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1.
BMC Oral Health ; 22(1): 522, 2022 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-36457071

RESUMO

BACKGROUND: SATB2-associated syndrome (SAS; OMIM: 612,313) is an autosomal dominant inherited multisystemic disorder caused by several variants of the SATB2 gene. SAS is characterized by intellectual disability, developmental delay, severe speech anomalies, craniofacial anomalies, and dental abnormalities. Here, we report the dental phenotype of primary dentition of three Chinese children with SAS. CASE PRESENTATION: All three cases with SAS showed intellectual disability, speech and language anomalies, and palate anomalies. For the dental phenotype, all three cases showed macrodontia, crowded dentition, extensive caries, periapical abscesses and fistulas. Radiographs showed the wide-open root apex of deciduous teeth, loss of mandibular second bicuspids, delayed root formation of permanent teeth, rotated teeth, and taurodontism. Sanger sequencing of case 1 showed that there was a heterozygous code shift variation, c1985delT (p.F662Sfs*9) in the SATB2 gene, which has not been reported in literature. Root canal therapy, carious restoration, and teeth extraction were managed promptly, while preventive dental care was given regularly. CONCLUSIONS: The dental phenotype of primary dentition in SAS may show macrodontia, crowded dentition, severe caries, wide-open root apex of deciduous teeth, loss of mandibular second bicuspids, delayed root formation of permanent teeth, rotated teeth, and taurodontism. Regular oral hygiene instructions and preventive dental care are both required.


Assuntos
Deficiência Intelectual , Proteínas de Ligação à Região de Interação com a Matriz , Humanos , Fenótipo , Tratamento do Canal Radicular , Dente Decíduo , Fatores de Transcrição/genética , Proteínas de Ligação à Região de Interação com a Matriz/genética
2.
BMC Oral Health ; 22(1): 564, 2022 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-36463133

RESUMO

BACKGROUND: This study aimed to compare the efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from the artificial grooves in root canal walls. METHODS: The root canals of 50 extracted human maxillary incisors were instrumented by using the ProTaper rotary system up to #F4 (size 40/0.06 ProTaper) and the teeth were split longitudinally. Lateral grooves were created in the apical and coronal parts of one half and the middle part of the other half. Calcium hydroxide paste was applied to the grooves and the root halves were reassembled. After seven days, the calcium hydroxide was removed from the canal by using one of the EndoActivator, passive ultrasonic irrigation, and Ultra X devices; one group went without irrigation (control group). The CH remnants in the grooves were scored at 20× magnification. The data were analyzed by using the Kruskal-Wallis, Dunn's post hoc, and Friedman tests. P < 0.05 was considered to be statistically significant. RESULTS: No statistically significant difference existed among the experimental groups at the coronal and middle grooves (P > 0.05). However, Ultra X was significantly more effective than passive ultrasonic irrigation at the apical grooves (P = 0.023). CONCLUSION: Within the limitations of this study, Ultra X can be reported to remove the calcium hydroxide from the apical third more efficiently than passive ultrasonic irrigation.


Assuntos
Hidróxido de Cálcio , Ultrassom , Humanos , Hidróxido de Cálcio/uso terapêutico , Cavidade Pulpar , Projetos de Pesquisa , Tratamento do Canal Radicular
3.
BMC Oral Health ; 22(1): 566, 2022 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-36463149

RESUMO

BACKGROUND: Most existing studies comparing the efficiency of sonic irrigation (SI) and conventional needle irrigation (CNI) in increasing the penetration of sealers into dentine tubules are controversial; and this study aimed to determine whether the use of SI can lead to greater sealing ability than CNI, during the root canal treatment. METHODS: The EMBASE, PubMed, and Cochrane Library databases were used to find confocal laser scanning microscopy studies evaluating percentage and maximum depth of sealer penetration following the use of SI or CNI in mature permanent teeth until October 2022. The critical estimative checklist of randomized controlled trials of the standardized Joanna Briggs Institute was adopted to independently score the quality of each study. The random-effect model for meta-analysis was used to analyse for each canal segment (apical, middle, coronal). The results are shown in the forest plots as weighted mean differences (WMDs) with 95% confidence intervals (95% CIs). RESULTS: Ninety-seven articles were included in the preliminary screening, and nine of them were included in this study. Eight studies were included in the meta-analysis.The meta-analysis exhibited great increases in the coronal (WMD: 8.09, 95% CI 2.78-13.40/WMD: 165.32, 95% CI 128.85-201.80), and middle segments (WMD: 8.81, 95% CI 5.76-11.87/WMD: 132.98, 95% CI 68.71-197.25) for the percentage and maximum depth of sealer penetration, respectively. The percentage of sealer penetration in the apical thirds region was nonsignificant (WMD: 4.73, 95% CI - 2.34-11.80). However, the maximum depth of sealer penetration in the apical thirds region was significant (WMD: 121.46, 95% CI 86.55-156.38). Chi-squared analysis revealed heterogeneity scores of 0.0-70.0% and 44.0-90.0% for the percentage and maximum depth of sealer penetration, respectively. DISCUSSION: This review verified that SI significantly improves tubular dentin sealer penetration in most areas of the root canal; thus, SI may lead to better filling efficiency and anti-reinfection effects than CNI during and after the root canal therapy. Nevertheless, a large heterogeneity in the current data comparing the irrigation efficiency of SI versus CNI in the apical third of the root canal was found, implying the necessity to standardize root canal irrigation procedures and obtain more accurate results in this area. TRIAL REGISTRATION: INPLASY database (INPLASY202270116).


Assuntos
Tratamento do Canal Radicular , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Bases de Dados Factuais , Microscopia Confocal
4.
Rev. Odontol. Araçatuba (Impr.) ; 43(3): 40-47, set.-dez. 2022. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1381100

RESUMO

Introdução: A revascularização pulpar é uma terapêutica que visa regenerar parte do complexo dentino pulpar, proporcionando a continuidade do desenvolvimento radicular, sanando a fragilidade e propensão a fratura que a apicificação apresentava. É um tratamento direcionado a dentes diagnosticados com rizogênese incompleta. Entretanto, a possibilidade de realização da técnica em dentes maduros tem sido alvo de pesquisas e estudo. Objetivo: O objetivo deste estudo, é apresentar através da revisão de literatura e caso clínico, os benefícios dos procedimentos endodônticos regenerativos (REPs), em dentes jovens e maduros, em relação à apicificação. Metodologia: O estudo é uma revisão de literatura, desenvolvida através de pesquisa exploratória e realizada uma abordagem qualitativa. Para a coleta de dados, foi aplicada a técnica de análise documental e revisão bibliográfica consultando PUBMED, Scielo, Google Acadêmico e monografias acadêmicas. O caso clínico foi realizado de acordo com o protocolo atualizado pela AAE em 2016. Discussão: A revascularização pulpar tem mostrado ser um tratamento promissor na endodontia, é preconizada a desinfecção e medicação intracanal, já que não pode haver instrumentação mecânica. Os agentes irrigadores devem ser bactericidas, bacteriostáticos e devem ter baixo teor de toxicidade, já a medicação intracanal deve ter papel inibidor em bactérias gram positivas e gram negativas. Conclusão: A apicificação mesmo com o uso de MTA, que não exige trocas excessivas de medicações, não sana as necessidades que um dente com rizogênese incompleta requer. Sendo assim, a revascularização foi eleita o tratamento de melhor prognóstico para dentes jovens e necrosados. O caso clínico demonstrou qualidade moderada, no tratamento regenerativo em um dente maduro com reabsorção externa, abrindo novas perspectivas para os (REPs)(AU)


Introduction: Pulp revascularization is a therapy that aims to regenerate part of the pulp dentin complex, providing continuity of root development, remedying the fragility and propensity to fracture that apexification presented. It is a treatment aimed at teeth diagnosed with incomplete rhizogenesis. However, the possibility of performing the technique on mature teeth has been the subject of research and study. Objective: The aim of this study is to present, through literature review and clinical case, the benefits of regenerative endodontic procedures (REPs), in young and mature teeth, in relation to apexification. Methodology: The study is a literature review, developed through exploratory research and carried out a qualitative approach. For data collection, the technique of document analysis and bibliographic review was applied, consulting PUBMED, Scielo, Academic Google and academic monographs. The clinical case was performed according to the protocol updated by the SEA in 2016. Discussion: Pulp revascularization has shown to be a promising treatment in endodontics, intracanal disinfection and medication is recommended, as there can be no mechanical instrumentation. Irrigating agents must be bactericidal, bacteriostatic and must have a low level of toxicity, whereas intracanal medication must have an inhibiting role in gram positive and gram negative bacteria. Conclusion: Apexification, even with the use of MTA, which does not require excessive medication changes, does not meet the needs that a tooth with incomplete rhizogenesis requires. Therefore, revascularization was chosen as the treatment with the best prognosis for young and necrotic teeth. The clinical case demonstrated moderate quality in regenerative treatment in a mature tooth with external resorption, opening new perspectives for (REPs)(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Tratamento do Canal Radicular , Necrose da Polpa Dentária/terapia , Endodontia Regenerativa , Necrose da Polpa Dentária , Polpa Dentária , Apexificação
5.
Rev. Odontol. Araçatuba (Impr.) ; 43(3): 48-53, set.-dez. 2022. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1381107

RESUMO

A ciência endodôntica possui um vasto conhecimento e com esse conhecimento os seus inúmeros questionamentos. Algumas teorias e conceitos mudam constantemente e trazem à tona contradições e divergências clínicas no âmbito biológico e prático. A patência foraminal é uma prática que permite que um instrumento de pequeno calibre ultrapasse o forame apical, com o intuito de limpar passivamente e prevenir o acúmulo de detritos e inibir a proliferação de microorganismos que podem causar infecções pós tratamento endodôntico. Essa prática gera discussão interna entre especialistas da área, mas as vantagens da técnica são inúmeras, principalmente no que diz respeito aos casos de polpa necrosada. Casos como esse não são solucionados com sucesso sem a utilização da patência apical. Por outro lado, existem contradições em relação aos casos em que a polpa está viva. Esse trabalho tem como objetivo analisar as vantagens e desvantagens da patência apical, bem como, se os benefícios excedem os possíveis danos que ela pode trazer(AU)


Endodontic science has vast knowledge and with this knowledge its countless questions. Some theories and concepts are constantly changing and bring to light clinical contradictions and divergences in the biological and practical scope. Foraminal patency is a practice that allows a small-caliber instrument to go beyond the apical foramen, in order to passively clean and prevent the accumulation of debris in the region and inhibit the proliferation of microorganisms that can cause infections after endodontic treatment. This practice generates internal discussion among specialists in the field, but the advantages of the technique are numerous, especially with regard to cases of necrotic pulp. Cases like this are not successfully resolved without the use of apical patency. On the other hand, there are contradictions regarding the cases where the pulp is alive. This work aims to analyze the advantages and disadvantages of apical patency, as well as whether the benefits exceed the harm it can bring(AU)


Assuntos
Humanos , Masculino , Adulto , Tratamento do Canal Radicular , Ápice Dentário , Preparo de Canal Radicular , Infecções
6.
J Ayub Med Coll Abbottabad ; 34(3): 569-572, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36377178

RESUMO

BACKGROUND: Intentional replantation (IR) is a reliable and predictable treatment option for cases with failed non-surgical root canal treatment. The success of IR is found to be 52-95%. The current case is of 35years old female who presented with severe pain and swelling in lower right first mandibular molar with previously initiated non-surgical root canal treatment that resulted in instrument separation in mesio-buccal canal. Periapical radiograph showed rarefactions at furcation area, mesial and distal root apices. It was decided to complete the non-surgical root canal treatment followed by intentional replantation and retrograde filling with MTA. The tooth was found to be asymptomatic after two years follow up and periapical radiographs depicted complete healing. Intentional replantation with careful case selection is a successful, easy and reliable treatment option for hopeless cases. Atraumatic extraction, minimum extra-alveolar time and aseptic techniques during the procedure are the key factors for success of the procedure.


Assuntos
Dente Molar , Reimplante Dentário , Humanos , Feminino , Seguimentos , Dente Molar/cirurgia , Tratamento do Canal Radicular , Raiz Dentária
8.
Sci Rep ; 12(1): 19664, 2022 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-36385132

RESUMO

Treatment planning is key to clinical success. Permanent teeth diagnosed with "irreversible pulpitis" have long been implied to have an irreversibly damaged dental pulp that is beyond repair and warranting root canal treatment. However, newer clinical approaches such as pulpotomy, a minimally invasive and biologically based procedure have re-emerged to manage teeth with pulpitis. The primary aim of the study was to conduct a meta-analysis to comprehensively estimate the overall success rate of pulpotomy in permanent teeth with irreversible pulpitis as a result of carious pulp exposure. The secondary aim of the study was to investigate the effect of predictors such as symptoms, root apex development (closed versus open), and type of pulp capping material on the success rate of pulpotomy. Articles were searched using PubMed, Scopus, CENTRAL, and Web of Science databases, until January 2021. Outcomes were calculated by pooling the success rates with a random effect model. Comparison between the different subgroups was conducted using the z statistic test for proportion with significance set at alpha = 0.05. A total of 1,116 records were retrieved and 11 studies were included in the quantitative analysis. The pooled success rate for pulpotomy in teeth with irreversible pulpitis was 86% [95% CI: 0.76-0.92; I2 = 81.9%]. Additionally, prognostic indicators of success were evaluated. Stratification of teeth based on (1) symptoms demonstrated that teeth with symptomatic and asymptomatic irreversible pulpitis demonstrated success rate of 84% and 91% respectively, with no significant difference (p = 0.18) using z-score analysis; (2) open apex teeth demonstrated a significantly greater success rate (96%) compared to teeth with closed apex (83%) (p = 0.02), and (3) pulp capping materials demonstrated that Biodentine yielded significantly better success rates compared to Mineral Trioxide Aggregate (MTA), calcium hydroxide, and Calcium Enriched Mixture (CEM.) Collectively, this is the first meta-analytical study to determine the clinical outcome of pulpotomy for carious teeth with irreversible pulpitis and it's predictors for success. Moreover, we identify the stage of root development and type of biomaterial as predictors for success of pulpotomy.


Assuntos
Pulpite , Pulpotomia , Humanos , Pulpotomia/métodos , Pulpite/cirurgia , Dentição Permanente , Hidróxido de Cálcio , Tratamento do Canal Radicular
9.
BMC Oral Health ; 22(1): 494, 2022 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-36384745

RESUMO

BACKGROUND: This study aimed to assess and update the content, reliability, and information quality of content related to root canal treatment (RCTx) on YouTube and evaluate the correlation between each evaluation index. METHODS: YouTube was searched using two terms related to RCTx ("root canal and endodontic treatment"). A total of 240 videos (120 for each search term) were screened. Exclusion criteria were as follows: no sound or visuals, non-English, irrelevant to the search term, longer than 15 min, duplicate, or old (uploaded before 2016). After exclusion, 50 videos of "root canal treatment" and 45 videos of "endodontic treatment" were analyzed. Video length, total number of views, likes, dislikes, comments, and days since upload were recorded using descriptive video data. Viewers' interaction, reliability and information quality of the video, and quality of video content were measured using nondescriptive video data. The interaction index and video power index were used for viewer interactions, and the modified DISCERN index, JAMA criteria, and Global Quality Score were used to assess the reliability and information quality of the video. The quality of the video content was measured using the completeness score. RESULTS: The videos of the "root canal treatment" group had a significantly higher completeness score for the etiology and symptoms (p < 0.05), and videos of the "endodontic treatment" group showed a higher interaction index, completeness score for the procedure (p < 0.05). Videos for dentists had significantly higher completeness scores for the procedure, while videos for laypersons had higher completeness scores for etiology, anatomy, symptoms, and prognosis (p < 0.05). Furthermore, the total completeness score and the interaction index of the videos for laypersons were significantly higher (p < 0.05). The videos uploaded by the university had a significantly higher modified DISCERN index (p = 0.044), and the JAMA score was significantly higher in the commercial group (p = 0.001). CONCLUSIONS: Although the accuracy of videos related to RCTx was higher in videos by universities and professionals, the total completeness of YouTube videos was low regardless of the video source. Therefore, professionals should be responsible for providing more accurate and reliable videos.


Assuntos
Tratamento do Canal Radicular , Mídias Sociais , Humanos , Cavidade Pulpar , Disseminação de Informação/métodos , Reprodutibilidade dos Testes , Gravação em Vídeo
10.
J Appl Oral Sci ; 30: e20220199, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36417594

RESUMO

INTRODUCTION: Aiming to kill bacteria in dentin tubules of infected dental pulp cavities, we evaluated the effects of sodium hypochlorite (NaOCl) solution agitated by different irrigation protocols, i.e., conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), the EDDY tip, and the neodymium-doped yttrium aluminum perovskite (Nd:YAP) laser. The EDDY achieved good antibacterial effects as passive ultrasonic irrigation in the coronal and middle thirds. Nd:YAP laser irradiation and PUI were effective in the apical third of the root canal. OBJECTIVES: To evaluate the ability of NaOCl agitated by high-frequency sonic irrigation-EDDY, PUI, and Nd:YAP laser-to kill bacteria in infected root canal walls and if the associated temperature increases at the root surface during application. METHODOLOGY: Infected root canal models were established, and roots were randomly divided into six groups: negative control, positive control, CNI, PUI, sonic agitation with EDDY, and Nd:YAP laser groups. After irrigation, the teeth were split and stained using the LIVE/DEAD BacLight Bacterial Viability Kit. Dead bacteria depth was evaluated by a confocal laser scanning microscopy and the temperature at the root surface was assessed using a thermal imaging camera during the irrigation process. RESULTS: In the coronal and middle thirds of the root canal, PUI and EDDY had stronger antibacterial effects than CNI (p<0.05); in the apical third, the antibacterial effects of PUI and Nd:YAP laser-activated irrigation were better than CNI (p<0.05). The maximum change in temperature was significantly greater during continuous Nd:YAP laser application compared with the other methods, but intermittent irrigation helped lessening this trend. CONCLUSIONS: NaOCl agitated by EDDY tip and PUI exhibited a similar bacteria elimination effect in the coronal and middle root canal. Nd:YAP laser was effective in the apical third and intermittent irrigation reduced its thermal impact.


Assuntos
Cavidade Pulpar , Ultrassom , Tratamento do Canal Radicular , Bactérias , Antibacterianos
11.
BMC Oral Health ; 22(1): 504, 2022 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-36384556

RESUMO

BACKGROUND: Guided endodontics is a successful technique that has been gradually applied to endodontic therapy in recent years without being affected by the operator's experience. However, the guided bur produces excessive heat during continuous rotation and friction with root canal walls, it is not clear whether the degree of temperature increase may lead to the periodontal ligament and alveolar bone damage. METHODS: A total of 58 teeth were used, of which 40 teeth were not grouped, all used to evaluate the accuracy. 40 single-rooted premolars were scanned using CBCT and an intra-oral scanner, and 3D-printed guided plates were made with the pre-designed access. A custom-made guided bur was used to prepare the access cavities. The postoperative CBCT data and pre-designed pathways were matched to evaluate the deviation between the planned and virtual paths. The other 18 teeth were randomly divided into three groups (ET20 and ProTaper F3 as the control group, guided endodontics as the test group), with 6 teeth in each group. The temperature changes on the root surfaces were inspected with a thermocouple thermometer. RESULTS: The average deviation on the tip and the base of the bur was 0.30 mm and 0.28 mm (mesial/distal), and 0.28 mm and 0.25 mm (buccal/lingual). The average angle deviation was 3.62°. The mean root surface temperature rise of the guided endodontics group was the lowest (5.07 °C) (P < 0.05). CONCLUSIONS: The access cavity preparation performed with guided endodontics has feasible accuracy and low-temperature rise on the root surfaces. Due to the limitations of the study, whether it has high reliability and safety in clinical applications needs to be further studied in vivo.


Assuntos
Endodontia , Humanos , Temperatura , Reprodutibilidade dos Testes , Preparo da Cavidade Dentária/métodos , Tratamento do Canal Radicular
12.
J Dent ; 127: 104353, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36349644

RESUMO

OBJECTIVES: The aim of this systematic review was to evaluate how treatment plans changed when cone beam computed tomography (CBCT) imaging was used in endodontic treatment decision-making. DATA: Studies examining changes in clinicians' treatment plans with and without the use of CBCT were included. Risk of bias assessment was completed using a modification of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. SOURCES: A systematic search was performed in PubMed, Embase, Scopus, Cochrane databases from inception to 14 September 2021. STUDY SELECTION: The initial search identified 3379 titles and abstracts; 20 articles fulfilled inclusion and exclusion criteria for full text review. An additional three articles were identified through citation searching. Sixteen studies met inclusion and exclusion criteria for data extraction and analysis. Fifteen studies reported changes in treatment plan with CBCT imaging. Five studies reported changes in 45 - 66.7% of the cases but did not mention specific treatment options. Of the 11 remaining studies, 10 studies reported changes in 24.3 - 56% of cases and changes in treatment options, while one study reported no significant change in treatment plan after CBCT imaging was introduced. With CBCT imaging, clinicians were more likely to prescribe further intervention that included endodontic treatment and extractions. CONCLUSION: Although the current evidence was heterogeneous, it was clear that CBCT offered more information than periapical radiography. This influenced endodontic treatment decision-making and in more complex cases, led to further intervention including non-surgical and surgical endodontic treatment and extractions. CLINICAL SIGNIFICANCE: Additional information from CBCT imaging influenced endodontic treatment decision-making in the following situations: high difficulty cases, diagnosis of symptomatic teeth after failed root canal treatment, evaluation of periapical healing, pre-surgical treatment planning, and management of traumatised immature teeth and external cervical resorption.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Tratamento do Canal Radicular , Humanos , Tratamento do Canal Radicular/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Assistência Odontológica
13.
J Ayub Med Coll Abbottabad ; 34(Suppl 1)(3): S627-S631, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36414581

RESUMO

Background: Knowledge of tooth morphology is obligatory for achieving success in dental treatment. The root canal configuration of maxillary first premolar (MFP) has been shown to be highly varying. The study was conducted to assess the canal configurations in the roots of upper first premolars within a sample population of Peshawar with the help of tooth cross-sectioning method. Methods: The extracted 250 maxillary first premolars had undergone access cavity preparation after cleaning and pulp was removed from each individual tooth. The root canals were located in the pulp chamber floor and then India ink was injected in to their orifices. When the canals get stained the roots were cross sectioned at three levels to assess the configurations of root canals using a categorization method devised by Weine. SPSS version 19 was used to analyze the data. A p-value of less than 0.05 was considered statistically significant. . Results: Among 250 maxillary first premolars, the common root canal configuration was Weine's type-IV in 30.4% and type-III in 30.0% teeth. Weine's type-I and type II were observed in 24.8% and 8.8% premolars, respectively. Variable root canal configurations were seen in 6.0% teeth. Apical delta was found in 1 (0.4%) tooth. A highly statistically significant difference was observed when root canal configuration was compared with external root morphology. Conclusion: Weine's type-IV and type-III root canal configurations were frequently observed in maxillary first bicuspids.


Assuntos
Cavidade Pulpar , Raiz Dentária , Humanos , Dente Pré-Molar/anatomia & histologia , Raiz Dentária/anatomia & histologia , Maxila , Tratamento do Canal Radicular
14.
Artigo em Inglês | MEDLINE | ID: mdl-36360780

RESUMO

The main objective of this paper is to perform an updated literature review of guided endodontics based on the available up-to-date scientific literature to identify and describe the technique, its benefits, and its limitations. Four electronic databases (PubMed, Scopus, Science Direct, and Web of Science) were used to perform a literature search from 1 January 2017 to 13 May 2022. After discarding duplicates, out of 1047 results, a total of 29 articles were eligible for review. Guided endodontics is a novel technique that is currently evolving. It is applied in multiple treatments, especially in accessing and locating root canals in teeth with pulp canal obliteration, microsurgical endodontics, and removing glass fiber posts in endodontic retreatments. In addition, it is independent of an operator's experience, requires less treatment time for the patient, and is more accurate and safer than conventional endodontics.


Assuntos
Endodontia , Dente , Humanos , Tratamento do Canal Radicular , Assistência Odontológica , Cavidade Pulpar
15.
Medicina (Kaunas) ; 58(10)2022 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-36295597

RESUMO

Background and Objectives: There is limited information regarding comparison of long-term dynamics of periapical bone destruction estimated by digital periapical radiography (DPR) and by cone-beam computed tomography (CBCT). This study aimed to compare the radiographically assessed periapical changes of endodontically treated teeth over 2 years of follow-up and to analyse disagreements in periapical lesion size estimates around the same roots using DPR and CBCT. Materials and Methods: A total of 176 endodontically treated teeth, of 128 patients with apical periodontitis, were assessed by DPR and CBCT, at baseline and after 2 years. All periapical radiolucencies were categorised by severity (S0, S1, S2, S3) concerning their size. Descriptive statistics were used to report distribution of the radiolucencies at baseline and at follow-up, and their size transitions over 2 years. Site-specific comparison of the radiolucencies identified by two methods was performed using Z test and Pearson's chi-square test. Results: majority of the detected radiolucencies were scored as S0: 65% and 68% at baseline; 89% and 83% at follow-up, by DPR and CBCT, respectively. Site-specific score comparison showed that disagreements comprised 18% and 20% of the total number of radiolucencies detected by DPR and CBCT, respectively. There were more disagreements between DPR and CBCT within categories S1 and S2 + S3 compared to S0: at baseline, they comprised 17-33% and after two years 62-95% of all detected radiolucencies within the category. 65% of non-matching score transitions over two years occurred between S0 and S1. The CBCT-based evaluation resulted in negative treatment outcomes for 10 more root canals than the DPR-based result. Conclusions: Most remarkable disagreement between DPR and CBCT recordings was observed within the radiolucency categories S2 and S3. However, the diagnostic accuracy of both radiographic methods was questionable as it resulted in a high proportion of non-matching S0-S1 lesion transitions over 2 years.


Assuntos
Dente não Vital , Humanos , Estudos Prospectivos , Cavidade Pulpar , Tratamento do Canal Radicular/efeitos adversos , Tratamento do Canal Radicular/métodos , Tomografia Computadorizada de Feixe Cônico/métodos
17.
Niger J Clin Pract ; 25(10): 1681-1686, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36308239

RESUMO

Background: In a pulpectomy, the eradication of microbes from the primary root canal is accomplished through biomechanical preparation, which could be carried out with either manual or rotary instruments. Aims: The objective of this clinical trial was to evaluate the efficiency of manual K-files, H-files, and Kedo-S Square rotary files in reducing microbial flora after canal preparation in primary molars. Materials and Methods: This randomized clinical trial consisted of 45 primary molars requiring pulpectomy. The teeth were randomly allocated to one of the three groups: Group I: Manual K-files, Group II: Manual H-files, and Group III: Kedo-S Square rotary files, based on the type of instrumentation. Pre-and Post-instrumentation sampling was performed using clean absorbent paper points and kept in a clean Eppendorf tube having thioglycolate broth as the transport medium. Culturing was performed on agar media from which both aerobic and anaerobic microbial counts were estimated. Collected data were statistically analyzed using one-way analysis of variance (ANOVA) and Wilcoxon signed-rank test. Following root canal preparation, 87-89% reduction of the aerobic and anaerobic microbial load was noted in group I, whereas it was an 89-92% reduction in group II and a 93-95% reduction in group III. Results: Biomechanical preparation with Kedo-S Square rotary file showed higher efficacy in microbial reduction compared to manual instrumentation. Conclusion: Manual and rotary files were equally effective in removing root canal microbes. Biomechanical preparation with a KedoS Square rotary file resulted in greater microbial efficacy. Hence In children, effective root canal cleaning in a short period of time is a major consideration.


Assuntos
Preparo de Canal Radicular , Dente Decíduo , Criança , Humanos , Pulpectomia , Tratamento do Canal Radicular , Cavidade Pulpar
18.
Shanghai Kou Qiang Yi Xue ; 31(3): 300-304, 2022 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-36204961

RESUMO

PURPOSE: To investigate the short-term and long-term effects of all-ceramic onlay on restoration of premolars and its influence on dental function. METHODS: Ninety-five premolars receiving root canal treatment in People's Hospital of Peking University from January 2017 to January 2018 were enrolled, and randomly divided into two groups based on different repairing methods. Patients in the control group (n=47) received full crown restoration, while patients in the experimental group(n=48) received all-ceramic onlay restoration. The success, survival and failure rates of the teeth were compared. The United States Public Health Service(USPHS) and occlusal function of the prosthesis were compared 6, 12 and 36 months after treatment. The data were processed using SPSS 19.0 software package. RESULTS: The success and survival rate of the experimental group were higher than those of the control group, but without significant difference (P>0.05). The morphology, marginal integrity, marginal coloration, surface texture, secondary caries, gingival health and proximal contacts showed no significant difference between the two groups 12 months after treatment(P>0.05). Thirty-six months after treatment, the marginal integrity, marginal coloration and surface texture showed no significant difference between the two groups (P>0.05), while the morphology, secondary caries, gingival health and proximal contacts were significantly better in the experimental group than in the control group (P<0.05). The occlusal function between the affected side and contralateral side of both groups showed no significant difference 6, 12 and 36 months after treatment(P>0.05). CONCLUSIONS: All-ceramic onlay restoration of premolars has high success and survival rate, and good short-term and long-term restoration effect, which is beneficial to improve the occlusal function of the affected teeth.


Assuntos
Porcelana Dentária , Restaurações Intracoronárias , Dente Pré-Molar , Cerâmica , Falha de Restauração Dentária , Humanos , Restaurações Intracoronárias/métodos , Tratamento do Canal Radicular
19.
Shanghai Kou Qiang Yi Xue ; 31(3): 318-321, 2022 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-36204965

RESUMO

PURPOSE: To compare the curative effect of microscopic revascularization and apexification in the treatment of pulp necrosis of permanent teeth. METHODS: Seventy-five cases of pulp necrosis in young permanent teeth were divided into two groups according to different treatment methods. Group A (n=30) underwent revascularization under microscope, while group B (n=45) underwent apexification. The treatment effect and pain improvement of the two groups were compared. The changes of the wall thickness and root canal length of the affected teeth before and after treatment were observed, and the bone-like deposition rate after treatment was recorded. SPSS 23.0 software package was used for statistical analysis. RESULTS: There was no significant difference in the length of root canal between the two groups before treatment (P>0.05); there was no significant difference in the length of root canal in group B before and after treatment (P>0.05); the length of root canal in group A was significantly longer than that in group B 6 months after treatment(P<0.05). There was no significant change in the thickness of root canal wall in group B before and after treatment (P>0.05). The thickness of root canal in group A was significantly higher than that in group A 6 months after treatment (P<0.05). Bone-like deposition rate of group A was significantly higher than that of group B 1 month and 6 months after treatment (P<0.05). The total effective rate of group A and B was 90.00% and 84.44%, the difference was not statistically significant (P>0.05). The cure rate of group A was 70.00%, which was significantly higher than that of group B (48.89%, P<0.05). COCLUSIONS: Microscopic revascularization for pulp necrosis of young permanent teeth can effectively promote root development, lengthen root canal and increase the thickness of canal wall, which is better than apexification.


Assuntos
Apexificação , Materiais Restauradores do Canal Radicular , Apexificação/métodos , Necrose da Polpa Dentária/terapia , Humanos , Óxidos , Tratamento do Canal Radicular/efeitos adversos , Tratamento do Canal Radicular/métodos , Silicatos , Ápice Dentário
20.
PLoS One ; 17(10): e0275634, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36191029

RESUMO

BACKGROUND: To assess the quality of endodontic record-keeping and root canal obturation performed by undergraduate final year dental students during the COVID-19 pandemic. MATERIALS AND METHODS: Dental records and dental radiographs of patients who received endodontic treatments between March 2020 and March 2022 by undergraduate students during the COVID-19 pandemic were included. The audit data were collected based on the European Society of Endodontology guidelines retrospectively via assessing the patient's clinical records and intraoral periapical radiograph. Root canal obturation quality was evaluated based on the following parameters: adaptation, length, taper, and mishap. A root filling is defined as satisfactory only when all four parameters were graded as acceptable. Subsequently, the data were recorded and analysed using Chi-Square test with the level of significance set at p = 0.05. RESULTS: A total of 111 patient records with 111 root canal-treated teeth were evaluated. The highest percentage of documented evidence was noted in the patient's general records, while the endodontic treatment records showed the lowest percentage of documented evidence. 78 (70.3%) of root canal-treated teeth were deemed satisfactory with acceptable adaptation, length, taper, and absence of mishap. Moreover, no statistical significance in terms of root canal filling quality was noted between anterior and posterior teeth, and between maxillary and mandibular arch. CONCLUSIONS: Although patient records and root canal fillings quality were deemed satisfactory in most cases, strict documentation requirements and continuing dental education in audit training are necessary for quality assurance.


Assuntos
COVID-19 , Estudantes de Odontologia , COVID-19/epidemiologia , Cavidade Pulpar/diagnóstico por imagem , Humanos , Pandemias , Estudos Retrospectivos , Obturação do Canal Radicular , Tratamento do Canal Radicular
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