Tratamento endodôntico em dente permanente traumatizado com rizogênese incompleta: relato de caso / Endodontic treatment in permanent traumatised tooth with incomplete rhizoganis: case report / Tratamiento endodóntico en diente permanente traumatizado con rizoganis incompleta: presentación de un caso

Os traumatismos dentários representam um problema de saúde pública devido à alta prevalência e impacto psicossocial, sendo muito frequentes em crianças podendo resultar em necrose pulpar e culminar na rizogênese incompleta de dentes permanentes. Nestes casos de traumatismos em dentes permanentes com rizogênese incompleta e necrose pulpar, o tratamento mais indicado pela literatura é a apicificação, sendo um tratamento complexo e longo. Considerando a importância deste tema, o objetivo deste trabalho é relatar o caso de um paciente com traumatismo dental e necrose pulpar, que acarretou a interrupção do desenvolvimento completo e adequado do ápice dentário, sendo necessária a intervenção por meio da técnica de apicificação e o acompanhamento a longo prazo. O caso trata-se de uma menina em que um traumatismo dentário acarretou fratura de um incisivo central superior com formação radicular incompleta, comprometendo tanto a estética quanto a vitalidade do dente. Foi realizado o tratamento endodôntico com apicificação e posteriormente ao plug apical de MTA. O dente foi restaurado definitivamente com resina composta e realizado acompanhamento do paciente. Nas consultas de acompanhamento houve ausência de sintomatologia dolorosa e satisfação da paciente com a aparência atual. Sendo assim, a apicificação apresenta-se como uma ótima alternativa para dentes com rizogênese incompleta e necrose pulpar, embora longo houve uma melhora estética e satisfação do paciente.

Dental trauma represents a public health problem due to its high prevalence and psychosocial impact, being very frequent in children and can result in pulp necrosis and culminate in incomplete root formation of permanent teeth. In these cases of trauma to permanent teeth with incomplete root formation and pulp necrosis, the most indicated treatment in the literature is apexification, which is a complex and long treatment. Considering the importance of this topic, the objective of this work is to report the case of a patient with dental trauma and pulp necrosis, which caused the interruption of the complete and adequate development of the dental apex, requiring intervention through the apexification technique and follow-up. long-term. The case is about a girl in which a dental trauma resulted in a fracture of a maxillary central incisor with incomplete root formation, compromising both the esthetics and the vitality of the tooth. Endodontic treatment was performed with apexification and then apical MTA plug. The tooth was definitively restored with composite resin and the patient was followed up. In the follow- up consultations, there was no painful symptomatology and the patient was satisfied with her current appearance. Thus, the apexification presents itself as a great alternative for teeth with incomplete root formation and pulp necrosis, although in the long run there was an aesthetic improvement and patient satisfaction.

Los traumatismos dentales representan un problema de salud pública debido a su alta prevalencia e impacto psicosocial, siendo muy frecuentes en niños y pudiendo dar lugar a necrosis pulpar y culminar en la formación incompleta de la raíz de los dientes permanentes. En estos casos de traumatismos en dientes permanentes con formación radicular incompleta y necrosis pulpar, el tratamiento más indicado en la literatura es la apexificación, que es un tratamiento complejo y largo. Considerando la importancia de este tema, el objetivo de este trabajo es relatar el caso de una paciente con traumatismo dentario y necrosis pulpar, que causó la interrupción del desarrollo completo y adecuado del ápice dentario, requiriendo intervención a través de la técnica de apexificación y seguimiento. a largo plazo. Se trata de una niña en la que un traumatismo dental provocó la fractura de un incisivo central maxilar con formación radicular incompleta, comprometiendo tanto la estética como la vitalidad del diente. Se realizó tratamiento endodóntico con apexificación y posterior taponamiento apical con MTA. El diente fue restaurado definitivamente con resina compuesta y el paciente fue sometido a seguimiento. En las consultas de seguimiento, no había sintomatología dolorosa y la paciente estaba satisfecha con su aspecto actual. Así, la apexificación se presenta como una gran alternativa para dientes con formación radicular incompleta y necrosis pulpar, aunque a la larga se produjo una mejoría estética y satisfacción de la paciente.

Polymicrobial Leakage and Retention of MTA and Portland Cement in a Model of Apexification

Abstract Objective: To evaluate the sealing capacity and retention of apical barriers made with mineral trioxide aggregate (MTA) and Portland cement (PC). Material and Methods: Fifty-six bovine incisors were sectioned 8 mm above and 12 mm below the cement-enamel junction. The root canal was enlarged with a diamond drill to create a standard 2.5 mm diameter opening. Apical sheets of 5 mm thickness were placed using white MTA-Angelus or white PC. Fifteen samples of each material were exposed to human saliva in a dual chamber apparatus and casting was evaluated at 30 days. Samples without apical barriers and fully sealed samples were used as positive and negative controls (n = 3), respectively. Data were analyzed by Fisher's exact test (p<0.05) after 3 periods: 1 to 10 days (P1); days 11 to 20 (P2); and days 21 to 30 (P3). Then, three 1 mm thick sections were obtained at the apical level of other root samples of each material (n = 10) and the push-out test was performed Results: The leakage rates in P1, P2 and P3 were 60%, 73.3% and 100% for the MTA; and 73.3%, 86.7% and 100% for CP, with no significant difference between materials, regardless of the period analyzed. There were no significant differences between the bond strengths for both cements (p>0.05) Conclusion: Mineral trioxide aggregate and Portland cement apical barriers presented similar sealing ability and bond strength values.

Apicoformación de un incisivo lateral superior con MTA tras un traumatismo / MTA apexification of a maxillary lateral incisor after trauma

Un traumatismo dentario puede producir muchas complicaciones. Entre ellas podemos destacar la interrupción del desarrollo radicular o la afectación de los tejidos perirradiculares, pudiendo producirse una leve luxación o incluso una avulsión total del diente fuera de su alveolo. En este tipo de situaciones un buen diagnóstico y tratamiento precoz es importante para el pronóstico del caso. El incisivo lateral superior que vamos a presentar en este caso clínico presentaba un desarrollo incompleto del ápice. Frente a este tipo de situaciones la literatura presenta dos escenarios: realizar una apicoformación o bien una endodoncia regenerativa. Son muchos los factores que decantan el tratamiento por una u otra opción. En este caso realizamos una apicoformación con MTA en una sola sesión, pues las paredes del conducto parecen ser suficientemente gruesas y el diente es resistente. La apicoformación con MTA puede tener una alta tasa de éxito a largo plazo, debido a las propiedades de biocompatibilidad y sellado de este material, mientras consigamos desinfectar con irrigación el sistema de conductos. En la evolución del caso, la paciente se encontraba asintómatica y con signos de salud periapical

Dental trauma can cause many complications. Among them we can highlight the interruption of the radicular development or the affectation of the periradicular tissues, being able to produce a slight dislocation or even a total avulsion of the tooth out of its alveolus. In this type of situations a good diagnosis and early treatment is important for the prognosis of the case. The upper lateral incisor that we are going to present in this clinical case presented an incomplete development of the apex. Faced with this type of situation, the literature presents two situations: apexification or a regenerative procedure. There are many factors that decide the treatment by one or another option. In this case, we performed apexification with MTA in a single visit, since the walls of the canal appear to be thick enough and the tooth is resistant to fracture. Apexification with MTA can have a high rate of success in the long term, due to the properties of biocompatibility and sealing, while we manage to disinfect with irrigation the root canal system. In the follow-up, the patient was asymptomatic and with signs of periapical health

Influence of different sized files on the accuracy of two electronic apex locators.

The aim of this study was to evaluate the impact of different file sizes on the accuracy of two electronic apex locators (EALs). Thirty extracted human single-rooted permanent mandibular incisors were used. A #10 K-file was inserted in the root canal until its end could be observed (using a light microscope) through the apical foramen. One millimetre was subtracted to establish working length (WL). Electronic readings were performed using MiniApex Locator or Root ZX II, from #10 K-file to #130 K-file. Statistical analysis was performed by two-way anova and Tukey test (P ≤ 0.05). From #60 to #130 K-file, observed differences were noted between the values obtained with both EALs and WL (P ≤ 0.05). The MiniApex Locator showed increased means when measurements were made with #50 to #70 and with #120 (P = 0.008) and #130 (P = 0.005) K-files. File sizes influenced the accuracy of EALs - the greater the instrumentation size, the higher mean differences compared to WL.

Tratamiento endodóncico en diente permanente avulsionado y con ápice inmaduro / Endodontic treatment in avulsed permanent teeth with immature apex

La avulsión es un desafío para la integridad dental y puede llevar a necrosis pulpar. En vista de estas características, es imperativo una apexificación para obtener una implantación periodontal más larga y un sellado apical adecuado. El siguiente caso clínico describe una reimplantación de un incisivo central avulsionado y el tratamiento de apexificación a través de curativos a base de hidróxido de calcio. Se concluye que la reimplantación asociada con la obturación radicular con mineral trióxido agregado (MTA) en el incisivo central llevó a una exitosa finalización terapéutica

Dental trauma such as avulsion is a challenge to dental integrity and can result in pulp necrosis. When these characteristics are observed, apexification becomes imperative to obtain an adequate apical seal. The objective of this case report is to demonstrate a replantation of an avulsed central incisor and apexification treatment through calcium-hydroxide-based dressing. It is concluded that the replantation associated with a mineral trioxide aggregate (MTA) root obturation in the central incisor led to a successful endodontic procedure