Reparación de una lesión endoperiodontal mediante tratamiento endodóntico no quirúrgico: reporte de un caso / Repair of an endo-periodontal lesion using a non-surgical endodontic treatment approach: report of a case

El tratamiento y pronóstico de las lesiones endoperiodontales depende del diagnóstico oportuno y preciso de la enfermedad endodóntica y/o periodontal. Cuando se trata de lesiones endodónticas primarias con involucración periodontal secundaria, la estrategia de tratamiento debe ser primeramente enfocada a la infección pulpar, al debridamiento y desinfección de los conductos radiculares. El objetivo de este estudio es demostrar la capacidad de reparación de una lesión endoperiodontal mediante terapia endodóntica no quirúrgica, sin posterior terapia periodontal. El caso es un paciente masculino de 10 años con necrosis pulpar del órgano dentario 46 con involucración periodontal mediante lesión en furca, la cual reparó completamente en tres meses tras el tratamiento endodóntico. Estos hallazgos se confirman radiográficamente y por la disminución de la profundidad sondeable en la zona de la lesión. Se concluye que en este tipo de casos, con involucración endodóntica primaria, la necesidad del tratamiento periodontal quirúrgico o no quirúrgico será determinada exclusivamente por la falta de reparación de la lesión por largos periodos de tiempo.

he treatment and prognosis of endo-periodontal lesions depend on the timely and accurate diagnosis of the endodontic and/or periodontal disease. In the case of primary endodontic lesions with secondary peri-odontal involvement, the treatment strategy should be focused primarily on the pulp infection and the debridement and disinfection of root canals. The aim of this study is to demonstrate the repair capacity of an endo-periodontal lesion treated with nonsurgical endodontic root therapy and no subsequent periodontal treatment. The case involves a 10-year-old male patient with pulpal necrosis and apical periodontitis of tooth 46; periodontal furcation involvement was also evident. The diagnosis was a primary endodontic lesion with secondary periodontal involvement. The furcation defect healed completely within three months of non-surgical root canal treatment, a fact confi rmed by X-rays and by the reduction in the probing depth in the area of the lesion. We conclude that in cases such as this, where there is primary endodontic involvement, surgical or non-surgical periodontal treatment should be considered exclusively if the periodontal lesion persists for long periods of time.

A parent motivational interviewing program for dental care in children of a rural population.

OBJECTIVES: To determine the effectiveness of a motivational interviewing-based educational program in reducing the number and intensity of new caries and bacterial dental plaque levels at 6 months post randomization. STUDY DESIGN: A randomized and single blind clinical trial in 100 schoolchildren between 6-10 years of age presenting the highest risk score of caries according to the Caries Management by Risk Assessment (CAMBRA) criteria was performed. These patients were randomized to two groups: control (in which the mothers initially received an oral prevention informative session) and experimental (in which the mothers received the initial informative session, followed by individual motivational interviewing sessions during a period of 6 months). The International Caries Detection and Assessment System (ICDAS) scores and bacterial plaque were evaluated at baseline, at 6 and 12 months. RESULTS: After 12 months, children in the experimental group had 2.12 ± 0.8 new caries versus 3.5 ± 0.9 in the control group (t=7.39; p<0.001). Caries in the experimental group was seen to be limited to the enamel, with a median intensity of 2 (range 0-3) versus 3 (0-6) in the control group (U=1594; p<0.0001). Bacterial plaque determined by the O'Leary index decreased in both groups; however, it decreased more in the experimental than in the control group (34.3 vs. 20.6; t=-3.12, p= 0.002) respectively. CONCLUSIONS: Motivational interviewing is better than traditional educational programs in preventing caries and decreasing bacterial plaque. Key words:Health educational, motivational interviewing, caries risk.