastas fur más pobre, Además se demuestra que los microorganismos: Bacteroides 28 por ciento, Difteros 24 por ciento y Estreptococos 20 por ciento: Se encuentran más frecuentes en los conductos putrecentes por gangrena pulpar con o sin complicación paraendodóncico en piezas temporarias

LA IONOFORESIS Y SU APLICACION EN CONDUCTOTERAPIA

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