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2.
Sci Rep ; 14(1): 13205, 2024 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851745

RESUMO

The evidence base on minimally invasive endodontic (MIE) treatment is limited. This study investigated the influence of MIE shaping on vertical root fracture (VRF) resistance and crack formation of root canal filled teeth. Human maxillary central incisors were randomized into six groups (n = 18, power = 0.9) and embedded in acrylic blocks with artificial periodontal ligaments. The root canals were either instrumented to size #40 and 0.04 taper (+MIE) or enlarged to ISO size #80 (-MIE). The canals were filled with cement-based (C) or adhesive resin-based (A) sealers in single-cone technique. The controls received no treatment or were left unfilled. After chewing simulation (staircase method, 25-150 N, 120,000×), the crack formation on the root surface was analyzed using stereomicroscope/digital imaging and classified (no defect, craze line, vertical crack, horizontal crack). Subsequently, the samples were loaded until fracture. The incidence of defects (56% vertical cracks) was not significantly different between the groups (p ≥ 0.077). VRF resistance was significantly higher in untreated teeth than in +MIE/C (p = 0.020) but did not significantly differ between the other groups (p ≥ 0.068). Minimal canal shaping did not reduce the risk of vertical root fracture and defects of root canal filled teeth.


Assuntos
Fraturas dos Dentes , Raiz Dentária , Humanos , Raiz Dentária/lesões , Tratamento do Canal Radicular/métodos , Incisivo/lesões , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Preparo de Canal Radicular/métodos , Preparo de Canal Radicular/efeitos adversos
3.
Clin Oral Investig ; 28(7): 362, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38849655

RESUMO

OBJECTIVES: This randomized clinical trial aimed to compare the effect of intracanal medicaments on the incidence of postoperative pain and flare-up with posttreatment apical periodontitis (PTAP) of retreatment cases. MATERIALS AND METHODS: One hundred twenty patients diagnosed with PTAP with single-rooted teeth with single-canal without spontaneous pain or swellings were included and randomly divided into three groups according to the intracanal medicament used. Intracanal medicaments were placed into the root canals following the removal of previous root canal fillings and re-instrumentation. Calcium hydroxide (Ca (OH)2), chlorhexidine gel (CHX), calcium hydroxide and chlorhexidine gel combinations were used as intracanal medicaments. Postoperative pain scores were recorded at 6 and 12 h and 1, 2, 3, 4, 5, 6, and 7 days using a visual analog scale (VAS). Sensitivity on percussion, spontaneous pain, swelling, antibiotic and analgesic requirements of the patients were evaluated during clinical examinations performed postoperatively after 2 and 7 days. RESULTS: There were no statistically significant differences between groups in terms of VAS scores following the intracanal medicament application (p > 0.05). However, compared to the patients of 20-34 and 50-65 age groups, greater VAS scores were observed in patients of 35-49 age groups at 12 h, and 3, 4, 7 days (p < 0.05). Flare-up was observed in only one patient in the CHX gel group, and no flare-up was observed in other groups. CONCLUSIONS: Similar postoperative pain incidence in all experimental groups indicates that all three medicaments are clinically acceptable in inter-appointment management of retreatment cases in terms of post-endodontic pain and flare-up. CLINICAL RELEVANCE: In this randomized clinical trial, three different intracanal medicaments were utilized in nonsurgical endodontic retreatment and their effect on postoperative pain and flare-up incidence was examined. Thus, this study will be a significant contribution in the decision-making during clinical practice; since there are a limited number of prospective clinical trials in the literature about the severity of pain following retreatment procedures including intracanal medicament use.


Assuntos
Hidróxido de Cálcio , Clorexidina , Medição da Dor , Dor Pós-Operatória , Periodontite Periapical , Irrigantes do Canal Radicular , Humanos , Periodontite Periapical/cirurgia , Periodontite Periapical/terapia , Dor Pós-Operatória/tratamento farmacológico , Feminino , Masculino , Hidróxido de Cálcio/uso terapêutico , Clorexidina/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Adulto , Incidência , Pessoa de Meia-Idade , Resultado do Tratamento , Retratamento , Tratamento do Canal Radicular/métodos
4.
Clin Oral Investig ; 28(7): 359, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38844571

RESUMO

OBJECTIVES: The study aimed to identify the preferred management techniques used by dentists in Greece for treating deep carious lesions or pulp exposure during the removal of carious tissue in teeth with irreversible pulpitis. Additionally, the study sought to explore how patient-related factors (such as age and symptoms) and operator-related factors (like material choice and the use of antibiotics) influence these management decisions. MATERIALS AND METHODS: The questionnaire, developed by five investigators, was divided into two parts: the first gathered respondent demographics, and the second presented clinical scenarios of deep carious lesions, requesting treatment strategies, materials used, and antibiotic prescription practices. The scenarios described patients with intense spontaneous pain and very deep carious lesions, differentiated by age and tooth development status.Data collection was via Google Drive, with analysis performed using SPSS 28, Chi-square, and Fisher's exact tests, with significance set at p < 0.05. RESULTS: The study polled 453 Greek dentists about their treatment choices, for deep carious lesions in mature and immature teeth with irreversible pulpitis The majority favored root canal treatment for mature teeth, however quite a few opted for partial or cervical pulpotomy. MTA emerged as the preferred capping material, emphasizing its biocompatibility. Hemostasis management varied, with saline and sodium hypochlorite as popular choices. In cases of immature teeth, a shift towards vital pulp therapy was evident, reflecting a preference for preserving healthy pulp to avoid complex procedures. CONCLUSIONS: Challenges identified include varying treatment preferences, the significance of bleeding control in vital pulp therapy, and the limited use of antibiotics for irreversible pulpitis. While the study has limitations, including sample size and potential biases, its findings offer valuable insights into the decision-making processes of Greek dentists. CLINICAL RELEVANCE: Future research and ongoing education within the dental community could contribute to standardizing treatment approaches and optimizing outcomes for patients with deep carious lesions and irreversible pulpitis.


Assuntos
Cárie Dentária , Padrões de Prática Odontológica , Pulpite , Humanos , Grécia , Pulpite/terapia , Cárie Dentária/terapia , Inquéritos e Questionários , Padrões de Prática Odontológica/estatística & dados numéricos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Exposição da Polpa Dentária/terapia , Tratamento do Canal Radicular , Pulpotomia/métodos , Antibacterianos/uso terapêutico
6.
Clin Exp Dent Res ; 10(3): e881, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38798057

RESUMO

BACKGROUND: In conjunction with post placement in root-filled teeth with periapical healthy conditions, root canal retreatment may be performed to improve the seal of the root canal. Whether root canal retreatment for technical reasons (retreatments in teeth without apical periodontitis (AP)) results in lower frequency of AP is unknown. OBJECTIVE: To examine whether there is a difference in frequency of AP between roots with root canals retreated for technical reasons, and roots with root canals not retreated before post placement, with a minimum follow-up of 5 years. Also, to examine changes in root filling quality following root canal retreatment for technical reasons. METHODS: This retrospective study included radiographs of 441 root-filled roots without periapical radiolucencies at baseline, scheduled for post and core treatment. Follow-up data for a minimum of 5 years were available for 305 roots (loss to follow-up 30.8%), 46 of which were retreated for technical reasons. Two calibrated observers assessed root filling sealing quality and length, respectively, and periapical status according to the Periapical Index. The main outcome of the study, AP, was used as the dependent variable and all analyses were performed at root level. RESULTS: The overall frequency of AP at follow-up was 13.8%. The difference in frequency of AP between retreated (4.3%) and nonretreated (15.4%) root canals was not statistically significant, p = .061. Analyses including only roots with preoperatively inadequate root filling quality showed a statistically significant difference (p = .017) between the two treatment groups (2.4% vs. 22.9%). CONCLUSIONS: Root canal retreatment for technical reasons before post and core placement significantly reduces the frequency of AP in roots with inadequate root filling quality.


Assuntos
Periodontite Periapical , Técnica para Retentor Intrarradicular , Humanos , Estudos Retrospectivos , Periodontite Periapical/terapia , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Tratamento do Canal Radicular/métodos , Tratamento do Canal Radicular/estatística & dados numéricos , Tratamento do Canal Radicular/efeitos adversos , Retratamento/estatística & dados numéricos , Idoso , Seguimentos
7.
Int Endod J ; 57(7): 861-871, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38761098

RESUMO

Microorganisms are the primary aetiological factor of apical periodontitis. The goal of endodontic treatment is to prevent and eliminate the infection by removing the microorganisms. However, microbial biofilms and the complex root canal anatomy impair the disinfection process. Effective and precise endodontic therapy could potentially be achieved using advanced multifunctional technologies that have the ability to access hard-to-reach surfaces and perform simultaneous biofilm killing, removal, and detection of microorganisms. Advances in microrobotics are providing novel therapeutic and diagnostic opportunities with high precision and efficacy to address current biofilm-related challenges in biomedicine. Concurrently, multifunctional magnetic microrobots have been developed to overcome the disinfection challenges of current approaches to disrupt, kill, and retrieve biofilms with the goal of enhancing the efficacy and precision of endodontic therapy. This article reviews the recent advances of microrobotics in healthcare and particularly advances to overcome disinfection challenges in endodontics, and provides perspectives for future research in the field.


Assuntos
Biofilmes , Desinfecção , Humanos , Desinfecção/métodos , Robótica , Endodontia/métodos , Endodontia/instrumentação , Periodontite Periapical/terapia , Periodontite Periapical/microbiologia , Tratamento do Canal Radicular/métodos , Tratamento do Canal Radicular/instrumentação , Cavidade Pulpar/microbiologia
8.
Eur J Paediatr Dent ; 25: 1, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38804663

RESUMO

BACKGROUND: Dilaceration can lead to impaction of maxillary incisors, resulting in both aesthetic and functional problems. This case report presents the multidisciplinary approach to managing an inverse impacted dilacerated left lateral incisor in a 9-year-old male patient. CASE REPORT: The orthodontic alignment of the remaining three incisors was achieved within six months. After using the diode laser to remove the gingiva covering the right lateral incisor during alignment process, a lingual button was bonded. The primary left canine and the impacted permanent left lateral incisor were extracted by raising the full-thickness mucoperiosteal flap, followed by the transplantation of the dilacerated lateral incisor into its correct position, splinted to the adjacent central incisors using composite resin. Root canal treatment was performed after the apical plug was created with mineral trioxide aggregate. The composite splint was removed after three weeks, and a new bracket was bonded to the left lateral incisor. It was left passively for 18 months until the permanent canines started to erupt. Light orthodontic forces were then applied for six months, and a passive eruption was expected over three months to properly position the canines within the dental arch. After an 11-year follow-up, the incisor displayed no clinical symptoms, although radiographic examination revealed external resorption in the long-term. CONCLUSION: This case demonstrates the successful and fast autotransplantation of an immature inverse impacted dilacerated incisor, highlighting the long-term clinical success and favorable aesthetic outcomes.


Assuntos
Incisivo , Dente Impactado , Humanos , Masculino , Criança , Incisivo/anormalidades , Dente Impactado/cirurgia , Dente Impactado/terapia , Seguimentos , Transplante Autólogo , Tratamento do Canal Radicular/métodos , Maxila/cirurgia , Resinas Compostas , Lasers Semicondutores/uso terapêutico , Dente Canino/anormalidades , Compostos de Cálcio/uso terapêutico , Óxidos/uso terapêutico , Combinação de Medicamentos , Compostos de Alumínio , Silicatos
9.
J Clin Pediatr Dent ; 48(3): 171-176, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38755996

RESUMO

To explore a new method to implant deciduous tooth pulp into the canal of young permanent teeth with necrotic pulps and apical periodontitis for the regenerative endodontic treatment of tooth no: 41 in a 7-year-old male. Briefly, 1.5% Sodium Hypochlorite (NaOCl) irrigation and calcium hydroxide-iodoform paste were used as root canal disinfectant at the first visit. After 2 weeks, the intracanal medication was removed, and the root canal was slowly rinsed with 17% Ethylene Diamine Tetraacetic Acid (EDTA), followed by flushing with 20 mL saline and then drying with paper points. Tooth no: 72 was extracted, and its pulp was extracted and subsequently implanted into the disinfected root canal along with induced apical bleeding. Calcium hydroxide iodoform paste was gently placed over the bleeding clot, and after forming a mineral trioxide aggregate (MTA) coronal barrier, the accessed cavities were restored using Z350 resin composite. The root developments were evaluated via radiographic imaging at 6 months, 1 year and 5 years after treatment. Imaging and clinical analysis showed closure of the apical foramen, thickening of the root canal wall, and satisfactory root length growth. Autologous transplantation might be useful to regenerate dental pulp in necrotic young permanent teeth.


Assuntos
Compostos de Alumínio , Compostos de Cálcio , Polpa Dentária , Incisivo , Dente Decíduo , Humanos , Masculino , Criança , Polpa Dentária/irrigação sanguínea , Compostos de Cálcio/uso terapêutico , Compostos de Alumínio/uso terapêutico , Óxidos/uso terapêutico , Combinação de Medicamentos , Necrose da Polpa Dentária/terapia , Silicatos/uso terapêutico , Seguimentos , Endodontia Regenerativa/métodos , Mandíbula/cirurgia , Hidróxido de Cálcio/uso terapêutico , Neovascularização Fisiológica , Tratamento do Canal Radicular/métodos , Irrigantes do Canal Radicular/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Periodontite Periapical/terapia , Periodontite Periapical/cirurgia , Hipoclorito de Sódio/uso terapêutico , Cavidade Pulpar , Hidrocarbonetos Iodados
10.
Clin Oral Investig ; 28(6): 316, 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38750289

RESUMO

OBJECTIVE: This study aimed to evaluate the fracture strength of teeth restored using fiber-reinforced direct restorative materials after endodontic treatment with a conservative mesio-occlusal access cavity design. MATERIALS AND METHODS: A total of 100 extracted intact mandibular first molars were selected and distributed into a positive control group where teeth left intact and the following four test groups comprised of teeth with conservative mesio-occlusal access cavities that had undergone root canal treatment (n = 20/group): access cavity without restoration (negative control), bulk-fill resin composite with horizontal glass fiber post reinforcement, fiber-reinforced composite with bulk-fill resin and bulk-fill resin composite. Following thermocycling (10,000 cycles), fracture resistance was measured using a universal testing machine. Statistical analyses (one-way analysis of variance and the Tamhane test) were performed, and statistical significance was set at p < 0.05. RESULTS: Groups with minimally invasive access cavities had lower fracture strength than intact teeth, regardless of the restoration material (p < 0.05). Fiber-reinforced composite groups demonstrated higher fracture strength than bulk-fill resin composite alone (p < 0.05). Fracture types varied among groups, with restorable fractures predominant in the fiber-reinforced composite groups. CONCLUSION: This study suggests that using fiber-reinforced composite materials, especially in combination with bulk-fill resin composites, can effectively enhance the fracture strength of endodontically treated teeth with conservative access cavities. However, using only bulk-fill resin composite is not recommended based on the fracture strength results. CLINICAL SIGNIFICANCE: When teeth that undergo endodontic treatment are restored using a conservative access cavity design and fiber-reinforced composite materials, especially in combination with bulk-fill resin composites, the fracture strength of the teeth can be effectively increased.


Assuntos
Resinas Compostas , Restauração Dentária Permanente , Análise do Estresse Dentário , Dente Molar , Fraturas dos Dentes , Dente não Vital , Resinas Compostas/química , Humanos , Dente não Vital/terapia , Fraturas dos Dentes/terapia , Restauração Dentária Permanente/métodos , Técnicas In Vitro , Mandíbula , Teste de Materiais , Vidro/química , Técnica para Retentor Intrarradicular , Preparo da Cavidade Dentária/métodos , Materiais Dentários/química , Tratamento do Canal Radicular/métodos
11.
Br Dent J ; 236(9): 718, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38730170
12.
Photobiomodul Photomed Laser Surg ; 42(5): 366-374, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38776543

RESUMO

Objective: The proposed study aims to compare the effectiveness of conventional endodontic treatment (ET) with that of ET associated with antimicrobial photodynamic therapy (aPDT) in patients with apical lesion. Methods: Controlled, double-blind, randomized clinical trial (RCT); superiority study with three parallel arms. Randomization will be conducted in exchange blocks of six, with allocation 1:1:1. The control group will receive conventional ET, while experimental group 1 (EG1) will receive conventional ET + aPDT with laser at 660 nm, fluence of 600 J/cm2; EG2 will receive conventional ET + aPDT with laser at 660 nm, fluence of 1200 J/cm2. The primary outcome will be canal disinfection before treatment, measured by analysis of colony formation (CFU/mL) and the success rate measured after 6 months on the clinical and radiographic evaluations. The mean and standard deviation will be calculated for continuous outcomes, and the CFU/mL mean between groups will be evaluated by ANOVA test. The Chi-squared test will be calculated for binary outcomes. A logistic regression analysis will be performed to assess differences in the success rate between groups, adjusted for the covariates. The Stata 18 software will be used, with a significance threshold of 5%. Conclusions: Few RCTs have evaluated the effectiveness of aPDT in root canal disinfection in patients with permanent dentition presenting apical lesion. New RCTs with larger numbers of participants are needed to support using aPDT as an adjuvant to conventional ET in root canal disinfection for routine use in clinical practice. The trial was registered prospectively in ClinicalTrials.gov (NCT05916859).


Assuntos
Desinfecção , Dente Molar , Fotoquimioterapia , Humanos , Fotoquimioterapia/métodos , Método Duplo-Cego , Desinfecção/métodos , Tratamento do Canal Radicular/métodos , Feminino , Masculino , Fármacos Fotossensibilizantes/uso terapêutico , Adulto , Cavidade Pulpar , Adolescente
13.
BMC Oral Health ; 24(1): 592, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38778368

RESUMO

BACKGROUND: Treating the coronal dens invaginatus (CDI) with pulp infection commonly involves the removal of invagination, which increases the risk of perforation and fracture, and compromises the tooth structure. Minimally invasive endodontic management of CDI is highly recommended. This report describes two cases of type II CDI with the application of personalized templates. CASE PRESENTATION: Two cases of type II CDI, affecting the main root canal in a maxillary canine and a lateral incisor, were diagnosed. A guided endodontics (GE) approach was applied. Cone-beam computed tomography and intraoral scans were imported and aligned in a virtual planning software to design debridement routes and templates. The MICRO principle (which involves the aspects of Mechanical (M) debridement, Irrigation (I), Access cavities (C), Rectilinear routes (R), and Obstruction (O)) was proposed for designing optimal debridement routes for future applications. The templates were innovatively personalized and designed to preserve the tooth structure maximally while effectively debriding the root canal. Root canal treatment with supplementary disinfection was then performed. The follow-up of the two patients revealed favorable clinical and radiographic outcomes. CONCLUSIONS: The GE approach could be a feasible method for preserving healthy dental structure while effectively debriding the root canal, thereby achieving successful and minimally invasive endodontic treatment for CDI.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Dens in Dente , Tratamento do Canal Radicular , Humanos , Dens in Dente/terapia , Dens in Dente/complicações , Dens in Dente/diagnóstico por imagem , Tratamento do Canal Radicular/métodos , Feminino , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Incisivo/anormalidades , Incisivo/diagnóstico por imagem , Desbridamento/métodos , Adolescente
14.
Sci Rep ; 14(1): 11621, 2024 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-38773252

RESUMO

Despite advancements in vital pulp therapy (VPT), a subset of cases fails to achieve desired outcomes. This study based on a previous large-scale cohort study involving 1257 VPT-treated teeth, aiming to describe the demographic data and clinical characteristics of all failed cases and their management protocols. Clinical records/images of 105 failed cases treated by a single endodontist (2011-2022) were examined, including 10 extracted teeth. Asymptomatic cases with PDL widening received no intervention, while others underwent management protocols, including (selective) RCT and (tampon) re-VPT. These retreatments were assessed for success (defined as radiographic evidence of healing) and survival (characterized by the retention/function of the treated tooth) using Kaplan-Meier analysis. While 51.4% of all initial failures were diagnosed due to symptoms, 48.6% were symptom-free. Notably, failed cases with symptomatic irreversible pulpitis, and apical periodontitis/widened PDL before initial treatment significantly outnumbered asymptomatic cases and normal PDL, respectively (P = 0.001). Moreover, most of the initial failures were observed in teeth with composite resin rather than amalgam restorations (P = 0.002). The success and survival rates for the management protocols were 91.78% and 95.79%, respectively, over an average follow-up period of 36.94 (± 23.30) months. RCT and re-VPT procedures provide successful outcomes for managing unsuccessful VPTs.


Assuntos
Dentição Permanente , Humanos , Masculino , Feminino , Estudos Retrospectivos , Adulto , Pessoa de Meia-Idade , Falha de Tratamento , Resultado do Tratamento , Pulpite/terapia , Polpa Dentária , Estimativa de Kaplan-Meier , Tratamento do Canal Radicular/métodos
16.
Rev. Odontol. Araçatuba (Impr.) ; 45(1): 43-49, jan.-abr. 2024. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1553264

RESUMO

A periodontite é uma doença inflamatória crônica dos tecidos de sustentação e proteção dos dentes. Em dentes posteriores, a perda de inserção pode resultar em vários graus de dano à furca, que se refere à destruição dos tecidos de suporte de dentes multirradiculares caracterizada por reabsorção óssea e perda de inserção no espaço interarradicular. Independente do grau de envolvimento da furca, o tratamento periodontal básico (RAR) é a primeira opção para estabilizar a periodontite, contudo, em algumas situações é utilizada uma terapia cirúrgica periodontal bastante conhecida: a rizectomia ou amputação radicular. O objetivo do trabalho é relatar o caso de uma amputação radicular de um dente comprometido periodontalmente, a fim de se preservar o elemento dentário. O dente 27 foi diagnosticado com periodontite, o que ocasionou a lesão de furca grau III. O tratamento endodôntico foi realizado prévio ao procedimento cirúrgico, viabilizando a amputação da raiz disto-vestibular deste elemento. A partir do relato deste caso, se pode concluir que a amputação radicular é considerada um procedimento conservador, capaz de manter em função molares com histórico de periodontite associado ao envolvimento de lesões de furca(AU)


Periodontitis is a chronic inflammatory disease of the supporting and protective tissues of the teeth. In posterior teeth, attachment loss can result in varying degrees of damage to the furcation, which refers to the destruction of the supporting tissues of multirooted teeth characterized by bone resorption and attachment loss in the interarticular space. Regardless of the degree of furcation involvement, basic periodontal treatment (RAR) is the first option to stabilize periodontitis; however, in some situations, a well-known periodontal surgical therapy is used: rhizectomy or root amputation. Rhizectomy is a treatment option for multirooted teeth. The technique preserves the crown and requires endodontic treatment of the affected tooth, preferably done before surgery(AU)


Assuntos
Tratamento do Canal Radicular , Raiz Dentária
17.
Gen Dent ; 72(3): 67-69, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38640009

RESUMO

This case report examines the atypical healing of an endodontic lesion without standard endodontic treatment, influenced by the patient's failure to attend treatment appointments. A 50-year-old woman with no notable medical history presented with a deep carious lesion on her mandibular right first molar, accompanied by localized pain. Citing forgetfulness as a reason, the patient missed her initially scheduled root canal treatment, necessitating an emergency intervention. The emergency treatment included access cavity preparation, irrigation with 5.25% sodium hypochlorite solution, application of a modified triple antibiotic paste (equal parts penicillin G, metronidazole, and ciprofloxacin), and temporary restoration with amalgam. A large apical lesion was detected in immediate postoperative radiographs. However, the patient failed to return for definitive endodontic treatment, due to a lack of symptoms and time for treatment. Follow-up examinations 1 and 5 years after emergency treatment disclosed gradual healing of the lesion, culminating in the establishment of a normal periodontal ligament. This case underscores the potential efficacy of a modified triple antibiotic paste and highlights the importance of a well-sealed coronal restoration in promoting the healing of endodontic lesions, even in the absence of pulpectomy and conventional root canal therapy. Additional research is needed to understand the mechanisms behind such healing events.


Assuntos
Periodontite Periapical , Humanos , Feminino , Pessoa de Meia-Idade , Periodontite Periapical/cirurgia , Preparo de Canal Radicular , Irrigantes do Canal Radicular , Antibacterianos/uso terapêutico , Tratamento do Canal Radicular
18.
Acta Odontol Scand ; 83: 190-196, 2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38660831

RESUMO

OBJECTIVE: The aim of this study was to explore the factors associated with the survival of root canal treated teeth in a practise-based study setting in a 5-year period. MATERIAL AND METHODS: This retrospective study used data from the electronic patient registration system of the public dental services of the City of Oulu, Finland. The inclusion criteria for this study were patients aged ≥ 20 years who had root canal treatment (RCT) that was initiated in 2014. One RCT per patient was included in the study. A total of 713 patients met the inclusion criteria. The outcome variable for this study was the extraction of the RCT tooth during the 5-year period. Explanatory variables included age, diagnosis, tooth type (incisive, canine, premolar, molar), RCT technique (manual, motorized), time from RCT initiation to final restoration and type of final restoration (composite, glass ionomer, fixed dental prosthesis). To evaluate the association between the outcome variable and explanatory variables, Cox regression analyses were performed. RESULTS: The overall survival rate was 91%. The middle-aged (40-59-years-old) and the oldest (60 and older) patients had a two-fold risk of extraction compared to younger (20-40-years-old) patients. Similarly, a short length of time from RCT initiation to final restoration (0-14 days) resulted in a nearly three times higher risk of extraction compared to a longer period (≥ 90 days). CONCLUSIONS: The 5-year survival rate of RCTs seems high. Extractions were more common among patients over 40 years of age and if the RCT was completed shortly after its initiation.


Assuntos
Sistema de Registros , Humanos , Pessoa de Meia-Idade , Finlândia/epidemiologia , Adulto , Feminino , Estudos Retrospectivos , Masculino , Tratamento do Canal Radicular/estatística & dados numéricos , Idoso , Dente não Vital , Adulto Jovem
19.
BMC Oral Health ; 24(1): 489, 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38658927

RESUMO

BACKGROUND: Up to 25% of the tooth extraction after root canal treatment could be attributed to the vertical root fracture (VRF). The treatment choice for teeth with VRF would mostly be the extraction despite some repairing methods were also reported. The repairing treatment result of VRF would mostly depend on the fixation strength and the bioactivity of the repairing materials, especially for the posterior teeth with high masticating stresses. This case report designed a novel surgical treatment approach for the VRF of posterior teeth. METHODS: a maxillary premolar with buccal-palatal complete VRF was treated with a new dual-layered repairing approach using adhesive resin + iRoot BP Plus bioceramic cement to fill the modified fracture line with retention forms through the intentional replantation. RESULTS: At the 24-month review, the tooth showed desirable periodontal healing and normal function. CONCLUSIONS: This case report indicated that the dual-layered repairing approach might be effective for saving the posterior teeth with VRF. Nevertheless, further clinical trials are needed for its long-term result.


Assuntos
Dente Pré-Molar , Fraturas dos Dentes , Raiz Dentária , Humanos , Fraturas dos Dentes/cirurgia , Raiz Dentária/lesões , Raiz Dentária/cirurgia , Dente Pré-Molar/cirurgia , Dente Pré-Molar/lesões , Masculino , Feminino , Reimplante Dentário/métodos , Tratamento do Canal Radicular/métodos
20.
J Coll Physicians Surg Pak ; 34(4): 390-393, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38576278

RESUMO

OBJECTIVE: To evaluate the efficacy of dexamethasone as a final intracanal rinse in relieving postoperative pain of teeth with symptomatic irreversible pulpitis. STUDY DESIGN: Randomised controlled trial. Place and Duration of the Study: Department of Operative Dentistry, PIMS, Islamabad, Pakistan, from June 2019 to December 2020. METHODOLOGY: Sixty patients aged 18- 50 years diagnosed with symptomatic irreversible pulpitis were selected according to the inclusion criterion. After obtaining informed consent, root canal therapy (RCT) was initiated under rubber dam. Pulpectomy was done followed by canal preparation. The lottery method was utilised for the division of patients. Group A (experimental) received dexamethasone (4mg/ml in 5ml syringe) as a final rinse, while Group B (control group) recalled after 1 week and asked whether their pain had relieved or not as a yes/no question. After data collection teeth were obturated and permanent restoration was placed. Data were analysed using Chi-square test. RESULTS: The efficacy of dexamethasone as a final intracanal rinse was greater than saline 86.67% and 20.0%, respectively (p < 0.05) in relieving postoperative pain in teeth with symptomatic irreversible pulpitis. CONCLUSION: Dexamethasone was proved to be more efficacious than saline in alleviating postoperative pain when used as a final intracanal rinse after canal instrumentation. KEY WORDS: Irreversible pulpitis, Dexamethasone, Postoperative pain, Pulpectomy.


Assuntos
Pulpite , Humanos , Pulpite/cirurgia , Tratamento do Canal Radicular/métodos , Dor Pós-Operatória/tratamento farmacológico , Preparo de Canal Radicular , Dexametasona/uso terapêutico
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