RESUMO
Dental trauma to the permanent dentition can lead to clinical complications and its management may considerably challenge a practitioner. The incidence of pulp canal obliteration following dental trauma has been reported to be approximately 4 - 24%. Attempting to locate canals following calcific metamorphosis and negotiating it to full working length may lead to iatrogenic errors such as fractured instrument and perforation. This review article describes the possible etiology of Calcific Metamorphosis, its clinical and radiographic features as well as its management.
RESUMO
The incidence of pulp canal obliteration following dental trauma has been reported to be approximately 4 - 24% and its management can be quite challenging for the practitioner. Locating the canal and negotiating it to full working length may lead to iatrogenic errors such as fractured instrument and perforation. This case report deals with such a case using the modified tip instrument technique to gain access and negotiate the canal to the apex followed by conventional root canal preparation and obturation.
RESUMO
OBJECTIVE: The aim was to review the bactericidal efficacy of photodynamic therapy (PDT) against Enterococcus faecalis (E. faecalis) in infected root canals. METHODS: To address the focused question "Does PDT exhibit bactericidal effects against E. faecalis in infected root canals?" PubMed/Medline and Google-Scholar databases were searched from 1985 up to August 2013 using various combinations of the following key words: "antibacterial; "bactericidal; "endodontic; "root canal" and "photodynamic therapy". Original studies, experimental studies and articles published only in English language were included. Letters to the editor, historic reviews and unpublished data were excluded. The pattern of the present review was customized to primarily summarize the pertinent information. RESULTS: Seventeen studies (16 ex vivo and one in vivo) were included. In these studies, numbers of teeth used ranged between 30 and 220 teeth. In these studies, wavelengths of diode laser used, diameter of fiber and power output ranged between 625 and 805 nm, 200 µm and 0.4 cm, and 40 mW and 5 W respectively. Twelve studies reported PDT to be effective in eliminating E. faecalis from infected root canals. Four studies reported conventional irrigation and instrumentation to be more efficient in killing E. faecalis than PDT. One study reported PDT and conventional endodontic regimes to be equally effective in eliminating E. faecalis from infected root canals. In most studies, toluidine blue and/or methylene blue were used as photosensitizers. CONCLUSION: Efficacy of PDT in eliminating E. faecalis from infected root canals remains questionable.