428 resultados para Endodontic perforations


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The ability to tridimensionally evaluate pathological and anatomical areas, in apical surgery planning, presents a number of advantages. Cone beam computed tomography (CBCT) was developed for dental applications. This paper aims to present a literature review on CBCT, highlighting its advantages over both conventional computed tomography (CT) and radiography. Moreover, its clinical applications in apical surgery are discussed. LITERATURE REVIEW AND CONCLUSION: Unlikely CT, CBCT captures a volume of data in a single 360º rotation, providing benefits such as higher accuracy, better resolution, reduced scanning time and reduced radiation dose. In the maxillofacial region, CBCT has been mainly used in the assessment of dento-alveolar pathology and oral traumatology. CBCT provides a better diagnosis and quantitative information on periodontal bone levels than conventional radiography. It has also been used for patients requiring surgical facial reconstruction, orthognathic surgery, dental implants, and more complex tooth extractions. Besides that, it seems to be a significant tool in modern endodontic practice, presenting useful applications in apical surgery.

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To evaluate the effectiveness of isopropyl alcohol, saline or distilled water to prevent the precipitate formed between sodium hypochlorite (NaOCl) and chlorhexidine (CHX) and its effect on the bond strength of an epoxy-based sealer in radicular dentine. Methodology The root canals of 50 extracted human canines (n = 10) were instrumented. In G1, root canals were irrigated with 17% EDTA and 2.5% NaOCl; G2, as G1, except that 2% CHX was used as the final irrigant. In the other groups, intermediate flushes with isopropyl alcohol (G3), saline (G4) or distilled water (G5) were used between NaOCl and CHX. The specimens were submitted to SEM analysis to evaluate the presence of debris and smear layer, in the apical and cervical segments. In sequence, fifty extracted human canines were distributed into five groups (n = 10), similar to the SEM study. After root filling, the roots were sectioned transversally to obtain dentine slices, in the cervical, middle and apical thirds. The root filling was submitted to a push-out bond strength test using an electromechanical testing machine. Statistical analysis was performed using Kruskal–Wallis and Dunn's tests (α = 5%). Results All groups had similar amounts of residue precipitated on the canal walls (P > 0.05). The push-out bond strength values were similar for all groups, independently of the root third evaluated (P > 0.05). Conclusions Isopropyl alcohol, saline and distilled water failed to prevent the precipitation of residues on canal walls following the use of NaOCl and CHX. The residues did not interfere with the push-out bond strength of the root filling.

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Aim The aim of the present study was to evaluate the effect of three different formulations of sodium hypochlorite on the microhardness of root canal dentin in cervical and apical segments. Methods Twenty-four extracted human teeth had their roots sectioned along their long axes in a buccolingual direction. One half of each root was selected, and transversely sectioned resulting in two segments, cervical and apical, with similar lengths. The specimens were divided into three groups (n = 16), according to the sodium hypochlorite formulation used: (a) group 1, 2.5% sodium hypochlorite; (b) group 2, Chlor-XTRA; and (c) group 3, 5.5% sodium hypochlorite gel. These groups were subdivided in two subgroups (n = 8): cervical and apical root segments. Before testing the substances, dentin microhardness was measured on each section, 100 μm from the root canal with a Knoop tester. After 15 min of application, a new measurement was performed on each segment. Data were collected and registered for statistical treatment. Results In both segments, the substances reduced dentin microhardness. No differences were observed between the groups, independent of the analyzed segment (P > 0.05). Conclusions All substances reduced dentin microhardness. Chlor-XTRA and 5.5% sodium hypochlorite gel promoted a reduction similar to the 2.5% sodium hypochlorite solution.

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The adhesiveness of six root canal sealers: Acroseal, Endo CPM, Epiphany, White MTA, Sealapex and Sealer 26 to dentin, was evaluated in a push-out test design. Methods: Twenty eight roots of freshly extracted teeth were gauged with a size 5 Largo drill. With a cutting machine slices of 2 mm were prepared, rinsed with 5.25% NaOCl and a final rinse with 17% EDTA, dried and filled with one of the sealers. After setting their bond strength was measured in a mechanical testing machine. The data were statistically analyzed by using a One Way ANOVA and post hoc Tukey test. Results: The mean and standard deviation from values of bond strength was: Sealapex 2.2±0.4; Endo CPM 3.8±1.3; White MTA 6.0±1.4; Epiphany 10.9±2.6; Sealer 26 12.3±2.3; and Acroseal 12.2±1.4. Acroseal, Sealer 26 and Epiphany presented a significantly (P<0.01) greater bond strength compared with the other sealers. Also White MTA showed higher adhesiveness compared with Endo CPM and Sealapex (P<0.01). Conclusion: The bond strength between endodontic sealers and root dentin was maximal when Acroseal, Sealer 26 and Epiphany were used; Sealapex e Endo CPM, in turn, presented the lowest bond strength mean values.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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In the treatment of extrusive luxation cases, it is important that the repositioning of extruded tooth in the socket is done as soon as possible. If this does not occur, periapical clot becomes organized and makes replantation difficult reposition. In this article the patient referred to the Clinics for dental trauma sustaining extrusive luxation of the maxillary right central incisor. The patient reported having suffered a bicycle accident 12 days before, which caused traumatic tooth injuries. The repositioning was attempted without success and an alternative form of treatment was necessary to solve the case. Intentional tooth replantation, which is the deliberate extraction of the tooth and its replantation, was indicated. This technique allows clot removal and correct repositioning of the extruded tooth. Care should be taken as endodontic treatment is required for the prevention of subsequent infection-related resorption. Intracanal dressing with calcium hydroxide was used for 30 days before final root filling. Splint, systemic antibiotics and avoidance of further damage to the root surface is also important. After 49 months, showed clinical and radiographic characteristics of normality and demonstrates the availability of this technique to adversity in trauma.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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This study analysed the effect of pastes formulated with calcium hydroxide P.A. and different vehicles (saline solution - paste A and Copaifera langsdorffii Desfon oil - paste B) on oral microorganisms and dentin bridge formation in dogs. The antimicrobial action of the pastes and their components was analysed by the minimum inhibitory concentration in agar gel technique. The components were diluted and tested on fifteen standard strains of microorganisms associated with endodontic diseases. The microorganisms were cultivated and after incubation data was analysed using One-Way ANOVA and Turkey's test (P≤0.05). Four superior incisors of ten animals were used to evaluate dentin bridge formation. Two incisors were capped with paste A (GA) and two with paste B (GB). After 90 days, the teeth were extracted for histological analysis and the degree of dentin bridge formation evaluated. Data was analysed by the Kruskal-Wallis test (P<0.05). The pastes and their components were classified in the following decreasing order of antimicrobial action: calcium hydroxide P.A., paste A, paste B and Copaifera langsdorffii Desfon oil. Calcium hydroxide P.A. showed significantly higher antimicrobial action than the pastes or their vehicles. No significant difference was observed between the two pastes in dentin bridge formation. Based on the microorganisms studied, it can be concluded that the pastes analysed showed similar antimicrobial potential but differed significantly from their individual components. No significant difference was observed in dentin bridge formation between the different pastes tested.