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1.
Vet Clin North Am Small Anim Pract ; 52(1): 185-220, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34838250

RESUMO

Endodontic therapy is intended to preserve the function of mature teeth with irreversible pulpitis or pulp necrosis or to maintain the vitality of endodontically compromised immature teeth. Standard root canal therapy and vital pulp therapy are 2 mainstays of endodontic treatment. Recent knowledge has improved the outcomes of endodontic treatment with newer materials, such as mineral trioxide aggregate. Composite or prosthodontic crown restoration is also a critical key to success.


Assuntos
Prostodontia , Pulpite , Animais , Pulpite/veterinária , Tratamento do Canal Radicular/veterinária
2.
Braz. j. oral sci ; 20: e213690, jan.-dez. 2021. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1281104

RESUMO

Aim: to develop a model for regenerative endodontics using newly-weaned Wistar rats immature molars with pulp necrosis to histologically describe the evolution of apical tissues following treatment with a bi-antibiotic paste, induced bloodclot formation and MTA. Methods: Ten 25-day-old female Wistar rats were divided into an initial control group (Ci) and two experimental groups in which pulp necrosis was experimentally induced on the left mandibular first molar by exposing the pulp chamber and leaving it open to the oral environment. One of the experimental groups was left untreated (E1) while the other was submitted to a protocol of regenerative endodontics 10 days thereafter (E2). Fifteen days after placement of a bi-antibiotic paste, bleeding was induced into the root canal space and MTA was placed upon. Animals were euthanized 30 days later. Right mandibular first molars served as an 80-day-old final control group (Cf). Each hemimandible was histologically processed to analyse parameters associated with root development. Statistical analysis was carried by means of ANOVA; p values below 0.05 were considered statistically significant. Results: baseline (i.e. 25-days old) mean root length and apical diameter of the distal root canal were 1.84±0.25 and 0.38±0.02mm respectively. Following the regenerative endodontic protocol, cells lining the walls of the root canal and significant increase to both length (2.37±0.22mm) and diameter (0.32±0.03 mm) were observed. Conclusions: newly-weaned Wistar rats serve as a suitable model to evaluate regenerative endodontic protocols. However, further research is needed in order to disclose the nature of the cells and/or cell mediators involved


Assuntos
Animais , Ratos , Tratamento do Canal Radicular , Necrose da Polpa Dentária , Endodontia Regenerativa , Antibacterianos
3.
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 39-44, set.-dez. 2021. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1291668

RESUMO

O objetivo do presente estudo in vitro foi avaliar, por meio de radiografia digital, a qualidade de preenchimento dos canais de dentes incisivos bovinos permanentes jovens quando realizado tampão apical com hidróxido de cálcio e MTA associados a outros materiais e posteriormente obturados. Foram utilizados dentes incisivos permanentes bovinos com rizogênese incompleta preparados de forma manual com as limas tipo K, irrigados com hipoclorito de sódio 1% e soro fisiológico. Após, foram utilizados os materiais indicados para confecção do tampão apical: hidróxido de cálcio P.A associado ao propilenoglicol e ao iodofórmio; hidróxido de cálcio P.A juntamente com MTA e propilenoglicol e somente MTA, em seguida obturados com cones de guta percha e cimento AH Plus e radiografados para avaliação. Os dados foram submetidos ao teste Qui-Quadrado de Pearson e Teste exato de Fisher com nível de significância de 5%. Os resultados obtidos não apresentaram diferença estatisticamente significativa entre os três grupos, sendo que o valor resultado foi de p=0,442, porém o grupo composto pelo cimento de hidróxido de cálcio P.A associado ao MTA e propilenoglicol apresentou uma qualidade de preenchimento boa (100 %) em relação aos outros cimentos avaliados, que se mostraram satisfatório (40%) e bom (60%) no procedimento de apicificação. Não houve diferença significativa de qualidade de preenchimento de tampão apical nos grupos, no entanto o grupo composto pelo hidróxido de cálcio P.A. associado ao MTA e propilenoglicol apresentou resultado superior(AU)


The objective of the present in vitro study was to evaluate, through digital radiography, the quality of filling in the young permanent bovine incisor teeth canals when the apical buffer was performed with calcium hydroxide and MTA associated with other materials and subsequently filled. Permanent bovine incisor teeth with incomplete rhizogenesis were prepared manually with K files type, irrigated with 1% sodium hypochlorite and saline. Afterwards, the materials indicated for making the apical buffer were used: calcium hydroxide P.A associated with propylene glycol and iodoform; calcium hydroxide P.A together with MTA and propylene glycol and only MTA, then filled with gutta-percha cones and AH Plus cement and radiographed for evaluation. The data were submitted to the Pearson's Chi-square test and Fisher's exact test with a significance level of 5%, once the result value was p=0,442. The results obtained showed no statistically significant difference between the three groups, the result being p=0,442, however the group composed of calcium hydroxideP.A. cement associated with MTA and propylene glycol showed a good filling quality (100%) in relation to the other evaluated cements, which were satisfactory (40%) and good (60%) in apexification procedure. There was no significant difference in quality of plug apical filling in the groups, however the group composed of calcium hydroxide P.A cement associated with MTA and propylene glycol showed a superior result(AU)


Assuntos
Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Tratamento do Canal Radicular , Hidróxido de Cálcio
4.
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 32-38, set.-dez. 2021. ilus, tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1284132

RESUMO

A manutenção dos dentes decíduos na cavidade bucal até o período de sua esfoliação fisiológica é de extrema importância. A terapia endodôntica é um tratamento indicado quando a saúde do tecido pulpar é comprometida e diversas técnicas e materiais podem ser empregados para realizar a obturação de canais radiculares. O objetivo deste estudo in vitro foi comparar a qualidade do preenchimento dos canais radiculares utilizando diferentes técnicas de obturação e pastas obturadoras em dentes decíduos bovinos submetidos à pulpectomia. Foram selecionados 30 incisivos decíduos bovinos, e preparados através da técnica manual com posterior obturação dos canais radiculares por meio de duas técnicas e três pastas obturadoras. Os dentes foram divididos em 6 grupos (n= 5/ grupo) da seguinte forma: GI ­ Técnica manual e pasta de Hidróxido de Cálcio PA espessada com Óxido de Zinco; GII ­ Técnica manual e pasta Guedes-Pinto Modificada; GIII ­ Técnica manual e pasta Feapex®; GIV ­ Técnica com auxílio da lentulo e pasta de Hidróxido de Cálcio PA espessada com Óxido de Zinco; GV ­ Técnica com auxílio da lentulo e pasta Guedes-Pinto Modificada; GVI ­ Técnica com auxílio da lentulo e pasta Feapex®. Foram realizadas as radiografias digitais para verificar a qualidade do preenchimento dos canais radiculares. Os resultados obtidos apresentaram diferenças significativas na qualidade do preenchimento dos canais radiculares entre os grupos de dentes decíduos bovinos obturados. Considerando os resultados obtidos e a metodologia empregada, pode-se concluir que existe diferença entre as técnicas de obturação e pastas obturadoras(AU)


Maintaining primary teeth in the oral cavity until the period of their physiological exfoliation is extremely important. An endodontic therapy is a treatment indicated when the health of the pulp tissue is compromised and several techniques and materials can be used to perform root canal filling. The aim of this in vitro study was to compare the quality of root canal filling using different filling techniques and filling masses in primary bovine teeth implanted under pulpectomy. Thirty bovine primary incisors were selected and prepared using the manual technique with subsequente filling of the root canals using two techniques and three filling materials. The teeth were divided into 6 groups (n= 5 / group) as follows: GI - Technical Manual and Calcium Hydroxide Mass PA thickened with Zinc Oxide; GII - Manual technique and modified Guedes-Pinto pasta; GIII - Manual technique and Feapex® paste; GIV - Technique with the aid of lentulo and mass of Calcium Hydroxide PA thickened with Zinc Oxide; GV ­ Technique with the aid of lentulo and modified Guedes-Pinto mass; GVI - Technique with the aid of lentulo and Feapex® mass. Digital radiographs were taken to check the quality of the filling of the root canals. The resulting results dissipated in the quality of filling the root canals between the groups of primary bovine teeth filled. Know the results obtained and the methodology used, it can be concluded that there is a difference between filling techniques and filling masses(AU)


Assuntos
Pulpectomia , Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Dente Decíduo , Tratamento do Canal Radicular , Óxido de Zinco , Hidróxido de Cálcio , Cavidade Pulpar
5.
Georgian Med News ; (319): 28-31, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34749318

RESUMO

The article describes the effectiveness of the treatment of chronic apical periodontitis in one visit compared to multiple visits. A systematic review of the literature was conducted analyzing articles published on PubMed, Google scholar, ResearchGate and ScienceDirect between 2011 and 2021, treatment effectiveness was the selected outcome variable. A total of 21 articles were selected, 9 of which were selected for detailed review. Chief question in this article was: which treatment approach is more effective? Cleaning, Shaping, disinfecting and obturating in one visit? Or multiple (two) visit protocol? Chronic Apical Periodontitis is treatable in one visit, if done properly. Chronic Apical Periodontitis is treatable in one visit, if done properly, with proper shaping, disinfection, and proper hermetic obturation of the root canal. Bioceramic sealers showed the highest success rate out of all sealers used, the usage of 3-5.25% sodium hydrochloride and 17% ethylenediaminetetraacetic acid showed favorable results, although photodynamic therapy and ultrasonic activated irrigation showed outstanding results.


Assuntos
Periodontite Periapical , Periodontite , Cavidade Pulpar , Humanos , Periodontite Periapical/terapia , Preparo de Canal Radicular , Tratamento do Canal Radicular , Resultado do Tratamento
6.
Stomatologiia (Mosk) ; 100(5): 96-101, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34752043

RESUMO

In the scientific literature, one can find conflicting assumptions about the presence of «proper mental bone¼ and «upper and lower lingual canals¼, which make up a separate ossified area in the chin of the mandible and the system of blood supply and innervation. However, calling these lesions «lingual canals¼ or «incisal canals¼, as is often found in various articles, is incorrect based on the position of International Anatomical Terminology. This is due to the lack of topographic reference in the term, which can equally be understood as the canal of the tongue, the neurovascular bundle of the same name, and the root canal system of the teeth of the lower jaw and can also be associated with the maxilla. We searched for information in English, without time limits, in the PubMed Central database, and searched on Google and analyzed the bibliography, relevant studies and reviews. The selection of publications was carried out by request «mental spine canals¼, 58 articles were found in PubMed, of which 21 were relevant. For the analysis, publications were selected that described in detail the anatomical, clinical and radiological features of the structure of the anterior part of the mandible. As a result of previous studies and the study of literature data, the intraosseous structures of the anterior part of the lower jaw were refined and classified, which solve not only terminological disputes, but also are important clinical guidelines for endodontic treatment, dental implantation and local anesthesia.


Assuntos
Mandíbula , Maxila , Queixo , Humanos , Mandíbula/diagnóstico por imagem , Radiografia , Tratamento do Canal Radicular
7.
J Hist Dent ; 69(2): 99-103, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34734790

RESUMO

Leonard Koecker was outspoken in 1821 when he criticized the procedure of pulp extirpation and tooth retention, a procedure that had been advocated and practiced by Fauchard and others. He again registered his thoughts on this issue in 1826 in the publication of his textbook entitled "Principles of Dental Surgery". He claimed the tooth was dead and a repugnant foreign body that impacted on the surrounding living tissues. This controversial position ensued for close to a century, with advocates for Koecker's position, especially in the time of the Focal Infection and those opposed who favored a biological/scientific approach to this issue. Although today the desire to retain teeth through pulpal extirpation and proper root canal procedures is the treatment of choice when possible, it is common globally to frame the pulpless tooth as a dead tooth by both the dental professional and laypersons alike.


Assuntos
Dente não Vital , Dente , Humanos , Masculino , Pulpectomia , Tratamento do Canal Radicular
8.
J Hist Dent ; 69(2): 114-123, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34734792

RESUMO

Microbial control and tooth retention in dentistry have been paramount for all clinicians for over 130 years. However, in the late 1800s and early 1900s the dental profession was challenged to devise methods to eradicate microbial species from the root canal system if teeth were to be retained in symptom-free function. One system that was devised was electrosterilization and its variations, the roots and methods of which will be explored in this paper.


Assuntos
Cavidade Pulpar , Desinfecção , Tratamento do Canal Radicular
9.
Niger J Clin Pract ; 24(11): 1656-1661, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34782505

RESUMO

Background: Apical periodontitis (AP) is one of the most important prognostic factors in almost all endodontic outcome studies. The high prevalence of AP has been reported in different populations. Aims: The aim of the present study was to investigate (a) the overall prevalence of AP among all permanent teeth, (b) the differences between root canal-treated (RCT) and non-treated teeth in association with AP, and (c) the influence of gender on AP in a Saudi Arabian population using cone-beam computed tomography (CBCT). Materials and Methods: A total of 208 CBCT radiographs (including 5,504 permanent teeth) were investigated. The CBCT machine used in this study was a 3D Accuitomo 170 (Morita, Japan) with the following features: 90 kV, 5-8 mA, 17.5 s exposure time, and 0.25 mm voxel size. The radiographs of the axial, coronal, and sagittal segments of each tooth were acquired to evaluate the presence or absence of RCT teeth and AP. The data were presented as frequencies and percentages. Z test was used to analyze the differences in proportions at the significance level of P < 0.05. Results: The overall prevalence of AP was 4.5% (264 out of 5,504 permanent teeth). AP had the highest frequencies in the mandibular and maxillary first molars (18.4 and 9.3%, respectively) with a higher prevalence in the maxillary teeth. AP was associated with endodontically treated teeth more than the untreated ones (66.3% compared with 33.7%) with a highly significant difference (P < 0.001). AP was more prevalent in females than in males but with no statistically significant difference (P > 0.05). Conclusion: AP had a low prevalence (4.5%) in all permanent teeth and was highly associated with RCT teeth (66.3%). First molars had the highest prevalence of AP. Care must be taken when examining patient radiographs to avoid missing AP, particularly in RCT teeth.


Assuntos
Periodontite Periapical , Tomografia Computadorizada de Feixe Cônico Espiral , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Feminino , Humanos , Masculino , Periodontite Periapical/diagnóstico por imagem , Periodontite Periapical/epidemiologia , Prevalência , Tratamento do Canal Radicular/efeitos adversos
10.
Braz Dent J ; 32(4): 1-7, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34787245

RESUMO

This study evaluated the 3D quality of root-end filling, assessing the presence (volume and percentage) of marginal gaps and internal voids formed after retro-filling with three calcium silicate-based materials: MTA Angelus (Angelus Soluçoes Odontologicas, Londrina, PR, Brazil), Biodentine (Septodont Ltd., Saint Maur-des-Faussés, France) and Neo MTA Plus (Avalon Biomed Inc., Bradenton, Florida, US). Thirty human, extracted, single rooted teeth were used. Orthograde root canal treatment, root resection (3mm shorter than the apex) and retrograde cavity preparation with ultrasonic tips were performed. Teeth were divided into 3 groups (n =10 each) following a stratified randomization according to the initial volume of the root-end cavity. After retrofilling, samples were stored for 7 days. Then, two rounds of micro-CT scans were performed: soon after root-end preparation (with the cavity still empty) and 7 days after root-end filling. Marginal gaps, internal voids volume (mm3 and %), as well as, the overall defects (sum of gaps and voids) were evaluated. Statistics compared the three groups in relation to those defects. There was not statistical difference between groups regarding the marginal gaps (P≥ 0.05), the internal voids (P≥ 0.05), and the overall defects (P≥ 0.05). Median (mm3) and % of overall air-entrapment defects (gaps and/or voids) was: 0.004mm3 and 1.749% for MTA Angelus, 0.018mm3 and 6.660% for Biodentine, and 0.012mm3 and 4.079% for Neo MTA Plus. All materials had gaps and/or voids. No differences were found between MTA Angelus, Biodentine and Neo MTA Plus.


Assuntos
Materiais Restauradores do Canal Radicular , Compostos de Cálcio , Humanos , Obturação do Canal Radicular , Tratamento do Canal Radicular , Silicatos , Microtomografia por Raio-X
11.
Kathmandu Univ Med J (KUMJ) ; 19(74): 168-172, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34819430

RESUMO

Background Endodontics is considered as one of the most difficult and stressful disciplines in dentistry. This might be due to the complex anatomical variations, recent advances in equipment, technology, materials and lack of self-confidence. Objective To determine the self-confidence level among the intern dentists in performing endodontic procedures from six different colleges of Kathmandu University, Nepal. Method A descriptive cross-sectional study was conducted among 145 intern dentists. The online questionnaire regarding confidence level (5 point Likert scale) in different endodontic procedures and difficulty level (easy, ok and difficult) with respect to teeth was distributed. For descriptive purpose, frequency and percentage for each response were calculated. Result Dental interns were confident in performing majority of the normal endodontic procedures, however, they showed less confidence in performing difficult steps like rubber dam application for anterior (74, 51%) and posterior tooth (91, 62.7%), use of electronic apex locator (89, 61.4%), using rotary files (114, 78.6%), management of flare-ups (86, 59.4%), assessment of quality of post-endodontic treatment (85, 58.5%), recall periods (75, 51.6%) and performing post and core (82, 56.6%). Likewise, upper first molars (84, 57.9%) and second molars (104, 71.7%) were found to be the most difficult teeth to treat. Conclusion It can be concluded that majority of the dental interns were confident in performing basic endodontic procedures, however, they were found to have low confidence in performing difficult steps. Further training and exposure should be incorporated to increase their confidence level.


Assuntos
Endodontia , Tratamento do Canal Radicular , Estudos Transversais , Odontólogos , Humanos , Nepal , Inquéritos e Questionários
12.
Indian J Dent Res ; 32(2): 216-220, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34810392

RESUMO

Aim: This study aimed to evaluate and compare the possibility of regaining pulp sensibility and objectives of regeneration procedure in mature necrotic teeth using regenerative endodontics. Materials and Methods: A total of 36 mature necrotic teeth were selected and a regenerative endodontic procedure was performed. A total of four groups, each involving n = 9 teeth per group were randomly grouped as (1) periapical bleeding, (2) platelet-rich fibrin (PRF), (3) collagen, and (4) hydroxyapatite. Pulp testing and radiographic assessment of periapical healing (PH) were recorded at every 3-month interval for 1 year. Readings were compared as qualitative data using the Kruskal-Wallis test to see the inter-group significant difference. Results: Readings of pulp sensibility revealed non-significant results in all intervals. At 3 and 6 months, 22.3% in the PRF group and 11.15% in collagen group; and at 9 months, 44.4% in PRF group, 33.3% in the collagen group and 22.2% in hydroxyapatite group; and at 12-months, 66.6% in PRF, 44.4% in the collagen group, 33.3% in the hydroxyapatite group and 11.1% in the periapical bleeding group showed a positive response to the cold test. But all groups did not show a positive response to heat and electric pulp testing and showed good PH in all groups at the end of 12 months. Conclusions: The presence of sensibility to cold test is indicative of the formation of vital pulp-like tissues, which was the highest in the PRF group, followed by the collagen, hydroxyapatite and periapical bleeding groups.


Assuntos
Fibrina Rica em Plaquetas , Endodontia Regenerativa , Polpa Dentária , Necrose da Polpa Dentária/terapia , Humanos , Tratamento do Canal Radicular
13.
Stomatologiia (Mosk) ; 100(5): 53-57, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34752035

RESUMO

The paper presents literature review and the analysis of three clinical cases of phantom root development. Phantom root is a rare complication occurring as a result of apical papilla detachment, usually after dental trauma. Some authors suggest regenerative endodontic procedure may contribute to phantom root development because of rude intervention in periapical tissues needed to induce apical bleeding required for intracanal blood clot formation. Phantom root is not an indication for endodontic treatment. The prognosis depends on initial root formation stage and root to crow length ratio at the time of trauma. In the majority of cases the teeth may be preserved, but continuous root development is not to be expected.


Assuntos
Necrose da Polpa Dentária , Periodontite Periapical , Humanos , Tratamento do Canal Radicular
14.
Artigo em Inglês | MEDLINE | ID: mdl-34639498

RESUMO

The aim of this study was to systematically review the root canal morphology and configuration (RCC) of mandibular canines (MaCa). The review was registered in the PROSPERO database (ID-272297) and it was carried out following the PRISMA guidelines. Three electronic databases (MEDLINE via PubMed, Embase, Scopus) were searched. Randomized controlled trials, cross-sectional, cohort, comparative, evaluation and validation studies have been included. The anatomical quality assessment (AQUA) tool was used for a quality assessment of the anatomical studies. Of 910 studies retrieved from the systematic search, 28 studies investigating RCCs were included. Most MaCa were single-rooted (87.9-100%), while two-rooted MaCa were present up to 12.1%. The 1-1-1/1 (35.8-96.4%) was the most commonly reported RCC, followed by 2-2-1/1 (0.2-22.0%) and 1-2-1/1 (0.9-20.0%). A high frequency of 1-1-1/1 RCC in MaCa has been described. Most systematic review reports confirm that two-rooted MaCa are found considerably less frequently than single-rooted ones.


Assuntos
Cavidade Pulpar , Mandíbula , Estudos Transversais , Humanos , Tratamento do Canal Radicular , Raiz Dentária
16.
Clin Oral Investig ; 25(11): 6027-6044, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34623506

RESUMO

OBJECTIVES: To assess related studies and discuss the clinical implications of endodontic access cavity (AC) designs. MATERIALS AND METHODS: A systematic review of studies comparing the fracture resistance and/or endodontic outcomes between different AC designs was conducted in two electronic search databases (PubMed and Web of Science) following the PRISMA guidelines. Study selection, data extraction, and quality assessment were performed. Meta-analyses were undertaken for fracture resistance and root canal detection, with the level of significance set at 0.05 (P = 0.05). RESULTS: A total of 33 articles were included in this systematic review. The global evaluation of the risk of bias in the included studies was assessed as moderate, and the level of evidence was rated as low. Four types of AC designs were categorized: traditional (TradAC), conservative (ConsAC), ultraconservative (UltraAC), and truss (TrussAC). Their impact on fracture resistance, cleaning/disinfection, procedural errors, root canal detection, treatment time, apical debris extrusion, and root canal filling was discussed. Meta-analysis showed that compared to TradAC, (i) there is a significant higher fracture resistance of teeth with ConsAC, TrussAC, or ConsAC/TrussAC when all marginal ridges are preserved (P < 0.05), (ii) there is no significant effect of the type of AC on the fracture resistance of teeth when one or two marginal ridges are lost (P > 0.05), and (iii) there is a significantly higher risk of undetected canals with ConsAC if not assisted by dental operating microscope and ultrasonic troughing (P < 0.05). CONCLUSIONS: Decreasing the AC extent does not necessarily present mechanical and biological advantages especially when one or more surfaces of the tooth structure are lost. To date, the evidence available does not support the application of TrussAC. UltraAC might be applied in limited occasions. CLINICAL RELEVANCE: Maintaining the extent of AC design as small as practical without jeopardizing the root canal treatment quality remains a pragmatic recommendation. Different criteria can guide the practitioner for the optimal extent of AC outline form which varies from case to case.


Assuntos
Preparo da Cavidade Dentária , Fraturas dos Dentes , Assistência Odontológica , Cavidade Pulpar , Humanos , Metanálise como Assunto , Dente Molar , Preparo de Canal Radicular , Tratamento do Canal Radicular , Revisões Sistemáticas como Assunto
17.
Pan Afr Med J ; 39: 218, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34630830

RESUMO

Introduction: this study aimed at finding out current practice of endodontics amongst Nigerian dentists undergoing postgraduate training (also referred to as dental resident doctors) in different institutions across the nation. Methods: a questionnaire-based, cross sectional study was conducted amongst dentists undergoing postgraduate training. Questions were asked on demographics, protocol for root canal treatment (RCT), materials employed in different stages. Opinions were also sought on satisfaction with their practice and training needs in endodontics. Data were analyzed with SPSS version 20.0 and presented as tables and charts. Significance level was set at p≤0.05. Results: ninety dentists undergoing postgraduate training (57 males and 33 females) with mean age of 34.81 ± 5.9 years participated in the study. Root canal treatment was mostly done in multiple visits in both single and multi-rooted teeth (p=0.01), only about 15% performed the procedure on multi rooted teeth. Sixty-five (72.2%) never used Rubber dam, stainless steel files were being used by 69%, step down technique of preparation by 53.9% and Sodium hypochlorite was the major irrigant (80%) used. Obturation was majorly with Cold lateral compaction technique (94%), 57.2% delayed definitive restoration for maximum of 1 week and amalgam was still the major material used for posterior teeth as reported by 62.9% of the participants. The majority (55.6%) were not satisfied with their current knowledge and practice and most were those that did not have good undergraduate training (p = 0.05). Conclusion: the practice of endodontics needs standardization across the nation as it is being advocated in other countries. There is need for hands on-training on endodontics to encourage adoption of new advances in technology, as well as improve the training of postgraduate dentists in endodontics. Also, emphasis should be placed on use of rubber dam in order to minimize the spread of infection and protect the patients from aspiration of small instruments involved in endodontic procedure.


Assuntos
Odontólogos/estatística & dados numéricos , Educação de Pós-Graduação em Odontologia , Endodontia/organização & administração , Adulto , Estudos Transversais , Endodontia/educação , Feminino , Humanos , Masculino , Nigéria , Tratamento do Canal Radicular/estatística & dados numéricos , Diques de Borracha/estatística & dados numéricos , Inquéritos e Questionários
18.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(5): 555-559, 2021 Oct 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34636203

RESUMO

OBJECTIVES: This study aimed to investigate the common types and directions of root fractures of the maxillary first molar and the influence of root canal treatment on the prevalent sites of root fractures. METHODS: A total of 274 maxillary first molars with root fractures diagnosed via cone beam computed tomography were included. The root fractures of nonendodontically and endodontically treated teeth were identified to be spontaneous and secondary root fractures, respectively. The sites, types, and directions of spontaneous and secondary root fractures were determined. RESULTS: Among the spontaneous root fractures, the proportion of palatal root fractures (56.1%) was higher than those of mesial buccal root fractures (36.1%) and distal buccal root fractures (7.8%). Among the secondary root fractures, the proportion of mesial buccal root fractures (52.7%) was higher than those of palatal root fractures (36.5%) and distal buccal root fractures (10.8%). The distribution of predominant fracture sites was statistically significant (P<0.05), and vertical root fracture was the most common type. Palatal and buccal roots were commonly fractured at the mesiodistal and buccal-palatal directions, respectively. CONCLUSIONS: This study provided an epidemiological basis for the clinical features of root fractures of the maxillary first molar. During the dia-gnosis and treatment of the maxillary first molar, the possibility of palatal root fractures should be considered. The occurrence of mesial buccal root fractures may be related to root canal treatment. Therefore, the risk of mesial buccal root fractures caused by iatrogenic factors should be minimized.


Assuntos
Dente Molar , Dente não Vital , Tomografia Computadorizada de Feixe Cônico , Humanos , Tratamento do Canal Radicular , Raiz Dentária
19.
Cochrane Database Syst Rev ; 10: CD005517, 2021 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-34647617

RESUMO

BACKGROUND: Root canal therapy is a sequence of treatments involving root canal cleaning, shaping, decontamination, and obturation. It is conventionally performed through a hole drilled into the crown of the affected tooth, namely orthograde root canal therapy. When it fails, retrograde filling, which seals the root canal from the root apex, is a good alternative. Many materials are used for retrograde filling. Since none meets all the criteria an ideal material should possess, selecting the most efficacious material is of utmost importance. This is an update of a Cochrane Review first published in 2016. OBJECTIVES: To determine the effects of different materials used for retrograde filling in children and adults for whom retrograde filling is necessary in order to save the tooth. SEARCH METHODS: An Information Specialist searched five bibliographic databases up to 21 April 2021 and used additional search methods to identify published, unpublished, and ongoing studies. We also searched four databases in the Chinese language. SELECTION CRITERIA: We selected randomised controlled trials (RCTs) that compared different retrograde filling materials, with the reported success rate that was assessed by clinical or radiological methods for which the follow-up period was at least 12 months. DATA COLLECTION AND ANALYSIS: Records were screened in duplicate by independent screeners. Two review authors extracted data independently and in duplicate. Original trial authors were contacted for any missing information. Two review authors independently assessed the risk of bias of the included studies. We followed Cochrane's statistical guidelines and assessed the certainty of the evidence using GRADE. MAIN RESULTS: We included eight studies, all at high risk of bias, involving 1399 participants with 1471 teeth, published between 1995 and 2019, and six comparisons of retrograde filling materials. - Mineral trioxide aggregate (MTA) versus intermediate restorative material (IRM): there may be little to no effect of MTA compared to IRM on success rate at one year, but the evidence is very uncertain (risk ratio (RR) 1.09, 95% confidence interval (CI) 0.97 to 1.22; I2 = 0%; 2 studies; 222 teeth; very low-certainty evidence). - MTA versus super ethoxybenzoic acid (Super-EBA): there may be little to no effect of MTA compared to Super-EBA on success rate at one year, but the evidence is very uncertain (RR 1.03, 95% CI 0.96 to 1.10; 1 study; 192 teeth; very low-certainty evidence). - Super-EBA versus IRM: the evidence is very uncertain about the effect of Super-EBA compared with IRM on success rate at 1 year, with results indicating Super-EBA may reduce or have no effect on success rate (RR 0.90, 95% CI 0.80 to 1.01; 1 study; 194 teeth; very low-certainty evidence). - Dentine-bonded resin composite versus glass ionomer cement: compared to glass ionomer cement, dentine-bonded resin composite may increase the success rate of the treatment at 1 year, but the evidence is very uncertain (RR 2.39, 95% CI 1.60 to 3.59; 1 study; 122 teeth; very low-certainty evidence). Same result was obtained when considering the root as unit of analysis at one year (RR 1.59, 95% CI 1.20 to 2.09; 1 study; 127 roots; very low-certainty evidence). - Glass ionomer cement versus amalgam: the evidence is very uncertain about the effect of glass ionomer cement compared with amalgam on success rate at one year, with results indicating glass ionomer cement may reduce or have no effect on success rate (RR 0.98, 95% CI 0.86 to 1.12; 1 study; 105 teeth; very low-certainty evidence). - MTA versus root repair material (RRM): there may be little to no effect of MTA compared to RRM on success rate at one year, but the evidence is very uncertain (RR 1.00, 95% CI 0.94 to 1.07; I2 = 0%; 2 studies; 278 teeth; very low-certainty evidence). Adverse events were not assessed by any of the included studies. AUTHORS' CONCLUSIONS: Based on the present limited evidence, there is insufficient evidence to draw any conclusion as to the benefits of any one material over another for retrograde filling in root canal therapy. We conclude that more high-quality RCTs are required.


Assuntos
Cimentos de Ionômeros de Vidro , Tratamento do Canal Radicular , Adulto , Criança , Coroas , Humanos
20.
J Appl Oral Sci ; 29: e20201079, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34495106

RESUMO

OBJECTIVE: To examine the factors affecting the transitions through treatment interventions after failure of non-surgical root canal treatment (NS-RCT). METHODOLOGY: Insurance enrollment and claim information for enrollees of Delta Dental of Wisconsin (DDWI), USA were analyzed for 438,487 initial NS-RCT procedures to determine the effect of initial provider type and other covariates on additional treatments (no additional treatment, nonsurgical retreatment, surgical retreatment and extraction). A multi-state model was created using the "mstate" R package. Transitions between the four states identified by Code on Dental Procedures and Nomenclature were analyzed. Cox proportional Hazards regression stratified by transition type was used to estimate the effect of provider type on the risk of each transition, adjusting for covariates. RESULTS: The overall survival rates for all teeth that were treated by NS-RCT was 82.8% [95% CI 82.57%, 83.11%] at 10 years. Approximately, 7% of cases changed from the first state of initial NS-RCT during the 13-year study period with ultimately 0.9%, 0.4% and 5% of cases receiving non-surgical retreatment, surgical retreatment or extraction, respectively. Teeth are more likely to be retreated non-surgically than surgically, and to be extracted than retreated. In general, the probability of a tooth having non-surgical retreatment was higher if the initial provider was not an endodontist (Hazard Ratio (HR)=3.2). Molars were more likely to be non-surgically retreated (HR=2.0) or extracted (HR=2.8) when compared to anterior teeth. The probability of non-surgical retreatment (HR=0.93) or extraction (HR=0.50) was lower when a crown was placed within 90 days after NS-RCT. CONCLUSION: Most teeth remained in the same state after treatment with no additional treatment transitions. When a transition occurred, it was more likely to be an extraction. Type of provider, age, location of the tooth, gender, and time to placement of final restoration significantly influence treatment transitions.


Assuntos
Cavidade Pulpar , Dente não Vital , Humanos , Retratamento , Estudos Retrospectivos , Tratamento do Canal Radicular , Resultado do Tratamento
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