RESUMEN
OBJECTIVES: The objective of this in vitro study was to evaluate the use of the Neodymium:Yttrium-Aluminium-Garnet (Nd:YAG) laser as part of the root canal treatment on the penetration of sealer into dentinal tubules. METHODS: Eighty extracted lower premolars were randomly assigned to two groups (n=40 each): Control group (CG), subjected to a conventional protocol of endodontic instrumentation and obturation; and Laser group (LG), in which Nd:YAG laser irradiations were combined with conventional preparation and obturation. Endodonted samples were sectioned at 3 and 5 mm from the apex and observed under a confocal scanning microscope (CLSM). The penetration depth into the dentinal tubules and the extension of the intracanal perimeter infiltrated by sealer were measured. The Student-Newman-Keuls test was run for between-group comparisons (α=.05). RESULTS: The depth of sealer penetration into dentinal tubules did not differ among groups. LG samples showed the significantly highest percentage of penetrated perimeter at 3 mm from the root apex. Within each group, the greatest depth of penetration (P=.0001), and the major percentage of penetrated perimeter (P<.001), were recorded at 5 mm. CONCLUSIONS: The application of the Nd:YAG laser after instrumentation did not improve the depth of sealer penetration into the dentinal tubules. The laser enlarged the total penetrable perimeter near the apex. CLINICAL SIGNIFICANCE: The Nd:YAG laser may be an appropriate complement in root canal treatment, as it enhances the sealer adaptation to the dentinal walls in the proximity of the apex.
Asunto(s)
Cavidad Pulpar/efectos de la radiación , Dentina/efectos de la radiación , Láseres de Estado Sólido/uso terapéutico , Materiales de Obturación del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular/métodos , Cavidad Pulpar/ultraestructura , Dentina/ultraestructura , Resinas Epoxi/química , Resinas Epoxi/uso terapéutico , Colorantes Fluorescentes , Gutapercha/química , Gutapercha/uso terapéutico , Humanos , Ensayo de Materiales , Microscopía Confocal , Distribución Aleatoria , Rodaminas , Materiales de Obturación del Conducto Radicular/química , Obturación del Conducto Radicular/métodos , Preparación del Conducto Radicular/instrumentación , Propiedades de Superficie , Ápice del Diente/efectos de la radiación , Ápice del Diente/ultraestructuraRESUMEN
Introducción: La pérdida dental en sectores posteriores del maxilar, implica en muchos casos una escasa cantidad de hueso remanente que imposibilita la colocación de implantes dentales. Para solucionar este problema existen técnicas como la elevación sinusal que si bien soluciona el problema en muchos casos, no está exenta de complicaciones. La migración o el desplazamiento de implantes dentales a regiones anatómicas como el seno maxilar, es una rara pero posible complicación. Objetivo: Presentar un caso clínico de un implante dental desplazado accidentalmente al seno maxilar, para describir los factores que justifican este fenómeno y establecer una pauta terapéutica para este tipo de casos. Caso clínico: Paciente varón de 32 años al que se le realizó la colocación de implantes osteoinegrados en el segundo cuadrante, acude a nuestro servicio y se le realiza un estudio radiológico en el que evidenciamos la imagen de un implante dental a nivel del seno maxilar que fue extraído mediante abordaje intraoral. Se realizaron controles radiográficos con un seguimiento de un año es de la extracción del implante. Conclusión: Existen múltiples factores que explican la migración de un implante dental al interior del seno maxilar, la actitud siempre debe ser la de extraerlo bien sea con abordaje intraoral o mediante endoscopio por vía nasal (AU)
Introduction: Tooth loss in the maxillary posterior sites, in many cases involves a small amount of remaining bone which precludes placing dental implants. To solve this problem there are techniques such as sinus lifting, but although it solves the problem in many cases, it is not without its complications. The migration or displacement of dental implants to anatomical regions such as the maxillarysinus is a rare but possible complication. Objective: To present a clinical case of a dental implant that accidentally moved to the maxillary sinus, to describe the factors causing this phenomenon and establish guidelines for treatment of this type of case. Clinical case: Male patient, aged 32, who was given osseointegrated implants in the second quadrant, came to our service and through a radiology study we saw the image of a dental implant at the level of the maxillary sinus that was extracted using the intraoral approach. There were radiography controls monitoring progress for a year after the extraction of the implant. Conclusion: There are many factors that can explain the migration of a dental implant into the maxillary sinus, and the current approach must be to extract it well using either with intraoral approach or through nasal endoscopy (AU)