ABSTRACT
Antecedentes: La morfología radicular en molares superiores presenta menos variabilidad anatómica, sin embargo, es muy importante tener en cuenta que existen alteraciones anatómicas, y que aun no están bien fundamentadas, se asocia a hiperactividad en la vaina epitelial de Hertwig o bien asociados a factores externos durante la odontogénesis. Descripción del caso: El presente artículo relata un caso de un segundo molar superior derecho con pulpitis irreversible sintomática, en el examen radiográfico se observa la existencia de una raíz supernumeraria palatina. Se realizó tratamiento endodontico con ProtaperNext® y se obturó con técnica lateral modificada con ultrasonido. Conclusión: Los molares con raíces supernumerarias requieren del conocimiento y experiencia del clínico para integrar los métodos de diagnóstico tales como exámenes radiográficos, tomográficos, de microscopía así como técnicas para el tratamiento endodóntico.
Background: Radiographic examination in upper molars is often deficient in order to diagnose abnormalities in the root canal system and to be able to choose the ideal treatment. Description of the case: This article shows the clinical case of a second right upper molar with symptomatic irreversible pulpitis. An accessory root on the palatal is observed in a radiographic examination. A therapy of the canal was carried out with ProtaperNext ® and the sealing was made by cold lateral condensation with ultrasonic condensation. Conclusión: It is very important to know the root canal system morphology of the tooth to be treated in order to offer the patient an adequate treatment.
Antecedentes: O exame radiográfico em molares superiores é frequentemente deficiente para diagnosticar anormalidades no sistema de canais radiculares e para poder escolher o tratamento ideal. Descrição do caso: Este artigo mostra o caso clínico de um segundo molar superior direito com pulpite irreversível sintomática. Uma raiz acessória no palato é observada em um exame radiográfico. A terapia do canal foi realizada com ProtaperNext ® e a vedação foi feita por condensação lateral fria com condensação ultra-sônica. Conclusão: É muito importante conhecer a morfologia do sistema de canais radiculares do dente a ser tratado, a fim de oferecer ao paciente um tratamento adequado.
Subject(s)
Humans , Endodontics/methods , Dentistry/methods , AnatomyABSTRACT
RESUMEN Introducción: De las malformaciones dentales una de las más frecuentes es el dens in vaginatus o dens in dente, esta alteración anatómica representa un reto para el clínico, debido a su anatomía compleja; sin embargo, gracias a los auxiliares de diagnóstico como la tomografía cone-beam, podremos planear el tratamiento para ofrecer el mejor pronóstico. El presente artículo relata un caso clínico de dens in dente presente en diente veintiuno, con necrosis pulpar y periodontitis apical asintomática. Se solicitó TAC cone-beam, se diagnosticó como tipo II según Oehlers; es instrumentado, irrigado con ultrasonido y obturado con técnica «onda continua de calor¼, con un éxito radiográfi co a seis meses de evolución. Actualmente, gracias a los métodos de diagnóstico y auxiliares de tratamiento tales como el ultrasonido, los sistemas de inyección de gutapercha, se pueden ofrecer tratamientos más efi cientes en la terapéutica endodóncica.
ABSTRACT Introduction: The Dens Invaginatus or Dens in dent it is the most common dental abnormal structure, this anatomic variation means a true clinic challenge because of its complex anatomy, however , thanks to the auxiliary tools for diagnosis just like Cone Beam Computerized Tomography, we can plan a good treatment to offer the best diagnosis. This article describes a clinic case about Dens in Dent in twenty one tooth with pulp necrosis and asymptomatic apical periodontitis. Cone Beam Computerized Tomography was requested, the image helped to classify the kind of Dens in Dent which is type II according to Oehlers´s classifi cation. It is instrumented, irrigated with ultrasound and sealed with "continuous wave of heat "technique. This technique ensures a radiographic success with six months of evolution. Currently, thanks to diagnostic methods and treatment aids such as ultrasound, gutta-percha injection system more effi cient treatments can be offered in endodontic therapeutics.
ABSTRACT
Non-Hodgkin lymphoma comprises a heterogeneous group of haematological malignancies, classified according to their clinic, anatomic-pathological features and, lately, to their molecular biomarkers. Despite the therapeutic advances, nearly half of the patients will die because of this disease. The new diagnostic tools have been the cornerstone to design recent therapy targets, which must be included in the current treatment guidelines of this sort of neoplasms by means of clinical trials and evidence-based medicine. In the face of poor diagnoses devices in most of the Mexican hospitals, we recommend the present diagnose stratification, and treatment guidelines for non-Hodgkin lymphoma, based on evidence. They include the latest and most innovative therapeutic approaches, as well as specific recommendations for hospitals with limited framework and therapy resources.
