RESUMEN
Endodontic treatment of second premolars is challenging due to their complex anatomy and the likelihood of anatomical variations. The current report presents successful treatments of mandibular and maxillary second premolars with different anatomies in a single patient. The first case involved a patient referred from a general practitioner who was unable to complete the root canal treatment of her mandibular second premolar with four root canals. The initial radiograph showed an apical radiolucency, periodontal ligament (PDL) widening, and a fast break suggesting the possibility of root canal branching. With the diagnosis of previous treatment and chronic apical periodontitis, the tooth was successfully retreated with the aid of cone-beam computed tomography (CBCT), a dental operating microscope, and ultrasonic tips. The second case was a maxillary second premolar with Vertucci's type VI root canal morphology, which was not responsive to pulpo-periapical tests. Along with a deep carious lesion and a PDL widening on the initial radiograph, a diagnosis of necrosis with chronic apical periodontitis was made. The root canals were located and treated using a combination of radiography with different angulation and CBCT. Both teeth were clinically and radiographically asymptomatic at the 4-month follow-up session. This case report highlights the importance of thorough preoperative evaluation and the use of advanced technology and techniques in achieving successful endodontic treatment outcomes.
RESUMEN
Diabetes mellitus is mostly interrelated to deficiency in wound healing. Low-level laser therapy has been shown to exert reliable effects on the acceleration of wound healing process. This study aimed to determine the potential influence of low-level laser therapy (LLLT) on the healing of extraction sockets in diabetic rats. A total of 24 healthy male Wistar rats were selected for this study. After diabetes induction, the maxillary first molars of all rats were extracted bilaterally. Then, the animals were subjected either to Ga-Al-As laser at 808 nm or to Al-Ga-In-P laser at 660 nm at the right extracted socket every day for the next 14 days. The left sockets served as controls. Rats were sacrificed on the 3rd, 5th, 7th, and 14th days after tooth extraction. The samples were examined by a pathologist. LLLT at 808 nm was able to significantly repress inflammation, improve osteoid formation, and promote vascularization in comparison to the non-treated sockets. LLLT at 660 nm significantly suppressed inflammation and developed vascularization in comparison to the non-treated sockets, but failed to improve osteoid formation in the treated sockets. This study suggests that LLLT could be considered as a reliable treatment for wound healing in diabetic experimental rats.