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1.
Rev. Odontol. Araçatuba (Online) ; 43(2): 43-48, maio-ago. 2022. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1362032

RESUMO

Casos de fraturas dentárias oblíquas muitas vezes possuem um prognóstico desfavorável, geralmente com indicação da extração do elemento dental. O presente artigo visou relatar o tratamento do caso clínico de um paciente do sexo masculino, 12 anos, que compareceu à Unidade de Saúde Bucal do Hospital Universitário de Brasília com encaminhamento de extração do dente 12, apresentando fratura oblíqua que se estendia subgengivalmente na face vestibular. O trauma havia ocorrido há três anos e o paciente havia sido submetido a diversas intervenções endodônticas, apresentando no momento da consulta inicial por nossa equipe uma lesão periapical extensa. Após a realização da anamnese, exame clínico e radiográfico, foi adotada uma abordagem multidisciplinar conservadora com a manutenção do dente e a realização da enucleação da lesão periapical por meio de intervenção cirúrgica e posterior reabilitação. Em uma mesma sessão, foi realizada a obturação do conduto com cone de guta percha e cimento sealer 26 e a cirurgia parendodôntica juntamente com a apicoplastia. Uma semana após a intervenção cirúrgica foi realizada restauração classe IV com resina composta baseada no enceramento dos modelos de diagnóstico montados em articulador. Com base em uma avaliação criteriosa e multidisciplinar, foi possível adotar uma abordagem conservadora no caso em questão, com a manutenção e reabilitação de um dente permanente em um paciente jovem, evitando a indicação de exodontia(AU)


Cases of oblique dental fractures often have an unfavorable prognosis, usually with the indication of extraction of the dental element. The present article aimed to report the treatment of the clinical case of a 12-year-old male patient, who attended the Oral Health Unit of the Hospital Universitário de Brasília with a referral for extraction of tooth 7, presenting an oblique fracture that extended subgingivally on the labial surface. The trauma had occurred three years ago and the patient had undergone several endodontic interventions, presenting an extensive periapical lesion at the time of the initial consultation by our team. After anamnesis, clinical and radiographic examination, a conservative multidisciplinar approach was adopted with the maintenance of the tooth and the enucleation of the periapical lesion through surgical intervention and subsequente rehabilitation. In the same session, the conduit was filled with gutta-percha cone and sealer cement 26 and parendodontic surgery was performed together with apicoplasty. One week after the surgical intervention, class IV restoration was performed with composite resin based on the waxing of the diagnostic models mounted on an articulator. Based on a careful and multidisciplinary evaluation, it was possible to adopt a conservative approach in the case in question, with the maintenance and rehabilitation of a permanent tooth in a young patient, avoiding the indication of extraction(AU)


Assuntos
Humanos , Masculino , Criança , Fraturas dos Dentes/terapia , Cavidade Pulpar/cirurgia , Cavidade Pulpar/lesões , Abscesso Periapical , Tratamento do Canal Radicular , Fraturas dos Dentes , Fraturas dos Dentes/cirurgia , Fraturas dos Dentes/diagnóstico , Incisivo
2.
BMC Oral Health ; 22(1): 171, 2022 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-35538514

RESUMO

BACKGROUND: Adequate knowledge of root canal morphology and possible variations is essential to achieve perfect root canal treatment and overcome treatment failure. Appropriate knowledge on root and canal morphology, communication, and documentation amongst dentists will be challenging from a diagnostic and successful treatment point of view. METHODS: A total of 3420 samples were included in this study from 285 cone-beam computed tomography images of the Saudi residents, including 171 males and 114 females aged 15 to 68 years from retrospective data dated from January 2018 to April 2021. The images were examined in sagittal, axial and coronal views using a 3D version software 1.0.10.6388. The number of canal and canal morphology was recorded using Vertucci and the new classification system. The SPSS 26 was used to conduct the statistical analysis as descriptive statistics such as mean; standard deviation and frequency were calculated. The Chi-square test analysed the data with the significance level set at 0.05. RESULTS: A total of 285 subjects participated in the study. Majority of the participants were Saudi nationals (80.7%), followed by Indian (7.4%), Pakistani (4.2%) and other nationalities. According to Vertucci and the new classification system, Type I and 1TN1 were the most common types, followed by Type III and Type IV, and then 1TN1-2-1 and 1TN1-2 in mandibular anteriors. The prevalence of canal variations in mandibular canine was higher in females than in males (P = 0.002). Maxillary laterals and mandibular anteriors showed the significant difference in the prevalence of root canal variation in relation to the ethnicity (P = 0.001) and age of the patients. Younger patients showed more variations than the older patients (P = 0.012, P = 0.023, P = 0.001, P = 0.001) in terms of maxillary laterals, mandibular central, laterals and canines, respectively. CONCLUSION: Mandibular permanent anteriors showed a wide range of canal variations and canal complexity. Males and females did not demonstrate a wide range of variation in the root canal morphology except for the canines in relation to the gender of the patients.


Assuntos
Cavidade Pulpar , Tomografia Computadorizada de Feixe Cônico Espiral , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Feminino , Humanos , Masculino , Estudos Retrospectivos , Arábia Saudita , Raiz Dentária/anatomia & histologia
3.
Eur Rev Med Pharmacol Sci ; 26(8): 2861-2866, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35503630

RESUMO

OBJECTIVE: For a successful root canal therapy, it is necessary to locate all the canals debride and seal them with an inert filling material. The clinician must be aware of the internal morphology and variations in a permanent tooth. Mandibular first molars are widely studied to identify variations in the anatomy of the pulp space. In this study, the primary objective was to measure the distance between the mesiobuccal (MB) and mesiolingual (ML) canals in patients with and without a middle mesial canal (MMC) using cone-beam computed tomography (CBCT). The secondary objectives were to assess the tapering degree of the mesial root and to measure the dentinal thickness in relation to the danger-zone area in patients with and without an MMC. MATERIALS AND METHODS: A total of 200 CBCT scans were evaluated for the presence of an MMC. Two observers performed the observations, and the results obtained were subject to statistical analyses. RESULTS: The results revealed the prevalence of MMC was 5%. The average distance between the MB and ML canals was higher when there was an MMC [M(SD) = 3.61 (0.6) vs. 2.69 (0.66)]. However, there were no differences between the groups in the distance to the danger-zone area and the tapering degree of the mesial root. On CBCT images, the MMC was clearly visible 3 mm apical to the level of the cementoenamel junction; beyond 3 mm, the MMC could not be traced. CONCLUSIONS: Based upon the results of this study, the average distance between the MB and ML canals was higher when there was an MMC. A lesser degree of taper would be preferred to prepare the MMC than to prepare the other canals. It is recommended that careful examination of the canal 3 mm apical to the cementoenamel junction should be carried out when attempting to detect an MMC.


Assuntos
Mandíbula , Dente Molar , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/diagnóstico por imagem , Humanos , Mandíbula/diagnóstico por imagem , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Raiz Dentária/anatomia & histologia
4.
BMC Oral Health ; 22(1): 166, 2022 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-35524244

RESUMO

BACKGROUND: A thorough understanding of the original root and canal anatomy is a critical technical prerequisite for performing cleaning and shaping treatments. Therefore, this research aimed to characterize maxillary first premolar teeth' root morphology and canal architecture. METHODS: One hundred forty-two extracted human adult maxillary first premolar teeth have been retrieved. The extracted teeth were thoroughly cleaned and irrigated to eliminate any remaining debris or blood. They were then preserved in formalin solution until they were eligible for screening. To begin, a visual examination was employed to ascertain the number of roots and their geometry in each sample. Then, utilizing digital radiography in two plains, mesiodistal and distomesial, to further determine those parameters. Finally, a sectioning technique had been used to have the samples cut mesiodistally into slices to validate the internal root canal architecture and identify the number of root canals and their varieties in accordance with Vertucci's categorization system. The canal layout, the pulp chamber, and the root canals were all highlighted (marked) using a fine tip marker in a permanent orange hue to make the canal features more accessible and accurate to visualize. All of the processes were conducted by two highly qualified dentists. The sample size was estimated statistically using the Sealed Envelope program, and the percentage of each configuration was derived in proportion to the overall sample size in order to establish the percentage of each type in each configuration. RESULTS: From the 142 teeth examined, 42 (29.57%) had one root, 97 (68.31%) had two roots, and only three premolars (2.12%) had three roots. Concerning canal configurations, 100 teeth (70.43%) had type (IV) canal configuration, followed by 37 teeth (26.05%) had types (V), three teeth (2.12%) had type (VIII), and one tooth (0.70%) for each of type (I) and type (II). CONCLUSIONS: The anatomical pattern of inspected maxillary first premolars are mainly two rooted and predominantly have a type (IV) canal morphology.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Raiz Dentária , Adulto , Dente Pré-Molar/anatomia & histologia , Dente Pré-Molar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Humanos , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Radiografia Dentária Digital , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem
5.
Braz Dent J ; 33(2): 12-21, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35508032

RESUMO

The purpose of this in vitro study was to evaluate the shaping ability of reciprocating and continuous rotary systems after root canal retreatment. After preparation and root canal filling, mesial canals of 54 mandibular molars were distributed into 3 groups (n=18), according to the filling material removal and re-instrumentation protocols: WOG group - WaveOne Gold system; PTN group - ProTaper Next system; and PTU group - ProTaper Universal system. Cone-beam computed tomographic (CBCT) images acquisition of the mesial root canals was performed at different moments: (1) before instrumentation (unprepared root canals), (2) after preparation and filling, (3) after filling material removal and (4) re-instrumentation. The apical transportation (AT), centering ability (CA) and change in root canal diameter were assessed by CBCT analysis. The remaining filling material quantification was performed by radiographic examination. The statistical analyses were performed using the 3-way ANOVA, Tukey-Kramer, Kruskal-Wallis and Dunn multiple Comparison tests (p<0.05). The tested instruments did not show full CA (=1.0). PTN group had greater AT at the 5th mm in comparison with the WOG group (p<0.05). After re-instrumentation, WOG group had greater root canal diameter change at the 1st and 5th mm than PTN and PTU groups (p<0.05). There was no significant difference among groups when comparing the amount of remaining filling material after re-instrumentation (p>0.05). The tested systems provided minimal alteration in root canal morphology at the apical portion after root canal retreatment. However, WOG promoted greater change in root canal diameter.


Assuntos
Materiais Restauradores do Canal Radicular , Tomografia Computadorizada de Feixe Cônico Espiral , Cavidade Pulpar/anatomia & histologia , Desenho de Equipamento , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Retratamento , Obturação do Canal Radicular , Preparo de Canal Radicular/métodos , Microtomografia por Raio-X/métodos
6.
Braz Dent J ; 33(2): 91-98, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35508041

RESUMO

This study aimed to evaluate the influence of calcium silicate-based sealers on the bond strength of fiber posts using conventional and self-adhesive resin cement. Sixty single-rooted teeth were selected. The canals were prepared with a reciprocating instrument 40.06. The roots were randomly distributed in six groups (n = 10) according to the strategies for root canal filling and fiber posts cementation: AH Plus/RelyX ARC; AH Plus/RelyX U200; Bio C Sealer/RelyX ARC; Bio C Sealer/RealyX U200; Sealer Plus BC/RelyX ARC; and Sealer Plus BC/RelyX U200. The roots were transversally sectioned, and one slice per post-third was obtained. The push-out test was performed at a crosshead speed of 1mm/min. The failure patterns were described after assessment with a stereomicroscope with a 10× magnification. Bond strength was calculated and analyzed using the ANOVA and Tukey test. AH Plus did not influence the bond strength of fiber posts cemented with conventional (RelyX ARC) or with self-adhesive resin cement (RelyX U200). The lowest bond strength values were obtained when calcium silicate-based sealers were associated with conventional resin cement (Bio C Sealer/RelyX ARC and Sealer Plus BC/RelyX ARC). Except for Sealer Plus BC/RelyX ARC, all groups presented lower bond strength at the apical portion compared to the cervical portion of the post. Adhesive failures between cement and post and cement and dentin were predominant (55.3%). Calcium silicate-based sealers decreased the bond strength of fiber posts cemented with conventional resin cement.


Assuntos
Colagem Dentária , Técnica para Retentor Intrarradicular , Cavidade Pulpar , Dentina , Teste de Materiais , Cimentos de Resina/química
7.
Sci Rep ; 12(1): 6531, 2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35444163

RESUMO

The aim of the present study was to evaluate the agreements between the root canal length estimations using cone-beam computed tomography (CBCT) at different slice thicknesses, dedicated software, or an electronic apex locator (EAL) and the actual lengths (AL). In total, 111 extracted human molars with 302 root canals were chosen. Teeth were scanned using a CBCT device at a voxel size of 0.075 mm. Root canal lengths were estimated using CBCT software at different slice thicknesses (0.6, 1.2, and 2.4 mm) and dedicated software for proposed or operator lengths. The endodontic access cavities were created, and root canal lengths were estimated with an EAL for electronic length (EL) and a ruler for AL. Data were tested using paired t-tests and Bland-Altman plots to detect the differences between the methods in length estimation at a significance of 0.05. The accuracy in the range of ± 0.5 mm was 100% for the EAL. There was an agreement between the EL and CBCT at a slice thickness of 1.2 mm (p = 0.349). CBCT at the smallest slice thickness estimation was not the best modality in agreement with the AL. The EAL was an accurate and reliable method for root canal length measurement.


Assuntos
Cavidade Pulpar , Ápice Dentário , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/diagnóstico por imagem , Eletrônica , Humanos , Odontometria , Software
8.
J Indian Soc Pedod Prev Dent ; 40(1): 9-18, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35439877

RESUMO

Aim: This study aimed to systematically review available literature of in vitro studies on apical extrusion of debris through rotary instrumentation in comparison to manual instrumentation in pediatric endodontics, and also to perform a comparison between various rotary instrumentation systems for assessment of debris extrusion. Materials and Methods: A comprehensive search was conducted on PubMed, Medline, Cochrane Library, Embase, Scopus, and Google Scholar without any language restriction and year of publication. A planned search strategy was made for PubMed and applied to other databases. After full-text reading, 7 articles were selected for quantitative synthesis. Modified CONSORT checklist of items for reporting in vitro studies of dental materials was used for quality assessment of included studies. Results: Root canal preparation with rotary instrumentation led to lesser apical debris extrusion than manual instrumentation. Self-adjusting file system was associated with the least debris extrusion among all included studies, followed by ProTaper Next, Kedo-S, ProTaper, K3, Mtwo, Revo-S, and Wave One. Conclusion: More apical debris extrusion was seen with manual instrumentation than rotary instrumentation. Furtrhermore, variance in debris extrusion was seen with different rotary file systems.


Assuntos
Cavidade Pulpar , Ápice Dentário , Criança , Humanos , Preparo de Canal Radicular , Dente Decíduo
9.
Niger J Clin Pract ; 25(4): 524-530, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35439914

RESUMO

Background: One of the most important goal of non surgical endodontic retreatment is the successful removal of gutta percha and sealers from the root canal system. A variety of techniques have been recommended for retreatment procedures for the removal of gutta-percha and sealers with or without the help of adjunctive chemical solvents, by using stainless steel hand files or nickel-titanium rotary files, gate glidden burs, heated instruments, ultrasonic instruments, and lasers 1,3. The current advancements in the design of NiTi instruments have proved efficacious in the removal of filling materials from the root canal wall and various studies have also confirmed their cleaning ability and efficacy 4,5. Nevertheless, the use of rotary instrumentation can lead to the formation of dentinal cracks in the root canal dentin. Many researchers have reported the incidence of crack formation and propagation after the procedure with manual, rotary and reciprocating instruments. The behavior of rotary instruments in the generation of defects have been the point of greatest interest during many years 6. These dentinal cracks can be defined as defects with a complete crack line extending from inner root canal space up to the outer surface of the root when the tensile stress in the root canal wall exceeds the tensile stress of dentin 7. Aim: This study was conducted to investigate and to compare the amount of dentinal microcracks formation with various new instrumentation methods and conventional hand filing method. It also looks into amount of gutta-percha removed after retreatment from the canal and the time required for all the instrumentation technique. Methodology: Sixty extracted human maxillary first molars with curved roots were mounted on addition silicone impression material incorporated in an aluminium hollow block, then instrumented using step-back preparation with 35 size K files. Obturation was done using gutta-percha with AH plus sealer. These were stored for 14 days and divided into three groups Mani GPR, Endostar Re Endo and H file and were subjected to retreatment procedures. Retreatment was considered complete when no filling material was observed on the canal wall and the canal was smooth and free of visible debris. The samples were examined under scanning electron microscope and the number of cracks were calculated. The percentage of root canal filling material and time taken was recorded. Statistical Analysis: The data obtained were analyzed by using descriptive statistics, ANOVA (Analysis of Variance), chi-square test and Scheffe's post hoc test through SPSS for window (version 22.0). Result: All the techniques showed similar amount of crack propagation, with no statistical difference between the group. Retreatment done using H Files required more time and removed less material. The coronal third showed less amount of gutta-percha remnants than the apical third in all groups. Conclusion: All the groups showed a similar amount of crack propagation. Less number of cracks were observed in the coronal one third and more amount of cracks were found at the apical third. Endostar RE Endo rotary instrument proved to be most effective and least time-consuming. Hedstrom Files required more time and removed less material.


Assuntos
Guta-Percha , Materiais Restauradores do Canal Radicular , Cavidade Pulpar , Humanos , Retratamento , Obturação do Canal Radicular/métodos , Preparo de Canal Radicular/métodos , Solventes , Titânio
10.
Braz Oral Res ; 36: e053, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35442382

RESUMO

This study assessed the ability of XP-endo Finisher R (FKG, La Chaux-de-Fonds, Switzerland) to remove filling remnants from curved mesiobuccal canals of maxillary molars, using the passive ultrasonic irrigation (PUI) technique as a comparison. Twenty-four curved main mesiobuccal canals (MB1) of maxillary molars were instrumented with Wave One (#25/07) and filled with gutta-percha points and AH Plus Sealer. Samples were then re-treated with a standardized protocol with Wave One (#35/06) as the master apical file. Micro-CT scans measured baseline volume of remaining filling material (in mm3). Samples were divided into two groups (n = 12) according to the supplementary cleaning approach: (PUI) or XP-endo Finisher R. Statistics compared baseline and final volume of filling material (within-group); and the percentage of filling material reduction (between-group). Mean baseline volumes, final volumes, and percentages of reduction (%) of filling material for XP-endo Finisher R and PUI were respectively: 0.060 mm3, 0.042 mm3, and 31.28%; and 0.064 mm3, 0.054 mm3, and 16.57%. Both tested protocols reduced the amount of filling material (p < 0.05). XP-endo Finisher R had higher percentage of reduction as compared to PUI (p < 0.05). XP-endo Finisher R and PUI used as supplementary cleaning protocols during re-treatment improved the removal of root filling material in curved canals; but XP-endo Finisher R was approximately twice more efficient. The complete filling material removal during re-treatment procedures is still a challenge. Supplementary cleaning protocols may help to remove the remaining material after the complete mechanical preparation of curved canals. XP-endo Finisher R was approximately twice more efficient than PUI.


Assuntos
Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Cavidade Pulpar/diagnóstico por imagem , Retratamento , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular , Ultrassom
11.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 57(4): 384-389, 2022 Apr 09.
Artigo em Chinês | MEDLINE | ID: mdl-35368164

RESUMO

Objectives: To evaluate the diagnostic consistency of working lengths by observing endodontic files in root canals and periapical subtle structures in digital intraoral radiographs presented in two smartphones, a tablet and a laptop computer. Methods: A dried human skull embedded in an acrylic compound was used for exposing radiographs of the upper and lower second premolars and first molars with two endodontic files (Kerr files size 10 and 15) positioned to the full length of the roots or 1.5 mm short of apexes. A total of 100 radiographs were taken for each of the file sizes. Five observers were asked to assess all the 200 digital radiographs according to a 5-category scale in smartphone A (HUAWEI P9 Plus), smartphjone B (Apple iPhone 7), tablet (Apple iPad 2018) and laptop computer (Lenovo Thinkpad E480), respectively. The gold standard for receiver operating characteristic curve (ROC) analysis was determined with the endodontic Kerr file size 20. A total of 150 roots with files were radiographed, 75 of which with files reaching the radiographic apexes of the respective roots and 75 of which with files 1.5 mm short of the radiographic apexes for each endodontic file size. Results from ROC analysis was analyzed with one-way ANOVA and independent sample t test. Results: For the Kerr file size 10, the area under the ROC curve for laptop, tablet and two smartphones were 0.891±0.037, 0.869±0.037, 0.870±0.017 and 0.849±0.037, while for the Kerr file size 15 the ROC values were 0.957±0.02, 0.961±0.02, 0.961±0.01 and 0.961±0.02, respectively. There were no significant differences for diagnostic accuracy for observing endodontic file positions among digital radiographs presented in the two smartphones, one tablet and one laptop devices (endodontic file size 10: F=1.39, P=0.281; endodontic file size 15: F=0.05, P=0.985). A significant difference was found in the diagnostic accuracy of endodontic file positions between size 10 and 15 files in different display devices (t=-10.65, P<0.001). Conclusions: There was a high diagnostic consistency in the determination of working length and periapical subtle structures of roots by observing digital radiographs displayed on smartphones, tablet and laptop computer.


Assuntos
Instrumentos Odontológicos , Cavidade Pulpar , Cavidade Pulpar/diagnóstico por imagem , Eletrônica , Humanos , Dente Molar , Variações Dependentes do Observador , Preparo de Canal Radicular
12.
Georgian Med News ; (324): 54-63, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35417863

RESUMO

The use of nickel-titanium instruments during endodontic treatment ensures high-quality treatment of root canals. However, during instrumentation in the curved root canals of nickel-titanium instruments experience cyclic loading, which leads to their breakage. The splinter of the tool in the root canal makes it difficult for high-quality processing and obturation of the root canal, which is a very urgent problem. To carry out instrumental processing in canals with various anatomical and topographic features, the files must have phenomenal flexibility, lack of straightening of the canal, and have a safe non-aggressive tip. And for this reason, one of the most popular nickel-titanium COXO SC PRO tools was selected as a study, which, according to the manufacturer, have all the listed properties. The aim of the study is to determine the limit of resistance to cyclic loading and signs of breakage of the nickel-titanium endodontic instrument COXO SC PRO. Sterilization treatment, which is based on autoclaving, significantly reduces the strength characteristics of COXO SC PRO nickel-titanium files, which limits the use of these tools to one-time use without the risk of their breakage.


Assuntos
Níquel , Titânio , Cavidade Pulpar/cirurgia , Desenho de Equipamento , Preparo de Canal Radicular
14.
Br Dent J ; 232(8): 524-530, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35459824

RESUMO

Background According to the Children's Dental Health Survey 2013, around one in ten children in Wales, Northern Ireland and England will have sustained dental trauma to a permanent incisor by the of age 15. Management of an exposed pulp in an immature permanent incisor is often urgent and has an impact on the long-term outcome of the tooth; therefore, it is essential that general dental practitioners feel confident in managing such a scenario to achieve an optimal outcome. This paper discusses the indications, technique, materials and outcomes.Aims This article aims to review the literature, which discusses various treatment modalities and materials for pulpal therapy and root canal treatment in the immature permanent tooth.Method Electronic searches were limited to English language, human studies, published within the past five years and the medical subject heading terms used were: direct pulp capping, apexogenesis, Cvek pulpotomy, full pulpotomy/pulpectomy, partial pulpotomy, apexification, non-vital pulp therapy and mineral trioxide aggregate apexification. Older, seminal articles identified through the references sections have also been included.Conclusion A number of options are available for the management of immature permanent teeth that have suffered an insult such as caries or trauma. This paper reviews the various methods of pulpal treatment, preservation therapy and root canal treatment options depending on the extent of the damage.


Assuntos
Cavidade Pulpar , Odontólogos , Adolescente , Compostos de Cálcio , Criança , Dentição Permanente , Combinação de Medicamentos , Humanos , Óxidos , Papel Profissional , Pulpotomia/métodos , Silicatos/uso terapêutico , Resultado do Tratamento
15.
Quintessence Int ; 53(6): 472-483, 2022 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-35380208

RESUMO

OBJECTIVE: To evaluate whether root canal obturation with resin-based sealers increases the incidence and intensity of postoperative pain compared to other sealer types. DATA SOURCES: Medline, Scopus, Web of Science, Google Scholar, Cochrane Library, and gray literature were searched through December 2020. Clinical studies evaluating postoperative pain after obturation with resin-based sealers and other sealer types were included. Risk of bias was assessed through the Cochrane RoB 2.0 tool for randomized clinical trials (RCTs) and ROBINS-I tool for non-randomized clinical trials (nRCTs). Pooled relative risks (RR), standardized mean differences (SMD), and 95% confidence intervals were calculated for quantitative analyses. Of 524 studies, 11 clinical studies (eight RCTs and three nRCTs) involving 1,123 teeth were included. Four studies were assigned low risk of overall bias while seven studies presented high risk of overall bias. Quantitative analyses were performed with six studies for pain incidence, five studies for pain intensity, and four studies for analgesic intake. There was no significant difference between resin- based sealers and other sealer types in postoperative pain incidence at 24 hours (RR 1.102, P = .53), 48 hours (RR 0.943, P = .93), 72 hours (RR 1.019, P = .93), and 1 week (RR 0.559, P = .31), in pain intensity at 12 hours (SMD 0.100, P = .35), 24 hours (SMD 0.090, P = .25), and 48 hours (SMD 0.217, P = .26), and in analgesic intake at 24 hours (RR 2.253, P = .15) and 72 hours (RR 0.650, P = .59). CONCLUSION: Based on the available evidence, resin-based sealers do not increase the postoperative pain incidence, intensity, and analgesic intake compared to other sealer types.


Assuntos
Materiais Restauradores do Canal Radicular , Cavidade Pulpar , Humanos , Medição da Dor , Dor Pós-Operatória/tratamento farmacológico , Materiais Restauradores do Canal Radicular/efeitos adversos , Obturação do Canal Radicular
16.
BMC Oral Health ; 22(1): 119, 2022 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-35397605

RESUMO

BACKGROUND: The main goal of an endodontic treatment is a complete debridement of the root canal system; however, currently mechanical shaping and chemical cleaning procedures for this purpose have deemed non-satisfactory. METHODS: The efficacy of peracetic acid (PAA; 0.5, 1.0, 2.0%), as a root canal irrigation solution, against Enterococcus faecalis (DSM 20478) and Parvimonas micra (DSM 20468) when compared with the one of sodium hypochlorite (NaOCI; 1.0, 3.0, 5.0%), chlorhexidine digluconate (CHX; 0.12, 0.2, 2.0%) and 0.9% NaCI (as a control solution) was in vitro investigated with the agar diffusion and direct contact methods. The inhibition zone diameters observed with the agar diffusion test were determined. The viable bacterial counts (CFU/ml) were calculated with the direct method. RESULTS: The agar diffusion test showed that all three root canal irrigation solutions had an efficacy against E. faecalis at all concentrations. The largest inhibition zone diameters against E. faecalis were observed with 5.0% NaOCI. At all three concentrations of PAA, NaOCI, and CHX, the inhibition zone diameter increased with increase in concentration. For P. micra, PAA had a similar inhibition zone diameter despite a concentration increase. In contrast, for NaOCI and CHX, the inhibition zone diameter increased with increasing concentration. 2.0% CHX produced the largest inhibition zone diameter against P. micra. For E. faecalis, only the comparison between 2.0% PAA and 5.0% NaOCI showed statistical significance (p = 0.004). For P. micra the efficacy comparison between the lowest, middle, and highest concentrations of each solution, a statistical significance (p < 0.05) was found for all three solutions. After direct contact with PAA, NaOCI and CHX, no viable bacteria could be determined for either P. micra or E. faecalis. CONCLUSIONS: PAA had a similar antibacterial efficacy as the one of NaOCl and CHX when in direct contact with E. faecalis and P. micra. In the agar diffusion test, PAA showed a similar antibacterial efficacy as the one of CHX and a lower one as the one of NaOCl for E. faecalis.


Assuntos
Enterococcus faecalis , Hipoclorito de Sódio , Ágar , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Clorexidina/farmacologia , Clorexidina/uso terapêutico , Cavidade Pulpar , Firmicutes , Humanos , Ácido Peracético/farmacologia , Irrigantes do Canal Radicular/farmacologia , Irrigantes do Canal Radicular/uso terapêutico , Hipoclorito de Sódio/farmacologia , Hipoclorito de Sódio/uso terapêutico
17.
BMC Oral Health ; 22(1): 130, 2022 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-35429982

RESUMO

BACKGROUND: Cone-beam computed tomography (CBCT) was used to study the root canal system of mandibular anteriors (MAs) in a Cantonese population and to evaluate the correlation between the complicated root canal configurations of mandibular lateral incisors (MLIs) and the presence of distolingual roots (DLRs) in mandibular first molars (MFMs). METHODS: A total of 11,376 mandibular anterior teeth were scanned by CBCT. Those whose images met the inclusion criteria were first analysed according to Vertucci's root canal configuration and then grouped based on gender, age, and side, and their effects on root canal morphology were analysed. Finally, statistical analysis was used to evaluate the correlation between the complicated root canal configurations of MLIs and the existence of DLRs in MFMs. All statistical analyses were performed by using SPSS 25.0 software. Quantitative data are presented as the mean ± standard deviation. Student's t tests were used to calculate statistical significance. P < 0.05 was considered statistically significant. RESULTS: In MAs in the Cantonese population, all mandibular central incisors (MCIs) and MLIs had one root, and 0.37% of mandibular canines (MCs) had two roots. The most common Vertucci's root canal configuration was Vertucci I followed by Vertucci III. A total of 30.91% of MLIs and approximately 8% of MCIs and MCs have complicated root canal configurations. There were no significant differences in the prevalence of DLRs in MFMs and the incidence of complicated root canal configurations of MLIs between males and females or between the right and left teeth. However, a significant difference was found in different age groups of root canal configurations in MLIs. Moreover, significant ipsilateral and contralateral correlations between MFMs with DLRs and MLIs with complicated root canal configurations were observed on both sides. CONCLUSION: In Cantonese population, the possibility of complicated root canal configuration in MLIs was higher, when DLR appeared in MFMs.


Assuntos
Cavidade Pulpar , Raiz Dentária , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem
18.
BMC Oral Health ; 22(1): 145, 2022 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-35473630

RESUMO

BACKGROUND: This study aimed to evaluate the root canal configurations and the association between mandibular first molars and distolingual root (DLR) and mandibular incisors using cone-beam computed tomography (CBCT). METHODS: Mandibular first molars and incisors were evaluated using CBCT images of 150 patients. Mandibular first molars were classified according to the presence or absence of DLR. The curvature of the DLR was evaluated using Schneider's method in buccolingual and mesiodistal orientations. The angle of the mesiolingual-distolingual-distobuccal canal orifices (ML-DL-DB) was evaluated at the pulpal floor level. The mandibular central and lateral incisors were classified as either single canal or two canals. The association between the root canal system of the mandibular first molar and mandibular incisors was evaluated. Data were analyzed using the Chi-square test, Student's t-test, and odds ratios from binary logistic regression. The significance level was set at 5%. RESULTS: The frequency of mandibular first molars with DLR was 27.0% and that of mandibular incisors with two canals was 25.8%. The curvature of the DLR was 37.1° in the buccolingual orientation and 10.4° in the mesiodistal orientation. The angle of ML-DL-DB was 79.0°. The presence of two canal systems in mandibular incisors was associated with the presence of DLR in the mandibular first molar (left central incisors: p = 0.001, odds ratio = 4.25; left lateral incisors: p < 0.001, odds ratio = 3.8; right central incisors: p = 0.003, odds ratio = 3.86; right lateral incisors: p = 0.001, odds ratio = 3.44) but not with the curvature of the DLR or angle of the ML-DL-DB orifice (p > 0.05). CONCLUSIONS: The mandibular first molar showed a high incidence of separate DLRs. It was confirmed that DLR in the mandibular first molar is highly associated with the presence of two-canal system in the mandibular incisors. This association can aid clinicians in successful endodontic treatments.


Assuntos
Incisivo , Raiz Dentária , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/diagnóstico por imagem , Humanos , Incisivo/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem
19.
Rev. Odontol. Araçatuba (Online) ; 43(1): 51-56, jan.-abr. 2022. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1361718

RESUMO

Este trabalho teve como objetivo apresentar um relato de caso clínico de uma restauração do tipo coroa endocrown cerâmica em um dente molar tratado endodonticamente. Paciente com 45 anos de idade, sexo feminino, procurou a clínica do Centro Universitário da Serra Gaúcha (FSG) relatando a necessidade de reabilitação protética no primeiro molar inferior do lado esquerdo. Com base no exame radiográfico e exame clínico foi constatado um primeiro molar inferior do lado esquerdo com tratamento endodôntico satisfatório, mas uma extensa destruição coronária. Após a aprovação da paciente e indicações para a utilização da técnica, optou-se pela confecção de uma coroa endocrown em cerâmica reforçada por dissilicato de lítio. Foi realizado o preparo do remanescente dentário, envolvendo a câmara pulpar, com ângulos arredondados e expulsivos e, após a moldagem do mesmo com silicone de adição, utilizando a técnica simultânea e duplo fio. O provisório foi realizado com resina quimicamente ativada na cor 62 e, na sessão seguinte a coroa endocrown foi ajustada e polida. Após receber o protocolo de condicionamento adequado da peça, a mesma foi cimentada com cimento autopolimerizável Multilink N. Pode-se concluir que a alternativa restauradora Endocrown é um tratamento conservador e favorável para dentes com extensa destruição coronária, permitindo adequada estética e função(AU)


This study aimed to present a clinical case report of an endocrown ceramic crown restoration in na endodontically treated molar tooth. A 45-year-old female patient sought the clinic at the Centro Universitário da Serra Gaúcha (FSG), reporting the need for prosthetic rehabilitation on the lower left first molar. Based on the radiographic and clinical examination, the first molar presented satisfactory endodontic treatment, but extensive coronary destruction. After the approval of the patient and indications for the use of the technique, it was decided to make an endocrown with reinforced ceramic by lithium disilicate. The remaining tooth was prepared, involving the pulp chamber, with rounded and expulsive angles and, after the impression with silicone using the simultaneous and double wire technique was taken. The provisional was made with chemically activated resin in color 62 and, in the following session, the endocrown crown was adjusted and polished. After receiving the proper conditioning protocol, it was lutted with Multilink N self-curing cement. It can be concluded that the Endocrown restorative alternative is a conservative and favorable treatment for teeth with extensive coronary destruction, allowing adequate aesthetics and function(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Cerâmica , Dente não Vital , Coroas , Dente Molar , Prótese Dentária , Cavidade Pulpar , Retenção da Prótese
20.
Stomatologiia (Mosk) ; 101(2): 19-24, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35362698

RESUMO

OBJECTIVE: To study the coupling of age-related systemic changes in inflammation-mediated apoptosis with the features of the anatomy of the pulp system of the first mandibular molars in patients with chronic pulpitis and periodontitis. MATERIAL AND METHODS: The study included 55 patients of both sexes from 18 to 75 years of age in three age groups - young (18-44 years) (n=17), middle (45-59 years) (n=18), elderly (60-74 years) (n=20) with indications for endodontic treatment. Diagnostic measures were supplemented with New Tom 3G cone-beam tomography. The concentration of anitapoptotic protein Bcl-XL and tumor necrosis factor-a (TNF-a) was determined in the blood, and the level of the nuclear transcription factor NF-KB subunit p65 was determined in the lysates of mononuclear cells. RESULTS: As a result of the analysis of the sections, significant obliteration of the pulp was revealed throughout and an increase in the frequency of occurrence of slit-shaped channels in the distal root of the first molar of the mandible in elderly patients. CONCLUSION: The pathogenetic factors leading to a change in the morphology of the pulp system include old age and an imbalance in the system of anti-inflammatory cytokine transcription mechanisms, which contributes to increased apoptosis and the protracted nature of inflammation.


Assuntos
Cavidade Pulpar , Dente Molar , Adolescente , Adulto , Idoso , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/anatomia & histologia , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Raiz Dentária/anatomia & histologia , Adulto Jovem
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