Influence of cervical preflaring on apical transportation in curved root canals instrumented by reciprocating file systems.

BACKGROUND: The aim of this study was to evaluate the influence of cervical preflaring on apical transportation in curved root canals prepared using the Reciproc and WaveOne reciprocating file systems. METHODS: Sixty curved canals were instrumented using Reciproc R25 and WaveOne Primary files, with and without preflaring (n = 15). A double-digital technique was used to digitally superimpose the file before instrumentation (#15 K-file) on the final apical reciprocating file (#25/08). The angle between the tip of the initial and final file was measured and recorded. Groups were compared using the Kruskal-Wallis test, and significance was set at p < 0.05. RESULTS: The mean and standard deviation for apical transportation was 0.93 ± 2.48 for the Reciproc Group, 0.84 ± 1.94 for the Preflaring + Reciproc Group, 0.40 ± 1.14 for the WaveOne Group, and 0.83 ± 2.20 for the Preflaring + WaveOne Group. No statistically significant differences were found among the groups (p = 0.9509). CONCLUSIONS: Under the conditions of this study, cervical preflaring did not influence apical transportation in curved root canals instrumented using Reciproc R25 and the WaveOne Primary files. Based on the in vitro measurements of apical transportation, the reciprocating files may be used without preflaring in curved root canals.

Apicoectomy after conventional endodontic treatment failure: case report

Introduction: Paraendodontic surgery is a safe and adequate alternative when teeth are not responding to conventional treatment and endodontic re-treatment. It must only be applied in specific situations. Endodontic treatment failures can be related to: extraradicular infections such as periapical actinomycosis; to foreign body reactions that can be caused by endodontic material extrusion; to endogenous cholesterol crystal accumulation in apical tissues; and unresolved cystic lesion. Paraendodontic surgery comprehends a set of procedures recommended in periapical diseases treatment, when traditional endodontic therapy does not obtain favorable outcomes. Objective: To report a clinical case where an apicoectomy was indicated due to failure in conventional endodontic treatment. Case report and Conclusion: Clinical case report of a tooth with unsatisfying conventional endodontic treatment history, due to lack of treatment in fourth root canal and an unsuccessful apicoectomy, since the lesion and the fistula had persisted. It was chosen to retreat tooth #26 and perform a new apicoectomy in the mesiobuccal root. The treatment was successful due to absence of fistula and painful symptoms and due to periapical bone repair.