Avaliação da capacidade de corte de um sistema rotatório assimétrico Durante o preparo biomecânico, quando alterados seus ângulos de corte e relaxamento / Cutting Capacity Assesment During Biomechanical Preparation Generated by changing the cutting angle of an asymmetric rotating system

O objetivo deste estudo foi avaliar a capacidade de remoção de dentina radicular utilizando diferentes angulações de corte de um instrumento com sistema reciprocante, em um determinado período de tempo. Quarenta e cinco raízes uniradiculares de dentes humanos foram selecionadas através de tomografia computadorizada e padronizados com preparo prévio, através de um instrumento manual (tipo k) #15. Os espécimes foram divididos em 3 grupos (n=15) para instrumentação com o sistema Genius, previamente alterada a angulação com o auxílio de um transferidor: Grupo 1 Genius (G1) - Sistema Genius 25.04 em 16 mm com ângulos de corte e relaxamento (90º/30º), preconizados pelo fabricante, por 30 segundos; Grupo 2 Genius (G2) - Sistema Genius 25.04 em 16 mm com ângulos de corte e relaxamento (120º/60) por 30 segundos; Grupo 3 Genius (G3) - os espécimes foram instrumentados com sistema Genius 25.04 em 16 mm com ângulos de corte e relaxamento (70º/10º) por 30 segundos. Os resultados foram avaliados através da pesagem dos espécimes e pela volumetria através da tomografia computadorizada ambas realizadas pré e pós-instrumentação, e em relação aos ângulos de corte e recuo, todos os grupos apresentaram alteração no preparo biomecânico, quando comparado as suas respectivas rotações programadas no motor endodôntico Genius (Ultradent,2005). Os dados obtidos foram submetidos a análise de variância (ANOVA) e ao teste de Kruskal Wallis, onde o mesmo não apresentou diferença estatística significante entre os grupos. Dessa forma pode-se observar que todos os ângulos de corte e recuo, apresentaram alterações, não mantendo um preparo individualizado para cada dente, de acordo com suas complexidades em relação a morfologia radicular(AU)

The aim of this study was to evaluate the ability to remove root dentin using different cutting angles of an instrument with a reciprocating system, in a given period of time. Forty-five uni-root roots of human teeth were selected using computed tomography and standardized with prior preparation, using a manual instrument (type k) # 15. The specimens were divided into 3 groups (n = 15) for instrumentation with the Genius system, previously changed the angle with the aid of a protractor: Group 1 Genius (G1) - Genius 25.04 system in 16 mm with cutting and relaxation angles ( 90º / 30º), recommended by the manufacturer, for 30 seconds; Genius Group 2 (G2) - Genius 25.04 system in 16 mm with cutting and relaxation angles (120º / 60) for 30 seconds; Group 3 Genius (G3) - the specimens were instrumented with the Genius 25.04 system in 16 mm with cutting and relaxation angles (70º / 10º) for 30 seconds. The results were evaluated by weighing the specimens and by volumetry using computed tomography, both performed pre- and post-instrumentation, and in relation to the cutting and receding angles, all groups showed changes in the biomechanical preparation, when compared to their respective programmed rotations. in the Genius endodontic engine (Ultradent, 2005). The data obtained were subjected to analysis of variance (ANOVA) and the Kruskal Wallis test, where it did not show a statistically significant difference between the groups. In this way, it can be observed that all the cut and setback angles showed alterations, not maintaining an individualized preparation for each tooth, according to their complexities in relation to root morphology(AU)

Radiographic assessment of endodontic accidents at a Nigerian tertiary health institution: a one-year retrospective study

Introduction: Dental treatment can produce iatrogenic injury to the tooth with endodontic procedural errors occurring during the various stages of endodontic treatment. This study determined the prevalence and pattern of endodontic accidents in clinical practice at a tertiary health center in Nigeria. Methodology: This was a retrospective study of teeth treated with conventional hand-held file systems. Digital peri-apical working length, pre-obturation and post obturation radiographic images of teeth which received root canal treatment, were assessed for the presence or absence of errors. All errors present were recorded and data analysis was done using IBM SPSS version 22.0. Results: The prevalence of procedural errors was 31.3% with ledges being the most prevalent error followed by transportation while gouging was the least encountered error. Majority (83.8%) of the errors occurred during root canal instrumentation. A higher proportion of molars had errors compared to the other types of teeth with the prevalence of errors increasing from incisors to premolars and then to molar teeth. The mandibular molars were found to be most frequently involved in procedural errors. Conclusion: The prevalence of procedural errors seems high. Practitioners should show greater care during the canal preparation stage and to maintain the accuracy of the working length throughout the procedure, as errors which occur during canal preparation accounted for the vast majority of errors seen in this study. Special care should be taken when working on molars, which had a significantly higher error rate when compared to anterior teeth or premolars

Aberrant anatomy in endodontically treated teeth in a Nigerian Teaching Hospital

Objective: The anatomical features of teeth show wide morphological variations. These variations include coronal and radicular aberrations. They are thought to be influenced by age, gender, race and evaluation methods. Therefore, an in-depth knowledge of both normal and unusual dental morphology is vital in the practice of endodontics. The objective of the study was to investigate the incidence of aberrant root anatomy in endodontically treated teeth among adult patients attending the Endodontic unit of a tertiary hospital in Southern Nigeria. Methods: A retrospective review of all clinical records of adult patients who attended the Endodontic unit of the Department of Restorative Dentistry, University of Benin Teaching Hospital (UBTH) Edo State, Nigeria from January 2013 to January 2018 for root canal treatment (RCT). The demographic and clinical data were retrieved from the patients' records and analyzed using IBM SPSS version 20. Results: A total of 927 patients, comprising445 (48.0%) males and 482 (52.0%) females (a ratio of 1:1.1) underwent endodontic treatment during the study period. The age range of patients was 18-80 years. The total number of teeth treated was 1016. Aberrant root anatomy was observed in 161 (15.8%) of the studied sample. It was more frequently seen in mandibular 118 (29.9%) than maxillary 43 (6.9%) teeth. Aberrant root anatomy occurred most frequently in mandibular second molars 42 (38.9%) followed by the maxillary first molars 32 (38.1%). These aberrations were observed in the roots and canal numbers of treated teeth while the occurrence of aberrant anatomy was higher in females (9.9%) than males (5.9%). Conclusion: In this study, aberrant root anatomies were mostly observed in mandibular teeth and among female patients. Clinicians should be aware of the existence of wide variations in root form and canal morphology during endodontic procedures. The alertness is helped by the use of Dental operating microscopes or other magnification devices, multiple periapical radiographs with angular cone shift or other contemporary imaging modalities in revealing tooth anatomy that would otherwise be missed

Implantes endodónticos - Vitalium vs. Titanio Caso clínico con un seguimiento de 18 años / Endodontic implants-Vitallium vs. Titanium Clinical case with 18 years follow-up

Resumen Una de las primeras consideraciones en la Odontología moderna, es preservar y mantener los dientes naturales, por lo que se han buscado técnicas alternativas que permiten conservar los órganos dentales en boca, el mayor tiempo posible. Por esta razón, se presenta un caso clínico donde se logra salvar dos piezas dentales anteriores, que poseían una movilidad grado tres, posterior a un tratamiento ortodóntico que le habían mantenido al paciente por más de dos años. Este caso, se resolvió exitosamente por medio de dos implantes endodónticos: uno de vitalium y otro de titanio, dándole un seguimiento de más de 18 años. A continuación, se expone una técnica de manejo y colocación de estabilizadores endodónticos, tomando en consideración indicaciones y contraindicaciones.

Abstract One of the first and main considerations in modern odontology, is to preserve and maintain natural teeth, reason why alternative techniques have been searched, to preserve dental organs in mouth, as long as possible. That is why this article presents a clinical case where two frontal dental pieces, that had mobility in grade three were saved, after an orthodontic treatment -maintained for more than two years- was removed. The case was successfully solved through two endodontic implants made from vitallium and titanium, with a follow-up for more than 18 years. The following is an exposition of the procedure of endodontic stabilizers, considering indications and contraindications.

Clinical fitting of a cast metal post and core obtained by means of an intraoral optical scanning (IOS) and digital workflow.

Customization of post-and-cores using computer-aided-design and computer-aided-manufacturing (CAD-CAM) requires the scanning of a pattern and the subsequent digital design. This case report describes the production of a CAD-CAM customized post-and-core designed from an intraoral scan and milled from a metal block. The use of an intraoral scanner (IOS) for post-endodontic rehabilitation could lead to a faster and more efficient CAD-CAM customized post-and-core realization. The use of a high resistance material such as metal is paramount in cases with high loss of coronal structure. The patient has been treated with bisphosphonate (BP) for years. The risk of osteonecrosis of the jaw after extraction was high.

[Diagnostic Test Requests in the Family Medicine Consultation: An Ethical Perspective Concerning Requests for Maxillofacial Computerized Tomography Scan Prior to Dental Implants]. / A Transcrição de Exames na Consulta de Medicina Geral e Familiar: Perspetiva Ética Sobre o Caso do Pedido de Tomografia Computorizada Maxilofacial para Realização de Implantes Dentários.

In the Portuguese National Health Service, little attention has been paid to oral health care. The almost nonexistence of a dentistry network raises concern about accessibility to services, and justifies the need to call on a predominantly private provision of services. The coexistence between the public and private settings is not always easy, especially when services need to interact and actively collaborate in order to find answers to the patient's problems. Dental implant procedures and the need to perform a previous maxillofacial computerized tomography to study the bone bed where osseointegrated dental implants are placed are a common situation. The current governmental regulation, blinded to the clinical context, may limit the accessibility to the tests. Based on this scenario, we discuss the possible options from an ethical point of view, framing the patient's and the physician's perspective and the relation between both. We conclude that the medical decision can't be disregarded from the clinical evaluation, in the intimacy of the medical consultation. This is an ethical duty that overrules the administrative and bureaucratic constraints. A good management of this apparent dichotomy may enhance better health and greater empowerment for the patient.

A saúde oral tem sido pouco cuidada no contexto do Serviço Nacional de Saúde em Portugal. A quase inexistência de uma rede de medicina dentária levanta problemas de acessibilidade que condicionam a necessidade de complementar os serviços públicos com uma oferta predominantemente privada. Mas esta coexistência não é sempre fácil, sobretudo quando há necessidade dos serviços se cruzarem e colaborarem ativamente na resolução dos problemas do doente. Uma situação comum é a colocação de implantes dentários e a necessidade de realizar uma tomografia computorizada maxilofacial prévia para estudo de leito para colocação de implantes dentários osteointegrados, onde a aplicação de regulação governamental desenquadrada do contexto clínico pode condicionar a acessibilidade aos tratamentos. Com base neste cenário, discutem-se as opções do ponto de vista ético, na perspetiva do doente, do médico e da relação entre ambos. Conclui-se que a decisão médica não pode ser desenquadrada de uma avaliação clínica que apenas o ambiente de intimidade da consulta médica pode proporcionar. É um imperativo ético que se sobrepõe aos constrangimentos administrativos e burocráticos e que se bem gerido é potenciador de uma melhor saúde e de maior capacitação da pessoa.

Abordaje quirúrgico combinado para la desinfección y regeneración de defectos periimplantarios. A propósito de tres casos / Combined surgical treatment for the decontamination and regeneration of peri-implant defects. A three cases series

Los implantes dentales sufren una alta incidencia de mucositis y periimplantitis, que pueden llevar a su fracaso. Existen múltiples abordajes terapéuticos no quirúrgicos y quirúrgicos para estas patologías, si bien en caso de periimplantitis deberá realizarse tratamiento quirúrgico. El tratamiento quirúrgico puede ser mediante cirugía de acceso, tratamiento resectivo o regenerativo. Para lograr la remoción del biofilm y la mejora de los tejidos periimplantarios, debe realizarse siempre la descontaminación previa del implante. Para ello pueden emplearse métodos mecánicos, químicos, antibióticos o láseres. En el presente artículo se presentan tres casos clínicos en los que se empleó un abordaje quirúrgico combinado de implantoplastia, descontaminación con clorhexidina y ácido ortofosfórico, aplicación de antibiótico local (piperacilina/tazobactam) y regeneración mediante hidroxiapatita sintética y membrana reabsorbible, que ha mostrado resultados favorables concordantes con la bibliografía

Dental implants suffer a high occurrence of mucositis and peri-implantitis, which may lead to implant failure. There are several therapeutical approaches both surgical and non-surgical for the treatment of these pathologies, though in peri-implantitis lesions a surgical procedure must be conducted. Surgical treatment can be trough: access surgery, resective or regenerative surgery. In order to remove the biofilm and to improve peri-implant tissues, decontamination of implant surface must be performed beforehand. For this, mechanical, chemical, antibiotics or lasers may be employed. In this article, we present three clinical cases of combined surgical treatment by implantoplasty, chemical decontamination with clorhexidine and orthophosphoric acid, local antibiotic (piperazilin/tazobactam) and regenerative treatment with synthetic hydroxyapatite and resorbable membrane. This treatment has shown favourable results, coinciding with the results found in the literature

Estabilización clínica de los tejidos periimplantarios mediante la combinación de la técnica "Socket Shield" y el pilar múltiple PGMU2 / Clinical stabilization of the periimplant tissues with the combination of the socket shield technique and the PGMU2 abutment

La técnica de Socket Shield fue descrita por primera vez por Zuhr y cols., en el año 2010 con la finalidad de preservar el volumen y la posición de los tejidos, así como el nivel original de la cortical vestibular tras la exodoncia, manteniendo un fragmento de la raíz dental a la par que se inserta un implante dental en el mismo alveolo y respetando una distancia entre ambos de uno o dos milímetros y que deberá ser ocupado por el coágulo sanguíneo. Caso clínico de un varón de 79 años de edad, con edentulismo parcial que es diagnosticado para tratamiento implantológico. El plan de tratamiento implica la extracción de dientes remanentes en maxilar superior y su posterior rehabilitación fija. Se colocaron dos implantes Biohorizons(R), uno de ellos postextracción, empleando la técnica de Socket-shield. Transcurridas 12 semanas, se conectó un pilar de cicatrización, 5 semanas después, se sustituyó el tapón por un pilar múltiple tipo Multi-unit(R) para confeccionar la prótesis fija. Transcurridos 12 meses de carga funcional, no habido complicaciones quirúrgicas ni protésicas. El volumen y la forma original de la cortical vestibular no se ha visto clínicamente alterada, el fragmento radicular se encuentra estable y el pilar PGMU2 ha permitido la rehabilitación del implante alejando la conexión de la prótesis del espacio biológico. Se ha conseguido estabilizar los tejidos periimplantarios con la técnica Socket Shield y salvaguardar el espacio biológico del implante inmediato con el pilar múltiple

The Socket Shield technique was described by Zuhr et all in 2010 with the main goal of preserve the volume and the initial position of the soft-tissues and the buccal plate after the tooth extraction, keeping a piece of the buccal dental root into the alveolar socket at same time of the dental implantation, keeping a security distance of 1 or 2 millimetres, that it should be occupied by the blood cloth. In this Clinical case, a male of 79 years old with partial edentulism requires dental implant treatment. The planning needs tooth extractions at the upper maxilla and posterior rehabilitation with fixed implant prosthesis. It was inserted two Biohorizons(R)dental implants, one of theme was after tooth extraction and using the Socket Shield technique. After 12 weeks, it was connected a healing abutment, 5 weeks later, It was substituted by a Multi-unit(R) abutment to make a prosthesis over it. After 12 months of functional load, non-surgical or prosthesis complications were described. The volume and the original shape of the buccal bone plate do not showed clinical changes, the root piece is stable and the PGMU2 abutment maintains an implant rehabilitation connection far away of the biological width. The Socket Shield technique stabilizes the periimplant tissues and preserves the biological width of the immediate dental implant using a Muti-unit(R) abutment

[Economic evaluation of treatments under dental general anesthesia and protective stabilization].

Objective: To conduct economic evaluation of treatments under dental general anesthesia (DGA) and protective stabilization (PS), in order to compare the cost and the final therapeutic effect of these two treatments. Methods: Retrospectively studied twenty-six 2 to 4 years old patients treated under DGA and twenty-seven treated under PS in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology. The general information, treatment information and total treatment cost information of patients were collected. The cost and cost-survival time ratio of the two groups were compared in units of people and tooth respectively. When compared in unit of people, patients were divided into two groups depending on the number of teeth treated, when compared in unit of tooth, teeth were divided into two groups depending on the treatment received, i.e. restoration or root canal treatment. In addition, we recalculated and compared two groups under the assumption that the treatment charges of DGA was consistent with common outpatient charges. Results: The tooth average cost and cost-survival time ratio of each patient in DGA group which were [(1 133.87±87.37) yuan] and [3.51 (1.30, 5.72) yuan/d] respectively were significantly higher than those in PS group which were [(303.81±155.34) yuan] and [1.54 (0.95, 2.13) yuan/d] respectively (P<0.01). The number of teeth and the way of treatments wouldn't change the result. The recalculated result of the cost-survival time ratio of each patient in DGA group [1.63 (0.72, 2.55) yuan/d] and PS group [1.54 (0.95, 2.13) yuan/d] showed no significant difference (P=0.455). Conclusions: Patients treated in Peking University School and Hospital of Stomatology showed a significant higher cost and cost-survival time radio in DGA group than that in PS group. If the treatment charges of DGA group was consistent with common outpatient charges, PS group will no longer have economic advantage.

Retreatment Efficacy of Endodontic Bioceramic Sealers: A Review of the Literature / Eficacia del retratamiento de cementos endodónticos biocerámicos: Revisión de Literatura

Abstract The endodontic retreatment is a feasible solution when post-operative apical periodontitis persists or develops. The complete removal of the filling materials is important in order to ensure the unobstructed contact of the intracanal disinfectants with the microbes. As a new generation of bioceramic endodontic sealers has emerged, their removal efficacy from the root canal system during retreatment is a matter of concern among clinicians. The aim of this article is to provide a comprehensive review of the current literature on the retreatability of these novel obturating materials. A significant amount of bioceramic sealer remnants in the root canal walls was observed in all studies. Even though canal cleanliness could not be obtained at an ideal level, the re-establishment of the working length and patency can be considered manageable and comparable to other endodontic sealers.

Resumen El retratamiento endodóntico es una solución factible cuando la periodontitis apical post-operatoria persiste o se desarrolla. La eliminación completa de los materiales obturadores es importante para garantizar el contacto y acción de los desinfectantes e irrigantes endodónticos con los microorganismos persistentes. A medida que ha surgido una nueva generación de selladores endodónticos biocerámicos, su eficacia de eliminación del sistema de conductos radiculares durante el retratamiento es motivo de preocupación entre los profesionales. El objetivo de este artículo es proporcionar una revisión exhaustiva de la literatura actual sobre la influencia o posibles limitantes del uso de este tipo de cementos bioactivos durante el retratamiento endodóntico. Los estudios determinaron una cantidad significativa de restos de selladores biocerámicos en las paredes del conducto radicular. Aunque la limpieza del canal no se pudo obtener a un nivel "ideal", el restablecimiento de la longitud de trabajo y la permeabilidad se puede considerar manejable y comparable a otros selladores endodónticos.

Evaluation of Frontal Teeth Stabilization after Root Apex Resection among the Ukrainian Young People

Objective: To develop a protocol of improved stabilization of teeth after root apex resection among young people using endodonto-endoossal implants and assessing its effectiveness. Material and Methods: Thirty-six patients were previously selected and divided into Group 1 (without additional stabilization) and Group 2 (with additional stabilization). The efficacy of treatment in both clinical groups was estimated at 90, 180 and 360 days, respectively. The results were evaluated on the Miller scale in the Flesrar modification. Density of bone tissue was expressed in Hounsfield units. Results: The average mobility indices over 90 days indicate a significant lower mobility of teeth in patients in Group 2, where as an advanced method, the RTR with an additional filling of the bone marrow defect with an osteoplastic material was chosen as the method of treatment (+ 18.0 ± 0.21 U.M. 10.0 ± 0.8 µm, p<0.05). In Group 1, 90 and 180 days after surgery, the density of bone tissue in the defect area was 756.3 ± 2.45 HU and 880.1 ± 4.34 HU. In Group 2, these indices were insignificantly higher and amounted to 834.3 ± 4.35 HU and 880.4 ± 2.56 HU. After 360 days after treatment in the first clinical group the bone density index was 957.4 ± 2.45 HU, while in the second group - 1003.3 ± 4.38 HU. Conclusion: The mobility of teeth among patients on 90-th day corresponded to level 1, and on 360-th day corresponded to level 0, indicating the effectiveness of the proposed method. The biomechanical stabilization of the teeth was confirmed by the results of densitometry among patients of both groups, in particular, the recovery of bone density in the affected site was observed after 360 days.

The haemostatic efficacy and foreign body reaction of epinephrine-Impregnated polyurethane foam in osseous defects.

The objective of this study was to compare the haemostatic efficacy and foreign body reaction of epinephrine-impregnated cotton pellets with those of epinephrine-impregnated polyurethane (PU) foam cubes in osseous defects created in guinea pigs. Initially, these substances were randomly applied to the osseous defects in guinea pigs for 2 min and blood loss was measured. The animals were then sacrificed 7 weeks later and the degree of foreign body reaction was scored. The data were analysed by the independent-samples Kruskal-Wallis test. Epinephrine-impregnated PU foam cubes showed significantly better haemostatic effect compared to epinephrine-impregnated cotton pellets. The PU foam containing epinephrine specimens elicited significantly less foreign body reaction compared to epinephrine cotton pellets (P < 0.05). Based on the results of this study, it is concluded that epinephrine-impregnated PU foam cubes are a good alternative to epinephrine-impregnated cotton pellets as a local haemostatic agent in endodontic surgery.

Relation between periapical lesions and sinus membrane thickening assessed by Cone Beam Computed Tomography.

The aim of this study was to evaluate thickening of the Schneiderian membrane and to determine its association with periapical pathologies, using computerized cone beam tomography. An observational, analytical, cross-sectional retrospective study was conducted. A total 179 maxillary sinuses were evaluated using CBCT. The presence of sinus membrane thickening and its association with unhealthy teeth was analyzed. Results are shown as percentages with 95% confidence intervals (95%CI); Chi square test was used with a significance level of 5%.Sinus membrane thickening was detected in 70 cases (39%; 95%CI=32% to 46%) and no sinus membrane thickening was observed in 109 (61%; 95%CI = 54% to 68%) (p<0.05). The 70 cases showing sinus membrane thickening included 46 of odontogenic origin (66%; 95%CI = 54% to 76%) and 24 (34%; 95%CI = 24% to 46%) of non odontogenic origin (p<0.05). The frequency of odontogenic causes followed a heterogeneous distribution (p<0.05): penetrating caries, failing endodontic therapy, root remnants, deep restorations, implants, periodontal pathology. The main cause was caries (46%; 95%CI=32% to 60%) followed by failing endodontic therapy (26%, 95% CI=16% to 40%). The frequency distribution of involved teeth was uneven (p<0.05), with tooth 16 (33%; 95%CI=21% to 47%) being the most frequently involved, followed by tooth 26 (30%; 95%CI=19% to 45%).The high incidence of sinus pathology of odontogenic origin shows the need for interdisciplinary work involving dentists and ear-nose-throat specialists. Caries, inadequate restorations, periodontal lesions, implants, and the presence of root remnants are the main causes of Schneiderian membrane thickening. The use of CBCT for diagnosis and treatment planning allows detecting maxillary sinus membrane thickening and determining its association with an odontogenic etiology.

El objetivo del presente trabajo fue evaluar el engrosamiento de la membrana de Schneider y determinar su asociación con patologías periapicales, mediante tomografía computarizada cone beam (CBCT). Se realizó un estudio observacional, analítico, retrospectivo y transversal. Un total de 179 senos maxilares fueron evaluados utilizando CBCT. Se analizó la presencia de engrosamiento de la membrana sinusal y su asociación con piezas dentarias sin vitalidad pulpar. Los resultados se muestran como porcentajes con intervalos de confianza del 95% (IC del 95%). Se utilizó la prueba de Chi cuadrado con un nivel de significación del 5%. Se detectó engrosamiento de la membrana sinusal en 70 casos (39%; IC del 95% = 32% a 46%) y no se observó engrosamiento de la membrana sinusal en 109 (61%; IC del 95% = 54% a 68%) (p < 0.05). Los 70 casos que mostraron engrosamiento de la membrana sinusal incluyeron 46 de origen odontogénico (66%; IC del 95% = 54% a 76%) y 24 (34%; IC del 95% = 24% a 46%) de origen no odontogénico (p <0,05). La frecuencia de las causas odontogénicas siguió una distribución heterogénea (p <0.05): caries penetrantes, tratamiento endodóntico deficiente, restos radiculares, restauraciones profundas, implantes, patología periodontal. La principal causa fue la caries (46%; IC 95% = 32% a 60%), seguida por endodoncia deficiente (26%, IC 95% = 16% a 40%). La frecuencia se distribuyó en forma heterogénea entre las distintas piezas (p<0,05). Las piezas más afectadas fueron la 16 (33%; IC95=21% a 47%) y la 26 (30%; IC95=19% a 45%). La alta incidencia de patología sinusal de origen odontogénico implica la necesidad del trabajo interdisciplinario entre odontólogos y otorrinolaringólogos. Caries, restauraciones inadecuadas, lesiones periodontales, implantes y la presencia de restos radiculares son las principales causas del engrosamiento de la membrana de Schneider. El uso de CBCT para el diagnóstico y la planificación del tratamiento permite detectar el engrosamiento de la membrana del seno maxilar y determinar su asociación con una etiología odontogénica.

Andodontic treatment: an analysis of demand by adult patients in a tertiary hospital in southern nigeria

Objective: An increase in dental awareness and need to maintain good oral health, in a growing population will necessitate an increased demand for root canal treatment (endodontic treatment). In emerging economies like Nigeria, the trend appears similar to what obtains in more developed economies where patients are keen on retaining their teeth. The objective was to determine the reasons for endodontic treatment and pattern of demand for treatment among adult patients attending the Endodontic unit of a tertiary hospital in Southern Nigeria. Methods: A retrospective review of all clinical records of adult patients who attended the Endodontic unit of the Department of Restorative Dentistry, University of Benin Teaching Hospital (UBTH) Edo State, Nigeria from January 2012 to December 2014 for root canal treatment (RCT). The demographic and clinical data were retrieved from the patients' records and analysed using SPSS version 20. Results: A total of 485 patients, comprising 226(46.6%) males and 259(53.4%) females (a ratio of 1:1.4) underwent endodontic treatment during the study period. The age range of patients was 18-68 years. In the studied population, the highest demand for endodontic treatment 219(45.2%) was among the 20-29 years' age range. The commonest indication for RCT was irreversible pulpitis (48.4%). The total number of teeth treated was 522. More posterior teeth 338(64.8%) were treated than anterior 184(35.2%). The mandibular first molar 96(18.4%) was the most frequently treated tooth. More maxillary teeth 332(63.6%) underwent RCT than mandibular teeth 190(36. 4%).Endodontic treatment was mostly completed in multiple visits 439(84.1%). A total of 279 (57.5%) patients had their treatments covered by the National Health Insurance Scheme (NHIS). Out of pocket payments accounted for 40.2% of patients who had endodontic treatment. Conclusion: There was a greater demand for root canal treatment among female and young adult patients. Most of the procedures were performed on maxillary teeth while the mandibular first molar was the most frequently treated tooth

Estabilizador Endodóntico en Fractura Complicada de Raíz en visita única / Endodontic Stabilizer in Complicated Root Fracture in a single visit

Introducción: La fractura complicada de raíz del tercio medio es una entidad compleja de pronóstico mayormente desfavorable y curso sintomático, donde el éxito clínico en no pocas oportunidades se convierte en una utopía, dado que la estabilidad en el afrontamiento de los bordes libres de los fragmentos fracturados es difícil de lograr. En este sentido el estabilizador edodóntico busca garantizar un anclaje bilateral satisfactorio, que posibilite unificar en una consulta los tiempos operatorios necesarios para un tratamiento exitoso. Objetivo: Describir la factibilidad del uso de un estabilizador endodóntico en el manejo de una fractura complicada de raíz del tercio medio en una visita. Presentación del caso: Paciente de 60 años, femenina que acude a consulta tras sufrir traumatismo dentoalveolar consistente con fractura complicada de raíz del tercio medio en 21; a los rayos X se observa ligero ensanchamiento periodontal y bordes discontinuos. Se realiza tratamiento edodóntico radical mediante la aplicación de un estabilizador intraconducto en la reducción de la fractura. Conclusiones: El uso de un estabilizador endodóntico en el manejo de una fractura complicada de raíz del tercio medio realizado en una sola visita es una alternativa factible de realizar en el tratamiento mediato e inmediato, ya que supone una rápida recuperación de las funciones buco-dentales del paciente(AU)

Introduction:The complicated fracture of the medium third of the root is a complex entity, particularly with an unfavorable prognosis and a symptomatic course in which the clinical success becomes a utopia in not just a few opportunities because the stability by confrontation of the free edges of the fractured fragments is difficult to achieve. In this respect, the endodontic stabilizer is used to guarantee a satisfactory bilateral anchorage that gives the possibility to unify, in a single visit, the necessary operation times for a successful treatment. Objective: To describe the feasibility of the use of an endodontic stabilizer in the management of a complicated fracture of the medium third of the root in a single visit. Case presentation: Female 60-year-old patient who comes to the consulting room after suffering from a consistent dentoalveolar trauma with a complicated fracture of the medium third of the root in tooth no.21; radiograph reveals a slight periodontal widening, and discontinuous edges. Radical endodontic treatment is performed with the placement of an intraductal stabilizer in the reduction of the fracture. Conclusions: The use of an endodontic stabilizer in the management of a complicated fracture of the medium third of the root in a single visit to the dentist is a feasible alternative in the mediate and immediate treatment seeing that it supposes a fast recovery of the bucco-dental functions of the patient(AU)

Reconstrucción del diente endodonciado con postes colados o espigas de fibra. Revisión bibliográfica / Reconstruction of tooth endodontic posts with fiber cast or ears

La restauración de los dientes endodonciados mediante postes prefabricados de fibra de vidrio o cuarzo es una práctica frecuente y aceptada, aunque su indicación o no y ventajas frente a otro tipo de postes, es algo aún en lo que no existe una evidencia científica suficiente. Este tipo de poste se puede indicar como una alternativa a los tradicionales postes colados. Existen diferentes tipos de postes prefabricados, aunque en la actualidad han adquirido una gran importancia los compuestos por fibras de vidrio. (1-3). Diferentes estudios muestran la implicación de factores biológicos, mecánicos y estéticos en el éxito de estas restauraciones. Siendo muy importante preservar la mayor cantidad posible de tejido dentario, conseguir un buen efecto ferrule, y una óptima adhesión para el éxito a largo plazo (1,4-6) Se revisarán los niveles de supervivencia de los dientes restaurados con postes colados frente a los restaurados con postes prefabricados. Siendo evidente como los postes de fibra de vidrio han mostrado un buen nivel de éxito a largo plazo en todas las cuestiones analizadas (AU)

The restoration of endodontic teeth with prefabricated fiberglass poles or quartz is a common and accepted practice, although its indication or not and advantages over other posts, is something even as there is insufficient scientific evidence. This type of post can be specified as an alternative to traditional cast posts. There are different types of prefabricated posts, but today have become very important compounds for glass fibers. (1-3). Different studies show the involvement of biological, mechanical and aesthetic in the success of these restorations factors. Being very important to preserve the greatest possible amount of tooth tissue, get a good ferrule effect and optimal adhesion for long-term success (1,4-6) survival rates of teeth restored with cast posts will be reviewed in front of the restored prefabricated posts. It is evident as fiberglass poles have shown a long-term good level of success in all issues discussed (AU)

Guided Tissue Regeneration Using a Barrier Membrane in Endodontic Surgery.

Endodontic surgery aims at the resolution of a periapical inflammatory process by surgical access followed by enucleation of the lesion and root-end filling to curb any potentially noxious agent within the physical confines of the affected root. Guided bone regeneration could be associated to endodontic surgery aiming to enhance periradicular tissue regeneration. The objective of this paper was to review the scientific literature about guided bone regeneration in endodontic surgery, evaluating the effects on periapical lesion healing process. The included articles are classified considering the anatomical characteristics of the lesion. Fourteen articles were included in the review after abstract and title selection. Eight articles were on studies on lesions affecting only the periapical region (three about through-and-through lesions) while six were about the treatment of apico-marginal lesions. On the basis of the currently available literature, there is a low scientific evidence of a benefit related. to the use of guided bone regeneration procedure in endodontic surgery.

[Endodontic filling points with gutta percha - requirements, composition and properties]. / Wurzelkanalfüllungen mit Guttapercha - Anforderungen, Zusammensetzung und Eigenschaften.

Gutta-percha is a tough plastic substance from the latex of several Malaysian trees of the sapodilla family that resembles rubber but contains more resin. It is especially used as insulation and in dentistry. Gutta-percha endodontic filling points were found to contain approximately 20% gutta-percha (matrix), 66% zinc oxide (filler), 11% heavy metal sulphates (radiopacifier), and 3% waxes and/or resins (plasticiser). The mechanical properties were indicative of a partially crystalline viscoelastic polymeric material.

Development of new radiopaque glass fiber posts.

The aim of this study was to analyze the radiopacity and filler content of three experimental glass fiber posts (EGFP) in comparison with other glass/carbon fibers and metal posts from the dental market. Three EGFP were obtained by pultrusion of glass fibers in a polymer matrix based on 2,2-bis[4-(2-hydroxy-3-methacryloyloxypropoxy)-phenyl]propane (bis-GMA) and triethyleneglycol dimethacrylate (TEGDMA) monomers. Using intraoral sensor disks 27 posts, as well as mesiodistal sections of human molar and aluminum step wedges were radiographed for evaluation of radiopacity. The percentage compositions of fillers by weight and volume were investigated by combustion analysis. Two EGFP showed radiopacity higher than enamel. The commercial endodontic posts showed radiopacity as follows: higher than enamel, between enamel and dentin, and lower than dentin. The results showed statistically significant differences (p b 0.05)when evaluatedwith one-way ANOVA statistical analysis. According to combustion analyses, the filler content of the tested posts ranges between 58.84wt.% and 86.02wt.%. The filler content of the tested EGFP ranged between 68.91 wt.% and 79.04 wt.%. EGFP could be an alternative to commercial glass fiber posts. Futureglass fiber posts are recommended to present higher radiopacity than dentin and perhaps ideally similar to or higher than that of enamel, for improved clinical detection. The posts with a lower radiopacity than dentin should be considered insufficiently radiopaque. The radiopacity of some glass fiber posts is not greatly influenced by the amount of filler.

Prognostic factors on periapical surgery: a systematic review

BACKGROUND: Analyze the most important prognostic factors when performing periapical surgery and compare the success rates of distinct authors. INTRODUCTION: Periapical surgery is an approach to treat non-healing periapical lesions and it should be viewed as an extension of endodontic treatment and not as a separate entity. MATERIAL AND METHODS: A search of articles published in Cochrane, PubMed (MEDLINE) and Scopus was conducted with the key words "prognostic factors", "prognosis", "periapical surgery", "endodontic surgery" and "surgical endodontic treatment". The inclusion criteria were articles including at least 10 patients, published in English, for the last 10 years. The exclusion criteria were nonhuman studies and case reports. RESULTS: 33 articles were selected from 321 initially found. Ten articles from 33 were excluded and finally the systematic review included 23 articles: 1 metaanalysis, 1 systematic review, 2 randomized clinical trials, 6 reviews, 12 prospective studies and 1 retrospective study. They were stratified according to their level of scientific evidence using the SORT criteria. CONCLUSIONS: Factors associated with a better outcome of periapical surgery are patients ≤45 years old, upper anterior or premolar teeth, ≤10 sized lesions, non cystic lesions, absence of preoperative signs and symptoms, lesions without periodontal involvement, teeth with an adequate root-filling length, MTA as root-end filling material, uniradicular teeth, absence of perforating lesions, apical resection < 3 mm, teeth not associated to an oroantral fistula and teeth with only one periapical surgery