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1.
Cient. dent. (Ed. impr.) ; 16(1): 47-54, ene.-abr. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183381

RESUMO

Cuando se combinan entre sí, las células madre, las matrices y los factores de crecimiento tienen la capacidad de regenerar un tejido, tal como el complejo dentino-pulpar. La ingeniería tisular está adquiriendo cada vez más importancia en el campo de la endodoncia como una alternativa a la obturación clásica con gutapercha. El objetivo de esta revisión es comparar los diferentes materiales que actuarían como matrices disponibles en la actualidad, así como conocer el alcance del conocimiento sobre los factores de crecimiento relacionados con la regeneración de la pulpa, señalando las principales limitaciones y elaborando un protocolo para futuros procedimientos regenerativos. Las matrices de colágeno han demostrado ser una opción óptima, ya que son biodegradables, pueden ser autólogos y existe una alta disposición. El factor de crecimiento insulínico tipo 1 y el factor de crecimiento derivado de plaquetas han demostrado estar implicados en la proliferación celular. El factor de crecimiento endotelial vascular es uno de los más importantes para la proliferación de la red vascular. El aislamiento celular y los altos costos son los principales obstáculos. La combinación de un andamio de colágeno, factor de crecimiento insulínico tipo 1, factor de crecimiento derivado de plaquetas, factor de crecimiento endotelial vascular y células madre de tejido pulpar de dientes deciduos (SHEDs) podría dar buenos resultados en la regeneración de la pulpa dental


When combined together, stem cells, scaffolds and growth factors have the ability of regenerating a whole tissue, for example the dental-pulp complex. Tissue engineering is getting more and more importance in the endodontic field as an alternative to the standard filling of root canals with gutta-percha material. The aim of this review is to compare the different scaffold materials available today, find out the extent of knowledge about the growth factors related to pulp regeneration, pointing out the main limitations and devise a protocol for future regenerative procedures. Collagen scaffolds material have shown to be an optimal choice as they are biodegradable, can be autologous and are highly available. Insulin-like growth factor 1 and platelet derived growth factor have shown to be involved in cells proliferation. Vascular endothelial growth factor is one of the most important for vascular network proliferation. Cells isolation and high costs are the main obstacles. As a conclusion, the combination of a collagen scaffold, insulin-like growth factor 1, platelet derived growth factor, vascular endothelial growth factor and dental pulp stem cells from deciduous teeth (SHEDs) might give good outcomes in dental pulp regeneration


Assuntos
Humanos , Engenharia Tecidual/métodos , Endodontia Regenerativa/métodos , Transplante de Células-Tronco , Tecido Periapical/citologia , Regeneração/fisiologia , Células-Tronco/fisiologia
2.
Endodoncia (Madr.) ; 36(3): 8-21, dic. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-178382

RESUMO

La Tomografía Computarizada de Haz Cónico (TCHC) (Cone Beam Computed Tomography - CBCT) es un método de imagen que nos ofrece en Endodoncia unas ventajas relevantes sobre la radiografía periapical y otras técnicas radiográficas a la hora de establecer un diagnóstico y plan de tratamiento adecuados. Debemos tener en cuenta, no obstante, que no se debe hacer de manera rutinaria y que no todos los aparatos ni todas las modalidades (campo de adquisición y resolución espacial) están indicadas para su uso en el campo de la endodoncia. Debemos tener un conocimiento técnico mínimo de las cualidades físicas de esta tecnología, para poder realizar una adquisición de datos que sea correcta en cuanto a la radiación del paciente (la menor posible), y en cuanto a la resolución espacial (la mayor posible) para la tarea diagnóstica que vamos a realizar. Repasaremos las indicaciones de uso de el CBCT en endodoncia, el porqué de sus indicaciones y casos clínicos que demuestran la relevancia de la utilización de esta tecnología en Endodoncia


No disponible


Assuntos
Humanos , Dente não Vital/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Endodontia/métodos , Doenças Periapicais/diagnóstico por imagem , Tecido Periapical/diagnóstico por imagem
3.
Endodoncia (Madr.) ; 36(3): 32-42, dic. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-178384

RESUMO

La evaluación radiográfica y las pruebas diagnósticas son de vital importancia para realizar un adecuado plan de tratamiento en endodoncia. En el campo de la endodoncia, tradicionalmente se han utilizado diferentes pruebas como la palpación, la percusión, las pruebas de sensibilidad pulpar y las radiografías periapicales (RP). Hasta la actualidad las RP (convencionales o digitales) han sido un complemento indispensable para realizar el tratamiento endodóntico, así como para determinar el éxito de dicho tratamiento. Sin embargo, está demostrado que las RP presentan ciertas limitaciones como superposiciones de estructuras anatómicas, la visión en dos dimensiones (2D) y la distorsión geométrica. Las imágenes obtenidas mediante RP ofrecen solamente datos de la dimensión mesio-distal, lo que dificulta la detección de cierta información como: la anatomía radicular, la presencia de alteraciones alrededor de las raíces, la pérdida ósea, los diferentes tipos de reabsorciones radiculares, las fracturas radiculares y otros aspectos importantes en la planificación de una cirugía apical. A través de la imágenes obtenidas a partir de la tomografía computarizada de haz cónico (TCHC), en inglés llamada cone-beam computed tomography (CBCT), se puede obtener una mayor información diagnóstica en comparación a las RP preoperatorias; información que influye directamente en el plan de tratamiento del clínico, especialmente en los casos de dificultad alta. Por todo a ello, en este artículo se presentan diferentes situaciones clínicas en las que la CBCT juega un papel fundamental en relación al plan de tratamiento endodóncico


No disponible


Assuntos
Humanos , Dente não Vital/diagnóstico por imagem , Dente não Vital/terapia , Tomografia Computadorizada de Feixe Cônico/métodos , Abscesso Periapical/diagnóstico por imagem , Reabsorção Óssea/diagnóstico por imagem , Reabsorção de Dente/diagnóstico por imagem , Traumatismos Dentários/diagnóstico por imagem , Doenças Periapicais/diagnóstico por imagem , Tecido Periapical/diagnóstico por imagem
4.
Endodoncia (Madr.) ; 36(3): 44-50, dic. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-178385

RESUMO

Introducción: La metamorfosis cálcica se presenta comúnmente tras lesiones traumáticas y se caracteriza por presentar depósitos de tejido duro dentro del espacio pulpar, obliterando parcial o totalmente la cámara pulpar y/o el conducto radicular. Este proceso suele provocar un cambio de coloración de la corona clínica haciéndola más oscura y opaca. Caso clínico: Paciente mujer de 40 años acude a la consulta motivada por una preocupación estética debido al oscurecimiento del diente 21. Se proponen varias opciones de tratamiento, hasta que finalmente se opta por el tratamiento de conductos de forma ortógrada, así como blanqueamiento interno del diente. Conclusión: El plan de tratamiento en dientes con metamorfosis cálcica sin patología periapical y con compromiso estético partirá siempre desde el más conservador. Es esencial en el tratamiento de estos dientes la experiencia del operador, así como el buen manejo del microscopio y los ultrasonidos, herramientas fundamentales para su abordaje


Introduction: Calcium metamorphosis commonly occurs after traumatic injuries and is characterized by hard tissue deposits within the pulp space, partially or totally obliterating the pulp chamber and/or the root canal. This process usually causes a change in the color of the clinical crown, making it darker and more opaque. Clinical case: A 40-year-old female patient came to the clinic motivated by an aesthetic concern due to the darkening of the tooth 21. Various treatment options are proposed, until finally the endodontic treatment is chosen, as well as internal bleaching of the tooth. Conclusion: The treatment in teeth with calcium metamorphosis, without periapical pathology and with aesthetic compromise, should always be the most conservative. It is essential in the treatment of these teeth the experience of the operator, as well as the correct use of the microscope and ultrasounds, which are fundamental tools for its approach


Assuntos
Humanos , Feminino , Adulto , Clareamento Dental/métodos , Dente não Vital/terapia , Depósitos Dentários/terapia , Traumatismos Dentários/diagnóstico por imagem , Traumatismos Dentários/terapia , Espectrometria de Fluorescência/métodos , Cavidade Pulpar/diagnóstico por imagem , Tecido Periapical/diagnóstico por imagem
6.
Med. oral patol. oral cir. bucal (Internet) ; 22(6): e737-e749, nov. 2017. graf, tab
Artigo em Inglês | IBECS | ID: ibc-168750

RESUMO

Purpose: The aim of this study was to systematically review the evidence for periapical implant lesion, which makes a patient more susceptible to the periapical lesion, frequency, symptoms, signs (including radiological findings) and possible treatment options. Material and Methods: A systematic literature review and analysis of publications included in PubMed, Embase and Cochrane; articles published until March 2016; with a populations, exposures and outcomes (PEO) search strategy was performed, focused on the issue: 'In patients with periapical lesion to the implant during the osseointegration, what symptoms, signs, and changes in complementary examination manifested, for according to that stage, be intervened with the appropriate approach? '. The set criteria for inclusion were peer-reviewed articles. Results: From a total of 212 papers identified, 36 studies were included in this systematic review, with 15461 implants evaluated and 183 periapical implant lesions. Which 8 papers included more than 5 cases and 28 included equal or less than 5 cases. Analysis of the papers revealed that periapical implant lesion is classified according to evolution stages into acute (non-suppurated and suppurated) and subacute (or suppurated-fistulized). In the acute stage and in the subacute if there is no loss of implant stability, the correct treatment approach is implant periapical surgery. In the subacute stage associated with implant mobility the implant must be removed. Conclusions: Evidence on the subject is very limited, there are few studies with small sample, without homogeneity of criteria for diagnosing the disease and without design of scientific evidence. Currently etiology lacks consensus. The early diagnosis of periapical implant periapical lesions during the osseointegration phase and early treatment, will lead to a higher survival rate of implants treated, hence preventing the need for implant extraction (AU)


No disponible


Assuntos
Humanos , Doenças Periapicais , Tecido Periapical/lesões , Implantes Dentários/efeitos adversos , Osseointegração , Prognóstico , Tecido Periapical/cirurgia , Bibliometria
7.
Med. oral patol. oral cir. bucal (Internet) ; 22(6): e750-e758, nov. 2017. graf, tab
Artigo em Inglês | IBECS | ID: ibc-168751

RESUMO

Background: Dry socket is one of the most common complications that develops after the extraction of a permanent tooth, and its prevention is more effective than its treatment. Objectives: Analyze the efficacy of different methods used in preventing dry socket in order to decrease its incidence after tooth extraction. Material and Methods: A Cochrane and PubMed-MEDLINE database search was conducted with the search terms 'dry socket', 'prevention', 'risk factors', 'alveolar osteitis' and 'fibrynolitic alveolitis', both individually and using the Boolean operator 'AND'. The inclusion criteria were: clinical studies including at least 30 patients, articles published from 2005 to 2015 and written in English. The exclusion criteria were case reports and nonhuman studies. Results: 30 publications were selected from a total of 250. Six of the 30 were excluded after reading the full text. The final review included 24 articles: 9 prospective studies, 2 retrospective studies and 13 clinical trials. They were stratified according to their level of scientific evidence using SIGN criteria (Scottish Intercollegiate Guidelines Network). Conclusions: All treatments included in the review were aimed at decreasing the incidence of dry socket. Locally administering chlorhexidine or applying platelet-rich plasma reduces the likelihood of developing this complication. Antibiotic prescription does not avoid postoperative complications after lower third molar surgery. With regard to risk factors, all of the articles selected suggest that patient age, history of previous infection and the difficulty of the extraction are the most common predisposing factors for developing dry socket. There is no consensus that smoking, gender or menstrual cycles are risk factors. Taking the scientific quality of the articles evaluated into account, a level B recommendation has been given for the proposed-procedures in the prevention of dry socket (AU)


No disponible


Assuntos
Humanos , Tecido Periapical/lesões , Tecido Periapical/cirurgia , Osseointegração/fisiologia , Implantes Dentários , Diagnóstico Precoce , Bibliometria , Extração Dentária/métodos
8.
Endodoncia (Madr.) ; 34(4): 243-249, oct.-dic. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-160982

RESUMO

Una infección endodóncica persistente (IEP) representa un desafío en el tratamiento de conductos radiculares. La remoción de bacterias es complicada cuando una terapia de endodoncia convencional no es efectiva, por lo que estrategias adicionales de desinfección deben aplicarse para obtener un tratamiento exitoso. Este artículo reporta el caso de una IEP en un hombre de 58 años de edad que fue referido al posgrado de endodoncia de la Universidad Autónoma de Nuevo León. Aunque un retratamiento endodóncico fue iniciado, el paciente decidió extraerse el diente con un dentista general; un conducto recurrente y una ramificación apical fueron detectados en el diente extraído


A persistent endodontic infection (PEI) represents a challenge in root canal treatments. The bacterial removal is complicated when a conventional endodontic therapy is ineffective; therefore additional strategies of disinfection should be applied to obtain a successful treatment. This article describes a PEI case of a 58-years-old man who was referred to the Department of Endodontics of Nuevo Leon Autonomous University. Although an endodontic retreatment was initiated, the patient decided to remove his tooth with a general dentist; a recurrent canal and an apical ramification were detected in the extracted tooth


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Dente Canino/patologia , Infecções/complicações , Tecido Periapical/patologia , Endodontia/instrumentação , Retratamento/métodos , Técnicas Histológicas/instrumentação , Cavidade Pulpar/patologia , Cavidade Pulpar , Anestesia Local , Ápice Dentário/microbiologia , Tomografia com Microscopia Eletrônica
9.
Rev. esp. cir. oral maxilofac ; 37(4): 188-195, oct.-dic. 2015. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-145160

RESUMO

Objetivos. Evaluar el protocolo quirúrgico y discutir los posibles factores predisponentes de la periimplantitis apical. Material y método. En el presente trabajo, se planteó un estudio descriptivo retrospectivo analizando una serie de 11 casos clínicos de periimplantitis apical diagnosticados y tratados en el ámbito del Hospital de La Princesa (Madrid) y la Clínica Universidad de Navarra (Pamplona) entre 2002 y 2013. Los pacientes sintomáticos fueron tratados mediante legrado de la zona con o sin relleno. Resultados. Se analizaron un número total de 11 casos de periimplantitis apical (4 asintomáticos y 7 con síntomas). La clínica observada fue parecida a la enfermedad dentaria periapical y el tiempo transcurrido hasta el diagnóstico fue variable, inferior a los 3 años. Se observó resolución completa del problema en 6 de los 7 casos tratados con legrado de la zona periapical del implante. En el caso restante se procedió a la explantación del implante afecto. En los casos asintomáticos no se realizó ningún tipo de tratamiento quirúrgico, presentando una tendencia autolimitada. Conclusión. La periimplantitis apical es una enfermedad que puede complicar el tratamiento implantológico. La cirugía conservadora ha tenido resultados satisfactorios en los casos sintomáticos (AU)


Objectives. The purpose of this study was to evaluate the surgical protocol and discuss possible predisposing factors of apical peri-implantitis. Material and methods. A retrospective study was performed by analyzing a series of cases involving 11 patients, all of whom where diagnosed with, and treated for, apical peri-implantitis at La Princesa Hospital in Madrid and at Navarre University Clinic in Pamplona, Spain, between 2002 and 2013. Symptomatic patients were treated with curettage of the area, which was, in some cases, combined with bone regeneration techniques. Results. A total of 11 cases of apical periimplantitis were included (4 asymptomatic and 7 symptomatic). The symptoms observed were similar to dental periapical pathology, and the period of time elapsed until the patients were diagnosed with API was variable, but was less than 3 years. Complete resolution of the pathology was observed in 6 of the 7 patients treated with curettage of the periapical implant area. In the remaining case the affected implant was removed. No surgical treatment was used in asymptomatic cases, as they were self-limiting. Conclusion. Apical periimplantitis is a condition which may complicate the dental implant treatment. Conservative surgical treatment has shown satisfactory results in symptomatic patients (AU)


Assuntos
Feminino , Humanos , Masculino , Implantes Dentários , Implantes Dentários/efeitos adversos , Transplante Autólogo/métodos , Inflamação/complicações , Doenças Periapicais/complicações , Doenças Periapicais/tratamento farmacológico , Doenças Periapicais/cirurgia , Tecido Periapical/patologia , Tecido Periapical , Ápice Dentário/patologia , Ápice Dentário/cirurgia , Ápice Dentário , Estudos Retrospectivos , Próteses e Implantes/efeitos adversos , Endodontia/métodos
10.
Med. oral patol. oral cir. bucal (Internet) ; 20(6): e715-e722, nov. 2015. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-144704

RESUMO

Background: Analyze the most important prognostic factors when performing periapical surgery and compare the success rates of distinct authors. Introduction: Periapical surgery is an approach to treat non-healing periapical lesions and it should be viewed as an extension of endodontic treatment and not as a separate entity. Material and Methods: A search of articles published in Cochrane, PubMed (MEDLINE) and Scopus was conducted with the key words “prognostic factors”, “prognosis”, “periapical surgery”, “endodontic surgery” and “surgical endodontic treatment”. The inclusion criteria were articles including at least 10 patients, published in English, for the last 10 years. The exclusion criteria were nonhuman studies and case reports. Results: 33 articles were selected from 321 initially found. Ten articles from 33 were excluded and finally the systematic review included 23 articles: 1 metaanalysis, 1 systematic review, 2 randomized clinical trials, 6 reviews, 12 prospective studies and 1 retrospective study. They were stratified according to their level of scientific evidence using the SORT criteria. Conclusions: Factors associated with a better outcome of periapical surgery are patients ≤45 years old, upper anterior or premolar teeth, ≤10 sized lesions, non cystic lesions, absence of preoperative signs and symptoms, lesions without periodontal involvement, teeth with an adequate root-filling length, MTA as root-end filling material, uniradicular teeth, absence of perforating lesions, apical resection < 3 mm, teeth not associated to an oroantral fistula and teeth with only one periapical surgery (AU)


Assuntos
Feminino , Humanos , Masculino , Prognóstico , Doenças Periapicais/cirurgia , Tecido Periapical/cirurgia , Endodontia/métodos , Implantação Dentária Endo-Óssea Endodôntica/métodos , Implantação Dentária Endo-Óssea Endodôntica/estatística & dados numéricos , Microcirurgia/métodos , Microcirurgia/estatística & dados numéricos , Estudos Prospectivos , Doenças Periodontais/epidemiologia
11.
Endodoncia (Madr.) ; 33(2): 55-62, abr.-jun. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-146578

RESUMO

Objetivo: El objetivo de este estudio consiste en comparar la capacidad de sellado apical de dos materiales empleados en la obturación de cavidades a retro en cirugía periapical: MTA y un cemento de óxido de cinc-eugenol reforzado (Super EBA(R)). Material y métodos: Se llevó a cabo un estudio in vitro con dientes unirradiculares extraídos, a fin de evaluar la capacidad de sellado apical de dos materiales empleados como material de obturación en cavidades a retro: cemento de óxido de cinc reforzado (Súper EBA(R)) (n = 30) y MTA (n = 30). Además, se creó un grupo control negativo (n = 5) y otro positivo (n = 5). Las muestras procesadas fueron sumergidas en tinta China y posteriormente diafanizadas. Tras secar las muestras, se cuantificó el grado de filtración (mm) mediante un software de análisis de imagen. Los resultados fueron analizados utilizando el test de la t de Student, empleando el programa SPSS versión 20.0. Un valor de p ≤ 0,05 fue considerado significativo. Resultados: El 6,6% y el 10% de las muestras obturadas con MTA o con Súper EBA(R), respectivamente, sufrieron una filtración completa. Estas referencias revelaron que el grado de filtración no depende del material empleado (p = 0,133). Conclusión: No existen diferencias respecto al grado de filtración entre ambos materiales empleados en el sellado retrocavitario


Objectives: The aim of this study was to compare the apical sealing capabilities of the mineral trioxide aggregate (MTA) and of the reinforced zinc oxide-eugenol cement Super EBA(R). Material and methods. An in vitro study was carried out using extracted single-rooted teeth samples. Two materials were tested as root-end filling materials: a reinforced zinc oxide-eugenol cement (Super EBA(R)) (n = 30) and mineral trioxide aggregate (MTA) (n = 30). Another two groups were created as negative (n = 5) and positive (n = 5) control groups. The samples were put in Chinese ink and then diafanizated. Once dried, the level of leakage (mm) was measured by an image software program. The results were analysed using Student's t-test, using the SPSS version 20.0. Differences with p value lower or equal 0.05 were considered significant. Results: Mean filtration in MTA group was 0.77 ± 1.006, whereas in the SuperEba group it was 1.20 ± 1.186 (p = 0.133). Complete leakage was found in 6.6% of the samples filled with MTA and in 10% of those filled with Super EBA(R) (p = 0.133). The level of leakage was not influenced by the material used and null hypothesis can be accepted. Conclusion: Both type of root-end filling materials analysed in this research, are indicated for sealing the retropreparation, without differences in the leakage


Assuntos
Selantes de Fossas e Fissuras/uso terapêutico , Cimento de Óxido de Zinco e Eugenol/uso terapêutico , Micropeneiramento/métodos , Irrigantes do Canal Radicular/uso terapêutico , Técnicas In Vitro , Tecido Periapical/cirurgia , Tecido Periapical , Endodontia/métodos
12.
Endodoncia (Madr.) ; 33(2): 68-76, abr.-jun. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-146580

RESUMO

Se presentan dos casos en los cuales fue identificado biofilm en la superficie radicular externa de los dientes con periodontitis apical persistente (PAP). En el primer caso presentado, dos incisivos centrales superiores derechos con tratamientos de conductos realizados previamente y con PAP, fueron retratados y después realizada una cirugía periapical. Los ápices radiculares resecados fueron examinados y se observaron sus superficies cubiertas con un material duro similar al cálculo. El análisis histológico del tejido blando apical indicó tejido de granulación y abundantes elementos granulomatosos. Examinados ambos ápices con microscopía electrónica de barrido (MEB), se pudieron observar gruesas capas de biofilm bacteriano, en su mayoría formado por cocos, sobre el material duro que se asemeja al cálculo. En el segundo caso presentado, un primer molar superior derecho con PAP, con un tratamiento incorrecto de conductos realizado anteriormente, fue retratado y posteriormente realizada una cirugía apical. Examinada la raíz palatina mediante MEB, se identificaron gruesas capas de biofilm bacteriano, compuestas por células del tipo actinomices con forma de bastoncillos irregulares, adheridos a la superficie del material duro que se asemeja al cálculo. Los casos que se exponen a continuación, apoyan el concepto de que las infecciones persistentes periapicales de origen pulpar, en especial los casos sintomáticos, pueden estar asociadas a la presencia de biofilms adheridos a la superficie externa de la raíz, interfiriendo con la reparación apical


Two cases in which biofim was identified on the external root surface of root-filled teeth with persistent apical periodontitis (PAP) are reported. In the first case, the root canals of two maxillary right incisors with PAP were retreated and the apices were surgically resected. The resected root ends were examined and the surfaces covered with a hard calculus-like material. Histological analysis of the apical soft tissue indicated both granulation and granulomatosus elements. Scanning electron microscopy (SEM) examination showed thick layers of bacterial biofilm, mostly cocciform bacteria, on the calculus-like material. In the second case, the root canals of a maxillary left first molar with PAP, were treated and the root end of the palatal root was resected. SEM examination of the palatal root tip indentified thick layers of bacterial biofilm composed of actinomyces-like cells and irregular rod-shaped bacteria attached to the surface of a calculus-like material. The cases reported here support the concept that persistent periapical infections of pulpal origin may be associated with the presence of biofilms on the external root surface infections, causing impaired healing of the, may be associated to bacterial biofilms on external root Surface


Assuntos
Adulto , Feminino , Humanos , Masculino , Tratamento do Canal Radicular/métodos , Cavidade Pulpar , Placa Dentária/terapia , Biofilmes , Periodontite Periapical/diagnóstico , Periodontite Periapical/terapia , Doenças da Polpa Dentária/microbiologia , Tecido Periapical
13.
Endodoncia (Madr.) ; 33(2): 77-83, abr.-jun. 2015. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-146581

RESUMO

Introducción: Las infecciones de origen endodóncico son infecciones polimicrobianas que pueden tener diversas manifestaciones clínicas y radiológicas. La presencia de virus en diferentes patologías pulpares y periapicales está en investigación con el fin de asociar su presencia con las lesiones radiolúcidas apicales y sus sintomatología. El objetivo de este estudio es analizar la evidencia científica disponible en la actualidad que relaciona la presencia de virus en diferentes patologías de endodoncia y sus posibles implicaciones clínicas. Métodos: Se hace una revisión en la base de datos Medline/Publine, utilizando diferentes parámetros de búsqueda, seleccionando posteriormente los artículos más relevantes, que cumplieron con el criterio de búsqueda. De igual manera se hace una búsqueda en Scielo e IME. Resultados: Se incluyeron un total de 21 artículos, de los cuales 17 detectan la presencia del virus en una de las muestras. En tres de los estudios, la presencia viral no se encontró en ninguna de las muestras estudiadas. Los virus que se encontraron con mayor frecuencia fueron el virus de Epstein-Barr y citomegalovirus; sin embargo, en algunos de estos estudios han aparecido agentes virales como el herpes humano 6 y 8 virus. La relación entre presencia viral y sintomatología no es posible detectarla en todos los estudios, y lo mismo sucede con el tamaño de la lesión. Conclusión: Es necesario examinar y comprender la relación microbiológica que se establece en las patologías de origen endodóncico, dando lugar a nuevas opciones terapéuticas y de tratamiento


Introduction: Infections of an endodontic origin are polymicrobiobial infections that can have diverse clinical and radiographic manifestations. Recently, the presence of viruses in different endodontic pathologies is a focus of new research, associating their presence with symptomology and with apical radiolucent lesions. The goal of this study is to analyze the scientific evidence available currently that relates the presence of viruses in different endodontic pathologies and their possible clinical implications. Methods: A revision was carried out of the Medline/Publine database, using different search parameters, subsequently selecting the most relevant articles, which complied with the search criterion. Results: A total of 21 articles were included, and 17 detected the presence of viruses in one of the samples. In 3 of the studies, viral presence was not found in any of the sample studied. The viruses that were most frequently found were the Epstein-Barr and Cytomegaloviruses; however in some of these studies viral agents have appeared such as the human herpes 6 and 8 viruses. The relation between viral presence and symptomology is not possible to detect in all of the studies, which is the same for the relationship with large apical lesions. Conclusion: It is necessary to examine and understand the microbiological relationships that are established in pathologies of endodontic origin, leading to new therapeutic and treatment options


Assuntos
Humanos , Doenças Periapicais/patologia , Periodontite Periapical/patologia , Estomatite Herpética/microbiologia , Periodontite Periapical/microbiologia , Controle de Infecções/tendências , Doenças Periapicais/virologia , Granuloma Periapical/virologia , Periodontite Periapical/virologia , Infecções por Papillomavirus/virologia , Infecções por Vírus Epstein-Barr/virologia , Tecido Periapical/lesões
14.
Med. oral patol. oral cir. bucal (Internet) ; 20(3): 334-339, mayo 2015. ilus
Artigo em Inglês | IBECS | ID: ibc-139049

RESUMO

BACKGROUND: Leptin, initially described as an adipocyte-derived hormone to regulate weight control, is expressed in normal and inflamed human dental pulp, being up-regulated during pulp experimental inflammation. Leptin receptor (LER) has been identified in human periapical granulomas. The aim of this study was to analyze and characterize the expression of leptin in human periapical granulomas. MATERIAL AND METHODS: Fifteen periapical inflammatory lesions were obtained from extracted human teeth and teeth which underwent periapical surgery. After their morphological categorization as periapical granulomas and gradation of the inflammatory infiltrate, they were examined by immunohistochemistry using human leptin policlonal antibodies. Leptin mRNA expression was also determined by quantitative real-time PCR (qRT-PCR) and the amount of leptin protein was analyzed by immunoblot. RESULTS: All periapical lesions exhibited the characteristic of chronic granulomatous inflammatory process with inflammatory infiltrate grade III. Leptin+ cells were detected in 13 periapical granulomas (86.6%). The median number of Leptin+ cells in periapical granulomas was 1.70 (0.00-7.4). Amongst the inflammatory cells in the periapical granulomas, only macrophages were reactive to leptin antibodies. Western blot analysis revealed the presence in all samples of a protein with apparent molecular weight of approximately 16 kDa, corresponding to the estimated molecular weights of leptin. The expression of leptin mRNA was confirmed by qRT-PCR analysis and the size of the amplified fragment (296 bp for leptin and 194 bp for cyclophilin) was assessed by agarose gel electrophoresis. CONCLUSIONS: For the first time, it has been demonstrated that human periapical granuloma expresses the adipokine leptin (AU)


Assuntos
Humanos , Leptina/isolamento & purificação , Granuloma Periapical/imunologia , Adipocinas/isolamento & purificação , Imuno-Histoquímica/métodos , Tecido Periapical/fisiopatologia
15.
Av. odontoestomatol ; 31(1): 11-18, ene.-feb. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-184246

RESUMO

Introducción: El primer molar maxilar permanente es el diente que presenta mayor complejidad y variación morfológica, que se refleja en la más alta tasa de fracaso clínico. Las principales causas de su fracaso en el tratamiento endodóntico es la imposibilidad de localizar el canal mesiovestibular secundario y el desconocimiento de su morfología. El objetivo de este estudio fue determinar, in vitro, la configuración del canal MB2 presente en la raíz mesiovestibular del primer molar maxilar, mediante radiografías periapicales. Material y métodos: Se seleccionaron 62 primeros molares maxilares. Se procedió a tomar radiografías iniciales periapicales de cada diente en sentido mesiodistal y vestíbulo-palatino. Los molares fueron trepanados y los canales fueron permeabilizados. Para evidenciar la anatomía de los canales radiculares, se posicionó en el canal MB1 una lima Headstrom no 0,8 o 10 y en el canal MB2 una lima k-flex no 0,8 o 10. Los especímenes fueron sometidos a una radiografía periapical, en sentido mesiodistal y vestíbulo-palatino. Resultados: El 30,38% de los dientes presentó un sistema de canales tipo I, 41,07% correspondió al tipo II, un 28,57% al tipo III y un 0% al tipo IV. La frecuencia del canal mesiovestibular secundario fue de un 69,64%. Discusión: El clínico debe tener la convicción de realizar la exploración en búsqueda del canal MB2, logrando un adecuado acceso endodóntico que permita una visualización correcta, utilizar herramientas como el microscopio, ultrasonido o TCHC para su detección y estudio morfológico


Introduction: Permanent maxillary first molar is the tooth that presents the most complex morphological variation, which is reflected in a higher rate of clinical failure. One of the main causes of endodontic treatment failure is the inability to locate the secondary mesiobuccal canal and the ignorance of their morphology. The aim of this study was to determine, in vitro, the configuration of MB2 canal present in the mesiobuccal root of the first maxillary molar, through periapical radiographs. Methods: Sixty-two maxillary first molars were selected. After this, we proceeded to take initial periapical radiographs of each tooth in mesio-distal and bucco-palatal faces. The molars were approached until pulp chamber and canals were permeabilized. In order to demonstrate the anatomy of root canals, a Hedstrom file no 0,8 or 10 was positioned over the MB1 canal and a K- flex file no 0,8 or 10 over the MB2 canal. Specimens were subjected to a periapical radiograph as a final control in the same mesio-distal and bucco-palatal faces. Results: 30,38% of teeth had type I canal system, 41,07% were type II, 28,57% had type III and 0% type IV. The frecuency of the second mesiobuccal canal was 69,64%. Discussion: The clinician must be satisfied to perform exploration in search of MB2 canal, making an adequate endodontic access to allow a correct display, to use tools like microscope, ultrasound or TCHC for its detection and morphological study


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Técnicas In Vitro , Endodontia/métodos , Raiz Dentária/diagnóstico por imagem , Estudos Transversais , Chile , Tecido Periapical/anatomia & histologia , Tecido Periapical/diagnóstico por imagem , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem
16.
Av. odontoestomatol ; 31(1): 31-42, ene.-feb. 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-184247

RESUMO

Las lesiones periapicales resultado de la necrosis de la pulpa dental son las patologías que más frecuentemente ocurren encontradas en el hueso alveolar. El tratamiento consiste en la eliminación de los agentes infecciosos mediante el tratamiento del canal radicular, permitiendo la cicatrización de la lesión


Periapical lesions, which are a result of the necrosis of the dental pulp, are the most frequently occurring diseases found in the alveolar bone. The treatment involves the removal of infectious agents by treating the root canal, allowing the wound healing


Assuntos
Humanos , Doenças Periapicais/diagnóstico , Doenças Periapicais/terapia , Tecido Periapical/lesões , Granuloma Periapical/diagnóstico , Granuloma Periapical/terapia , Granuloma Periapical/cirurgia , Cavidade Pulpar/lesões , Cavidade Pulpar/cirurgia , Periodontite Periapical/diagnóstico , Periodontite Periapical/terapia
17.
Med. oral patol. oral cir. bucal (Internet) ; 19(4): 419-425, jul. 2014. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-124807

RESUMO

Objectives: Analyse the effectiveness of different materials and techniques used in guided tissue regeneration (GTR) applied in periapical surgery, comparing the success rate obtained in 4-wall defects and in through-and-through bone lesions as well as to establish prognostic factors. Material and Methods: A Cochrane, PubMed-MEDLINE and Scopus database search (October 2012 to March 2013) was conducted with the search terms "periapical surgery", "surgical endodontic treatment", "guided tissue regeneration", "bone regeneration", "bone grafts", "barrier membranes" and "periapical lesions" individually and next, using the Boolean operator "AND". The inclusion criteria were the use of GTR (bone graft and/or membrane barrier), clinical studies including at least 10 patients, 10 years aged articles published in English or French. The exclusion criteria were case reports and nonhuman studies. Results: 34 publications were selected from a total of 483. 9 of the 34 were excluded. Finally, the systematic review included 25 articles: 2 metaanalysis, 8 reviews, 13 prospective studies and 2 retrospective studies. They were stratified according to their level of scientific evidence using the SORT criteria. The 4-wall periapical and through-and-through lesions improve more their prognosis by combining bone grafts and barrier membranes than using these materials exclusively, respect to the control groups. The results show lower failure rates in in 4-wall le-sions than in through-and-through lesions using GTR. Conclusions: The combined GTR technique (filling material and membranes) obtains a greater success rate both in 4-wall lesions and in through-and-through lesions, respect to the control groups. The use of regeneration materials seems to be more necessary in through-and-through lesions, > 5mm lesions, lower teeth and apicomarginal lesions as they have the worst healing prognosis. In function of the articles scientific quality, a type B recommendation is given in favour to the use of GTR in association of periapical surgery in case of 4-wall and through-and-through lesions


No disponible


Assuntos
Humanos , Periodontite Periapical/cirurgia , Tecido Periapical/cirurgia , Regeneração Óssea , Regeneração Tecidual Guiada Periodontal/métodos , Retalhos de Tecido Biológico
18.
Cient. dent. (Ed. impr.) ; 10(1): 7-14, ene.-abr. 2013. ilus
Artigo em Espanhol | IBECS | ID: ibc-111946

RESUMO

El ultrasonido es una forma de energía sonora transmitida en forma de ondas, que se propaga a través de distintos medios. En Odontología se ha estudiado para ver sus posibles aplicaciones y ventajas en las diferentes etapas de la terapéutica endodóntica. En el presente trabajo hemos revisado artículos científicos de los últimos diez años sobre aplicaciones del ultrasonido en el campo de la endodoncia. Las aplicaciones y ventajas encontradas en las que el Ultrasonido es una herramienta en el campo de la Endodoncia son: eliminación de restauraciones para acceder al sistema de conductos, localización de conductos, eliminación de obstrucciones (como instrumentos fracturados, medicamentos intra-conducto, pernos o postes), preparación biomecánica, irrigación ultrasónica(activación de irrigantes), obturación del sistema de conductos y cirugía endodóntica. Los ultrasonidos ofrecen varias ventajas y aplicaciones en el campo de la endodoncia, siendo su uso recomendado y obligatorio en determinadas situaciones (AU)


Ultrasound is a form of energy transmitted in the form of sound waves propagating through different media. In Dentistry has been studied to see its potential applications and advantages at different stages of endodontic therapy. In this paper we review scientific papers the last ten years on applications of ultrasound in the field of endodontic. Applications and advantages found in that ultrasound is a tool in the field of Endodonticare: removing restorations to enter the duct system. Locating of ducts, removal of obstructions (such as fractured instruments, intracanal medications, bolts or studs), preparation biomechanics, ultrasonic irrigation(irrigating activation), sealing duct system and endodontic surgery. Ultrasound offers several advantages and applications in the field of endodontic, being recommended and mandatory use in certain situations (AU)


Assuntos
Humanos , Tratamento do Canal Radicular/métodos , Ultrassom/métodos , Procedimentos Cirúrgicos Ultrassônicos/métodos , Tecido Periapical , Cavidade Pulpar
19.
Endodoncia (Madr.) ; 30(4): 171-177, oct.-dic. 2012.
Artigo em Espanhol | IBECS | ID: ibc-117495

RESUMO

Objetivo: Calibrar y determinar cuál es el diámetro apical adecuado en función del caso y del tipo de conducto. Para llegar a determinar el diámetro apical adecuado nos propusimos, por un lado, valorar si el preflaring facilita la instrumentación apical, y por otro, verificar si los conductos pueden ser instrumentados a tamaños ISO mayores a los que habitualmente lo son. Material y métodos: Después de realizar una preparación del tercio coronal de 40 conductos mesiales (mv-ml) de 23 molares inferiores exodonciados mediante instrumentación rotatoria, se determinó la longitud de trabajo (LT) tras la cual se llevó a cabo la preparación apical. Para ello, se instrumentó (manualmente) en primer lugar, el conducto a LT-1 mm para eliminar cualquier tipo de interferencia posterior entre las limas y el propio conducto. Una vez finalizado dicho ensanchamiento, se procedió a repermeabilizar el conducto y continuar con la preparación apical a LT (manualmente). Nuestros datos se analizaron estadísticamente por medio del test de ANOVA y t de Student. Resultados: De la muestra estudiada, los datos obtenidos fueron que de un 87,5% de los conductos (35) su diámetro apical se encontraba entre 0,30 y 0,35 mm (30-35 ISO) (15 y 20 conductos respectivamente), el 10% de los conductos (4) tenían un diámetro apical de 0,40 mm (40 ISO) y el 2,5% restante de los conductos (1) se correspondían con un diámetro apical de 0,25 mm (25 ISO). Conclusiones: Se debe tratar de alcanzar un diámetro apical adecuado que nos permite el paso de irrigantes y conseguir así un desbridamiento químico y mécanico del conducto y del periápice, pero sin debilitar en exceso el conducto, De ahí la importancia del ensanche del tercio coronal (preflaring) y del equilibrio de los binomios instrumentación-irrigantes y limpieza-debilitamiento (AU)


Objetive: To calibrate and determine the appropriate apical diameter regarding to the case and the type of root canal. In other to determine the appropriate apical diameter, first of all we set out to assess whether or not the apical instrumentation facilitates preflaring and secondly, to verify if root canal can be instrumented to ISO sizes larger than the ones usually used. Material and Methods: After performing an expansion of the coronal third of 40 mesial root canals (mv-ml) of 23 extracted lower molars done by mechanical instrumentation, we investigated the working length (WL) in which the apical preparation was conducted. To that end, the duct first was implemented (manually) to 1mm above the working length WL) so any further interference between the files and the duct itself would be eliminated. Having completed this enlargement, we continue to working the canal and proceed to the apical preparation to WL (manually). Results. Of the sample studied, data obtained was that 87.5% of the ducts (35) apical diameter was between 0,30 and 0,35 mm (30-35 ISO) (15 and 20 channels respectively), 10% of the ducts (4) had an apical diameter of 0,40 mm the remaining 2.5% of the tubes (1) correspond to apical diameter of 0,25 mm (25 ISO). Conclusions. Proper apical diameter should be obtain in order to let the irrigants flow trough the canal and thereby achieving a chemical and mechanical debridement of the canal and the periapical, but without excessively weaken the canal. That is the reason of the importance of widening the coronal third of the duct (opreflaring) and the balance of the binomial-instrumentation irrigants and cleaning-weakening (AU)


Assuntos
Humanos , Tecido Periapical/anatomia & histologia , Obturação do Canal Radicular/métodos , Tratamento do Canal Radicular/métodos , Preparo de Canal Radicular/instrumentação , Materiais Restauradores do Canal Radicular/uso terapêutico , Instrumentos Odontológicos
20.
Endodoncia (Madr.) ; 30(4): 178-182, oct.-dic. 2012.
Artigo em Espanhol | IBECS | ID: ibc-117496

RESUMO

Introducción: El objetivo del estudio fue evaluar el transporte apical después de la instrumetnación con sistema Mtwo 40/.04. Material y métodos: Se utilizó la técnica de superposición radiográfica para evaluar el transporte apical producido a 0,5 mm de la longitud de traajo en molares divididos según el ángulo de curvatura. Se usaron los conductos mesiales de 40 molares mandibulares divididos en dos grupos en función del ángulo de curvatura. Grupo A (n=40): ángulos de 0 a 24º y grupo B (n=40): ángulos de 24 a 56º. La prueba de Mann-Whitney se utilizó para las comapraciones por pares. El nivel de significación estadística se fijó en p<0,05. Resultados: La media de transporte apical para el grupo A fue de 0,17±0,04 mm, mientras que el valor para el grupo B fue de 0,19±0,03 mm. No se encontraron diferencias estadísticamente significativas entre los dos grupos. Conclusiones: Bajo las condiciones del estudio no existen diferencias en cuanto a transporte apical entre los distintos tipos de curvatura (AU)


Introduction: The aim of this study was to evaluate the apical transportation after instumetnation with 40/.04 Mtwo system. Methods. We used the overlay technique to assess radiographic apical transport produced 0.5 mm of working length in molars divided by the angle of curvature. We used the mesial canals of 40 mandibular molars divided into two groups depending on the angle of curvature. Group A (m=40): angles form 0 to 24º. Results: Mean apical transportation for group A was 0,17±0,04 mm, while the value for group B was 0,19±0,03 mm. There were no statistically significant differences between the two groups. Conclusions: Under the study conditions there are no differences in apical transport between different types of curvature (AU)


Assuntos
Humanos , Tecido Periapical/anatomia & histologia , Preparo de Canal Radicular/métodos , Estudos de Casos e Controles
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