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Sample records for apicoectomy

  1. Apicoectomy Versus Apexification

    OpenAIRE

    Chalakkal, Paul; Akkara, Francis; Ataide, Ida De Noronha De; Pavaskar, Rajdeep

    2015-01-01

    The aim was to evaluate treatment outcomes after apicoectomy and apexification in adjacent non-vital maxillary central incisors with large periapical radiolucencies, in a 10-year-old boy. The patient had complained of tenderness in the upper central incisors on mastication and gave a history of trauma to those teeth three years ago. On examination, there were found to be non-vital. Apexification (using Metapex) and apicoectomy (obturation with gutta percha) were performed on 11 and 21, respec...

  2. Apicoectomy versus apexification.

    Science.gov (United States)

    Chalakkal, Paul; Akkara, Francis; Ataide, Ida De Noronha De; Pavaskar, Rajdeep

    2015-02-01

    The aim was to evaluate treatment outcomes after apicoectomy and apexification in adjacent non-vital maxillary central incisors with large periapical radiolucencies, in a 10-year-old boy. The patient had complained of tenderness in the upper central incisors on mastication and gave a history of trauma to those teeth three years ago. On examination, there were found to be non-vital. Apexification (using Metapex) and apicoectomy (obturation with gutta percha) were performed on 11 and 21, respectively. Radiographical observations were made six months, one year and two years, post-operatively. Apical repair was found to be more favorable after apicoectomy than apexification, for a non-vital maxillary central incisor with an open apex and large periapical radiolucency. PMID:25859529

  3. Endodontic surgery: Evaluation of different techniques for accomplishment of apicoectomy

    OpenAIRE

    Flares BARATTO FILHO; Tomazinho, Paulo Henrique; Gisele Aihara HARAGUSHIKU; Denise Piotto LEONARDI; Flávia Sens FAGUNDES

    2006-01-01

    Apicoectomy is the surgery in which the apical resection of the dental root is carried through. Among the indications there are cases of ripped root that can prevent conventional treatment, perforations of the root into the third apical, presence of not filled ramifications and fractured endodontic instruments, whose treatments had been incapable to solve the problem by the root canal. The failure in the endodontic treatment is normally related with the presence of microorganisms in the depth...

  4. Apicoectomy after conventional endodontic treatment failure: case report

    Directory of Open Access Journals (Sweden)

    Lorena Oliveira Pedroche

    2013-06-01

    Full Text Available 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.

  5. Endodontic surgery: Evaluation of different techniques for accomplishment of apicoectomy

    Directory of Open Access Journals (Sweden)

    Flares BARATTO FILHO

    2006-11-01

    Full Text Available Apicoectomy is the surgery in which the apical resection of the dental root is carried through. Among the indications there are cases of ripped root that can prevent conventional treatment, perforations of the root into the third apical, presence of not filled ramifications and fractured endodontic instruments, whose treatments had been incapable to solve the problem by the root canal. The failure in the endodontic treatment is normally related with the presence of microorganisms in the depths of the root canal system,resistant to the procedures of cleanness and modeling. The objective of the present study was to make a literature review on the factors related to the technical resources, anatomical and histological conditions for the accomplishment of the apicoectomy. It was concluded that some factors influence for the success of the apicoectomy, among them: the root region in which the cut is made, the use of drills or laser in its confection and the involvement of the apical anatomical variations.

  6. Surgical treatment of cementoblastoma associated with apicoectomy and endodontic therapy: Case report.

    Science.gov (United States)

    Costa, Bernardo Cesar; de Oliveira, Guilherme José Pimentel Lopes; Chaves, Maria das Graças Afonso Miranda; da Costa, Renan Roberto; Gabrielli, Mário Francisco Real; Guerreiro-Tanomaru, Juliane Maria; Tanomaru-Filho, Mário

    2016-09-16

    This case report describes the surgical removal of cementoblastoma associated with apicoectomy and endodontic therapy. The patient, an 18-year-old man, presented pain in the region of the mandibular body on the right side. On clinical exam, bone expansion was observed in the region at the bottom of the vestibular sulcus, pain on palpation, slight extrusion of tooth 46 with presence of pulp vitality. Radiographic exams demonstrated the presence of a radiopaque area and discrete radiolucent halo associated with the root of tooth 46, suggesting the diagnosis of cementoblastoma. Endodontic treatment of tooth 46 was performed and exeresis of the lesion by apicoectomy. Twelve months after the first surgery, recurrence of the lesion was observed, and a new apicoectomy was necessary, this time up to the middle third of the root. Clinical radiographic control 12 mo after the second surgical intervention demonstrated absence of signs and symptoms, radiographic repair, with tooth 46 shown to be fully functional. PMID:27672646

  7. Apical leakage following CO2 laser apicoectomy and conventional amalgam retrofilling: a comparative study in vitro

    Science.gov (United States)

    Pinheiro, Antonio L. B.; Cavalcanti, P. H. H. A.; Brugnera, Aldo, Jr.

    1999-05-01

    To perform this study, 40 extracted single rooted human teeth were used to compare dye leakage between apicoectomy following amalgam retrofill and apicoectomy using CO2 laser irradiation. All the 40 teeth were endodontically treated and than were separate in two groups of 20 teeth each. A bur was used to ressect the apexes of the sample of group I followed by silver amalgam retrofill. the 20 teeth of group II had their apexes ressected with a Carbon Dioxide laser beam. All the samples were submerged into a methylene blue dye solution, washed, longitudinally sectioned and graded upon the level of leakage by two separate examiners. The result showed a perfect concordance between both examiners and also, a non significant difference on the level of leakage in the two groups.

  8. Evaluation quality of life after apicoectomy using two different flap design

    OpenAIRE

    Dimova, Cena; Popovska, Mirjana; Popovska, Lidija; Evrosimovska, Biljana

    2016-01-01

    INTRODUCTION. Apicectomy has become an integral part of a comprehensive dental treatment. The primary objective of apicectomy is to eradicate the etiological agents of periapical pathoses and to restore the periodontium to a state of biologic and functional health. MATERIAL AND METHOD. The study consisted of 60 patients referred for oral surgical treatment - apicoectomy with periapical osteotomy. All patients were given a questionnaire with 15 questions to evaluate their quality of lif...

  9. Evaluation quality of life after apicoectomy using two defferent flap design

    OpenAIRE

    Dimova, Cena; Popovska, Lidija; Popovska, Mirjana; Evrosimovska, Biljana

    2015-01-01

    INTRODUCTION. Apicectomy has become an integral part of a comprehensive dental treatment. The primary objective of apicectomy is to eradicate the etiological agents of periapical pathoses and to restore the periodontium to a state of biologic and functional health. The aim of this study was to evaluate patient experience of quality of life following apicoectomy using two different flap design gingival (envelope) and semilunar. MATERIAL AND METHOD. The study consisted of 60 patients ref...

  10. Is an apicoectomy ever successful? if so, under what conditions? A historical assessment with contemporary overtones.

    Science.gov (United States)

    Gutmann, James L

    2013-01-01

    In 1921, Dr. Thomas R Hinman of Atlanta, Georgia read a paper before the First district Dental Society in New York City that dealt with the management of infected teeth. Adherents of the theories of focal infection and elective localization advocated the extraction of teeth with necrotic pulps and particularly those with periapical lesions. In his presentation, Dr. Hinman overlooked the procedures of root amputation or apicoectomy (terms that were was synonymous at that time), stating that the technique had been abandoned as a failure by oral surgeons. Dr. Hinman later claimed that he had been misunderstood, and that what he really meant was that apicoectomy is only rarely successful. Out of this incident there appeared a lengthy symposium, with contributions from across the United States. While this debate ensued, the techniques of this procedure were being applied and evaluated in the European sector, with a number of treatises expounding on their versatility, acceptability, and applicability far beyond what was being addressed in the United States. This paper will focus on some of the unique historical perspectives from all parties, and clarify these perspectives relative to contemporary philosophies and rationales. PMID:23691774

  11. In-vitro study of the conventional and laser apicoectomy effects on dentin permeability

    Science.gov (United States)

    Paradella, Thais C.; de Mello, Guilherme P. E.; Munin, Egberto; Redigolo, Marcela L.; Pacheco, Marcos T. T.

    2001-10-01

    In the past years, lasers have become a special tool in dentistry. To study the effects of laser apicoectomy compared to the conventional surgical treatment, freshly-extracted single-root teeth were used, submitted to traditional endodontic treatment and divided into four groups: Group I, conventional apicoectomy using diamond burs; Group II, the same treatment as Group I, however, with a 15 second orthophosphoric acid application; Group III Er:YAG laser cut (10 Hz - 400 mJ); and finally, Group IV Er:YAG laser cut (10 Hz - 400 mJ) and surface treatment with Nd:YAG laser (10 Hz - 2 W). The samples were submitted to 2,5 % blue methylene dye solution, at 25 degree(s)C and 37 degree(s)C for 36 h and 18 h, respectively, and analyzed under optical microscope. The results show that Group II had the higher permeability of all the groups and Group IV had the lower one, due to the successful Nd:YAG laser surface treatment.

  12. A case of a benign cementoblastoma treated by enucleation and apicoectomy.

    Science.gov (United States)

    Gulses, Aydin; Bayar, Gurkan Rasit; Aydin, Cumhur; Sencimen, Metin

    2012-01-01

    Cementoblastoma is a rare, benign, odontogenic neoplasm of ectomesenchymal origin, representing less than 6% of all odontogenic tumors. Despite its well-known typical features, there are still controversies regarding the management of the condition. This article presents the case of a benign cementoblastoma in a 17-year-old girl. The lesion was typical and associated with the mandibular right first molar. Endodontic treatment of the involved tooth, enucleation of the cementoblastoma, and apicoectomy of the affected roots were performed. Removal of the tumor while preserving the associated tooth resulted in normal osseous healing and no evidence of recurrence after one year. Based on the findings of the current report, it can be suggested that, in properly selected cases, it is possible to remove cementoblastomas that affect molars without extracting the involved teeth. PMID:23220315

  13. Evaluation of Er:YAG, CO2, and Nd:YAG lasers on apical dentine permeability after apicoectomies

    Science.gov (United States)

    Careli de Castro, Fabiana; Gariba Silva, Ricardo; Marchesan, Melissa A.; Zanin, Fatima; Brugnera, Aldo, Jr.; Pecora, Jesus D.

    2004-05-01

    Apicoectomy is a surgical procedure that consists of radicular apex resection, eliminating periapical lesion. This study evaluated the effect of CO2 and Nd:YAG lasers on root dentine permeability after apicoectomy with Er:YAG laser. Forty-four single-rooted teeth, obtained from the Endodontic Laboratory stock from the Faculty of Dentistry of Ribeirao Preto, University of Sao Paulo, were used. The teeth were instrumented with the step-back technique, irrigated with 1.0% sodium hypochlorite and sealed with Sealer 26 (Dentsply, Brazil; lateral condensation. The samples were divided into four groups of 11 teeth each that had the root sectioned 2mm from the apex: G1 - roots were sectioned with a 4138 diamond bur with cooling; G2 - roots were sectioned with pulsed Er:YAG laser at the following parameters: 15 Hz and 250 mJ; G3 - roots were sectioned with pulsed Er:YAG laser and Nd:YAG laser (10 Hz, 100 mJ, and 1 W) was app0lied on the sectioned surface; G4 - roots were sectioned with pulsed Er:YAG laser and CO2 laser (5 W, 10 seconds ON and 20 seconds OFF) was applied to the sectioned surface. The teeth were then impermeabilized with cyanoacrylate and placed in 0.5% methylene blue for 7 days. The proximal surface of the samples was removed for exposure of the sealed root canal and dye penetration was measured by means of microscopic evaluation. The results showed a statistically significant difference at the level of 1%. We conclude that all treatments presented microleakage and can placed in increasing order: Er:YAG (G2), Bur (G1), Er:YAG + Nd:YAG (G3); Er:YAG laser presented the lowest microleakage values, showing its viability for clinical use in apicoectomies.

  14. Apicectomía quirúrgica: propuesta de un protocolo basado en la evidencia Surgical apicoectomy: proposed evidence-based protocol

    Directory of Open Access Journals (Sweden)

    Víctor Gómez-Carrillo

    2011-06-01

    Full Text Available Diversos refinamientos de la técnica quirúrgica de apicectomía han propiciado que su tasa de éxito haya aumentado de modo considerable. Se revisa la bibliografía científica para determinar cuáles de estos procedimientos son superiores. Se realiza un protocolo que aúna racionalmente esas técnicas, con lo que así se optimiza el resultado final de la intervención.Diverse refinements of the apicoectomy surgical technique have considerably increased the success rate of the procedure. The scientific literature was reviewed to identify the most relevant procedures for the final outcome of surgery. A protocol was prepared to facilitate the rational selection of technique, thus optimizing the surgical outcome.

  15. Evaluation of the permeability and morphological alteration of the dental surface after apicoectomy, treatment and preparation with Er:YAG and Nd:YAG lasers

    International Nuclear Information System (INIS)

    One of the objectives of endodontic treatment is to resolve pathological periapical processes caused by microbial contamination of the dental pulp. Correct execution of the necessary chemical preparation prior to surgery generally results in positive outcomes. However, a percentage of cases do not respond favorably and therefore require retreatment, a conservative therapeutic option. There are meanwhile a number of treatment failures which do not respond to these conservative measures and must therefore be subjected to paraendodontic surgical procedures. One of the principal problems of this therapeutic conduct is linked to the surface permeability of the dentin after apicoectomy and the lack of adequate marginal adaptation between the retrofilling material and the cavity walls. This permits the percolation of microorganisms and their metabolic by products from the system of root canals to the periapical region, thereby compromising the necessary tissue repair. The present work proposes the evaluation of the surface and marginal permeability of cut dentin after apicoectomy and treatment with Er:YAG and Nd:YAG lasers with fiber optics and then retrofilled with intermediate restorative material (IRM). A total of 24 single rooted teeth whose canals were endodontically treated were divided into 3 experimental groups: group I, whose apices were sectioned with an Er:YAG laser and the resulting cavity and the cut dental surface were irradiated with this laser via a 50/10 type fiber; in group II the apicoectomy was conducted with an Er:YAG laser and the resulting cavity and the cut surface were irradiated with a Nd:YAG laser; in group III, the samples were apicoectomized and the cavities were treated with a high speed bur (control group). Analysis of the infiltration of the dye methylene blue throughout the cut dental surface and the reconstruction demonstrated that the samples in the irradiated groups presented lower indices of infiltration than the control group. The

  16. Association of Er:YAG and Nd:YAG irradiation for apicoectomy and retrofilling cavity preparation compared to conventional technique: a permeability study

    Science.gov (United States)

    Camargo, Selma C. C.; Gavini, Giulio; Eduardo, Carlos d. P.; Aun, Carlos E.; Ribeiro, Luciano W.; Coil, Jeffrey M.

    1999-05-01

    The aim of this research was to evaluate dentin permeability effects at the apical cut surface prepared with Er:YAG laser and irradiated with Nd:YAG laser compared to conventional techniques. 62 extracted human teeth were divided into four groups of 7 teeth each. For Group 1 apicoectomy was performed using high speed handpiece and diamond burs. Group 2 was prepared as group 1 and lased with Nd:YAG (1W,15Hz of energy before retrograde cavity filling). For group 3 Er:YAG* laser irradiation (wavelength of 2.94μm, pulse width of 250-500μs)was used in 400mJ of energy, frequency of 6Hz, on focus mode under distilled water refrigeration and group 4 was performed as group 3 and lased with Nd:YAG (1W, 15Hz of energy before retrograde cavity filling). Permeability was evaluated by the extent of methylene blue dye penetration into the tubules. There were statistically significant differences in permeability between groups. Nd:YAG laser irradiation significantly reduced apical dentin permeability when compared to unlased groups. Er:YAG laser by itself showed higher percentage of dye penetration.

  17. In-vitro evaluation of Er:YAG laser irradiation in apicoectomy and retrofilling cavity preparation compared to two other techniques

    Science.gov (United States)

    Camargo, Selma C. C.; Gavini, Giulio; Eduardo, Carlos d. P.; Aun, Carlos E.; Coil, Jeffrey M.

    1998-04-01

    The aim of this research was to evaluate under SEM observation, the apical cut surface and retrofilling cavity prepared with Er:YAG laser and two other conventional techniques. Thirty extracted human teeth were divided into two groups of 15 teeth each. For Group 1 apicoectomy was performed using high speed handpiece and diamond burs. For Group 2 Er:YAG* laser irradiation (wavelength of 2.94 micrometer, pulse width of 250 - 500 microseconds) was used in 400 mJ of energy, frequency of 6 Hz, on focus mode under destiled water refrigeration. Each group was divided into 3 subgroups. For groups G1A and G2A, retrofilling cavity preparations were performed using low speed handpiece and burs, for groups G1B and G2B Enac technique was indicated. Groups G1C and G2C Er:YAG laser irradiation was used under same energy level previously described. All specimens were prepared for SEM observations. Pictures were taken under 30x and 600x magnification. Two different observers analyzed the smoothness and morphological appearance of those preparations. Data's were collected showing a smoothness surface, no debries or smear layer on group 2 (Laser irradiation) compared to group 1. Differences were also noted when retrofiling cavities were analyzed.

  18. Evaluation of the permeability and morphological alteration of the dental surface after apicoectomy, treatment and preparation with Er:YAG and Nd:YAG lasers; Avaliacao da permeabilidade e da alteracao morfologica da superficie dentinaria apos apicectomia, tratamento e retropreparo com os lasers de Er:YAG e Nd:YAG

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Rodrigo Guerra de

    2001-07-01

    One of the objectives of endodontic treatment is to resolve pathological periapical processes caused by microbial contamination of the dental pulp. Correct execution of the necessary chemical preparation prior to surgery generally results in positive outcomes. However, a percentage of cases do not respond favorably and therefore require retreatment, a conservative therapeutic option. There are meanwhile a number of treatment failures which do not respond to these conservative measures and must therefore be subjected to paraendodontic surgical procedures. One of the principal problems of this therapeutic conduct is linked to the surface permeability of the dentin after apicoectomy and the lack of adequate marginal adaptation between the retrofilling material and the cavity walls. This permits the percolation of microorganisms and their metabolic by products from the system of root canals to the periapical region, thereby compromising the necessary tissue repair. The present work proposes the evaluation of the surface and marginal permeability of cut dentin after apicoectomy and treatment with Er:YAG and Nd:YAG lasers with fiber optics and then retrofilled with intermediate restorative material (IRM). A total of 24 single rooted teeth whose canals were endodontically treated were divided into 3 experimental groups: group I, whose apices were sectioned with an Er:YAG laser and the resulting cavity and the cut dental surface were irradiated with this laser via a 50/10 type fiber; in group II the apicoectomy was conducted with an Er:YAG laser and the resulting cavity and the cut surface were irradiated with a Nd:YAG laser; in group III, the samples were apicoectomized and the cavities were treated with a high speed bur (control group). Analysis of the infiltration of the dye methylene blue throughout the cut dental surface and the reconstruction demonstrated that the samples in the irradiated groups presented lower indices of infiltration than the control group. The

  19. Apicoectomy after conventional endodontic treatment failure: case report

    OpenAIRE

    Lorena Oliveira Pedroche; Neisiana Barbieri; Flávia Sens Fagundes Tomazinho; Luciene Miranda Ulbrich; Denise Piotto Leonardi; Stephanie Martins Sicuro

    2013-01-01

    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. Paraendo...

  20. Fuji Ortho LC®: uma alternativa para retrobturações = Fuji ortho LC ®: an alternative for apicoectomy

    Directory of Open Access Journals (Sweden)

    Hellwig, Ingeburg

    2007-01-01

    Full Text Available A apicectomia com retrobturação apical é uma alternativa cirúrgica para tratamento de lesões apicais persistentes ou quando ocorre insucesso em terapia endodôntica convencional. Existe na literatura, um grande número de estudos sobre as técnicas para ressecções apicais, retrocavitações e materiais retrobturadores. Nesse estudo foram utilizados 10 dentes humanos unirradiculares tratados endodonticamente, apicetomizados, retrocavitados e retrobturados com um cimento de ionômero de vidro (Fuji Ortho LC®. O objetivo desse estudo foi verificar se o material testado preenchia as condições necessárias para ser utilizado como retrobturador. Os resultados revelaram que o Fuji ORTHO LC® é um material com propriedades suficientes para promover selamento adequado do conduto radicular quando usado em retrobturações apicais

  1. 補綴前処置として歯根端切除術を施した症例

    OpenAIRE

    片岡, 滋; 若松, 正憲; 土屋, 総一郎; 岩井, 啓三; 甘利, 光治

    1992-01-01

    Occasionally we cannot use non-surgical endodontics. At that time, depending on the circumstances, apicoectomy can be effective. This paper is a report of a case observation; the affected tooth, for which non-surgical endodontics could not be use, required apicoectomy. Namely, a post crown, difficult to remove, existed on the 2 tooth, causing a problem with the next tooth, therefore requiring apicoectomy and retrofilling at sealer and guttapercha point. After that, it was crowned with a porce...

  2. Traditional endodontic surgery versus modern technique: a 5-year controlled clinical trial.

    Science.gov (United States)

    Tortorici, Silvia; Difalco, Paolo; Caradonna, Luigi; Tetè, Stefano

    2014-05-01

    In this study, we compared outcomes of traditional apicoectomy versus modern apicoectomy, by means of a controlled clinical trial with a 5-year follow-up. The study investigated 938 teeth in 843 patients. On the basis of the procedure performed, the teeth were grouped in 3 groups. Differences between the groups were the method of osteotomy (type of instruments used), type of preparation of retrograde cavity (different apicoectomy angles and instruments used for root-end preparation), and root-end filling material used (gray mineral trioxide aggregate or silver amalgam). Outcome (tooth healing) was estimated after 1 and 5 years, postoperatively. Clinical success rates after 1 year were 67% (306 teeth), 90% (186 teeth), and 94% (256 teeth) according to traditional apicoectomy (group 1), modern microsurgical apicoectomy using burns for osteotomy (group 2) or using piezo-osteotomy (group 3), respectively. After 1 year, group comparison results were statistically significant (P apicoectomy resulted in a probability of success more than 5 times higher (odds ratio, 5.20 [95% confidence interval, 3.94-6.92]; P < 0.001) compared with the traditional technique. PMID:24469371

  3. 一次性根管充填加根尖切除治疗慢性根尖瘘管临床观察%CLINICAL OBSERVATION OF PERMANENT ROOT CANAL FILLING AND APICOECTOMY IN THE TREATMENT OF CHRONIC APICAL FISTULA

    Institute of Scientific and Technical Information of China (English)

    周云; 孙成科; 刘登祥

    2001-01-01

    目的观察一次性根管充填加根尖切除术治疗慢性根尖瘘管的临床疗效.方法对慢性根尖瘘管进行常规根充后,即刻行根尖切除术.结果治疗56颗患牙,随访2~3年,总成功率83.9%.结论:一次性根管充填加根尖切除术治疗慢性根尖瘘管,疗程短,治疗效果确切,操作简单,治愈率高.

  4. Stress distribution of single-root tooth after apicoectomy and its influencing factors%根切术后单根牙应力分布变化及(牙合)力方向对其影响的有限元研究

    Institute of Scientific and Technical Information of China (English)

    朱玥妮; 赵守亮

    2016-01-01

    目的 本课题利用三维有限元法,模拟上颌中切牙根切术后模型,并进行应力分析,继而评估不同咬合形态造成的不同咬合力方向,可能对此带来的影响.以期对临床病例的选择和预后提供理论依据.方法 建立上颌中切牙三维模型,继而根据根切术基本要求,模拟出根切术后模型和根切术骨完全愈合后模型,计3个模型;在Ansys Workbench有限元软件中按照一定的载荷条件,观测根切术前、后,不同受力方向下的应力分布和大小,并进行对比分析,了解应力变化趋势.结果 当加载情况相同时,根切术后即刻受力,牙颈部以及整体应力的最大值、分布情况,最大位移值均较完整牙齿增大,当根尖骨组织愈合完全,上述参数又有改善,但仍高于完整牙齿状态.而当所有条件一致时,载荷方向与牙长轴所成角度越大,整体应力水平越大,应力集中区域范围越大,总体位移值也越大.结论 根切术后即刻至根尖牙槽骨质完全愈合之前,较完整牙齿生物力学稳定性下降.在完全愈合后,稳定性又获得一定程度的改善.所以根尖区骨质的再生是关乎根切术成败也是维持术后牙齿机械稳定性的关键.咬合状态使患牙承受水平(牙合)力较大,根切术后带来的应力增加越大,选择根切术作为治疗方案时建议将咬合形态纳入考虑因素,避免造成应力集中,松动等不良后果.

  5. CO2, Er: YAG and Nd:YAG lasers in endodontic surgery

    Directory of Open Access Journals (Sweden)

    Daniel Humberto Pozza

    2009-12-01

    Full Text Available OBJECTIVES: CO2, Er:YAG and Nd:YAG lasers have been used in endodontic surgery. This in vitro study evaluated 1% Rhodamine B dye penetration using computer-assisted morphometry (ImageTool Software® of 108 endodontically treated human permanent canines. MATERIAL AND METHODS: Teeth were divided into 9 groups according to the technique used: A: 90-degree apicoectomy with bur, root-end cavity preparation with ultrasound and filled with MTA; B: 90-degree apicoectomy with bur, root-end cavity prepared with ultrasound and filled with MTA, and treatment of apical surface with CO2 laser (1 W, CW/CW; C: 90-degree apicoectomy with bur, and treatment of apical surface with Nd:YAG laser (150 mJ, 10 Hz; D: 90-degree apicoectomy with bur, and treatment of apical surface with CO2 laser,(1 W, CW/CW; E: apicoectomy with Er:YAG laser (400 mJ, 10 Hz, root-end cavity prepared with ultrasound and filled with MTA; F: apicoectomy with Er:YAG laser (400 mJ, 10 Hz and treatment of apical surface with Nd:YAG laser (150 mJ, 10Hz; G: apicoectomy with CO2 laser (5W, CW/SP, root-end cavity prepared with ultrasound and filled with MTA; H: irradiation of apical end with CO2 laser (1 W, CW/CW; I: irradiation of apical end with Nd:YAG laser (150 mJ, 10 Hz. RESULTS: Dye penetration was found in all specimens at different rates, the lowest penetration occurring in groups C (16.20%, B (17.24% and F (17.84%. CONCLUSIONS: Groups B, C and F represent the best technical sequences to perform endodontic surgery.

  6. com e sem remoção do delta apical

    Directory of Open Access Journals (Sweden)

    Guilherme Mello

    2006-01-01

    Full Text Available This study evaluated the apex cut and apical fusion by Nd:YAG laser at apical surgery. 24 human canines were endodontic treated and randomly divided into two groups. In A group the apicoectomy was performed at 90 degrees and 3mm from the apex extreme; in B group the apex was kept. Both groups were irradiated by Nd:YAG laser (10Hz, 150mJ, 60s. The results showed less infiltration to A group (p<0,001. When Nd:YAG laser apical fusion after apicoectomy were performed at the parameters of this study, best apical isolation is obtained.

  7. CO(2), Er: YAG and Nd:YAG lasers in endodontic surgery

    OpenAIRE

    Daniel Humberto Pozza; Patrícia Wehmeyer Fregapani; Cristina Braga Xavier; João Batista Blessmann Weber; Marília Gerhardt de Oliveira

    2009-01-01

    OBJECTIVES: CO(2), Er:YAG and Nd:YAG lasers have been used in endodontic surgery. This in vitro study evaluated 1% Rhodamine B dye penetration using computer-assisted morphometry (ImageTool Software) of 108 endodontically treated human permanent canines.MATERIAL AND METHODS: Teeth were divided into 9 groups according to the technique used: A: 90-degree apicoectomy with bur, root-end cavity preparation with ultrasound and filled with MTA; B: 90-degree apicoectomy with bur, root-end cavity prep...

  8. Enlargement of the apical gap after laser root resection

    Science.gov (United States)

    Mello, Guilherme P. S.; Paradella, Thais C.; Munin, Egberto; Mello, Jose B.; Pacheco, Marcos T. T.

    2000-11-01

    An apical filling material should establish, as perfect as possible, the hermetic sealing of an apical cavity. However, a gap is formed between the filling material (gutta-percha) and the root canal wall. The egress of irritants into the root canal system to the periapical tissues is considered the principal cause of fails in apicoectomy and retro-filling, being assumed that irritants penetrate mainly through the gap located between the gutta-percha and the dentin. In this paper, we report the observation of an enlargement of the apical gap, after laser apicoectomy, comparing to conventional apicoectomy. The samples were divided into groups, and the conventional apicoectomy group, together with the Er:YAG laser group (400 mJ/10 Hz) produced both similar results, being the gap unaltered. On the other hand, the samples that were irradiated with the Er:YAG laser, followed by Nd:YAG laser irradiation (1.5 W/10 Hz) presented a larger gap, conclusions that were drawn from Scanning Electronic Microscope analysis. The enlargement of the gap was due to the fusion of the dentin on the border, close to the gutta-percha. This pronounced behavior might have been caused by the surface discontinuity, imposing a non-homogeneous condition, in relation to heat propagation, existing many clinical applications of these observations.

  9. Results of intentional replantation of molars

    NARCIS (Netherlands)

    Raghoebar, GM; Vissink, A

    1999-01-01

    Purpose: This study evaluated the treatment outcome of intentional replantation of molars. Patients and Methods: Twenty-nine patients were treated with intentional replantation because conventional apicoectomy was not possible. The success rate was judged by clinical and radiographic parameters. Res

  10. [Nonsurgical retreatment of lateral radiopacity after surgical treatment].

    Science.gov (United States)

    Arias de Luxan, A

    1990-01-01

    A case report is presented of an upper central incisor with incomplete endodontic procedure evidencing a radiolucent image that was treated by apicoectomy and retroamalgam. A year later the periapical lesion had healed completely but a new lateral radiolucency is observed. A reentry of the canal is performed eliminating the old obturating material, biomechanical preparation and obturation with sealer and thermo gutta-percha. The lesion was cured in nine months. PMID:1964068

  11. [Nonsurgical retreatment of lateral radiopacity after surgical treatment].

    Science.gov (United States)

    Arias de Luxan, A

    1990-01-01

    A case report is presented of an upper central incisor with incomplete endodontic procedure evidencing a radiolucent image that was treated by apicoectomy and retroamalgam. A year later the periapical lesion had healed completely but a new lateral radiolucency is observed. A reentry of the canal is performed eliminating the old obturating material, biomechanical preparation and obturation with sealer and thermo gutta-percha. The lesion was cured in nine months.

  12. An innovative approach for rubber dam isolation of root end tip: A case report.

    Science.gov (United States)

    Mittal, Sunandan; Kumar, Tarun; Mittal, Shifali; Sharma, Jyotika

    2015-01-01

    The success of an apicoectomy with a retrofilling is dependent upon obtaining an acceptable apical seal. The placement of the variously approved retrograde materials requires adequate access, visibility, lighting, and a sterile dry environment. There are instances, however, in which it is difficult to use the rubber dam. One such instance is during retrograde filling. This case report highlights an innovative technique for rubber dam isolation of root end retrograde filling. PMID:26069419

  13. An innovative approach for rubber dam isolation of root end tip: A case report

    Directory of Open Access Journals (Sweden)

    Sunandan Mittal

    2015-01-01

    Full Text Available The success of an apicoectomy with a retrofilling is dependent upon obtaining an acceptable apical seal. The placement of the variously approved retrograde materials requires adequate access, visibility, lighting, and a sterile dry environment. There are instances, however, in which it is difficult to use the rubber dam. One such instance is during retrograde filling. This case report highlights an innovative technique for rubber dam isolation of root end retrograde filling.

  14. [A new method for combined auto-alloplastic tooth reimplantation with a parallel A1203-ceramic root].

    Science.gov (United States)

    Kirschner, H; Bolz, U; Enomoto, S; Hüttemann, R W; Meinel, W; Sturm, J

    1978-09-01

    The operative procedure for partially replacing the root with A12O3 ceramic represents a good possibility for preserving teeth in which the pulpa is devitalized. The method used in connection with the well known autoplastic reimplantation not only presents an alternative to the traditional apicoectomy but also provides additional stabilization of the tooth by lengthing the root with cocotostabile and biocompatible A1203 ceramic. The method was tested in humans and monkeys. Argumentation was based on histological examination via light microscopy. PMID:100304

  15. Reasons for Apical Surgery Treatment in an Underserved New York City Population.

    Science.gov (United States)

    Hasselgren, Gunnar; Patel, Pratik; Alhassany, Hashim; Kunzel, Carol

    2016-04-01

    Endodontic retreatment often involves remaking restorations. The total cost may steer the treatment towards surgery. The aim of this study was to retrospectively record the reasons for performing apical surgery in an economically deprived patient population. The clinical reasons (59%) for apical surgery were most common, but the nonclinical (financial) reasons (41%) emerged as a major cause. The finding that 41% of the apicoectomies were performed because of nonclinical constraints is a high figure and may not reflect the situation generally. Still, economic factors potentially play a major role in the selection of surgical versus nonsurgical endodontic retreatment. PMID:27348949

  16. Doença periapical em eqüinos: estudo de quatro casos Periapical disease in equine: study of four cases

    Directory of Open Access Journals (Sweden)

    G.M. Pagliosa

    2004-02-01

    Full Text Available Estudaram-se quatro casos de doença periapical (DP em eqüinos submetidos à apicectomia e extração dentária. O diagnóstico baseou-se na anamnese, nos exames físico geral e oral e na radiologia. A apicectomia foi ineficaz devido à falta de tratamento endodôntico e a extração dentária mostrou-se a melhor conduta de tratamento, apesar da dificuldade de cura completa da infecção. A DP pode ter causas adicionais a serem definidas, além das classificadas como primária e secundária pela literatura.Four cases of periapical disease (PC in equines submitted to apicoectomy and dental extraction were studied. The diagnosis was based on anamnesis, physical and oral examination and radiology. The apicoectomy was not effective due of the lack of endodontic treatment. The dental extraction was the better treatment, despite of the difficulty of complete cure of the infection. The PC can have other causes, beyond of those classified as primary and secondary by the literature.

  17. Er:YAG and Nd:YAG laser irradiation effect on dental root cut: a SEM analysis

    Science.gov (United States)

    Mello, Guilherme P. S.; Paradella, Thais C.; Munin, Egberto; Mello, Jose B.; Pacheco, Marcos T. T.; Neto, Sizenando P.

    2000-11-01

    The root end cut, also called apicoectomy, consists on the surgical removal of the root's end, as one of the last alternatives for teeth preservation. This procedure may be done with conventional diamond burs, as well as Er:YAG laser only, or in association with Nd:YAG laser. In this paper, the quality of the root end cut for the different mentioned procedures, was compared for a better analysis of these techniques, regarding surface finishing. The Er:YAG laser dosimetry applied during the experiment was of 400 mJ/10 Hz, using a laser beam with a 0.8 mm diameter. The Nd:YAG laser was irradiated at 1.5 W/10 Hz, being the samples submitted to a scanning electron microscope. On the Er:YAG laser irradiated samples, there was absence of smear layer, as well as the presence of some open dentinal tubules, presenting the surface a smooth texture. On the roots cut with the Er:YAG laser, in association with the Nd:YAG laser, below the ablative regime, there was the presence of a melted dentin surface, with an appearance which suggests a non-crystalline structure, closing the tubules. Regarding the conventional apicoectomy, the samples presented a plain surface, with the dentinal tubules being closed by the smear layer.

  18. Effect of the CO2 laser on the microleakage of conventional and laser apicetomized teeth retrofilled with glass ionomer: in vitro study

    Science.gov (United States)

    Pinheiro, Antonio L. B.; Martorelli, Sergio B. F.

    2000-03-01

    There is a need for further improvement on the level of apical sealing. The use of lasers on apical surgery is still not fully understood, however some good results have been reported. The aim of this study was to assess the effect of the use of the CO2 laser following conventional apicoectomy and retrofilling with glass ionomer using different combinations of power and types of emission 'In Vitro.' Seventy extracted human upper anterior teeth were used on this study. The teeth after conventional apicoectomy were retrofilled with VitremerTM. The samples were randomized into seven groups of 10, Group I acted as negative control. Groups II, III and IV were lased on defocused mode with superpulsed CO2 laser on CW with power output of 0,5; 3 and 7 Watts during 5 seconds respectively. Groups V, VI e VII were lased on defocused mode with continuous emission on CW mode with power output of 1, 10 and 20 Watts during 5 seconds respectively. All specimens were immersed on 2% Methylene Blue solution during 48 h, washed in running tap water and longitudinally sectioned. Three calibrated examiners regarding apical infiltration graded the samples. The results showed difference between groups, where Group II showed smaller level of apical infiltration. It is concluded that improving on apical sealing is better achieved by using 0.5 W on superpulsed on CW.

  19. Multidisciplinary approach for the treatment of a complicated crown-root fracture in a young patient: a case report.

    Science.gov (United States)

    de Castro, José Carlos Monteiro; Poi, Wilson Roberto; Pedrini, Denise; Tiveron, Adelisa Rodolfo Ferreira; Brandini, Daniela Atili; de Castro, Mara Antônio Monteiro

    2011-10-01

    Crown-root fractures in permanent teeth cause esthetic and functional problems. This paper reports the case of a complicated crown-root fracture in the maxillary right central incisor of a young patient who was treated with a multidisciplinary approach in two phases. A modified Widman flap, root canal therapy, glass fiber post cementation, and adhesive tooth fragment reattachment were performed shortly after an accident. Satisfactory esthetic and functional outcomes were obtained. However, the patient did not attend follow-up visits and returned after 7 years. During this second phase, the clinical and radiographic examination showed stability and adaptation of the fragment and good periodontal health conditions, but crown darkening and a radiolucent image associated with the root apex of the fractured tooth were also observed. The periapical lesion was surgically removed by apicoectomy, and the esthetics were recovered with a direct composite resin veneer on the traumatized tooth. PMID:21909497

  20. Intentional replantation: case report of an alternative treatment for endodontic therapy failure

    Directory of Open Access Journals (Sweden)

    Flares BARATTO FILHO

    2004-11-01

    Full Text Available The aim of this study was to present an alternative treatment after the occurrence of endodontic therapy failure. The authors report a clinical case of a second maxillary permanent molar, which was indicated for intentional replantation as an alternative treatment. Extraction was performed followed by apicoectomy of the three roots and radicular decontamination with citric acid (pH=1 for 1min; the roots were then retro-obturated with amalgam and the tooth replanted in the alveolus. The extra-buccal period lasted 15 min. Clinico-radiographical follow-up examinations were done at 2, 3 and 5 years and no symptoms or radicular resorption were found. There was bone neo-formation at the palatal root that had presented a periapical lesion. Intentional replantation can be indicated correctly as an alternative treatment for cases in which conservativeendodontic therapy or surgical technique cannot be performed.

  1. Progression of periapical cystic lesion after incomplete endodontic treatment

    Science.gov (United States)

    Yang, Dong-Kyu; Jeon, Kug-Jin

    2016-01-01

    We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment. PMID:27200282

  2. Esthetic periodontal surgery for impacted dilacerated maxillary central incisors.

    Science.gov (United States)

    Wei, Yu-Ju; Lin, Yi-Chun; Kaung, Shou-Shin; Yang, Shue-Fen; Lee, Shyh-Yuan; Lai, Yu-Lin

    2012-10-01

    Clinicians do not frequently see impacted dilacerated maxillary incisors in their patients. When they do, there are several diagnostic and management challenges for correcting root dilacerations. An unfavorable esthetic outcome might occur as a result of soft-tissue complications during surgical eruption procedures. We present 2 patients with an impacted and dilacerated maxillary central incisor. Computed tomography scans with 3-dimensional reformation were used to accurately assess the positions of the dilacerated teeth, the degree of dilaceration, and the stage of root formation. The therapy primarily involved 2-stage crown exposure surgery combined with orthodontic traction. An apicoectomy was performed on 1 dilacerated tooth; the other exhibited pulp vitality. This article highlights the periodontal surgical strategies for the esthetic management of inverted crowns. Through periodontal plastic surgery and interdisciplinary cooperation, the impacted dilacerated central incisors were properly aligned, and successful esthetic results were achieved. PMID:22999678

  3. Orthodontic treatment of a mandibular incisor fenestration resulting from a broken retainer.

    Science.gov (United States)

    Farret, Marcel M; Farret, Milton M B; da Luz Vieira, Gustavo; Assaf, Jamal Hassan; de Lima, Eduardo Martinelli S

    2015-08-01

    This article describes the orthodontic relapse with mandibular incisor fenestration in a 36-year-old man who had undergone orthodontic treatment 21 years previously. The patient reported that his mandibular 3 × 3 bonded retainer had been partially debonded and broken 4 years earlier. The mandibular left lateral incisor remained bonded to the retainer and received the entire load of the incisors; consequently, there was extreme labial movement of the root, resulting in dental avulsion. As part of the treatment, the root was repositioned lingually using a titanium-molybdenum segmented archwire for 8 months, followed by endodontic treatment, an apicoectomy, and 4 months of alignment and leveling of both arches. The treatment outcomes were excellent, and the tooth remained stable, with good integrity of the mesial, distal, and lingual alveolar bones and periodontal ligament. The 1-year follow-up showed good stability of the results. PMID:26232842

  4. A case of glandular odontogenic cyst in the mandible treated with the dredging method.

    Science.gov (United States)

    Motooka, Naomi; Ohba, Seigo; Uehara, Masataka; Fujita, Syuichi; Asahina, Izumi

    2015-01-01

    Glandular odontogenic cyst (GOC) is a rare odontogenic cyst derived from the odontogenic epithelium. GOC shows unpredictable and potentially aggressive behavior. Although enucleation and curettage are applied in most cases, the recurrence rate remains relatively high. Because a standard care procedure for GOC has not been established, we propose a new treatment procedure for GOC. In this case report, we describe a 62-year-old Japanese woman who suffered from GOC arising at the anterior region of her mandible and who was treated using the dredging method. She underwent enucleation and curettage twice using the dredging method with preservation of the teeth, which were involved with the lesion, but the lesion recurred 2 years later. In addition to enucleation and curettage, apicoectomy of the teeth was performed with a third dredging method procedure, and prognosis has been good with no recurrence for 18 months since the last treatment. PMID:24374982

  5. An ambiguous asymptomatic swelling in the maxillary anterior region—A case report

    Science.gov (United States)

    Surej Kumar, L.K.; Manuel, Suvy; Nair, Bindu J.; Nair S, Vinod

    2016-01-01

    Introduction Glandular odontogenic cyst is a rare and recently recognized type of developmental odontogenic cyst. Being odontogenic in origin, because of the pluripotentiality of the odontogenic epithelium it can show glandular or salivary features. Presentation of a case A 46 year old female patient was referred to the Oral and Maxillofacial Surgery department with chief complaint of painless swelling in the right anterior region of maxilla, radiographically associated with teeth 12, 13. Mucosa over the swelling was slightly bluish in colour and no associated palatal swelling was seen. No incidence of trauma was reported and involved teeth were not mobile. Discussion Although we have many differential diagnoses, our working diagnosis was a periapical cyst, so conventional treatment of root canal treatment, cyst enucleation, and apicoectomy was planned. Conclusion Here we present a case which was initially misdiagnosed and mismanaged but on subsequent histopathologic examination revealed the final diagnosis. PMID:27093689

  6. Progression of periapical cystic lesion after incomplete endodontic treatment.

    Science.gov (United States)

    Huh, Jong-Ki; Yang, Dong-Kyu; Jeon, Kug-Jin; Shin, Su-Jung

    2016-05-01

    We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment. PMID:27200282

  7. Management of Radicular Cyst Using Platelet-Rich Fibrin & Iliac Bone Graft - A Case Report.

    Science.gov (United States)

    Vidhale, Gaurav; Jain, Deepali; Jain, Sourabh; Godhane, Alkesh Vijayrao; Pawar, Ganesh R

    2015-06-01

    Radicular cyst is one of the most commonly occurring cyst in the oral cavity it is usually preceded by trauma or an infectious condition which is followed by enlargement. In recent times there are several treatment procedures that are being applied in order to improve the postoperative condition and to accelerate the process of healing and regeneration in the affected site. A 22-year-old patient reported to our OPD with the chief complaint of swelling on the left side of the face since 2-3 months, on investigating it was diagnosed as Radicular cyst which was initially treated by endodontic treatment of the involved tooth followed by enucleation of the cyst further an apicoectomy was done. Finally a PRF and iliac crest graft was placed for aesthetic rehabilitation with 21. PMID:26266233

  8. Extranodal large B cell lymphoma of the anterior maxilla. Case report and review of literature.

    Science.gov (United States)

    Webber, Brian; Webber, Mariel; Keinan, David

    2015-01-01

    In the oral cavity, lymphoproliferative disorders can manifest in various ways, often as an extranodal externalization. In the case presented here, it was a B cell lymphoma originating in the periapical bone of the anterior maxilla. X-ray revealed a periapical radiolucency associated with an intact tooth with no decay, fillings or history of trauma. The tooth tested non-vital. After root canal treatment, an apicoectomy was performed with a biopsy. The most common diagnosis would be of dental etiology. The pathology report revealed a non-Hodgkin's B cell lymphoma. Most often, this disease appears as localized dental or oral pathology. Non-specific signs and symptoms present in association with lymphoproliferative disorders include lymphadenopathy, trismus, pain, swelling, sinusitis, fever, sepsis, prosthetic instability and paresthesia. Early detection results in decreased morbidity and a better prognosis for the patient. PMID:25707167

  9. e cimento ionômero de vidro

    Directory of Open Access Journals (Sweden)

    Ingeburg Hellwig

    2007-01-01

    Full Text Available The purpose of periapical surgery is to remove persistent periapical disease. This procedureconsists of exposure and excision of the affected dental apex, root-end cavity preparation, andretrograde filling with a sealing material. This in vitro study used apical microleakage testing,0.2% Rhodamine B dye penetration, and computer-assisted morphometry to evaluate 30endodontically-treated, single-rooted permanent human teeth divided in three groups. Specimens in the three groups underwent apicoectomy with bur at a 90-degree cutting angle, ultrasonic root-end cavity preparation, and retrograde filling with one of three sealing materials: group A – MTAAngelus®; group B – Vitremer®; group C – ProRoot® MTA. Vitremer® had the best results inthe comparative analysis. The two MTA materials had similar results. Results for the threematerials under study were satisfactory for apical retrograde filling.

  10. Endodontic Microsurgical Treatment of a Three-rooted Mandibular First Molar with Separate Distolingual Root: Report of One Case.

    Science.gov (United States)

    Wang, Han Guo; Xu, Ning; Yu, Qing

    2016-01-01

    The separate distolingual (DL) roots of three-rooted mandibular first molars are thought to be too difficult for performing apical surgery. This article represents microsurgical treatment of a three-rooted mandibular first molar with a separate DL root. The procedure includes incision and flap retraction, osteotomy, apicoectomy, retropreparation and retrofilling of the root canal, using micro instruments, ultrasonic retrotips and mineral trioxide aggregate (MTA) under a dental operating microscope. Two mm in length of apical root resection, 2 mm in depth of root canal retropreparation with a personalised ultrasonic retrotip, and 2 mm in length of retrofilling with MTA are the key points for accomplishment of apical surgery on separate DL roots. The case was followed up for 15 months after surgery. Clinical and radiographic examinations revealed complete healing of periapical tissue. Separate DL roots of three-rooted mandibular first molars can be treated by endodontic microsurgery with modifications from standard protocol. PMID:27622221

  11. An Investigation on the Histologic Responses of Periapical Tissues Following Retrofilling with Root MTA and Portland Cement Type I Versus Pro Root MTA in the Canine Teeth of Cats

    Directory of Open Access Journals (Sweden)

    D. Sharifi

    2004-12-01

    Full Text Available Statement of the Problem: Endodontic surgery if required is considered as an additive therapy after classic endodontic treatments. The most prevalent type of endodontic surgeries are apicoectomy and corrective surgeries. Type of material applied inapicoectomies is of high importance. Root end filling material should not only be biocompatible but also provide appropriate seal. Considering these findings, the subject of this paper was to compare the histologic responses of the periradicular tissues after usingRoot MTA and Portland cement, as Root end fillings, with Pro Root MTA.Purpose: The aim of the present study was to introduce a suitable material for root end filling.Materials and Methods: The canals of sixty maxillary canines of cats, after cutting the crowns and exposing the pulps, were instrumented 1 mm beyond the apex until 25 # file to develop periapical lesion after 28 days. They were then randomly divided into five groups.After apicoectomy, Pro Root MTA, Root MTA and Portland cement were placed, as root end filling materials in three experimental groups whereas the two remaining groups were considered as positive and negative controls.After 3, 6 and 12 weeks the animals were sacrificed and the specimens were stained forhistologic evaluation under light microscope. The data were submitted to statistical analyses (Fisher exact test, k2 test and one- way variance analysis.Results: No statistically significant difference was found between these three materials in cementum apposition on roots and implanted materials, fibrous capsule formation and the severity of inflammation, however, bone formation in Root MTA group was significantly less than pro Root MTA and Portland cement groups. The extent of inflammation thickness in Portland cement group was significantly less than Pro Root MTA group.Conclusion: According to these findings if long term investigations with larger sample size confirm the obtained results of the present study, Root MTA

  12. Common problems and analysis in periradicular microsurgery%显微根尖外科手术中的常见问题与解析

    Institute of Scientific and Technical Information of China (English)

    陈蕾; 童方丽

    2016-01-01

    With the advent of dental operating microscope, periradicular microsurgery significantly improved success rate of traditional periradicular surgery, which includes periradiacular curettage, apicoectomy and retrograde filling. The present paper summarizes indication, apical sealing inspection, incision and flap design in anterior aesthetic region, and healing criteria for periradicular microsurgery.%传统根尖外科手术包括根尖刮治术、根尖切除术和根尖倒充填术.随着牙科手术显微镜的临床应用,显微根尖外科手术大大提高了传统根尖手术的成功率.本文总结了关于显微根尖外科手术的适应证、前牙美学区软组织瓣切口设计的特点和并发症、根尖封闭的检查以及手术成功的评价标准等常见的临床问题,并做相应解析.

  13. Radiological, histological and immunohistochemical evaluation of periapical inflammatory lesions.

    Science.gov (United States)

    Berar, Antonela Marcela; Bondor, Cosmina Ioana; Matroş, LuminiŢa; Câmpian, Radu Septimiu

    2016-01-01

    The loss of teeth is largely caused by supporting tissue damage, because of bacterial invasion from the infected root canals. Sixty patients with periapical lesions (PLs) of endodontic origin were included in the study. Clinical and radiological examination was performed. Periapical radiographs were analyzed by two independent observers to determine the size and severity of PLs, using Periapical Index (PAI) scores. The tissue samples collected by periapical curettage during apicoectomy or after dental extractions by alveolar curettage were histologically and immunohistochemically analyzed. The PLs were histologically diagnosed as: periapical granulomas (PGs), granulomas with cystic potential and radicular cysts (RCs) with various degrees of inflammation. Capillary density was evaluated using the angiogenic index after immunohistochemical staining with CD34 monoclonal antibody. A statistically significant correlation was observed between PAI scores and the size of the lesions. 68.33% of cases were PGs, 18.33% PGs with cystic potential and 18.33% RCs with different degrees of inflammation. Seventy-five percent PLs had an angiogenic index 1 and 25% had an angiogenic index 2. Statistically significant differences were obtained between the angiogenic index and lesion size (p<0.05). Capillary density within PLs did not influence the severity scores of lesions detected on radiographs. The angiogenic index appeared not to be associated with the histological lesion type and the intensity of inflammation, but was more likely correlated with the degree of granulation tissue maturation and the size of PLs. PMID:27516014

  14. Sealing ability of MTA used as a root end filling material: effect of the sonic and ultrasonic condensation.

    Science.gov (United States)

    Bernabé, Pedro Felício Estrada; Gomes-Filho, João Eduardo; Bernabé, Daniel Galera; Nery, Mauro Juvenal; Otoboni-Filho, José Arlindo; Dezan-Jr, Eloi; Cintra, Luciano Tavares Angelo

    2013-01-01

    Despite the excellent properties of mineral trioxide aggregate (MTA), the condensation technique may have some influence in its sealing ability. The purpose of this study was to compare the sealing ability of sonic and ultrasonic setting of MTA. Thirty-four extracted human teeth had their canals prepared and filled with Sealapex sealer and gutta-percha using the active lateral condensation technique. The teeth were rendered waterproof and apicoectomy performed at 3 mm from the apex. Root-end cavities (3.0 mm deep and 1.4 mm diameter) were prepared with diamond ultrasonic tips. The root-end cavities were filled with Pro-Root MTA® with ultrasonic vibration, sonic vibration or no vibration. The positive control group did not receive any material while the negative control group was totally rendered waterproof. After material set, the specimens were immersed in Rodhamine B for 24 h, under vacuum in the first 15 min, then washed, dried and split longitudinally for evaluating the infiltration at the dentin/material interface. Data were analyzed using ANOVA and Tukey's tests at 5% significance level. Sonic vibration promoted the lowest infiltration values (p<0.05). It was concluded that sonic vibration could be considered an efficient aid to improve the sealing ability of MTA when used as root-end filling material. PMID:23780366

  15. Laser scanning dental probe for endodontic root canal treatment

    Science.gov (United States)

    Blank, Molly A. B.; Friedrich, Michal; Hamilton, Jeffrey D.; Lee, Peggy; Berg, Joel; Seibel, Eric J.

    2011-03-01

    Complications that arise during endodontic procedures pose serious threats to the long-term integrity and health of the tooth. Potential complexities of root canals include residual pulpal tissue, cracks, mesial-buccal 2 and accessory canals. In the case of a failed root canal, a successful apicoectomy can be jeopardized by isthmuses, accessory canals, and root microfracture. Confirming diagnosis using a small imaging probe would allow proper treatment and prevent retreatment of endodontic procedures. An ultrathin and flexible laser scanning endoscope of 1.2 to 1.6mm outer diameter was used in vitro to image extracted teeth with varied root configurations. Teeth were opened using a conventional bur and high speed drill. Imaging within the opened access cavity clarified the location of the roots where canal filing would initiate. Although radiographs are commonly used to determine the root canal size, position, and shape, the limited 2D image perspective leaves ambiguity that could be clarified if used in conjunction with a direct visual imaging tool. Direct visualization may avoid difficulties in locating the root canal and reduce the number of radiographs needed. A transillumination imaging device with the separated illumination and light collection functions rendered cracks visible in the prepared teeth that were otherwise indiscernible using reflected visible light. Our work demonstrates that a small diameter endoscope with high spatial resolution may significantly increase the efficiency and success of endodontic procedures.

  16. In vitro study of apical leakage of root canals after different root apex resection techniques

    Directory of Open Access Journals (Sweden)

    André Augusto Franco MARQUES

    2008-12-01

    Full Text Available Objective:The aim of the present study was to evaluate in vitro apicalmarginal leakage of root canals after three root apex resectiontechniques.Material and methods: Thirty maxillary canines wereprepared chemo-mechanically to a size 40 master apical file, andenlarged by using Gates Glidden burs 2, 3 and 4. Teeth were obturatedby Tagger thermomechanical compaction technique and then dividedinto three groups (n = 10. The first group (GI was 3 mm apicalresected with Endo Z in high speed handpiece. The specimens of secondgroup (GII were 3 mm apical weared with Endo Z, and the third group(GIII had 3 mm apical resected with Er:YAG laser (500 impulse, 12pps and 300 mJ energy. After the apical sections, IRM cement wasplaced into the root-end cavity and teeth of each group were immersedin India ink for 5 days and submitted to decalcification and clarifying for marginal apical microleakage visualization with microscope.Results: The results showed statistically difference (p < 0.01 between GI and the other groups.Conclusion: The root apex cut using Endo Z promotes the lowest values of microleakage when used in apicoectomy.

  17. Ambulatory oral surgery: 1-year experience with 11 680 patients from Zagreb district, Croatia

    Science.gov (United States)

    Jokić, Dražen; Macan, Darko; Perić, Berislav; Tadić, Marinka; Biočić, Josip; Đanić, Petar; Brajdić, Davor

    2013-01-01

    Aim To examine the types and frequencies of oral surgery diagnoses and ambulatory oral surgical treatments during one year period at the Department of Oral Surgery, University Hospital Dubrava in Zagreb, Croatia. Methods Sociodemographic and clinical data on 11 680 ambulatory patients, treated between January 1 and of December 31, 2011 were retrieved from the hospital database using a specific protocol. The obtained data were subsequently analyzed in order to assess the frequency of diagnoses and differences in sex and age. Results The most common ambulatory procedure was tooth extraction (37.67%) and the most common procedure in ambulatory operating room was alveolectomy (57.25%). The test of proportions showed that significantly more extractions (P apicoectomies were performed among female patients (P < 0.001). A greater prevalence of periodontal disease was found in patients residing in Zagreb than in patients residing in rural areas. Conclusion The data from this study may be useful for planning of ambulatory oral surgery services, budgeting, and sustaining quality improvement, enhancing oral surgical curricula, training and education of primary health care doctors and oral surgery specialists, and promoting patients’ awareness of the importance of oral health. PMID:23444246

  18. Lasers in endodontics: an overview

    Science.gov (United States)

    Frentzen, Matthias; Braun, Andreas; Koort, Hans J.

    2002-06-01

    The interest in endodontic use of dental laser systems is increasing. Developing laser technology and a better understanding of laser effects widened the spectrum of possible endodontic indications. Various laser systems including excimer-, argon+-, diode-, Nd:YAG-, Er:YAG- and CO2-lasers are used in pulp diagnosis, treatment of hypersensitivity, pulp capping, sterilization of root canals, root canal shaping and obturation or apicoectomy. With the development of new delivery systems - thin and flexible fibers - for many different wavelengths laser applications in endodontics may increase. Since laser devices are still relatively costly, access to them is limited. Most of the clinical applications are laser assisted procedures such as the removing of pulp remnants and debris or disinfection of infected root canals. The essential question is whether a laser can provide improved treatment over conventional care. To perform laser therapy in endodontics today different laser types with adopted wavelengths and pulse widths are needed, each specific to a particular application. Looking into the future we will need endodontic laser equipment providing optimal laser parameters for different treatment modalities. Nevertheless, the quantity of research reports from the last decade promises a genuine future for lasers in endodontics.

  19. Multidisciplinary Treatment of a Fenestration-type Defect.

    Science.gov (United States)

    Travassos, Rafael; Soares, Bruno; Bhandi, Shilpa H; Silva, Monica Barros da; Bandéca, Matheus Coelho; Mouchrek, José Carlos Elias; Silva, Vanessa Camila da; Benatti, Bruno Braga

    2015-04-01

    The case report aimed at treating a fenestration-type defect with multidisciplinary conventional and advanced surgical techniques. Fenestrations are isolated areas in which the exposed root surface is covered only by the periosteum and gingiva, but the remaining cortical bone remains intact. Root coverage is indicated in cases of root hypersensitivity, treatment of shallow caries lesions, cervical abrasions, and esthetic and cosmetic needs. In this case report, after proper hygiene instruction and dental biofilm control, a fenestration-type defect was treated using guided tissue regeneration (anorganic bovine matrix and resorbable membrane) and a connective tissue grafts, associated to an endodontic apicoectomy. After reevaluation, the remaining gingival recession was treated with a second gingival connective tissue graft covered with q double papillae type in order to reconstruct the periodontal tissues of the involved tooth. In this clinical case, the interaction between the different areas of dentistry has made it possible to correct a fenestration-type defect, following procedures based on scientific evidence, restoring periodontal health, esthetics, self-esteem, and meeting the patient's expectations regarding her initial complaint. This case report shows the important role of interdisciplinary approach to treating a patient with a complex periodontal defect that required different types of knowledge and abilities to achieve the best results based on the current status of dentistry possibilities. PMID:26067739

  20. Root canal filling using MTA in association with parendodontic surgery in the retreatment of an external apical root resorption – case report

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    Marcos JACOBOVITZ

    2009-06-01

    Full Text Available Introduction and objective: The treatment of external apical root resorption should be directed to eliminate the endodontic infection. In some cases, the clinical resolution by conventional endodontic treatment cannot be performed, due to instrumentation and root canal filling complexity. In these cases, alternative instrumentation and obturation techniques may be necessary,additionally to apical surgery. Case report: This case report shows an alternative to external apical root resorption retreatment, using obturation with MTA associated to parendodontic surgery. After the removal of obturation material and the root canal cleaning and shaping, calcium hydroxide therapy was performed during 45 days. After that the canal was filled with MTA, and in a posterior session apical curettage and apicoectomy were performed. After 34 months, the periapical healing could be radiographically noticed, with close contact between trabecular bone and MTA. Conclusion: The use of MTA as a root canal filling material associated with parendodontic surgery seemed to be an adequate alternative to external apical root resorptions.

  1. Root canal overfilling as an influencing factor for the success of endodontic treatment

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    Ardo Sabir

    2005-12-01

    Full Text Available The goal of endodontic treatment is to keep the teeth as long as possible in the mouth. The obturation process in the root canal is one of the most important processes in endodontic treatment. The purpose of this article is to explain that overfilling is an influencing factor to the success of endodontic treatment. It has been widely known that overfilling should be avoided during an obturation process. Overfilling of the root canal is indicated only in cases which will be followed by apicoectomy, when the foreign material is removed. Accidental overfilling may occur with soft material (for example, certain pastes and cements or with solid material (such as gutta-percha or silver cones. Such overfilling may cause an unnecessary mechanical and chemical irritation, which hinders the repair of periapical tissue, and thus, diminishes the probability of a successful endodontic treatment prognosis. Many things could cause overfilling, which makes overfilling unpleasant feeling for the patient such as severe pain, periapical lesion, gingival discoloration, periodontal ligament breakage, or even paresthesia. There are several ways to overcome this root canal overfilling, from the conventional endodontic treatment up to endodontic surgery. The main conclusion from this article is to avoid overfilling and the importance of clinicians’ compliance to the right procedures.

  2. Laser-assisted oral surgery in general practice

    Science.gov (United States)

    McCauley, Mark C.

    1995-04-01

    This presentation will demonstrate and discuss any surgical applications of the Argon dental laser. This presentation will also increase the awareness and basic understanding of the physical principals of the Argon laser. The wavelength of the Argon laser is specifically absorbed by red pigments such a hemoglobin which is abundant in oral soft tissue. The result is a sharp clean incision with minimal thermal damage to adjacent healthy tissue. Preprosthetic procedures such as full arch vestibuloplasty, labial and lingual frenectomy, and epulis fissuratum removal will be demonstrated. Other soft tissue management procedures such as minor periodontal pocket elimination surgery (gingivectomy), removal of hyperplastic granulation tissue from around poorly maintained implants, and the removal of granulation and/or cystic tissue from the apex of teeth undergoing endodontic (apicoec-tomy) surgery will also be demonstrated and discussed. Provided basic oral surgery protocol is followed, surgical procedures utilizing the Argon laser can be accomplished with minimal bleeding, minimal trauma and with minimal post-operative discomfort.

  3. 埋伏弯根上颌中切牙序列矫治的研究%Sequence orthodontic treatment of impacted dilacerated maxillary central incisors

    Institute of Scientific and Technical Information of China (English)

    郑怡; 庞煊奈; 南澜; 莫水学

    2012-01-01

    目的 探讨埋伏弯根上颌中切牙有效的正畸牵引治疗方法.方法 选择11例患者共12颗埋伏弯根上颌中切牙为研究对象,常规拍摄定位X线片,配合口内检查、模型分析等,确定埋伏牙的位置及其与邻牙的相互关系,采用封闭式导萌、选择性根管治疗及根尖切除术、修复治疗等方法进行矫治.结果 12颗埋伏牙通过治疗后顺利进入正常牙列,未见牙根吸收粘连,建立了良好的咬合关系.9例唇侧埋伏弯根上颌中切牙患者的临床牙冠唇倾角度较大,4例根尖位于唇侧黏膜下,进行了根管治疗加根尖切除术,其中1例行烤瓷冠改形修复;其余5例未做根管治疗,暂行观察.2例腭侧埋伏弯根上颌中切牙的疗效稳定.结论 埋伏弯根上颌中切牙采用序列矫治可以取得良好的美观和功能效果.%Objective To explore an effective orthodontic method for treating impacted dilacerated maxillary central incisors. Methods 12 impacted teeth of 11 cases were chosen. The position of the impacted teeth and the relations with neighbour tissues weie assessed by X-ray images, oral examination and plaster model, etc. The impacted teeth were induced to erupt with the closed-eruption technique and fixed orthodontic appliances, root canal therapy, apicoectomy and prosthetic treatment. Results 12 impacted teeth were moved into arches, and the occlusal relationship was normal. There were no root resorption or conglutination in those impacted teeth. The labial impacted teeth of nine cases had bigger labial crown torsion. The root apexes of four impacted teeth were palpable under mucosa of the labial sulcus and operated by root canal therapy and apicoectomy. One of them received prosthetic treatment Others (five cases) hadn't accepted root canal therapy, and were observed temporarily. The effects of two palatal impacted teeth was stable. Conclusion It was a good method to expand indication with sequence orthodontic treatment. The

  4. Choice of surgical suture material used in oral cavity: Clinical study

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    Mirković Siniša

    2010-01-01

    Full Text Available Introduction. Historical data on closing and suturing of surgical wounds describe a wide range of various suture materials. The choice of the surgical catgut, i.e. type and diameter, depends on the localization, characteristics and condition of the tissue to be treated. From the stand-point of oral-surgical practice the following clinical parameters are of the outstanding importance regarding the choice of suture material: accumulation of soft deposits on the sutures, decubitus of the adjacent soft tissues and dehiscence of the operative wound. Aim. The aim of this research was to determine the correlation between different types of suture materials and accumulation of soft deposits on the sutures, decubitus of the adjacent soft tissues and dehiscence of the operative wound. Material and methods. Our prospective clinical study included 150 patients distributed into three groups of 50 subjects. The surgical procedure performed on each patient involved resection (apicoectomy of the tooth root end in the intercanine sector of the upper jaw. The following suture materials were applied: BLACK SILK 5-0, NYLON 5-0 and VICRYL 5-0. The effects of the selected sutures were evaluated by using several parameters: accumulation of soft deposits, wound dehiscence and decubitus of the adjacent soft tissues. The effects of the applied sutures were recorded on days 2, 5 and 7 after the surgery. Conclusion. The comparison of cited parameters of the investigated materials after suture of oral cavity mucosa revealed that none of the used material was ideal; however, a certain preference might be given to the synthetic monofilament suture materials.

  5. Short-term tissue response to potential root-end filling materials in infected root canals.

    Science.gov (United States)

    Chong, B S; Pitt Ford, T R; Kariyawasam, S P

    1997-07-01

    The short-term tissue responses to two potential root-end filling materials, a light-cured glass ionomer cement (Vitrebond) and a reinforced zinc oxide-eugenol cement (Kalzinol), were compared with that to amalgam using a previously devised experimental model. In 24 premolar teeth of beagle dogs (47 roots), a collection of endodontic pathogenic bacteria was first inoculated into the root canals to induce periradicular lesions. On each root, an apicoectomy was performed and root-end cavities prepared to receive fillings of each material. The teeth and surrounding jaw were removed after 2 weeks (23 roots) and 1 week (24 roots); they were then prepared for histological examination. The tissue response to amalgam fillings after 2 weeks and 1 week was marked by moderate or severe inflammation on all roots, and extended to 0.5 mm in 15 out of 16 roots. In contrast, after 2 weeks, the majority of roots filled with Kalzinol showed little or moderate inflammation, while the tissue response to Vitrebond was the best of the three materials, and was also the least extensive. After 1 week, the overall best tissue response was with Vitrebond, followed by Kalzinol. The differences between materials for both time periods with either none or few inflammatory cells when compared with that with either moderate or severe inflammation were not statistically significant (P inflammation or inflammation extending inflammation extending > 0.2 mm ( 0.5 mm) were statistically significant (P inflammation adjacent to the root-end filling, even though there were intersample variations, there was little overall difference in the temporal and qualitative healing response to Vitrebond and Kalzinol. Both Vitrebond and Kalzinol have potential as root-end filling materials, as the tissue response was considerably more favourable than that to amalgam even in the short-term.

  6. Apices of maxillary premolars observed by swept source optical coherence tomography

    Science.gov (United States)

    Ebihara, Arata; Iino, Yoshiko; Yoshioka, Toshihiko; Hanada, Takahiro; Sunakawa, Mitsuhiro; Sumi, Yasunori; Suda, Hideaki

    2015-02-01

    Apicoectomy is performed for the management of apical periodontitis when orthograde root canal treatment is not possible or is ineffective. Prior to the surgery, cone beam computed tomography (CBCT) examination is often performed to evaluate the lesion and the adjacent tissues. During the surgical procedure, the root apex is resected and the resected surface is usually observed under dental operating microscope (DOM). However, it is difficult to evaluate the details and the subsurface structure of the root using CBCT and DOM. A new diagnostic system, swept source optical coherence tomography (SS-OCT), has been developed to observe the subsurface anatomical structure. The aim of this study was to observe resected apical root canals of human maxillary premolars using SS-OCT and compare the findings with those observed using CBCT and DOM. Six extracted human maxillary premolars were used. After microfocus computed tomography (Micro CT; for gold standard) and CBCT scanning of the root, 1 mm of the apex was cut perpendicular to the long axis of the tooth. Each resected surface was treated with EDTA, irrigated with saline solution, and stained with methylene blue dye. The resected surface was observed with DOM and SS-OCT. This sequence was repeated three times. The number of root canals was counted and statistically evaluated. There was no significant difference in the accuracy of detecting root canals among CBCT, DOM and SS-OCT (p > 0.05, Wilcoxon test). Because SS-OCT can be used in real time during surgery, it would be a useful tool for observing resected apical root canals.

  7. SEM evaluation of the interface between filling and root-end filling materials.

    Science.gov (United States)

    Rosa, R A; Santini, M F; Heiden, K; Só, B B; Kuga, M C; Pereira, J R; Só, M V R

    2014-01-01

    The aim of this ex vivo study was to evaluate, by scanning electron microscopy (SEM), the presence of gaps at the interface between filling material and three root-end filling materials. Thirty human upper molars disto-buccal roots were instrumented and filled with gutta-percha and eugenol-based sealer. The apicoectomy was performed 2 mm from the apex and retrograde cavities were prepared with ultrasonic points (3 mm in deep). The samples were divided into three experimental groups (n = 10): Group I-white mineral trioxide aggregate (MTA); Group II-Super EBA; and Group III-Portland cement. The root-end filling materials were inserted into the retocavities using a MTA carrier. After 48 h, the roots were transversally sectioned in order to obtain the apical 5 mm. Next, each specimen was prepared longitudinally with crescent granulation of abrasives water-wet sandpapers in order to expose the filling and root-end filling materials. Then, the specimens were subjected to slow dehydration with silica gel, mounted onto specific stubs and coated with paladium coverage for SEM analysis of the interface between filling and root-end filling materials. The percentage of gaps at the interfacial area was calculated by using Image Tool 3.0 software. Super EBA presented the higher percentage of gaps (1.5 ± 0.67%), whereas MTA presented the lowest values (0.33 ± 0.20%; p = 0.0004). Despite the statistical differences observed between Super EBA and MTA, all the root-end filling materials presented great adaptation to the filling material, presenting small amount of gaps. PMID:23733414

  8. Scanning electron microscopy reveals severe external root resorption in the large periapical lesion.

    Science.gov (United States)

    Ookubo, Kensuke; Ookubo, Atsushi; Tsujimoto, Masaki; Sugimoto, Kouji; Yamada, Shizuka; Hayashi, Yoshihiko

    2016-06-01

    The present study was designed to investigate the relationships between clinicopathological findings and the resorptive conditions of root apices of teeth with periodontitis. The samples included 21 root apices with large periapical radiolucent lesions. The preoperative computed tomography (CT) and intraoperative findings were correlated with the presence, extension, and the progression pattern of periapical resorption using a scanning electron microscope. The subjects' age, gender, chief complaint, type of tooth, percussion test results, size of periapical lesion using CT, and intraoperative findings were recorded. All apicoectomies were performed under an operative microscope for endodontic microsurgery. A significant large size was observed in cystic lesions compared with granulomatous lesions. The cementum surface at the periphery of the lesion was covered with globular structures (2-3 μm in diameter). Cementum resorption started as small defect formations at the surface. As the defect formation progressed, a lamellar structure appeared at the resorption area, and the size of globular structures became smaller than that of globules at the surface. Further resorption produced typical lacuna formation, which was particularly observed in fracture cases. The most morphologically severe destructive pattern of dentin resorption was observed in large cystic lesions. This study is the first report to elucidate the relationships between three clinical types of undesirable periapical lesions: (1) undertreatment, (2) periapical fracture, (3) macro-level resorption, and the microstructure of external root resorption including from small defects at the cementum surface to a significant destructive pattern inside the dentin. Microsc. Res. Tech. 79:495-500, 2016. © 2016 Wiley Periodicals, Inc. PMID:26957368

  9. Effectiveness of Different Therapies for Chronic Periapical Lesions: A Systematic Review%不同方法治疗慢性根尖周病变疗效的系统评价

    Institute of Scientific and Technical Information of China (English)

    刘佳怡; 迪丽努尔·阿吉

    2013-01-01

    Objective To systematically review the effectiveness of different therapies for chronic periapical lesion (CPL), such as different root canal surgeries and conventional root canal obturation. Methods The following databases such as The Cochrane Library, MEDLINE, EMbase, VIP, CNKI, CMB and WanFang Data were searched to collect the randomized controlled trials (RCTs) and concurrent controlled trials (CCTs) on CPL treated by both conventional root canal obturation and different root canal surgeries such as periapical curettage, retrograde obturation and apicoectomy. The references of the included studies were also retrieved, and the retrieval time was from inception to October 2012. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality. Then after cross-checking, the meta-analyses were performed by using RevMan 5.0 software. Results A total of 7 RCTs and 11 CCTs involving 1 663 patients were included. Among all 1 727 teeth, 1 661 met the inclusion criteria which contained 1 151 in the root canal surgeries groups, and 510 in the conventional groups. The methodological quality of all included studies was low. The results of meta-analysis showed that, in general, different root canal surgeries plus conventional root canal obturation were more effective than root canal obturation alone (RR=1.12, 95%CI 1.08 to 1.18, P<0.000 01). The results of sub-group analysis revealed that, the total effective rate of both retrograde obturation (RR=1.3, 95% CI 1.15 to 1.46, P<0.000 1) and apicoectomy (RR=1.23, 95% CI 1.04 to 1.46, P=0.02) was superior to that of periapical curettage, with significant differences in both sub-groups. But retrograde obturation took similar effect as apicoectomy did, without a significant difference (RR=0.96, 95% CI 0.83 to 1.11, P=0.61). Conclusion This systematic review suggests that, root canal obturation plus root canal surgeries is superior to root canal

  10. MICROLEAKAGE ASSOCIATED WITH RETROGRADE FILLING AFTER ROOT END RESECTION (in vitro study

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    Elka Radeva

    2014-09-01

    Full Text Available The purpose of the study is to compare microleakage after root end resection of the two materials (MTA and Biodentine for two different apical cavity preparation using the method of penetration of dye - 0, 2 % Rodamine B. Materials and Methods: Forty-eight extracted single-rooted human teeth were used in this study. The resection was made at 3 mm from the root tip with a high speed diamond bur at an angle of 90 degree to the long axis of the tooth. For the retrofilling, ProRoot MTA and Biodentine were used. The teeth were divided into 5 groups: 1st group (10 teeth – the apical cavity was prepared with stainless steel fissure bur #10 at 3 mm depth in the root canal parallel to the long axis of the tooth and is filled retrograde with MTA. 3rd group (10 teeth - retrofilling with Biodentine. 2 nd group (10 teeth - with a round bur apical cavity was prepared with a concave shape and cavity along the root canal with a depth of 3 mm and retrograde obturation with MTA. 4th group (10 teeth - retrofilling with Biodentine. 5th group (8 teeth - control group - with preparation of the cavity after resection without retrofilling. The outer surface of the root is covered with two layers of varnish, with the exception of the apical 3 mm then immersed in 0.2% Rodamine B for 72 h. The degree of penetration of the dye is measured in millimeters. Results: Relative highest median value of penetration of the dye in mm is in the control group. MTA group has a higher value in mm versus the Biodentine. The apical preparation with a concave shape and cavity along the root canal with a depth of 3 mm after apicoectomy is important to reduce apical microleakage. Conclusion: Different apical cavity preparations in both types of material have led to the microleakage dye, but to varying degrees.

  11. SEM investigation of Er:YAG laser apical preparation

    Science.gov (United States)

    Bǎlǎbuc, Cosmin; Todea, Carmen; Locovei, Cosmin; RǎduÅ£ǎ, Aurel

    2016-03-01

    Endodontic surgery involves the incision and flap elevation, the access to the root tip, its resection, the cavity retrograde preparation and filling it with biocompatible material that provides a good seal of the apex[1]. Apicoectomy is compulsory in endodontic surgery. The final stage involves the root retropreparation and the carrying out of the retrograde obturation. In order to perform the retrograde preparation the endodontist can use various tools such as lowspeed conventional handpieces, sonic and ultrasonic equipment. The ideal depth of the preparation should be 3 mm, exceeding this value may affect the long-term success of the obturation [2]. Resection at the depth of 3 mm reduces apical ramifications by 98% and lateral root canals by 93%. The ultrasonic retropreparation has numerous advantages compared to the dental drill. Firstly, the cavity will be in the axis of the tooth which implies a minimum destruction of the root canal morphology. The preparations are precise, and the cutting pattern is perpendicular to the long axis of the root, the advantage being the reduction in the number of dentinal tubules exposed at the resected area [3]. Therefore, the retrograde filling is the procedure when an inert and non-toxic material is compacted in the apically created cavity.[4,5]. The Er:YAG laser is the most common wavelength indicated for dental hard tissue preparation. Its natural selectivity offers a significant advantage compared to the conventional hard tissue preparation [6-9].The purpose of this in vitro study was to investigate the quality of Er:YAG laser apical third preparation using Scanning Electron Microscopy (SEM), in comparison with the conventional ultrasonic method.

  12. Apicectomia con obturación retrograda e injerto óseo para el tratamiento de una lesión apical

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    Antonio Diaz Caballero

    2013-10-01

    lesion and overfilling root system, describes the surgical technique of apicectomy and retrograde filling with bone graft as a better alternative for bone regeneration.Keywords: Apicoectomy; Sealing retrograde; bone graft. 

  13. Lateral periodontal kist görünümlü radiküler kistin ve eksternal kök rezorpsiyonunun tedavisi

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    Hakan Bayindir

    2012-01-01

    Full Text Available

    Radicular cysts are inflammatory jaw cysts at the apices of teeth with infected and necrotic pulps. Radicular cyst treatment is mainly based on root canal treatment and if necessary surgical excision of the cyst lining with apicoectomy with retrograde filling. The lateral periodontal cyst (LPC is an uncommon developmental odontogenic cyst. The LPC appears as a well circumscribed round or ovoid radiolucent area, usually with a sclerotic margin on the lateral aspect of a root. The vitality of adjacent teeth plays an important role in the differential diagnosis. Although radiographic examination is an important resource in clinical diagnosis; misdiagnosis may lead to extraction of teeth, unnecessary periodontal treatment and recurrence of the lesion because of inadequate radiologic examination. In this present case, surgical endodontic theraphy of a radicular cyst mimicking lateral periodontal cyst with external root resorption related to previous unsuccessful root canal treatment and large diameters of the lesion by a Erbium, Cronium: Yittrium: Scandium, Gallium and Garnet Er,Cr:YSGG laser and mineral trioxiside aggregate (MTA is presented.

     

    ÖZET

    Radiküler kistler, enfekte ve nekrotik pulpalı dişlerin apekslerinde oluşan enflamatuar çene kistleridir. Radiküler kistlerin tedavisinde öncelikle ilgili dişe kanal tedavisi uygulanmakta, eğer gerekli görülürse apiksektomi ve retrograd dolgu ile birlikte kistin cerrahi eksizyonu yapılmaktadır. Lateral periodontal kist (LPK ise çok yaygın olarak görülmeyen, gelişimsel bir odontojenik kisttir. Kökün lateral yüzeyinde, sklerotik kenarlı, iyi sınırlanmış yuvarlak veya oval radyolusent bir görüntü veren LPK genellikle rutin radyografik muayenedetespit

  14. A retrospective study of 180 cases of apical microsurgery%显微根尖外科手术180例回顾性分析

    Institute of Scientific and Technical Information of China (English)

    王捍国; 李丹; 田宇; 余擎

    2014-01-01

    Objective To evaluate the outcome and the potential prognostic factors of apical microsurgery.Methods The teeth with persistent periapical diseases were treated by microsurgery using micro instruments,ultrasonic retrotips and mineral trioxide aggregate(MTA) under dental operate microscope.The procedure includes incision and flap retraction,osteotomy,apicoectomy,retro-preparation and retro-filling of root canal.Patients were recalled at 1,3,6,and 12-month intervals.The outcome was evaluated by clinical and radiographic examinations,and the potential prognostic factors were analyzed.Results One hundred and eighty cases(240 teeth),including 132 upper anterior teeth,22 lower anterior teeth,31 upper premolars,18 lower premolars,19 upper molars and 18 lower molars,were treated by microsurgery between July 2010 and December 2012.A total of 152 cases(207 teeth) were recalled.The application of the apical microsurgery included failure of previous endodontic treatment,periapical lesion with post,periapical cyst,calcified canals,separated instruments,overfilling,open apex,root facture,failure of previous apical surgery,apical fenestration,and special root canal system.The success rate was 90.8% (188/207).Age,sex,tooth position,type of periapical radiolucency,fistula and clinical application type appeared to have a negative effect on the outcome.Endo-perio lesion was a significant factor.Eighteen cases (19 teeth) failed mainly because of periodontally involved lesion and vertical root fracture.Conclusions Apical microsurgery,which combines the magnification and illumination provided by the microscope with the proper use of micro instruments,can treat the teeth with persistent periapical diseases precisely and less traumatically with high success rate.Case selection and standardized operations play a key role for success.%目的 分析显微根尖外科手术的临床应用、成功率及其预后影响因素,以期为临床提供参考.方法 回顾性分析进行显微根