RESUMEN
This is a series of 7 cases in which the operator penetrated lateral canals with instruments. Two teeth presented with irreversible pulpitis, 4 with necrotic pulps, and 1 with previous treatment. Except for the teeth with pulpitis, all the others were associated with apical periodontitis. The main root canal was always relatively straight, with the lateral canals at the middle third of the root. Suggestive images of lateral canal presence were seen on periapical radiographs in five cases. The clinician introduced intentionally small hand instruments in the lateral canal in 5 cases, while the penetration was fortuitous in the others. The lateral canals were obturated in all cases. Follow-up examination was possible in five cases, all of them showed evidence of successful clinical and radiographic outcomes. Introducing files into lateral canals may permit some preparation and penetration of irrigant solution, favoring disinfection and, consequently, enhancing the treatment outcome. (EEJ-2023-05-063).
Asunto(s)
Cavidad Pulpar , Necrosis de la Pulpa Dental , Periodontitis Periapical , Pulpitis , Preparación del Conducto Radicular , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Cavidad Pulpar/diagnóstico por imagen , Necrosis de la Pulpa Dental/terapia , Periodontitis Periapical/terapia , Pulpitis/terapia , Irrigantes del Conducto Radicular/uso terapéutico , Obturación del Conducto Radicular/métodos , Preparación del Conducto Radicular/métodos , Preparación del Conducto Radicular/instrumentación , Tratamiento del Conducto Radicular/métodos , Resultado del TratamientoRESUMEN
Missed canals can be a common cause of persistent intraradicular infection and post-treatment apical periodontitis. This article reports on a rare case of a maxillary lateral incisor with two roots exhibiting symptomatic post-treatment apical periodontitis regardless of a radiographically adequate root canal treatment. The second root, which was only revealed by cone-beam computed tomography, had passed unnoticed during the first treatment, and its missed canal was the most likely cause of symptoms and treatment failure. Reintervention including the proper management of the extra root canal and retreatment of the main canal resulted in the resolution of symptoms and periradicular tissue healing. This case report reinforces the need for three-dimensional radiographic diagnosis to search for the cause of post-treatment disease and guide the decision-making process for proper management.
Asunto(s)
Cavidad Pulpar , Periodontitis Periapical , Humanos , Cavidad Pulpar/diagnóstico por imagen , Incisivo/diagnóstico por imagen , Tratamiento del Conducto Radicular/métodos , Periodontitis Periapical/diagnóstico por imagen , Periodontitis Periapical/terapia , RadiografíaRESUMEN
This article shows the follow-up of several cases of maxillary sinusitis of dental (usually endodontic) origin, with different manifestations, diagnostic challenges, and outcomes.Cases from 14 patients from 3 countries and treated by 7 different endodontists are presented, all of them with inflammatory sinus changes represented by mucositis, osteoperiostitis, and/or partial/full obstruction. All cases showed dental and/or sinus signs/symptoms that resolved after dental management. In 13 cases, the sinus condition had an endodontic origin, 4 of them concurrently with periodontal involvement. In 1 case, sinusitis was caused by trauma to the face. All cases but 1 had a satisfactory response of the periradicular tissues and maxillary sinus to treatment that consisted of root canal therapy, root amputation, extraction, or trauma management.The successful management of most cases reported in this article emphasizes the importance of endodontics as a specialty engaged in saving teeth and promoting health not only in the oral cavity but also in other areas that may be affected by infections of endodontic origin, including the maxillary sinus.