RESUMEN
This case report highlights the intricate anatomy of root canals and the challenges they pose for clinicians. A 26-year-old female patient presented to the department with a chief complaint of pain in her left upper back tooth region. After thorough clinical and radiographical examinations, the diagnosis of pulpal necrosis with symptomatic apical periodontitis in the maxillary left first molar was confirmed. An intraoperative cone-beam computed tomography was performed. The axial imaging unveiled that there were, two distal (DB1 and DB2) canals, two palatal (P1 and P2) canals, and three mesiobuccal (MB1, MB2, and MB3) canals. The appearance of a convoluted root canal configuration serves to highlight the inherent complexity that clinicians may encounter during endodontic procedures. However, when this complexity is further compounded by the incident of separation of root canal instruments, the challenges faced by clinicians become significantly more demanding. It exemplifies the increased difficulty posed by the combination of tortuous root canal morphology and the additional complication of instrument separation, highlighting the importance of careful management and precise techniques in such scenarios and the significance of modern adjuncts, into the diagnostic process and magnification in the surgical and endodontic therapy.
RESUMEN
Background and objective Rehabilitation of edentulous jaw areas is a complex procedure that has witnessed numerous advancements in technique and materials for better functional and aesthetic outcomes over the years. Dental implants have emerged as a cutting-edge, cost-effective, and non-invasive alternative to traditional removable partial dentures (RPDs), fixed partial dentures (FPDs), and full dentures. In this study, the basal implant was tested in traumatically deficient ridges on the mandible and the maxilla to determine its effectiveness and acceptability. Materials and methods The purpose of this research was to determine whether basal implants might be successfully used to restore traumatized ridges in the maxilla and mandible. Eleven individuals aged 20-55 years participated in the trial, and a total of 30 implants were used. All patients were evaluated for pain, soft tissue health around the basal implant, and patient satisfaction, with follow-ups on the third day and at three and six months postoperatively. Results The mean pain score measured using the visual analog scale (VAS) of patients during follow-ups was 2.00 ±1.15 on the third day, 0.40 ±0.84 at three months, and 0.00 ±0.00 at six months postoperatively. The mean gingival index score of patients was 1.30 ±0.48 on the third day, 0.10 ±0.31 at three months, and 0.00 ±0.00 at six months postoperatively. The mean patient satisfaction score was 34.77±5.54 on the third day, 41.11 ±6.27 at three months, and 40.7 7±10.91 at six months postoperatively. The mean immediate postoperative marginal bone level was 12.33 ±2.26 mm, and it was 10.85 ±2.29 mm after six months postoperatively. The mean preoperative crestal bone level was 10.76 ±1.77 mm and it was 9.70 ±1.79 mm after six months postoperatively. Conclusion Due to the fact that basal implantology does not involve extensive augmentation procedures necessary for the placement of conventional implants, it plays an important role in the rehabilitation of edentulous maxillary and mandibular arches, especially in traumatic, moderate to severely atrophic maxillary and mandibular arches.
