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1.
Oral Dis ; 29(2): 786-795, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34369045

RESUMO

OBJECTIVE: Mechanisms underlying the oral outcomes in sickle cell anemia (HbSS) have been less explored. This study aimed to investigate the association of morbimortality indicators and hydroxyurea use with adaptive pulp and jaw bone trabecular changes in HbSS. METHODS: This cross-sectional study included 123 individuals with HbSS. The exposures were the morbimortality indicators of HbSS (number of vaso-occlusive crises, organ damage, hemoglobin level, and leukocyte count) and the use of hydroxyurea for HbSS treatment. The outcomes were adaptive pulp and jaw bone trabecular changes confirmed by radiographic examination. Associations were estimated by Poisson regression in crude and adjusted analyses for sex, skin color, socioeconomic class, and age. RESULTS: The vaso-occlusive crises (mean ratio (MR) = 3.5, p = 0.045), lower hemoglobin (MR = 2.4, p = 0.037), and higher leukocyte count (MR = 2.17, p = 0.036) were risk factors, while the use of hydroxyurea was inversely associated with adaptive pulp changes (MR = 0.23, p = 0.024). The vaso-occlusive crises were associated with jaw bone trabecular changes (MR = 1.33, p = 0.02). CONCLUSION: Adaptive pulp changes may be a potential clinical marker of chronic vasculopathy in HbSS. The use of hydroxyurea may reduce the frequency of adaptive pulp changes.


Assuntos
Anemia Falciforme , Doenças da Polpa Dentária , Hidroxiureia , Doenças Maxilomandibulares , Humanos , Anemia Falciforme/complicações , Anemia Falciforme/tratamento farmacológico , Estudos Transversais , Doenças da Polpa Dentária/diagnóstico por imagem , Doenças da Polpa Dentária/etiologia , Doenças da Polpa Dentária/fisiopatologia , Hemoglobinas , Hidroxiureia/uso terapêutico , Doenças Maxilomandibulares/diagnóstico por imagem , Doenças Maxilomandibulares/etiologia , Fatores de Risco
2.
Rev. Fac. Odontol. (B.Aires) ; 37(86): 1-6, 2022. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1412056

RESUMO

La comunicación patológica entre la pulpa y el pe-riodonto se denomina lesión endoperiodontal. Puede presentarse de forma aguda o crónica, y su mani-festación más común es la presencia de un absceso acompañado de dolor. Es importante realizar una detenida evaluación clínica y radiográfica para esta-blecer un correcto diagnóstico y plan de tratamiento. Por este motivo, el objetivo de esta guía es presentar un protocolo consensuado entre las Cátedras de Pe-riodoncia y Endodoncia de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA), para su tratamiento (AU)


The pathological communication between the pulp and the periodontium is called Endoperiodontal Lesion. It can be presented in an acutely or chronically form and its most common manifestation is the presence of an abscess accompanied by pain. It is important to carry out a careful clinical and radiographic evaluation to establish a correct diagnosis, prognosis, and treatment plan. For this reason, the objective of this guide is to present a consensus protocol between Periodontics and Endodontics Departments of the Faculty of Dentistry of the University of Buenos Aires (FOUBA) for their treatment (AU)


Assuntos
Humanos , Doenças Periodontais/terapia , Protocolos Clínicos , Doenças da Polpa Dentária/terapia , Abscesso Periodontal/complicações , Doenças Periodontais/cirurgia , Doenças Periodontais/complicações , Doenças Periodontais/diagnóstico por imagem , Argentina , Tratamento do Canal Radicular/métodos , Faculdades de Odontologia , Sinais e Sintomas , Raspagem Dentária/métodos , Doenças da Polpa Dentária/diagnóstico por imagem , Diagnóstico Diferencial , Medicina de Emergência
3.
Braz Oral Res ; 32(suppl 1): e73, 2018 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-30365614

RESUMO

Root perforation results in the communication between root canal walls and periodontal space (external tooth surface). It is commonly caused by an operative procedural accident or pathological alteration (such as extensive dental caries, and external or internal inflammatory root resorption). Different factors may predispose to this communication, such as the presence of pulp stones, calcification, resorptions, tooth malposition (unusual inclination in the arch, tipping or rotation), an extra-coronal restoration or intracanal posts. The diagnosis of dental pulp and/or periapical tissue previous to root perforation is an important predictor of prognosis (including such issues as clinically healthy pulp, inflamed or infected pulp, primary or secondary infection, and presence or absence of intracanal post). Clinical and imaging exams are necessary to identify root perforation. Cone-beam computed tomography constitutes an important resource for the diagnosis and prognosis of this clinical condition. Clinical factors influencing the prognosis and healing of root perforations include its treatment timeline, extent and location. A small root perforation, sealed immediately and apical to the crest bone and epithelial attachment, presents with a better prognosis. The three most widely recommended materials to seal root perforations have been calcium hydroxide, mineral trioxide aggregate and calcium silicate cements. This review aimed to discuss contemporary therapeutic alternatives to treat root canal perforations. Accordingly, the essential aspects for repairing this deleterious tissue injury will be addressed, including its diagnosis, prognosis, and a discussion about the materials actually suggested to seal root canal perforation.


Assuntos
Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/lesões , Doenças da Polpa Dentária/diagnóstico por imagem , Doenças da Polpa Dentária/terapia , Materiais Restauradores do Canal Radicular/uso terapêutico , Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Combinação de Medicamentos , Humanos , Óxidos/uso terapêutico , Prognóstico , Preparo de Canal Radicular/efeitos adversos , Silicatos/uso terapêutico
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 53(6): 386-391, 2018 Jun 09.
Artigo em Chinês | MEDLINE | ID: mdl-29886632

RESUMO

The excellent magnification and illumination of the operating microscope not only helps to improve the quality of conventional root canal therapy, but also plays an important role in the diagnosis and treatment of the difficult cases of endodontic diseases. It has an irreplaceable position over other equipment especially for the treatment of root canal therapy complications and the apical surgery. The structure and operation of the operating microscope are relatively complicated. The proficiency of the dentist may influence the evaluation of its clinical application effect. Based on the review of literature and author's clinical experience, this paper evaluates the role of operating microscope in the diagnosis and treatment of endodontic diseases.


Assuntos
Doenças da Polpa Dentária/diagnóstico por imagem , Doenças da Polpa Dentária/terapia , Microscopia/instrumentação , Humanos , Tratamento do Canal Radicular/instrumentação
5.
J Indian Soc Pedod Prev Dent ; 36(1): 65-70, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29607842

RESUMO

AIMS: This triple blinded clinical trial was undertaken to check whether Platelet rich firin in its membrane form is as reliable as when it is in the gel form. SETTINGS AND DESIGN: Triple blinded randomized clinical trial. METHODS AND MATERIAL: 20 patients in PRF gel group and 20 patients in PRF membrane group selected after randomization and considering inclusion and exclusion criteria were taken up for this study. The samples were clinically and radiographically evaluated for success. RESULTS AND CONCLUSIONS: Regenerative endodontics with PRF membrane is easier and less time consuming. They have similar clinical success.PRF gel gave a better radiographic success in 12 months period.


Assuntos
Apexificação/métodos , Fibrina Rica em Plaquetas , Materiais Restauradores do Canal Radicular , Tecidos Suporte , Raiz Dentária/diagnóstico por imagem , Criança , Doenças da Polpa Dentária/diagnóstico por imagem , Doenças da Polpa Dentária/terapia , Géis , Humanos , Membranas Artificiais , Radiografia
6.
Braz. oral res. (Online) ; 32(supl.1): e73, 2018.
Artigo em Inglês | LILACS | ID: biblio-974476

RESUMO

Abstract: Root perforation results in the communication between root canal walls and periodontal space (external tooth surface). It is commonly caused by an operative procedural accident or pathological alteration (such as extensive dental caries, and external or internal inflammatory root resorption). Different factors may predispose to this communication, such as the presence of pulp stones, calcification, resorptions, tooth malposition (unusual inclination in the arch, tipping or rotation), an extra-coronal restoration or intracanal posts. The diagnosis of dental pulp and/or periapical tissue previous to root perforation is an important predictor of prognosis (including such issues as clinically healthy pulp, inflamed or infected pulp, primary or secondary infection, and presence or absence of intracanal post). Clinical and imaging exams are necessary to identify root perforation. Cone-beam computed tomography constitutes an important resource for the diagnosis and prognosis of this clinical condition. Clinical factors influencing the prognosis and healing of root perforations include its treatment timeline, extent and location. A small root perforation, sealed immediately and apical to the crest bone and epithelial attachment, presents with a better prognosis. The three most widely recommended materials to seal root perforations have been calcium hydroxide, mineral trioxide aggregate and calcium silicate cements. This review aimed to discuss contemporary therapeutic alternatives to treat root canal perforations. Accordingly, the essential aspects for repairing this deleterious tissue injury will be addressed, including its diagnosis, prognosis, and a discussion about the materials actually suggested to seal root canal perforation.


Assuntos
Humanos , Materiais Restauradores do Canal Radicular/uso terapêutico , Cavidade Pulpar/lesões , Cavidade Pulpar/diagnóstico por imagem , Doenças da Polpa Dentária/terapia , Doenças da Polpa Dentária/diagnóstico por imagem , Óxidos , Prognóstico , Hidróxido de Cálcio/uso terapêutico , Silicatos/efeitos adversos , Compostos de Cálcio/uso terapêutico , Compostos de Alumínio/uso terapêutico , Preparo de Canal Radicular/efeitos adversos , Combinação de Medicamentos
7.
Rev. Ateneo Argent. Odontol ; 57(2): 39-44, nov. 2017. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-973122

RESUMO

Introducción: el diagnóstico en endodoncia incorporó los estudios de tomografías de haz cónico (CBCT). Esnecesario entender el alcance y la utilidad de estos para saber cuándo solicitarlos. Objetivos: el objetivo de este estudio fue determinar la indicación de CBCT previa al tratamiento endodóntico y su relación con el nivel de dificultad del caso atratar. Métodos: se seleccionaron al azar 15 casos clínicos de alta dificultad derivados a tratamiento de endodoncia.Se realizó diagnóstico clínico y radiográfico. Se estimaron los recursos necesarios para el tratamiento con unformulario diseñado para ello. Se solicitó un estudio de CBCT. Una vez obtenido el estudio, el mismoprofesional que realizó el diagnóstico clínico navegó el software de visualización y llenó nuevamente el formulario. Fueron comparados los formularios previos y posteriores a las CBCT. Se establecieron las diferencias encontradas entre ellos. Resultados: todos los casos analizados tuvieron diferencias en la comparación entre los formularios. Conclusiones: el uso de CBCT en los casos de elevada dificultad permite un diseño de plan de tratamiento más preciso.


Introduction: the endodontic diagnosis includes the study of cone beam tomography (CBCT). It is necessary to understand the scope and usefulness of CBCTto know when to request it.Objectives: the aim of this study was to determine the requirement of CBCT before endodontic treatment and its connection with the level of difficulty that the case presents. Methods: 15 endodontic cases of high difficulty were taken randomly. Clinical and radiographic diagnosis was made. The necessary resourcesfor the treatment were estimated according to aspecially designed form. A CBCT study was request. Once the study was obtain, the same professionalwho performed the clinical diagnosis browsed the software to read CBCT results and filled a new form.Both CBCT forms need to be compared to establish differences between them. Results: all the cases analysed were compare, andshowed differences between the two forms. Conclusion: the use of CBCT in high difficult cases provides a more accurate design of the treatment plans.


Assuntos
Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Planejamento de Assistência ao Paciente , Tratamento do Canal Radicular/métodos , Doenças da Polpa Dentária/diagnóstico por imagem , Tomada de Decisão Clínica , Diagnóstico Clínico , Prognóstico
8.
Rev. cuba. estomatol ; 54(3): 0-0, jul.-set. 2017. tab
Artigo em Espanhol | LILACS | ID: biblio-901045

RESUMO

Introducción: cuando las estructuras dentales permanentes tienen pulpas jóvenes e inmaduras, son más grandes y las paredes del canal radicular muy delgadas. Si estas son afectadas por alguna enfermedad pulpar o periapical, la integridad de la pulpa se ve dañada y consecuentemente el desarrollo radicular. Objetivo: identificar las enfermedades pulpares y periapicales en estructuras dentales permanentes y su grado de desarrollo según la clasificación de Patterson, de pacientes con edades de seis a catorce años. Métodos: estudio observacional descriptivo y transversal. De 357 pequeños que acudieron a la Unidad Universitaria de Inserción Social de la Universidad Autónoma de Yucatán, México, 2013, por afectaciones pulpar o periapical, 56 infantes presentaron estas, en estructuras dentales inmaduras permanentes. Los criterios de inclusión fueron: edad, estructura dentaria, enfermedades pulpares y periapicales, clasificación de Patterson para observar radiográficamente el grado de desarrollo radicular. Se proporcionó a los padres una carta de consentimiento informado, realizándoles un cuestionario con datos demográficos del niño. Al niño, se le preguntó su historia de dolor, se realizaron pruebas, exámenes clínicos y toma radiográfica. Con pruebas Ji-cuadrada se comparó la proporción de pacientes según: 1) estructura dentaria; 2) edad; 3) clasificación de Patterson; 4) enfermedad pulpar y periapical. Resultados: el 57 por ciento fueron niñas y 43 por ciento niños. El 15,69 por ciento de los infantes tuvo enfermedad pulpar y/o periapical en estructuras dentales permanentes presentándose con mayor frecuencia en el estadio 1, 2 y 3 de Patterson. Difirió significativamente (X2= 22,6429; p= 0,0004; g.l.= 5) la estructura dentaria afectada. La proporción de pacientes con enfermedad pulpar o periapical según edad difirió significativamente (X2= 30,75; p< 0,0001; g.l.= 6). La proporción de pacientes con alguna estructura dentaria permanente afectada según la clasificación de Patterson, difirió significativamente (X2= 7,75; p= 0,0208; g.l.= 2). Hubo diferencias estadísticas entre los tipos de enfermedades pulpares (X 2= 7,2; p= 0,0273; g.l.= 2), no difirió significativamente entre los tipos de enfermedades periapicales (X2= 1,4615; p=0,4815; g.l.= 2). Conclusiones: desde muy temprana edad los niños y niñas, están presentando mayor cantidad de enfermedades pulpares que periapicales en estructuras dentales permanentes aún sin terminar su desarrollo radicular, lo que pone en riesgo la conservación de sus dientes en la edad adulta, y afecta severamente el sistema estomatognático con probabilidad de padecer maloclusiones a temprana edad(AU)


Introduction: when permanent dental structures have young, immature pulps, they are bigger and their root canal walls are very thin. If they are affected by some pulp or periapical disease, damage is caused to pulp integrity and consequently to root development as well. Objective: identify pulp and periapical diseases in permanent dental structures of patients aged six to fourteen years, and their degree of development according to Patterson's classification. Methods: a cross-sectional observational descriptive study was conducted. Of the 357 children attending the Social Service University Unit at the Autonomous University of Yucatán, Mexico, in the year 2013, for pulp or periapical diseases, 56 presented them in immature permanent dental structures. The following inclusion criteria were applied: age, dental structure, pulp and periapical diseases, and Patterson's classification, to radiographically observe the degree of root development. Parents provided their informed consent in writing, and answered a questionnaire with personal details of the child. Children were asked about the antecedents of their pain, and underwent tests and clinical and radiographic examination. Chi-square tests were used to sort out the patients according to: 1) dental structure, 2) age, 3) Patterson's classification, 4) pulp and periapical disease. Results: 57 percent of the sample were girls and 43 percent were boys. 15.69 percent had pulp and/or periapical disease in permanent dental structures, with a higher prevalence of Patterson's stages 1, 2 and 3. The dental structure affected varied significantly (X2= 22.6429; p= 0.0004; g.l.= 5). The proportion of patients with pulp or periapical disease varied significantly with age (X2= 30.75; p< 0.0001; g.l.= 6). The proportion of patients with some permanent dental structure affected varied significantly according to Patterson's classification (X2= 7.75; p= 0.0208; g.l.= 2). Significant statistical differences were found between the types of pulp diseases (X2= 7.2; p= 0.0273; g.l.= 2), not between the types of periapical diseases (X2= 1.4615; p=0.4815; g.l.= 2). Conclusions: incidence of pulp diseases is higher than that of periapical diseases in very young children. These affect permanent dental structures with incomplete root development, jeopardizing tooth preservation in adult age and severely affecting the stomatognathic system with a potential for causing malocclusion at an early age(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Doenças da Polpa Dentária/diagnóstico por imagem , Dentição Permanente , Doenças da Boca/prevenção & controle , Doenças Periapicais/epidemiologia , Estudos Transversais , Epidemiologia Descritiva , Estudo Observacional
9.
J Appl Oral Sci ; 25(3): 274-281, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28678946

RESUMO

OBJECTIVE: The aim of this study was to investigate the prevalence of isolated Candida albicans from periodontal endodontic lesions in diabetic and normoglycemic patients, and the fungi's virulence in different atmospheric conditions. MATERIAL AND METHODS: A case-control study was conducted on 15 patients with type 2 diabetes mellitus (G1) and 15 non-diabetics (G2) with periodontal endodontic lesions. Samples of root canals and periodontal pockets were plated on CHROMagar for later identification by polymerase chain reaction (PCR) and virulence test. RESULTS: C. albicans was identified in 79.2% and 20.8% of the 60 samples collected from diabetic and normoglycemic patients, respectively. Of the 30 samples collected from periodontal pockets, 13 showed a positive culture for C. albicans, with 77% belonging to G1 and 23% to G2. Of the 11 positive samples from root canals, 82% were from G1 and 18% from G2. Production of proteinase presented a precipitation zone Pz<0.63 of 100% in G1 and 72% in G2, in redox and negative (Pz=1), under anaerobic conditions in both groups. Hydrophobicity of the strains from G1 indicated 16.4% with low, 19.3% with moderate, and 64.3% with high hydrophobicity in redox. In G2, 42.2% had low, 39.8% had moderate, 18% had high hydrophobicity in redox. In anaerobic conditions, G1 showed 15.2% with low, 12.8% with moderate, and 72% with high hydrophobicity; in G2, 33.6% had low, 28.8% had moderate, and 37.6% had high hydrophobicity. There was statistical difference in the number of positive cultures between G1 and G2 (p<0.05) with predominance in G1. There was statistical difference for all virulence factors, except hemolysis (p=0.001). CONCLUSIONS: Candida albicans was isolated more frequently and had higher virulence in diabetic patients.


Assuntos
Candida albicans/isolamento & purificação , Candida albicans/patogenicidade , Doenças da Polpa Dentária/microbiologia , Diabetes Mellitus Tipo 2/microbiologia , Doenças Periodontais/microbiologia , Adulto , Idoso , Estudos de Casos e Controles , DNA Fúngico , Cavidade Pulpar/microbiologia , Doenças da Polpa Dentária/diagnóstico por imagem , Doenças da Polpa Dentária/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Eletroforese , Feminino , Humanos , Interações Hidrofóbicas e Hidrofílicas , Masculino , Pessoa de Meia-Idade , Oxirredução , Peptídeo Hidrolases/análise , Doenças Periodontais/diagnóstico por imagem , Doenças Periodontais/fisiopatologia , Bolsa Periodontal/microbiologia , Fosfolipases/análise , Reação em Cadeia da Polimerase , Radiografia Dentária , Estatísticas não Paramétricas , Virulência
10.
J. appl. oral sci ; 25(3): 274-281, May-June 2017. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-893617

RESUMO

Abstract Pulpal and periodontal tissues have similar microbiota that allows cross-contamination between the pulp and periodontal tissues. Objective The aim of this study was to investigate the prevalence of isolated Candida albicans from periodontal endodontic lesions in diabetic and normoglycemic patients, and the fungi's virulence in different atmospheric conditions. Material and Methods A case-control study was conducted on 15 patients with type 2 diabetes mellitus (G1) and 15 non-diabetics (G2) with periodontal endodontic lesions. Samples of root canals and periodontal pockets were plated on CHROMagar for later identification by polymerase chain reaction (PCR) and virulence test. Results C. albicans was identified in 79.2% and 20.8% of the 60 samples collected from diabetic and normoglycemic patients, respectively. Of the 30 samples collected from periodontal pockets, 13 showed a positive culture for C. albicans, with 77% belonging to G1 and 23% to G2. Of the 11 positive samples from root canals, 82% were from G1 and 18% from G2. Production of proteinase presented a precipitation zone Pz<0.63 of 100% in G1 and 72% in G2, in redox and negative (Pz=1), under anaerobic conditions in both groups. Hydrophobicity of the strains from G1 indicated 16.4% with low, 19.3% with moderate, and 64.3% with high hydrophobicity in redox. In G2, 42.2% had low, 39.8% had moderate, 18% had high hydrophobicity in redox. In anaerobic conditions, G1 showed 15.2% with low, 12.8% with moderate, and 72% with high hydrophobicity; in G2, 33.6% had low, 28.8% had moderate, and 37.6% had high hydrophobicity. There was statistical difference in the number of positive cultures between G1 and G2 (p<0.05) with predominance in G1. There was statistical difference for all virulence factors, except hemolysis (p=0.001). Conclusions Candida albicans was isolated more frequently and had higher virulence in diabetic patients.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Doenças Periodontais/microbiologia , Candida albicans/isolamento & purificação , Candida albicans/patogenicidade , Doenças da Polpa Dentária/microbiologia , Diabetes Mellitus Tipo 2/microbiologia , Oxirredução , Peptídeo Hidrolases/análise , Doenças Periodontais/fisiopatologia , Doenças Periodontais/diagnóstico por imagem , Bolsa Periodontal/microbiologia , Fosfolipases/análise , Virulência , DNA Fúngico , Radiografia Dentária , Estudos de Casos e Controles , Reação em Cadeia da Polimerase , Estatísticas não Paramétricas , Cavidade Pulpar/microbiologia , Doenças da Polpa Dentária/fisiopatologia , Doenças da Polpa Dentária/diagnóstico por imagem , Diabetes Mellitus Tipo 2/fisiopatologia , Eletroforese , Interações Hidrofóbicas e Hidrofílicas
11.
J Med Life ; 10(1): 70-75, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28255382

RESUMO

Damage of pulp tissue usually begins in the coronal pulp. Its mistreatment or its lack of on time detection determines the progressive inclusion of the whole endodontic space in its evolution, opening the way of its expansion in the surrounding tissues of the tooth, and on the marginal apical tissue. Aim. The goal of this study was to highlight that the primary endodontic lesions with secondary periodontal implication healed and bone repair was obtained due to a proper disinfection and an adequate sealing of the endodontic system. In primary endodontic lesion with secondary periodontal involvement, endodontic treatment is required in the first stage followed by specific periodontal treatment. The prognosis is good if an appropriate endodontic approach is chosen, depending on the stage of the periodontal disease and the treatment response. The identification of the etiological factors is the most important to establish the appropriate treatment. In all clinical cases selected in this article, the healing tendency was noticed after an adequate disinfection and sealing of the endodontic system.


Assuntos
Doenças da Polpa Dentária/complicações , Doenças da Polpa Dentária/diagnóstico por imagem , Doenças Periodontais/complicações , Doenças Periodontais/diagnóstico por imagem , Adulto , Humanos , Pessoa de Meia-Idade , Ápice Dentário/diagnóstico por imagem , Ápice Dentário/patologia
12.
J Endod ; 43(2): 252-256, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28041682

RESUMO

INTRODUCTION: This case report presents the treatment of a 16-year-old boy with a maxillary lateral incisor (tooth #10) presenting with Oehlers type II dens invaginatus and diagnosed with previously initiated therapy and asymptomatic apical periodontitis. METHODS: A regenerative endodontic procedure (REP) was performed for the tooth but complicated by apically displaced mineral trioxide aggregate (MTA). Clinical and radiographic examination was undertaken yearly, and a cone-beam computed tomography scan was taken to investigate further the formation of hard tissues within the root canal. Subsequently, tooth #10 was re-accessed and then root-filled with MTA. RESULTS: There was complete periapical healing, thickening of the dentinal root walls, and completed apex formation 3 years after REP. Hard tissue formation was noted within the root canal, on the root canal wall, and the root apex through clinical and radiographic examination. Less hard tissue formation was noted on the labial root canal wall where the displaced MTA was located, which was identified on the cone-beam computed tomography scan. CONCLUSIONS: This report demonstrates that REP can potentially provide excellent treatment outcomes for structurally compromised teeth. REP should be considered as a first-line treatment before proceeding with a root filling when root development is incomplete, but attention to technical detail is essential.


Assuntos
Compostos de Alumínio/efeitos adversos , Compostos de Cálcio/efeitos adversos , Materiais Dentários/efeitos adversos , Óxidos/efeitos adversos , Medicina Regenerativa/métodos , Tratamento do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos , Raiz Dentária/crescimento & desenvolvimento , Adolescente , Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Materiais Dentários/uso terapêutico , Doenças da Polpa Dentária/diagnóstico por imagem , Doenças da Polpa Dentária/cirurgia , Combinação de Medicamentos , Humanos , Masculino , Óxidos/uso terapêutico , Radiografia Dentária , Tratamento do Canal Radicular/métodos , Silicatos/uso terapêutico
15.
Br Dent J ; 219(2): 69-72, 2015 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-26205934

RESUMO

AIM: To assess the quality of radiographs accompanying endodontic referrals, from general dental practitioners, to a health authority clinic. METHODS: A total of 200 conventional film and digital radiographs accompanying referrals were assessed and rated as 'excellent', 'diagnostically acceptable' or 'unacceptable' according to the National Radiographic Protection Board (NRPB) guidelines. Statistical analyses of the results included inter- and intra-observer agreement to achieve a kappa score and the chi-squared test. RESULTS: Out of the 200 radiographs assessed, 38 (19%) were conventional film and 162 (81%) were digital. Of the conventional film radiographs, 55% were rated 'excellent' and 37% were 'diagnostically acceptable', whilst 27% of digital radiographs were rated 'excellent' and 40% were 'diagnostically acceptable'. In the 'unacceptable' category, 33% were digital and 8% were conventional film radiographs (p <0.001). CONCLUSIONS: The quality of digital radiographs was significantly lower compared with conventional film radiographs. The percentage of 'unacceptable' digital radiographs was above the target according to the NRPB guidelines. Hence, there is a need for improvement in quality to avoid repeat radiographs and unnecessary ionising radiation exposure. Instead of hard, printed copies, digital radiographs accompanying referrals should, within the parameters of information governance, be supplied electronically so that they may be optimised, if necessary, for better diagnostic value.


Assuntos
Doenças da Polpa Dentária/diagnóstico por imagem , Doenças da Polpa Dentária/diagnóstico , Pesquisa sobre Serviços de Saúde , Atenção Primária à Saúde/métodos , Radiografia Dentária/métodos , Encaminhamento e Consulta , Endodontia , Humanos
16.
J Endod ; 41(7): 1008-14, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25843753

RESUMO

INTRODUCTION: The aim of this study was to evaluate the diagnostic efficacy of cone-beam computed tomographic (CBCT) imaging in endodontics based on a systematic search and analysis of the literature using an efficacy model. METHODS: A systematic search of the literature was performed to identify studies evaluating the use of CBCT imaging in endodontics. The identified studies were subjected to strict inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for appraisal of the literature on the levels of efficacy of a diagnostic imaging modality. RESULTS: Initially, 485 possible relevant articles were identified. After title and abstract screening and a full-text evaluation, 58 articles (12%) that met the inclusion criteria were analyzed and allocated to levels of efficacy. Most eligible articles (n = 52, 90%) evaluated technical characteristics or the accuracy of CBCT imaging, which was defined in this model as low levels of efficacy. Only 6 articles (10%) proclaimed to evaluate the efficacy of CBCT imaging to support the practitioner's decision making; treatment planning; and, ultimately, the treatment outcome, which was defined as higher levels of efficacy. CONCLUSIONS: The expected ultimate benefit of CBCT imaging to the endodontic patient as evaluated by its level of diagnostic efficacy is unclear and is mainly limited to its technical and diagnostic accuracy efficacies. Even for these low levels of efficacy, current knowledge is limited. Therefore, a cautious and rational approach is advised when considering CBCT imaging for endodontic purposes.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Endodontia/métodos , Doenças da Polpa Dentária/diagnóstico por imagem , Odontologia Baseada em Evidências/métodos , Humanos
17.
Dent Update ; 42(10): 972-6, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26856005

RESUMO

Root resorption of the permanent teeth involves an elaborate interaction among inflammatory cells resulting in loss of dental hard tissues. This report describes three clinical cases where idiopathic root resorption occurred in wind instrument playing patients. These patients produce adequate non-orthodontic forces, while playing their instruments, to expose their teeth to root resorbing force. Careful clinical monitoring of patients' teeth should be undertaken, as the additive effects of orthodontic treatment and musical habits are unknown. CPD/Clinical Relevance: This paper advises that questioning about wind instrument playing during case history-taking would be beneficial to clinicians. Furthermore, careful clinical monitoring of these patients' teeth during orthodontic treatment should be undertaken.


Assuntos
Incisivo/diagnóstico por imagem , Música , Reabsorção da Raiz/diagnóstico por imagem , Ápice Dentário/diagnóstico por imagem , Adolescente , Fenômenos Biomecânicos , Criança , Doenças da Polpa Dentária/diagnóstico por imagem , Feminino , Humanos , Incisivo/lesões , Radiografia Interproximal , Estresse Mecânico , Descoloração de Dente/diagnóstico por imagem , Mobilidade Dentária/diagnóstico por imagem
18.
Minerva Stomatol ; 63(9): 325-31, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25308570

RESUMO

Successful management of endodontic problems is reliant on diagnostic imaging techniques to provide critical information about the teeth under investigation, and their surrounding anatomy. Until recently, most of this core information was obtained from conventional radiographs. The introduction of cone-beam computed tomography (CBCT) specifically dedicated to imaging the maxillofacial region heralds a true paradigm shift from a two dimensional (2D) to a three dimensional (3D) approach to data acquisition and image reconstruction. CBCT systems provide small field of view images at low dose with sufficient spatial resolution for applications in endodontic diagnosis, treatment guidance, and post treatment evaluation. CBCT has been the subject of unparalleled levels of independent research in dental imaging in the area of endodontics. It gives the edge of 3D imaging at lower radiation level in comparison to conventional CT and has helped to treat endodontic cases with external resoption, root canal variations and apical periodontitis providing the size, site and extent accurately. This paper reviews the fundamentals of CBCT and presents the applications of this imaging system in contemporary endodontic practice.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Tratamento do Canal Radicular , Doenças da Polpa Dentária/diagnóstico por imagem , Humanos , Tratamento do Canal Radicular/métodos
19.
Pediatr Blood Cancer ; 61(12): 2297-301, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25214367

RESUMO

BACKGROUND: Childhood cancer treatment negatively affects the immune system, increasing the risk for bacteremia and septicemia. As the oral cavity is a major entry portal for pathogens into the bloodstream dental care in such children tends to be radical, favouring tooth extraction over less drastic treatments such as pulpotomy, the amputation of infected dental pulp. The present study aimed to compare pulpotomy treatment success rate in children with cancer receiving immunosuppressive therapy with that of healthy children, and investigate if unsuccessful pulpotomy treatment in oncologic patients may lead to systemic complications. PROCEDURE: Twenty-six medical records of children from a paediatric oncology referral centre who had dental pulpotomy treatment (in 41 teeth) while receiving active cancer care during the years 2006-2012 were compared with records of 41 randomly selected healthy children who had undergone pulpotomy treatment (41 teeth) in the same institute during these years. Clinical and radiographic data were collected during treatments and at the end of the follow-up period (six months post dental treatment). RESULTS: No statisticaly significant difference was found between pulpotomy success rate amongst the two groups. Treatments success rates in the study and control groups were 82.9% (± 5.9) and 90.2% (± 4.7), respectively. No patient in the study group suffered from sepsis from a dental origin during follow-up period. CONCLUSIONS: Pulpotomy in paediatric cancer patients did not increase the risk for bacteremia or systemic complications from oral origin. We therefore recommend the re-evaluation of the current protocol for treating paediatric oncology patients.


Assuntos
Bacteriemia/prevenção & controle , Doenças da Polpa Dentária/terapia , Neoplasias/complicações , Pulpotomia/métodos , Dente Decíduo , Estudos de Casos e Controles , Criança , Pré-Escolar , Doenças da Polpa Dentária/diagnóstico por imagem , Doenças da Polpa Dentária/etiologia , Feminino , Seguimentos , Humanos , Masculino , Neoplasias/terapia , Radiografia
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