ABSTRACT
Objetivo: La reabsorción dentinaria interna es un pro- ceso causado por la actividad odontoclástica asociada princi- palmente a la inflamación pulpar crónica y/o traumatismos, y se caracteriza por la pérdida progresiva de tejido dentinario y la posible invasión al cemento. El presente informe describe el diagnóstico y tratamiento de un molar inferior que presentó un cuadro sintomático de reabsorción dentinaria interna. Caso clínico: Un paciente de 38 años fue derivado a la consulta por presentar una zona de reabsorción interna en un segundo molar inferior. Durante el examen clínico y ra- diográfico se tomó una radiografía preoperatoria periapical con radiovisiógrafo en la que se observó la presencia de un área compatible con el diagnóstico de reabsorción dentinaria interna, el que fue posteriormente confirmado por medio de una tomografía computada de haz cónico. La imagen de la lesión se presentó como una zona radiolúcida deformante de bordes nítidos, localizada a nivel de la cámara pulpar. El tra- tamiento consistió en la extirpación de la pulpa coronaria y de la instrumentación, desinfección y obturación de los conduc- tos radiculares y la cavidad de acceso. En el control clínico y radiográfico realizado luego de 3 años se observó que el paciente estaba asintomático y las estructuras perirradiculares se encontraban dentro de los límites normales. La observación histológica del material removido de la cámara pulpar reveló la presencia de un tejido granulomatoso con numerosos vasos sanguíneos y escasos focos micro hemorrágicos. Hasta el momento, el tratamiento endodóntico es el pro- cedimiento indicado para el tratamiento de la reabsorción dentinaria interna. Se destaca la importancia de la tomografía computada de haz cónico para el diagnóstico y tratamiento temprano de las reabsorciones dentinarias internas a efectos de contar con un pronóstico favorable (AU)
Aim: Internal dentine resorption is aprocess caused by odontoclastic activity, mainly associated with chronic pulpal inflammation and/or trauma, and it'scharacterized by a pro- gressive loss of dentine tissue and the possible invasion of the cementum. This report describes the diagnosis and treatment of a lower molar that presented a symptomatic case of inter- nal dentine resorption. Clinical case: A 38-years old patient was referred to the office because of presenting an area of internal resorption in a lower second molar. During clinical and radiographic exam- ination, a periapical preoperative radiograph with radiovisio- graph was taken, in which the presence of an area compatible with the diagnosis of internal dentine resorption was observed, which was later confirmed by a cone-beam computed tomog- raphy.The image of the lesion was presented as a deforming radiolucent area with sharp edges, located at pulp chamber level. Treatment consisted of the removal of the coronary pulp and the instrumentation, disinfection and filling of the root ca- nals and the access cavity. In the clinical and radiographic control carried out 3 years after procedure, it was observed that the patient was asymptomatic and the periradicular struc- tures were within normal limits. The histological observation of the removed material from the pulp chamber revealed the presence of a granulomatous tissue with numerous blood ves- sels and scarce micro hemorrhagic focus. Until now, the endodontic treatment is the indicated pro- cedure to treat internal dentine resorption. It is necessary to highlight the importance of the cone-beam computerized to- mography for the early diagnosis and treatment of internal dentine resorptions in order to have a favorable outlook (AU)
Subject(s)
Humans , Male , Adult , Root Resorption/therapy , Root Resorption/diagnostic imaging , Tooth Crown/physiopathology , Root Canal Therapy/methods , Follow-Up Studies , Dental Pulp Diseases/complications , Cone-Beam Computed Tomography/methods , Molar/physiopathologyABSTRACT
Abstract: Evidence shows the polymicrobial etiology of endodontic infections, in which bacteria and their products are the main agents for the development, progression, and dissemination of apical periodontitis. Microbial factors in necrotic root canals (e.g., endotoxin) may spread into apical tissue, evoking and supporting a chronic inflammatory load. Thus, apical periodontitis is the result of the complex interplay between microbial factors and host defense against invasion of periradicular tissues. This review of the literature aims to discuss the complex network between endodontic infectious content and host immune response in apical periodontitis. A better understanding of the relationship of microbial factors with clinical symptomatology is important to establish appropriate therapeutic procedures for a more predictable outcome of endodontic treatment.
Subject(s)
Humans , Periapical Periodontitis/microbiology , Dental Pulp Cavity/microbiology , Dental Pulp Diseases/complications , Dental Pulp Diseases/microbiology , Periapical Periodontitis/pathology , Bacterial Infections/complications , Bacterial Infections/microbiology , Lipopolysaccharides/physiology , Cytokines/analysis , Cytokines/physiology , Matrix Metalloproteinases/analysis , Matrix Metalloproteinases/physiology , Dental Pulp Cavity/pathology , Dental Pulp Diseases/pathology , Endotoxins/physiologyABSTRACT
Introducción: la enfermedad pulpar es la respuesta de la pulpa en presencia de un irritante, la falta de tratamiento oportuno se traduce en urgencia estomatológica. Objetivo: determinar las enfermedades pulpares presentes en los pacientes objeto de estudio. Métodos: estudio de tipo descriptivo, transversal y prospectivo del comportamiento de algunas enfermedades pulpares como urgencias en pacientes mayores de 15 años de edad; consultorio estomatológico Robles 2 del ASIC El Gaitero, municipio Maracaibo, estado Zulia, Venezuela, enero - agosto 2007. De 2120 pacientes la muestra quedó integrada por 103. La información se obtuvo a través del interrogatorio y el examen clínico de los pacientes en el consultorio estomatológico. Se utilizaron los números absolutos y porcentajes.Resultados: las enfermedades pulpares afectaron al grupo entre 19-34 años (51.45 por ciento) y al sexo femenino (59.22 por ciento), fueron más frecuentes la necrosis pulpar (49.51por ciento) y la pulpitis inicial reversible (37.86 por ciento). Predominó el dolor severo (32.03 por ciento) y como causa se encontró la caries dental (41.74 por ciento). Conclusiones: la edad de 1934 años y el sexo femenino fue la población afectada por enfermedades pulpares. La necrosis pulpar y la pulpitis inicial reversible fueron las más frecuentes, predominó el dolor severo, la causa principal fue la caries dental(AU)
Introduction: the pulpal disease is the answer of the pulp in the presence of an irritant, the lack of an oportune treatment is translated into the stomatological emergency. Objective: to determine the pulpal diseases in the patients object of study. Methods: a descriptive, transversal and prospective study of the behavior of some pulpar diseases like emergencies in patients older than 15 years; at the estomatological office Robles 2 of the ASIC El Gaitero in the municipality of Maracaibo, on Zulia state in Venezuela, since January - August 2007. From the 2120 patients the sample was integrated by 103. The information was obtained through the interview and the clinical examination of the patients in the stomatological office. There were used the absolute numbers and percentages. Results: the pulpal diseases affected the group between 19-34 years (51.45 percent) and the female sex (59.22 percent), there were more frequent the pulpal necrosis (49.51 percent) and the initial reversible pulpitis (37.86 percent). The acute pain prevailed (32.03 percent) and the cause found was the dental decay (41.74 percent). Conclusions: the age between 19 to 34 years and the feminine sex was the population affected by pulpal diseases. The pulpal necrosis and the reversible initial pulpitis were the most frequent conditions, the acute pain prevailed, the main cause was the dental decay(EU)
Subject(s)
Humans , Adolescent , Young Adult , Dental Pulp Necrosis/complications , Dental Pulp Diseases/complications , Dental Caries/etiology , Pulpitis/complications , Epidemiology, Descriptive , Cross-Sectional Studies , Prospective StudiesABSTRACT
The aim of this study was to determine whether the presence of leprosy reactional episodes could be associated with chronic oral infection. Thirty-eight leprosy patients were selected and divided into 2 groups: group I - 19 leprosy patients with oral infections, and group II - 19 leprosy patients without oral infections. Ten patients without leprosy, but presenting oral infections, were assigned to the control group. Leprosy patients were classified according to Ridley and Jopling classification and reactional episodes of the erythema nodosum type or reversal reaction were identified by clinical and histopathological features associated with serum IL-1, TNF-?, IL-6, IFN-? and IL-10 levels. These analyses were performed immediately before and 7 days after the oral infection elimination. Patients from group I presenting oral infections reported clinical improvement of the symptoms of reactional episodes after dental treatment. Serum IL-1, TNF-?, IL-6, IFN-? and IL-10 levels did not differ significantly before and after dental treatment as determined by the Wilcoxon test (p>0.05). Comparison of the 2 groups showed statistically significant differences in IL-1 and IL-6 at baseline and in IL-1, IL-6 and IL-10 on the occasion of both collections 7 days after therapy. Serum IL-6 and IL-10 levels in group I differed significantly at baseline compared to control (Mann-Whitney test; p<0.05). These results suggest that oral infection could be involved as a maintenance factor in the pathogenesis of leprosy reactional episodes.
O objetivo deste estudo foi determinar se os episódios reacionais da hanseníase podem estar associados a infecções orais crônicas. Trinta e oito pacientes com hanseníase foram selecionados e divididos em dois grupos: grupo I & 19 pacientes com hanseníase apresentando infecções orais, e grupo II & 19 pacientes com hanseníase sem infecções orais. Os pacientes foram classificados, quanto à forma clínica da doença, de acordo com Ridley and Jopling, e os episódios reacionais, tipo eritema nodoso e reação reversa, foram identificados pelas características clínicas, histopatológicas associadas à quantificação no soro de IL-1, TNF-?, IL-6, IFN-? e IL-10. Estas analises foram realizadas imediatamente antes e 7 dias após a resolução dos focos de infecção. Pacientes do grupo I aprentando infecções orais relataram melhora clínica dos sintomas dos episódios reacionais após o tratamento odontológico. Os níveis séricos de IL-1, TNF-?, IL-6, IFN-? e IL-10 não diferiram significantemente antes e após o tratamento odontológico, como determinado pelo teste Wilcoxon (p>0,05). As comparações entre os grupos mostrou diferenças estatisticamente significantes nos níveis de IL-1 e IL-6 na coleta inicial e nos níveis de IL-1, IL-6 e IL-10 nas duas coletas 7 dias após o tratamento (teste Mann-Whitney; p<0,05). Estes resultados sugerem que infecções orais estão envolvidas na patogênese dos episódios reacionais da hanseníase, como fatores mantenedores.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Cytokines/immunology , Dental Pulp Diseases/complications , Hypersensitivity/immunology , Leprosy/immunology , Periapical Periodontitis/immunology , Case-Control Studies , Chronic Disease , Cytokines/blood , Dental Pulp Diseases/blood , Dental Pulp Diseases/immunology , Hypersensitivity/blood , Hypersensitivity/complications , Interferon-gamma/blood , Interferon-gamma/immunology , Interleukin-1/blood , Interleukin-1/immunology , /blood , /immunology , /blood , /immunology , Leprosy/blood , Leprosy/complications , Periapical Periodontitis/blood , Periapical Periodontitis/complications , Recurrence , Reference Values , Statistics, Nonparametric , Tumor Necrosis Factor-alpha/blood , Tumor Necrosis Factor-alpha/immunology , Young AdultABSTRACT
Apical periodontitis is produced in the majority of cases by intraradicular infection. Treatment consists in the elimination of the infectious agents by endodontia. Even when carrying out a correct cleansing and filling of canals, it is possible that periapical periodontitis will persist in the form of an asymptomatic radiolucency, giving rise to the post-endodonticperiapical lesion.The chronic inflammatory periapical lesion is the most common pathology found in relation to alveolar bone of the jaw. From the histological point of view, it can be classified as chronic periapical periodontitis (periapical granuloma), radicular cyst, and as scar tissue. The most frequent is the periapical granuloma, constituted by a mass of chronic inflammatorytissue, in which isolated nests of epithelium can be found. The radicular cyst is characterized by the presence of a cavity, partially or wholly lined by epithelium. Scar tissue is a reparative response by the body, producing fibrousconnective tissue.The aim of this study is to review and update the etiopathogenic and histological aspects of chronic post-endodontic periapical lesions
Subject(s)
Humans , Dental Pulp Diseases/surgery , Tooth, Nonvital/complications , Periapical Granuloma/diagnosis , Postoperative Complications/diagnosis , Dental Pulp Diseases/complications , Periapical Tissue/injuriesABSTRACT
Todos los pacientes fueron derivados para un estudio preimplantológico con PDRTC. En los mismos se hallaron CBS relacionadas con lesiones dentarias crónicas de etiología endoperiodontal. Se estudiaron seis pacientes, los que presentaban ocho comunicaciones bucosinusales (CBS). En 7 casos (87.50 por ciento) las CBS se presentaron en áreas dentales y en 1 caso (12,50 por ciento) en área desdentada. Con relación a las piezas dentarias, la más afectada resultó ser el primer molar con 4 casos (50 por ciento). Se destaca la relación de las CBS con las raíces dentarias, la más afectada fue la raíz palatina. De las imágenes estudiadas en 7 casos (87.50 por ciento), la CBS se encontraba en la parte central o media del piso del seno, conservándose la integridad del resto del mismo. En 1 caso (12.50 por ciento) en la pared vestibular. En todos los casos, la mucosa del piso del seno maxilar se hallaba engrosada, ya sea en forma localizada a nivel de la comunicación o bien en la totalidad del suelo antral. Los autores creen que puede haber un número importante de CBS de origen odontógeno no diagnosticadas y debido a la ausencia de síntomas clínicos los pacientes no concurren a la consulta (AU)
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Aged , Oroantral Fistula/diagnosis , Oroantral Fistula/etiology , Oroantral Fistula/diagnostic imaging , Tomography, X-Ray Computed/methods , Dental Pulp Diseases/complications , Tooth Root/injuries , Maxillary Sinus/pathology , Tomography, X-Ray Computed , Signs and Symptoms , Age Distribution , Sex Distribution , Periodontal Diseases/complications , Periapical Diseases/diagnosisSubject(s)
Furcation Defects/diagnosis , Furcation Defects/etiology , Evidence-Based Medicine , Molar/injuries , Bicuspid/injuries , Terminology , Dental Pulp Diseases/complications , Dental Occlusion, Traumatic , Furcation Defects/classification , Furcation Defects/surgery , Tooth Root/injuries , Tooth Root/anatomy & histology , Tooth Root/surgery , Guided Tissue Regeneration , Bone Transplantation/methods , Freeze Drying/methodsSubject(s)
Furcation Defects/diagnosis , Furcation Defects/etiology , Evidence-Based Medicine , Molar/injuries , Bicuspid/injuries , Terminology , Dental Pulp Diseases/complications , Dental Occlusion, Traumatic , Furcation Defects/classification , Furcation Defects/surgery , Tooth Root/injuries , Tooth Root/anatomy & histology , Tooth Root/surgery , Guided Tissue Regeneration , Bone Transplantation/methods , Freeze Drying/methodsABSTRACT
El presente trabajo de divulgación científica tiene por finalidad describir los distintos tipos de reabsorciones que afectan los tejidos duros del diente. Generalmente, estas patologías son difíciles de diagnosticar y de tratar y, en numerosas ocasiones, pueden comprometer la permanencia del elemento dentario en boca. Las reabsorciones se clasifican, según su ubicación, en dentinarias internas y cemento dentinarias externas y, por su etiología, en aquellas que se vinculan a factores físicos como los traumatismos y las presiones que sufren las piezas dentarias, a agentes infecciosos que provienen de la cavidad pulpar o del periodonto, a afeciones sistémicas y a causas idiopáticas. Se pone especial énfasis en la importancia de arribar al diagnóstico clínico-radiográfico a los fines de estabvlecer el pronóstico y el tratamiento adecuado (AU)
Subject(s)
Humans , Tooth Resorption/classification , Tooth Resorption/diagnosis , Tooth Resorption/therapy , Periodontium/injuries , Dental Pulp Diseases/complications , Tooth Cervix/pathology , Chronic Disease , Root Canal Therapy , Root Canal Obturation , Tooth Ankylosis/diagnosis , Tooth Ankylosis/etiology , Tooth Avulsion/complications , Tooth Fractures/complications , Periapical Diseases/complications , Gutta-Percha , Tooth Root/pathologyABSTRACT
Las fístulas cutáneas de origen odontogénico, son quizás las más comunes de todos los tipos de fístulas que se forman a nivel de la cara y cuello. Cabe destacar que este tipo de lesiones nódulo quísticas son diagnosticadas y tratadas frecuentemente de manera incorrecta. Presentamos un caso clínico de fístula cutánea de origen pulpar, por afectación del canino e incisivo lateral inferior derechos, donde el tratamiento de conductos convencional originó la curación completa del proceso, sin necesidad de recurrir a técnicas cruentas (AU)