RESUMO
Background: One of the aim of root canal treatment is filling the root canals in a 3D way. It is not always possible to achieve due to the existence of anatomical variations. The obturation of oval canal usually provides great difficulties. Its complex anatomy can cause obstacles in instrumentation, irrigation and obturation. Aim: The main aim of this study is to quantify the area filled by gutta-percha, the area filled by cement and the area of voids present in oval canals, treated by thermoplastic filling techniques in comparison with the lateral condensation technique and observe the adaptation of the gutta-percha to the anatomy of the oval root canals according to the obturation technique. Material and Methods: 80 mandibular incisors were selected. The teeth were instrumented with Protaper Gold® and divided into 4 groups of 20. Group 1 was filled with Thermafill®; group 2 with GuttaCore®; group 3 with continuous wave vertical condensation and group 4 with the lateral condensation technique. Two horizontal sections were cut at 5mm and 7mm from the apex and they were set in putty silicone. The samples were analyzed with a Leica DMS 1000 digital microscope and processed with Leica Suite for Windows XP. The area of gutta-percha, cement and voids and the percentages, of each one, were calculated. A statistical analysis was performed using the T-Student, ANOVA tests and Kruskal-Wallis tests. Results: All thermoplastic techniques achieved a high percentage of obturation. The percentages of voids in group 4 were the highest. Statistically significant differences were found between thermoplastic techniques compared with lateral condensation. Conclusions: Thermoplastic techniques achieve better adaptation of the gutta-percha in the oval canals and low amount of cement and voids in the middle and coronal thirds respect to the lateral condensation group. Moreover, comparing termoplasthicized techniques among them, continuous wave vertical condensation got the lowest percentage of voids. Key words:Warm gutta-percha, thermoplastic obturation, oval canals, oval-shaped canals.
RESUMO
BACKGROUND: The embryonic root groove is an anatomical abnormality that starts in the cingulum and extends longitudinally down the long axis root towards the apex. This developmental anomaly is more frequently reported in maxillary lateral incisors. Gu YC in 2011 established three types of radicular grooves depending on its severity. According to this classification, type III presents a greater diagnostic and therapeutic complexity. The prevalence of palatogingival grooves in maxillary lateral incisors ranges from 1.9 to 14%. This case report provides valuable information about the diagnosis and treatment plan of palatogingival grooves with Cone-beam computed tomography (CBCT) scan. CASE REPORT: The patient was referred to the University Dental Clinic of European University of Valencia, with recurrent abscesses at the upper right lateral incisor region for the last two years. Palpation and percussion tests were positive for tooth 1.2. There was no clinical history of caries or previous trauma. Periapical radiography showed periapical radiolucent lesions located, not only in the apical area of tooth 1.2, but also in tooth 1.3. Both teeth had previously been endodontically treated. Periodontal probing showed normal values. CBCT scan was perfomed in order to establish a definitive diagnosis and appropriate treatment plan. DISCUSSION: The complex anatomy of the palatal root groove requires detailed knowledge of the internal root morphology for endodontic treatment success. This complementary tool allows a more accurate image of hard tissue structures, such as palatal grooves and/or accessory roots, in comparison to conventional periapical radiography. The treatment plan of this primary periodontal lesion with secondary endodontic involvement was as follows: periapical surgery combined with root amputation and sealing with MTA, and guided bone regeneration. Key words:Palatal radicular groove, palatogingival groove, maxillary lateral incisor, cone-beam computed tomography, endodontic-periodontal lesion, guided bone regeneration.
RESUMO
BACKGROUND: The success of endodontic treatment derives from the complete elimination of microorganisms capable of causing an intraradicular or extraradicular infection. To achieve a more effective eradication of these microorganisms, endodontic instrumentation must always be implemented with abundant irrigation, which has to achieve chemical, mechanical and biological effects. The irrigators most used today are NaOCl, CHX and EDTA, released into the ducts through different techniques such as syringe, manual agitation, positive or negative apical pressure, sonic or ultrasonic activation, PIPS and PDT. The objective of this review is to update the different irrigating solutions and intracanal disinfection drugs, as well as to establish an irrigation protocol in the endodontic treatment. MATERIAL AND METHODS: Systematic search of scientific articles in the databases PubMed, Medline and Google Scholar, with the following keywords Endodontic, Infection, Failure, Irrigation, Retreatment and Irrigation protocol. The exclusion criteria were "case report" articles and articles with a publication date prior to 2000. RESULTS: 48 articles that met the inclusion criteria were analyzed. Comparing the different articles it can be seen that the NaOCl is the "gold standard" in terms of immediate antimicrobial efficacy, followed by the CHX that has a long-term antibacterial effect. As an intra-conductive drug it is advisable to use the combination of Ca(OH)2 with CPMC. CONCLUSIONS: The most adequate irrigation protocol consists of using 2.5% NaOCl activated with ultrasound followed by a final wash with 7% MA or 0.2% CTR combined with 2% CHX. Key words:Endodontic failure, endodontic infection, enterococcus faecalis, endodontic retreatment, irrigation, sodium hipoclorite, irrigation protocol.
