Effect of Different Resin Cements on the Bond Strength of Custom-made Reinforced Glass Fiber Posts-A Push-out Study.

AIM AND OBJECTIVE: This study aims to evaluate the effect of different resin cements on the bond strength (BS) of custom-made glass fiber posts (GFPs) using the push-out test. MATERIALS AND METHODS: Twenty-four uniradicular bovine teeth were selected. The crowns were sectioned at the cementoenamel junction, and the root canals were treated. The post spaces of the teeth were prepared to a length of 12 mm to receive a GFP. The specimens were randomly assigned to three experimental groups (n = 8), according to the resin cement used to fix the GFPs: RelyX U200 (U200), Allcem Core (ACC), and Allcem Dual (ACD). Each specimen was sectioned into six slices per root third (cervical, middle, and apical), which were subjected to the push-out test. BS values were calculated and compared using the Kruskal-Wallis and Friedman tests. RESULTS: There were significant differences in the middle third, according to the resin cement type used (p < 0.05). ACD showed lower BS values (p < 0.05). Significant differences were observed for ACD among the thirds of the slices, with the lowest values also observed for the middle third (p < 0.05). CONCLUSION: The present study shows that ACC and U200 showed higher BS values compared with ACD, and were also less influenced by the depth of the root dentin. CLINICAL SIGNIFICANCE: The restoration of endodontically treated teeth is a challenge in dentistry, and, in most cases, will require installation of fiberglass pins. In this respect, several types of resin cements are indicated for cementation of these pins; for this reason, their adhesiveness must be adequately investigated. Conventional cements and self-adhesive cements have shown satisfactory performance in cementing the custom-made GFPs, thereby making these cements satisfactory clinical choices. The present study suggests that ACD had lower performance than the other two cements evaluated.

A Short Time Period in the Treatment of an Open Apice Intruded Tooth: An 8-year Follow-up.

AIM: Among traumatic dental injuries, intrusive dislocation is considered to be one of the most serious injuries. Despite the high success rate in complacent patients, the traditional technique of calcium hydroxide inoculation has drawbacks. The good antimicrobial and sealing properties combined with excellent biocompatibility and high success rates of the mineral trioxide aggregate (MTA) encourage its use. BACKGROUND: The objective of this study was to report a successful case of intrusive dislocation in a short time with a follow-up of eight years. CASE DESCRIPTION: A patient, seven years of age, presented intrusive dental dislocation, confirmed by radiographic examination, which revealed besides axial displacement of the central incisor towards the bone, incomplete root development. The passive repositioning was chosen as the treatment modality. After cleansing of the root canal, therapy with hydroxide paste was performed for 30 days, and then the apex was closed using an artificial barrier made with apical MTA buffer to facilitate root canal obturation. CONCLUSION: Clinical and radiographic signs at 6 months and 8 years of preservation evidence the success of the therapy. CLINICAL RELEVANCE: Teeth with incomplete root formation when traumatized may have their development process interrupted; consequently their root canals remained ample with thin and fragile walls and the open apex which represents a great challenge to the accomplishment of endodontic therapy. The process of apexification with MTA as in this case is an alternative to traditional therapy based on calcium hydroxide, conferring a faster treatment and a decrease in the odds of fracture of the tooth since from the confection of the apical barrier there is a possibility of being the same restored at an early stage. HOW TO CITE THIS ARTICLE: de Sá MAB, Nunes E, et al. A Short Time Period in the Treatment of an Open Apice Intruded Tooth: An 8-year Follow-up. Int J Clin Pediatr Dent 2019;12(2):160-163.

Apical periodontitis associated with a calculus-like deposit: A case report of a rare fan-shaped manifestation.

INTRODUCTION: Bacterial biofilms can be calcified. Granulomas or cystic lesions are the most commonly found entities in endodontics. Surprisingly, this case report presents a rare radiopaque image, in a fan shape, of a calculus-like deposit in the periapical region of the maxillary left central incisor. CASE PRESENTATION: A 34-year-old male, with a history of trauma, presented with apical periodontitis associated with an uncommon image, similar to a calculus-like deposit adhered to the apical region of the maxillary left central incisor. Nonsurgical endodontic intervention was performed, followed by apicoectomy and histopathological analysis of the collected material. The results of the biopsy were not compatible with a cyst or granuloma but showed fibrous connective tissue with calcified areas. DISCUSSION: Correct diagnosis in endodontics is possible with a well-conducted anamnesis, complementary imaging exams and, in some cases, histopathological analysis. The periapical calculus-like deposit, associated with a periapical radiolucent lesion, was a result of the body's fight for healing, producing unusual radiopacity. CONCLUSION: The presence of the calculus-like deposit in a fan shape at the root surface represented dystrophic calcification as a manifestation of the attempt to heal. In the present case, apicoectomy and tissue biopsy for histological evaluation were fundamental for the correct diagnosis.

Tratamento endodôntico não cirúrgico em dente com sobreobturação de cone de prata / Endodontic treatment in non-surgical tooth with silver cone overfilling

A remoção de cones de prata durante o retratamento endodôntico pode ser muito difícil e algumas vezes uma tarefa impossível. Este artigo relata um caso clínico de retratamento endodôntico de um molar inferior com sobreobturação de cone de prata no canal mésio-vestibular. Após o acesso coronário, uma lima K foi utilizada para explorar a interface entre o cone de prata e as paredes dentinárias. Posteriormente, uma ponta ultrassônica foi usada para deslocar os cones e a pinça de Steiglitz para removê-los de dentro dos canais. O cone de prata sobreobturado no canal MV fraturou-se e não foi possível a sua remoção. Após o preparo químico-mecânico e três trocas de medicação intracanal à base de hidróxido de cálcio, com intervalos de 3 meses, foi observado que as lesões periapicais das raízes distal e mesial regrediram drasticamente. Após follow-up de 18 anos, constatou-se sucesso do retratamento.

The removal of silver cones in endodontic retreatment can be very difficult and sometimes an impossible task. This article reports a case of endodontic retreatment of a mandibular molar with silver cone overfilling in mesiobuccal canal. After the coronal access, a K- -file was used to explore the interface between the silver cone and the dentinal walls. Later, an ultrasonic tip was used to dislodge these cones and the Steiglitz forceps to remove them from within the canals. The silver cone overfilled in MV canal fractured and it was not possible to remove. After the chemico-mechanical preparation and three exchanges of intracanal dressing with calcium hydroxide paste, with intervals of three months, it was observed that the periapical lesions of the distal and mesial roots regressed dramatically. After follow-up of 18 years, there was success retreatment.

Treatment of perforating internal root resorption with MTA: a case report.

Endodontic treatment of teeth with perforating internal root resorption represents a clinical challenge. In most cases, extraction of the tooth and subsequent replacement with an osseointegrated implant is indicated. Presented herein is a case report of a maxillary lateral incisor with advanced perforating internal root resorption in the middle third of the root and the presence of a sinus tract. Mineral Trioxide Aggregate (MTA) was used with the aid of a surgical microscope in order to fill the resorption area after conventional root canal therapy of the apical segment. At the follow-up after 11 years and 8 months, the patient was clinically asymptomatic and the sinus tract had disappeared. The radiographic examination and computerized tomography indicated periodontal bone repair.

Double 'pink tooth' associated with extensive internal root resorption after orthodontic treatment: a case report.

Advanced internal resorption affecting the crown of teeth may result in the appearance of a 'pink tooth', which, when located in the root canal, can perforate the external root surface. Therapeutically, this condition represents a clinical challenge and normally requires a combined endodontic and surgical focus. Presented herein are cases of double 'pink tooth' which appeared at different times after orthodontic treatment. In the most severe case, upon radiographic examination and computed tomography, the maxillary right central incisor presented an internal resorption, extending from the pulp chamber to the root middle third. After pulp removal, the debridement of the defect was performed using a 2.5% sodium hypochlorite solution, a #80 Kerr file, and an ultrasonic tip ST-17, aided by a surgical microscope. During the cleaning process, various sites of periodontal communication were identified. Upon controlling the hemorrhaging, the root canal was completely filled with White mineral trioxide aggregate. Within the 3-month follow-up treatment, a pink spot appeared on the maxillary left central incisor, which received conventional root canal therapy. Clinically and radiographically, over 18 months of follow up, both cases responded favorably to the proposed treatments. Therefore, it is important to monitor the patient due to the fact that pulp and periodontal sequelae can develop at varied moments after orthodontic treatment. Furthermore, with the current technology and biomaterials, it is possible to resolve cases with extensive internal perforating resorption through endodontic treatment.

Favorable response of an extensive periapical lesion to root canal treatment.

This article presents non-surgical resolution of an extensive periapical lesion of endodontic origin associated with the maxillary left lateral incisor. Clinical examination revealed an asymptomatic bony hard swelling confined to the palate, while radiographic analysis showed a lesion measuring 22 mm in diameter and nearly 389 mm(2) in area. Through apical patency, 4 ml of intracanal exudate was drained. After thorough biomechanical preparation, a calcium hydroxide/CPMC root canal dressing was applied and periodically renewed for 11 months. The exudate was eliminated at treatment onset and significant bone formation was observed at the periapical region in the following months with concomitant resolution of the cortical expansion. Complete radiographic resolution of the periapical lesion was observed two years after the root canal filling. Thus, non-surgical treatment of this supposedly cystic, extensive periapical lesion provided favorable clinical and radiographic response.

Negative influence of continuous wave technique on apical sealing of the root canal system with Resilon.

The aim of this study was to investigate apical microleakage after use of the Resilon system in comparison with gutta-percha. The materials used were 54 mesial roots of mandibular molars with an apical curvature of 20-40 degrees . The root canals were instrumented with the Prosystem GT(R) and obturated with: Group I: Gutta-percha + Sealer by lateral condensation (n = 25); Group II: Gutta-percha + Sealer, complemented by System B and Obtura II (n = 25); Group III: Resilon + System B and Obtura II (n = 25); Group IV: Resilon by lateral condensation (n = 25). After immersion in India ink, the specimens were demineralized and rendered transparent. Apical dye leakage was analyzed with a stereomicroscope and a digital camera connected to a computerized system. All groups showed different degrees of apical dye microleakage. The Kruskal-Wallis test revealed that the largest leakage occurred in Group I (P < 0.05), whereas the other groups presented a similar pattern of microleakage (P > 0.05). Thermoplastification negatively influenced the apical sealing ability of Resilon. Gutta-percha points and conventional sealer yielded the highest values of apical leakage, especially when the lateral condensation technique was used. Regardless of the obturation technique employed, the Resilon system provided the lowest mean values of apical leakage, but did not provide hermetic sealing of the root canal system.

Apical surgery with calcium hydroxide capping of the exposed dentine: a case report.

Among a variety of biomaterials that have been reported to be ideal for dental repair, calcium hydroxide has been shown to have excellent long-term biocompatibility in the pulp and periapical areas. Here we report an alternative method employing calcium hydroxide for periapical surgery in a patient who developed internal apical resorption after traumatic injury, which negatively affected the quality of the cleaning, shaping and filling of the root canal. Obturation of the root canal as far as the middle third was followed by apicoectomy and ultrasonic retropreparation, and then retrograde root filling with resin cement sealer (Sealer 26) and zinc oxide powder. Calcium hydroxide paste was applied over the exposed dentinal surface, forming a barrier over the root apex. Radiographic follow-up after 24 months showed absence of apical resorption and complete periapical bone repair associated with a continuous apical lamina dura.