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Background: One of the aim of root canal treatment is filling the root canals in a 3D way. It is not always possible to achieve due to the existence of anatomical variations. The obturation of oval canal usually provides great difficulties. Its complex anatomy can cause obstacles in instrumentation, irrigation and obturation. Aim: The main aim of this study is to quantify the area filled by gutta-percha, the area filled by cement and the area of voids present in oval canals, treated by thermoplastic filling techniques in comparison with the lateral condensation technique and observe the adaptation of the gutta-percha to the anatomy of the oval root canals according to the obturation technique. Material and Methods: 80 mandibular incisors were selected. The teeth were instrumented with Protaper Gold® and divided into 4 groups of 20. Group 1 was filled with Thermafill®; group 2 with GuttaCore®; group 3 with continuous wave vertical condensation and group 4 with the lateral condensation technique. Two horizontal sections were cut at 5mm and 7mm from the apex and they were set in putty silicone. The samples were analyzed with a Leica DMS 1000 digital microscope and processed with Leica Suite for Windows XP. The area of gutta-percha, cement and voids and the percentages, of each one, were calculated. A statistical analysis was performed using the T-Student, ANOVA tests and Kruskal-Wallis tests. Results: All thermoplastic techniques achieved a high percentage of obturation. The percentages of voids in group 4 were the highest. Statistically significant differences were found between thermoplastic techniques compared with lateral condensation. Conclusions: Thermoplastic techniques achieve better adaptation of the gutta-percha in the oval canals and low amount of cement and voids in the middle and coronal thirds respect to the lateral condensation group. Moreover, comparing termoplasthicized techniques among them, continuous wave vertical condensation got the lowest percentage of voids. Key words:Warm gutta-percha, thermoplastic obturation, oval canals, oval-shaped canals.
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BACKGROUND: The embryonic root groove is an anatomical abnormality that starts in the cingulum and extends longitudinally down the long axis root towards the apex. This developmental anomaly is more frequently reported in maxillary lateral incisors. Gu YC in 2011 established three types of radicular grooves depending on its severity. According to this classification, type III presents a greater diagnostic and therapeutic complexity. The prevalence of palatogingival grooves in maxillary lateral incisors ranges from 1.9 to 14%. This case report provides valuable information about the diagnosis and treatment plan of palatogingival grooves with Cone-beam computed tomography (CBCT) scan. CASE REPORT: The patient was referred to the University Dental Clinic of European University of Valencia, with recurrent abscesses at the upper right lateral incisor region for the last two years. Palpation and percussion tests were positive for tooth 1.2. There was no clinical history of caries or previous trauma. Periapical radiography showed periapical radiolucent lesions located, not only in the apical area of tooth 1.2, but also in tooth 1.3. Both teeth had previously been endodontically treated. Periodontal probing showed normal values. CBCT scan was perfomed in order to establish a definitive diagnosis and appropriate treatment plan. DISCUSSION: The complex anatomy of the palatal root groove requires detailed knowledge of the internal root morphology for endodontic treatment success. This complementary tool allows a more accurate image of hard tissue structures, such as palatal grooves and/or accessory roots, in comparison to conventional periapical radiography. The treatment plan of this primary periodontal lesion with secondary endodontic involvement was as follows: periapical surgery combined with root amputation and sealing with MTA, and guided bone regeneration. Key words:Palatal radicular groove, palatogingival groove, maxillary lateral incisor, cone-beam computed tomography, endodontic-periodontal lesion, guided bone regeneration.
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Background: The main cause of endodontic failure is the persistence of microorganisms that cause an intraradicular or extratradicular infection and that become resistant to disinfection measures. The objective of this review is to identify the microbiota associated with endodontic failure, as well as the reasons why these microorganisms are capable of surviving basic disinfection measures. Material and Methods: Systematic search of scientific articles in the databases PubMed with the following key-words "Endodontic Infections", "Endodontic Microbiology, "Endodontic Failure", "Enterococcus Faecalis", "Endodontics Retreatment" was carried out. Case reports and articles with publication date prior to 2000 were not included in this review. Results: Most authors highlight E. faecalis as the main microorganism associated with endodontic failure, nevertheless there are recent studies that isolate, to a greater extent, other bacteria such as Fusobacterium nucleatum and Propioni bacterium. Discussion: These microorganisms have in common the following proprieties, which make them able to escape the disinfection measures: the ability to form a biofilm, to locate in areas unreachable to root canal instrumentation techniques, synergism, the ability to express survival genes and activate alternative metabolic pathways
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Assuntos
Humanos , Cavidade Pulpar , Tratamento do Canal Radicular , Bactérias , Biofilmes , Enterococcus faecalisRESUMO
BACKGROUND: The success of endodontic treatment derives from the complete elimination of microorganisms capable of causing an intraradicular or extraradicular infection. To achieve a more effective eradication of these microorganisms, endodontic instrumentation must always be implemented with abundant irrigation, which has to achieve chemical, mechanical and biological effects. The irrigators most used today are NaOCl, CHX and EDTA, released into the ducts through different techniques such as syringe, manual agitation, positive or negative apical pressure, sonic or ultrasonic activation, PIPS and PDT. The objective of this review is to update the different irrigating solutions and intracanal disinfection drugs, as well as to establish an irrigation protocol in the endodontic treatment. MATERIAL AND METHODS: Systematic search of scientific articles in the databases PubMed, Medline and Google Scholar, with the following keywords Endodontic, Infection, Failure, Irrigation, Retreatment and Irrigation protocol. The exclusion criteria were "case report" articles and articles with a publication date prior to 2000. RESULTS: 48 articles that met the inclusion criteria were analyzed. Comparing the different articles it can be seen that the NaOCl is the "gold standard" in terms of immediate antimicrobial efficacy, followed by the CHX that has a long-term antibacterial effect. As an intra-conductive drug it is advisable to use the combination of Ca(OH)2 with CPMC. CONCLUSIONS: The most adequate irrigation protocol consists of using 2.5% NaOCl activated with ultrasound followed by a final wash with 7% MA or 0.2% CTR combined with 2% CHX. Key words:Endodontic failure, endodontic infection, enterococcus faecalis, endodontic retreatment, irrigation, sodium hipoclorite, irrigation protocol.
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BACKGROUND: The apexification is the first alternative treatment on a permanent tooth when, after a tooth trauma and in the presence of immature apex trauma, pulp necrosis occurs. Many studies have demonstrated the efficacy of mineral trioxide aggregate (MTA) as apical sealing material of choice in these cases, but has a degree of filtration as all other materials. The objective of this study was to analyze the seal ability of MTA on the duct walls in immature teeth unirradicular apexes, using indirect vibration. MATERIAL AND METHODS: The study was conducted on 45 teeth divided into 3 groups: Group A or control group in which no vibration for placing the MTA was used, Group B and C or groups where indirect vibration analysis was used. All samples were immersed in methylene blue to assess filtration. After performing longitudinal cuts millimetric measuring were made of the degree of filtration, divided into 3 degrees (2mm each grade filtration). RESULTS: Results obtained confirm our hypothesis, obtaining lesser degree of filtration those groups in which indirect vibration (Groups B and C) was performed. It was shown that the degree of filtration is closely linked to the degree of adaptation. CONCLUSIONS: MTA vibration offers better results in its adaptation to the canal walls, significantly reducing the degree of filtration. KEY WORDS: Apexification, MTA, filtration, indirect vibration.
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Presentamos el caso de un tratamiento endodóncico en un premolar inferior que fracasó a los cinco años por un problema endoperiodontal causado por un surco radicular ubicado en la concavidad de un conducto en C. En la bibliografía consultada, podemos observar que los fracasos endoperiodontales ocasionados por un surco en la raíz están bien descritos en los incisivos laterales superiores, pero no en molares y premolares inferiores asociados a un conducto en C, por lo que conviene tener presente esta eventualidad cuando encontramos dicha variación anatómica (AU)
Assuntos
Adulto , Masculino , Humanos , Falha de Restauração Dentária , Tratamento do Canal Radicular/efeitos adversos , Cavidade Pulpar/anormalidadesRESUMO
Presentamos el caso de un paciente con un diente necrótico, ápice abierto y radiolucidez periapical en el que, por determinadas circunstancias, no pudimos instrumentar con limas el conducto, por lo que la acción terapéutica quedó a merced de una irrigación exhaustiva del interior del conducto con hipoclorito sódico y de su relleno con hidróxido de calcio. Una vez formada la barrera apical, la obturación definitiva se realizó con gutapercha (AU)
