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Métodos Terapéuticos y Terapias MTCI
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1.
J Clin Pediatr Dent ; 44(1): 15-19, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31995420

RESUMEN

Regenerative endodontic therapy (RET) provides a novel treatment modality for the immature teeth with pulp necrosis. The aim of this case series was to evaluate RET of immature permanent teeth using platelet rich fibrin (PRF) at 36-month follow-up periods. In the present case series, three immature maxillary incisors diagnosed with pulp necrosis and apical periodontitis were treated with RET. The root canals were irrigated with 1.5% sodium hypochlorite (NaOCl) and medicated with triple antibiotic paste(TAP). At the second visit, TAP was removed and root canals were conditioned with 17% EDTA. PRF was used as a scaffold. MTA was placed over PRF and the teeth were restored with composite resin. Periapical radiographs and cone beam computerized tomography(CBCT) were used to evaluate the healing. At the end of the 36-month follow-up periods, there was no response to pulp sensibility tests with cold and electric pulp tester, but all teeth showed decreased periapical lesions or evidence of healing.


Asunto(s)
Periodontitis Periapical , Fibrina Rica en Plaquetas , Necrosis de la Pulpa Dental , Humanos , Incisivo , Endodoncia Regenerativa , Tratamiento del Conducto Radicular
2.
Int Endod J ; 51(10): 1069-1076, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29603299

RESUMEN

AIM: To evaluate postoperative pain and radiographic evidence of periapical healing in teeth with apical periodontitis treated in one visit with an additional final irrigation using 2% chlorhexidine (CHX) and to compare the results with conventional two-visit root canal treatment (RCT) with an intracanal calcium hydroxide (CH) dressing as a control group. METHODOLOGY: Ninety asymptomatic maxillary anterior teeth with periapical lesions were treated by a single operator. Root canals were prepared using the step-back technique with manual instrumentation with 2.5% NaOCl and 5% EDTA as irrigants. Half of the teeth were randomly assigned to the one-visit (OV) group and received an additional final rinse with 2% CHX before canal filling. The other teeth were treated in two visits (TV) with a CH paste made by mixing CH powder and distilled water as an interappointment dressing. All patients were recalled and investigated clinically and radiographically for 24 months. Postoperative pain at 24-48 h and changes in apical bone density indicating radiographic healing were evaluated statistically using the Mann-Whitney U-test followed by the Friedman and the Wilcoxon tests (α = 0.05). RESULTS: There were no significant differences between two groups regarding the incidence of postoperative pain at 24 h (OV group 50% no pain, 47.6% mild, 2.4% moderate pain/TV group 55% no pain, 42.5% mild, 2.5% moderate pain) and at 48 h (OV group 95% no pain, 5% mild pain/TV group 98% no pain, 2% mild pain). None of the patients reported severe postoperative pain, swelling and/or flare-ups during the follow-up period. There was no significant difference in the radiographic healing rates (OV group 97.6% PAI 1 and/or PAI 2 and 2.4% PAI 3/TV group 95% PAI 1 and/or PAI 2 and 5% PAI 3; P > 0.05). CONCLUSION: Both groups provided favourable and similar postoperative pain and periapical healing rates at 24 months. Thus, one-visit RCT with a final rinse with 2% CHX is an acceptable alternative to two-visit RCT with CH as temporary dressing in maxillary anterior teeth.


Asunto(s)
Clorhexidina/uso terapéutico , Dolor Postoperatorio/epidemiología , Periodontitis Periapical/tratamiento farmacológico , Irrigantes del Conducto Radicular/uso terapéutico , Tratamiento del Conducto Radicular/métodos , Adulto , Femenino , Humanos , Incidencia , Masculino , Dimensión del Dolor , Periodontitis Periapical/diagnóstico por imagen , Tejido Periapical/diagnóstico por imagen , Estudios Prospectivos , Radiografía Dental , Materiales de Obturación del Conducto Radicular , Obturación del Conducto Radicular , Irrigación Terapéutica
3.
Int Endod J ; 51(1): 128-137, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28439906

RESUMEN

AIM: To present the regenerative endodontic treatment procedure of a perforated internal root resorption case and its clinical and radiographic findings after 2 years. SUMMARY: A 14-year-old female patient was referred complaining of moderate pain associated with her maxillary left lateral incisor. After radiographic examination, a perforated internal resorption lesion in the middle third of tooth 22 was detected. Under local anaesthesia and rubber dam isolation, an access cavity was prepared and the root canal was shaped using K-files under copious irrigation with 1% NaOCl, 17% EDTA and distilled water. At the end of the first and second appointments, calcium hydroxide (CH) paste was placed in the root canal using a lentulo. After 3 months, the CH paste was removed using 1% NaOCl and 17% EDTA solutions and bleeding in the root canal was achieved by placing a size 20 K-file into the periapical tissues. Mineral trioxide aggregate was then placed over the blood clot. The access cavity was restored using glass-ionomer cement and resin composite. After 2 years, the tooth was asymptomatic and radiographic examination revealed hard tissue formation in the perforated resorption area and remodelling of the root surface. KEY LEARNING POINTS: Regenerative endodontic treatment procedures are an alternative approach to treat perforated internal root resorption lesions. Calcium hydroxide was effective as an intracanal medicament in regenerative endodontic treatment procedures.


Asunto(s)
Materiales de Obturación del Conducto Radicular , Resorción Radicular/terapia , Adolescente , Hidróxido de Calcio , Femenino , Cementos de Ionómero Vítreo , Humanos , Resinas Sintéticas , Irrigación Terapéutica
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