RESUMEN
The aim of this study was to evaluate three reciprocating systems and complementary cleaning methods on filling material removal during retreatment of flattened canals. Thirty-six mandibular incisors were prepared using rotary instruments up to size 25.08 and filled using the single-cone technique. Subsequently, the teeth were divided into three groups (n = 12) according to retreatment procedures: Reciproc Blue (RB): 25/0.08 and 40/0.06; ProDesign R (PDR): 25/0.06 and 35/0.05; and WaveOne Gold (WOG): 25/0.07 and 35/0.06. The remaining filling volume materials were assessed by means of micro-CT imaging before and after retreatment. After this, the specimens were subdivided into three groups according to complementary cleaning methods: XP-Endo Shaper (30/0.01); passive ultrasonic irrigation (PUI); 60° oscillatory instrumentation with #30 H-file, and micro-CT scan was taken. Then, the roots were cut in half and the samples were analyzed by scanning electron microscope (SEM). The data were analyzed statistically using Kruskal-Wallis and Dunn's Multiple Comparison test with significance level of 5%. None of the reciprocating files promoted complete removal of filling material and there was no statistical difference between the groups, regardless instrument size (p > 0.05). Complementary cleaning methods increased remnant filling removal (p < 0.05). XP-endo Shaper significantly reduced the amount of filling material in the apical and middle thirds, compared with H-files (p < 0.05), with no difference with PUI. In the SEM, there was no statistical difference among the instruments (p > 0.05). The reciprocating systems showed similar effectiveness in removing root filling material. Complementary cleaning method with the XP-Shaper enhanced filling material removal.
Asunto(s)
Cavidad Pulpar/efectos de los fármacos , Materiales de Obturación del Conducto Radicular/farmacología , Obturación del Conducto Radicular/normas , Preparación del Conducto Radicular/métodos , Humanos , Microscopía Electrónica de Rastreo , Retratamiento , Preparación del Conducto Radicular/normas , Microtomografía por Rayos XRESUMEN
Objectives: To evaluate radiographically the technical quality of root canal fillings performed by dental students at the School of Dentistry, University of the West Indies. Methods: The dental school's database of student clinical activity between the period 2000-2004 was investigated for patients who completed root canal treatment. For each root filled tooth, at least four periapical radiographs were examined: preoperative, working length determination, try in GP point and postoperative. The final sample consisted of 198 patients with 288 root filled teeth and 460 canals. The length, presence of voids, taper, curvature of canal and fractured instruments were recorded and scored. Chi-squared analysis was used to determine statistically significant differences between the technical quality of root fillings and tooth type. Results: Sixty-three percent, 27.6% and 72.2% of root filled canals had adequate length, density and taper respectively. Fractured instruments were found in only 7 of the root canals (1.5%).The acceptability for both length and taper was found in 31.5% of canals. A significantly greater proportion of root fillings of adequate length and taper were observed in straight canals compared to curved canals (P<0.05). However no significant difference was observed for the presence of voids in straight or curved canals. The percentage of root fillings with adequate length was significantly greater in maxillary teeth than in mandibular teeth (P <0.05) and in anterior teeth compared to posterior teeth (P< 0.001).The overall acceptability of root fillings having adequate length and taper, absence of voids and no fractured instruments was found in 10.9% of canals. The mandibular incisors had the greatest level of acceptability for all observed parameters (27.3%). Conclusion: The overall acceptability of root fillings performed by dental undergraduate students was only 10.9%. Changes in teaching methods may be required to improve the quality of root canal treatment among dental students.
Asunto(s)
Humanos , Materiales de Obturación del Conducto Radicular/normas , Obturación del Conducto Radicular/normas , Estudiantes de Odontología , Preparación del Conducto Radicular/normas , Trinidad y Tobago , Competencia Clínica/normas , Cavidad Pulpar/diagnóstico por imagen , Endodoncia/educaciónRESUMEN
Objetivo: O objetivo deste estudo foi avaliar, por microtomografia computadorizada (micro-CT), a qualidade da obturação de canais mesiais de molares inferiores utilizando os cimentos EndoSequence BC Sealer e AH Plus. Metodologia: Vinte molares inferiores foram divididos em dois grupos (n=10) de acordo com o cimento utilizado na obturação. O preparo quimico-mecânico foi realizado com as limas rotatórias K3XF. As amostras foram escaneadas por micro-CT antes e depois da intrumentação, e depois da obturação. O volume do sistema de canais radiculares (SCR) após a instrumentação e o volume da obturação foram calculados, assim, o volume percentual da obturação e dos espaços vazios pôde ser obtido. Resultados: Todas as amostras apresentaram volumes de obturação menores do que o volume pós instrumentação do SCR (p < 0,05). Não houve diferença estatística significante entre os grupos quanto ao volume da obturação e o volume de espaços vazios (p >0,05). Conclusões: Os cimentos endodônticos EndoSequence BC Sealer e AH Plus proporcionaram uma qualidade semelhante de obturação em canais mesiais de molares inferiores. Nenhum dos cimentos foi capaz de proporcionar total preenchimento do SCR. (AU)
Aim: The aim of this study was to evaluate, by computadorized microtomography (micro-CT), the root canal filling quality of mesial roots of mandibullar molars using EndoSequence BC Sealer and AH Plus sealers. Methodology: Twenty mandibular molars were divided into two groups (n=10) according to the sealer used in the obturation. Root canals were prepared using K3XF rotary files. The specimens were scanned before and after instrumentation, and after obturation by using micro-CT. The root canal system volume after instrumentation, and the filling volume were calculated, so the percentage volume of the filling, and voids and gaps could be obtained. Results: All the specimens presented the final volume smaller than the inicial volume (P < 0.05). There was no significant difference between groups with regard to the filling volume and voids and gaps volume (P > 0.05). Conclusions: EndoSequence BC Sealer and AH Plus sealer promoted a similar root filling quality in mesial root canals of madibullar molars. None of the sealers was able to fill the entire area of the root canal system. (AU)
Asunto(s)
Humanos , Cementos Dentales/normas , Materiales de Obturación del Conducto Radicular/normas , Obturación del Conducto Radicular/normas , Ensayo de Materiales , Diente Molar , Microtomografía por Rayos XRESUMEN
OBJECTIVE: The aim of this study was to investigate the relationship between quality of root canal obturations and the presence/absence of periapical lesion in elderly patients. METHODOLOGY: This was a systematic conducted by means analysing studies on the quality of root canal obturations and their relationship with periapical health in elderly patients. The methodological procedures were based on Cochrane. The inclusion criteria for selection of the titles were the following: (i) studies in humans; (ii) sample consisting of individuals aged 60 years or older; (iii) intending criteria defined for the evaluation of quality of root canal obturations; (iv) intending criteria defined for the evaluation of periapical health; (v) determination of the relationship between quality of endodontic treatment and presence of periapical lesions; and (vi) articles published between 1st March 2003 and 1st March 2013. RESULTS: A total of 3161 potentially relevant studies were found in three databases chosen for the literature review, with 1669 being repeated and 395 duplicated. Therefore, the abstracts of 1097 studies were read. A total of 1022 studies were excluded, resulting in 75 articles for full analysis. However, no study could be included in the present literature review. CONCLUSION: There is no consensus on the relationship between the quality of root canal obturations and periapical health in older patients.
Asunto(s)
Periodontitis Periapical/patología , Obturación del Conducto Radicular/normas , Anciano , Humanos , Periodontitis Periapical/etiologíaRESUMEN
INTRODUCTION: This cross-sectional study determined the prevalence of apical periodontitis in 1086 root canal-treated teeth from an urban Colombian population and evaluated the association of several factors with the periradicular status. METHODS: Periapical radiographs were used for analyses, and teeth were classified as healthy or diseased according to the periradicular status. Other factors were also evaluated for their association with the periradicular conditions, including gender, quality of both endodontic treatment and coronal restoration, apical level of filling, and presence of post restoration. RESULTS: Fifty-one percent of the treated teeth were classified as healthy. Only 33% of the teeth had endodontic treatment rated as adequate. The quality of both endodontic treatment and coronal restoration significantly influenced the periradicular conditions (P < .001). Combined data revealed that teeth with both adequate endodontic treatment and adequate restorations showed significantly better periradicular status than the other combinations (P < .01), except for teeth with adequate treatment and inadequate restoration (P = .08). Canals filled up to 0-2 mm short of the apex had a significantly higher number of teeth rated as healthy than overfilled or underfilled cases (P = .02). Regression analysis showed that the quality of endodontic treatment was the most significant factor influencing the periradicular status (P < .001). Gender and presence of post restoration had no association with the periradicular conditions. CONCLUSIONS: Data from this Colombian population showed a relatively high prevalence of apical periodontitis in root canal-treated teeth. This was largely due to an equally high prevalence of treatments performed under substandard technical quality. The quality of the endodontic treatment was the most determinant factor for healthy periradicular status.
Asunto(s)
Periodontitis Periapical/epidemiología , Tratamiento del Conducto Radicular/estadística & datos numéricos , Diente no Vital/epidemiología , Salud Urbana/estadística & datos numéricos , Adulto , Colombia/epidemiología , Estudios Transversales , Restauración Dental Permanente/normas , Restauración Dental Permanente/estadística & datos numéricos , Femenino , Humanos , Masculino , Técnica de Perno Muñón/estadística & datos numéricos , Prevalencia , Calidad de la Atención de Salud , Radiografía de Mordida Lateral/estadística & datos numéricos , Radiografía Dental Digital/estadística & datos numéricos , Obturación del Conducto Radicular/normas , Obturación del Conducto Radicular/estadística & datos numéricos , Tratamiento del Conducto Radicular/normasRESUMEN
OBJECTIVES: This study was aimed to evaluate different endodontic obturation techniques (Thermafil, lateral condensation, and Tagger's hybrid technique) regarding the homogeneity of the obturation radiopacity. MATERIALS AND METHODS: Seventy roots of human upper central incisors were filled using the Thermafil system, lateral condensation. and Tagger's hybrid technique. Radiopacity of the filling was evaluated based on mean of grey levels, and its homogeneity was assessed by the coefficient of variation (CV), analyzing the histograms obtained of digitized and digital radiographs. RESULTS: The increase in mean grey levels (p < 0.001) and reduction in the CV (p < 0.05) were higher for Tagger's hybrid technique compared with other methods. CONCLUSIONS: Tagger's hybrid technique provided better homogeneity of the obturation radiopacity and better apical sealing compared with lateral condensation technique. CLINICAL RELEVANCE: The results suggest that Tagger's hybrid technique provided the best compaction of the root canal filling material, an important factor for the sealing of obturations and, consequently, for the effectiveness of treatment.
Asunto(s)
Cavidad Pulpar/diagnóstico por imagen , Radiografía Dental Digital , Obturación del Conducto Radicular/normas , Absorciometría de Fotón , Colorantes , Medios de Contraste/química , Filtración Dental/clasificación , Ácido Edético/uso terapéutico , Gutapercha/química , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Incisivo/diagnóstico por imagen , Azul de Metileno , Materiales de Obturación del Conducto Radicular/química , Irrigantes del Conducto Radicular/uso terapéutico , Obturación del Conducto Radicular/métodos , Preparación del Conducto Radicular/instrumentación , Preparación del Conducto Radicular/métodos , Hipoclorito de Sodio/uso terapéutico , Propiedades de Superficie , Raíz del Diente/diagnóstico por imagen , Película para Rayos XRESUMEN
The objective of this study was to evaluate radiographically the technical quality of root canal fillings performed by dental students at the School of Dentistry, University of the West Indies. The school's database between 2000 and 2004 was investigated for patients with completed root canal treatment. The final sample consisted of 198 patients with 288 root-filled teeth and 460 canals. The length, presence of voids, taper, curvature of canal and fractured instruments were recorded and scored. Chi-squared analysis was used to determine statistically significant differences between the technical quality of root fillings and tooth type. Sixty-three per cent, 27.6% and 72.2% of root-filled canals had adequate length, density and taper respectively. The overall acceptability of root fillings having adequate length and taper, absence of voids and no fractured instruments was found in 10.9% of canals. Changes in teaching methods may be required to improve the technical quality of root canal treatment done by dental students.
Asunto(s)
Competencia Clínica/estadística & datos numéricos , Restauración Dental Permanente/normas , Endodoncia/educación , Obturación del Conducto Radicular/normas , Estudiantes de Odontología , Adulto , Cavidad Pulpar/diagnóstico por imagen , Humanos , Calidad de la Atención de Salud , Radiografía , Obturación del Conducto Radicular/efectos adversos , Obturación del Conducto Radicular/métodos , Raíz del Diente/diagnóstico por imagen , Trinidad y TobagoRESUMEN
Este trabalho teve como objetivo avaliar qualitativamente a obturação de canais radiculares, observando a interação entre a técnica híbrida de Tagger com a condensação lateral ativa quando do emprego dos cimentos Endomethasone® e Sealer 26®. Para isso foram utilizados quarenta caninos superiores humanos, que foram instrumentados pela técnica escalonada regressiva. Feito isso foram divididos em 4 grupos com 10 dentes cada, obedecendo a seguinte ordem: Grupo I: Condensação lateral ativa + Endomethasone ®; Grupo II: técnica híbrida de Tagger + Endomethasone®; Grupo III: Condensação lateral ativa + Sealer 26 ® e Grupo IV: Técnica híbrida de Tagger + Sealer 26®. Após a obturação os dentes foram radiografados tanto no sentido mésiodistal, quanto no vestíbulo-lingual e em seguida clivados no sentido longitudinal. As radiografias foram utilizadas para avaliar possíveis falhas na obturação, nas quais foram atribuídos escores de acordo com as mesmas. Já as hemisecções foram analisadas por meio de lupa esterioscópica. Os dados obtidos foram submetidos ao teste de Krusskal-Wallis para análise global e o teste de Miller para comparações individuais, ambos com o nível de significância 5%. De acordo com os resultados ficou evidenciado melhor qualidade da obturação quando da associação da técnica híbrida de Tagger com o cimento Endomethasone®. Assim conclui-se que a técnica híbrida de Tagger foi superior a condensação lateral ativa e que cimentos derivados do óxido de zinco e eugenol propiciam, principalmente na radiografia, obturações mais homogêneas que os cimentos resinosos, especialmente na técnica híbrida de Tagger
The aim of this study was to evaluate the quality of root canal fillings, observing the interaction between the Taggers hybrid technique and active lateral condensation when applying Endomethasone and Sealer 26 cements. The root canals of forty extracted maxillary canines were prepared by the classic technique. The teeth were divided into four groups of 10 teeth each, following this order: Group I: Active lateral condensation + Endomethasone, Group II: Taggers hybrid technique + Endomethasone, Group III: Active lateral condensation + Sealer 26 and Group IV: Taggers hybrid technique + Sealer 26. After root canal filling, each tooth was exposed to X-rays, in both direction as in the mesiodistal and buccolingual and then cleaved longitudinally. The resulting images were interpreted for presence of gaps and scores were assigned by endodontists. The half-sections were analyzed by stereoscopic magnifying glass. The data were tested using the Krusskal-Wallis test for global analysis of individual comparisons to Miller test, both with the significance level 5%. According to the results was apparent the quality of the filling when using the association of Taggers hybrid technique with Endomethasone cement. It was concluded that the Taggers hybrid technique was superior to active lateral condensation and cements derived from zinc oxide and eugenol provided, especially in X-rays, more homogeneous fillings than the resin cements, especially in the Taggers hybrid technique
Asunto(s)
Humanos , Cemento de Óxido de Zinc-Eugenol/química , Gutapercha , Hidróxido de Calcio/química , Obturación del Conducto Radicular/normas , Radiografía/métodos , Tratamiento del Conducto Radicular/métodos , Endodoncia/métodos , Estadísticas no ParamétricasRESUMEN
O prognóstico do tratamento endodôntico está geralmente correlacionado à sua qualidade técnica de forma direta, seguido de uma adequada restauração. O objetivo deste trabalho foi verificar o status periapical em dentes com tratamento endodôntico em uma população adulta da cidade de Belo Horizonte, Minas Gerais,Brasil. O estudo correlacionou a qualidade das restaurações coronárias e sua interrelação com a situação periapical em amostras de 603 pacientes, perfazendo um total de 1006 dentes, os quais foram submetidos a completo exame radiográfico periapical. A análise dos resultados relacionou a qualidade dos tratamentos endodônticos e das restaurações coronárias, correlacionando com a situação periapical dos dentes. Concluiu-se que a qualidade das restaurações coronárias é tão importante quanto à qualidade do tratamento endodôntico.
Generally speaking, the prognosis of endodontic treatment is directly related to its technical quality, followed by an appropriate restoration. The aim of this study was to verify the incidence of periapical lesions in teeth treated endodontically in the adult population of Belo Horizonte, Minas Gerais, Brazil. This study correlated the quality of coronary obturations of these teeth and their interrelation with the teeths periapical situation. Samples from 603 patients, were analyzed, 1006 teeth in all, which were then submitted to a complete periapical radiographic examination. The analysis of the results, correlating the endodontic treatment with the periapicalsituation, was proven. It could be concluded that both, an appropriate coronary restoration as well as an appropriate endodontic treatment should have a direct influence on the success of the treatment.
Asunto(s)
Obturación del Conducto Radicular/normas , Enfermedades Periapicales , Restauración Dental Permanente/normas , Tratamiento del Conducto Radicular/normasRESUMEN
INTRODUCTION: The aim of this study was to radiographically evaluate the relationship between the quality parameters of root canal fillings (apical extension, homogeneity, and taper) and periapical status. In addition, groups of teeth and complicating factors of endodontic treatment were assessed. METHODS: This retrospective cohort study assessed the quality and periapical status of root-filled canals in a 4- to 7-year follow-up period. Each parameter was dichotomized into ideal and altered conditions. A root-filled canal with an ideal condition for all 3 parameters was considered perfect, whereas the loss of 1 or more ideal conditions defined satisfactory or deficient fillings, respectively. The periapical statuses at baseline and follow-up were classified as normal, slight widening of the apical periodontal ligament, or periapical lesion. RESULTS: A total of 291 root-filled canals were evaluated. The prevalence of perfect, satisfactory, and deficient fillings was 54.6%, 37.5%, and 7.9%, respectively (P < .05). The periapical status at follow-up showed normal, slight widening of the apical periodontal ligament, or periapical lesion in 69.8%, 19.2%, and 11% of the roots, respectively (P < .05). The multivariate logistic regression showed that only preoperative periapical lesions (odds ratio, 2.99; 95% confidence interval, 1.27-7.03) and altered tapers (odds ratio, 3.73; 95% confidence interval, 1.51-9.24) were significantly associated with postoperative periapical lesions. CONCLUSIONS: Radiographic parameters of the quality of root-filled canals showed a significant relationship with the periapical status. Nevertheless, an altered taper was the main factor associated with the maintenance or development of periapical lesions after 4- to 7-year follow-up period.
Asunto(s)
Enfermedades Periapicales/diagnóstico por imagen , Calidad de la Atención de Salud , Obturación del Conducto Radicular/normas , Distribución de Chi-Cuadrado , Estudios de Cohortes , Cavidad Pulpar/diagnóstico por imagen , Estudios de Seguimiento , Humanos , Modelos Logísticos , Variaciones Dependientes del Observador , Enfermedades Periapicales/etiología , Enfermedades Periapicales/terapia , Ligamento Periodontal/diagnóstico por imagen , Radiografía Dental , Estudios Retrospectivos , Obturación del Conducto Radicular/efectos adversos , Estadísticas no ParamétricasRESUMEN
The aim of this ex vivo was to investigate if two radiopaque root canal sealers with different formulations would influence the radiographic perception of root canal fillings. The root canals of 48 extracted maxillary canines were prepared and randomly assigned to 3 groups of 16 specimens each. In each group, the root canals were filled by lateral condensation of gutta-percha and one of the tested sealers: Endométhasone, Sealer 26, or a non-radiopaque sealer. A through-and-through void was simulated in half of the specimens from each group (n=8). The buccolingual radiographic images obtained were randomly interpreted for voids existence by a radiologist and an endodontist. The differences in sensitivity and specificity between groups and examiners were compared using, respectively, Fisher's Exact and McNemar tests at 5% significance level. Both radiopaque sealers caused a significant decrease in sensitivity at the coronal part of fillings. The use of Endométhasone increased specificity values for both coronal and apical portions of the root canal fillings. In conclusion, the tested sealers influenced the radiographic perceptions of laterally condensed root canal fillings in a different way.
Asunto(s)
Adaptación Marginal Dental/normas , Cavidad Pulpar/diagnóstico por imagen , Radiografía Dental/normas , Materiales de Obturación del Conducto Radicular/química , Obturación del Conducto Radicular/normas , Bismuto/química , Hidróxido de Calcio/química , Diente Canino , Dexametasona/química , Combinación de Medicamentos , Formaldehído/química , Humanos , Hidrocortisona/química , Maxilar , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Estadísticas no Paramétricas , Timol/análogos & derivados , Timol/químicaRESUMEN
The aim of this ex vivo was to investigate if two radiopaque root canal sealers with different formulations would influence the radiographic perception of root canal fillings. The root canals of 48 extracted maxillary canines were prepared and randomly assigned to 3 groups of 16 specimens each. In each group, the root canals were filled by lateral condensation of gutta-percha and one of the tested sealers: Endométhasone, Sealer 26, or a non-radiopaque sealer. A through-and-through void was simulated in half of the specimens from each group (n=8). The buccolingual radiographic images obtained were randomly interpreted for voids existence by a radiologist and an endodontist. The differences in sensitivity and specificity between groups and examiners were compared using, respectively, Fisher's Exact and McNemar tests at 5 percent significance level. Both radiopaque sealers caused a significant decrease in sensitivity at the coronal part of fillings. The use of Endométhasone increased specificity values for both coronal and apical portions of the root canal fillings. In conclusion, the tested sealers influenced the radiographic perceptions of laterally condensed root canal fillings in a different way.
O propósito deste estudo ex vivo foi investigar se dois cimentos obturadores de fórmulas diferentes influenciariam a percepção radiográfica de obturações de canais radiculares. Os canais radiculares de 48 caninos superiores extraídos foram preparados e divididos em 3 grupos. Em cada grupo os canais foram preenchidos através da condensação lateral da guta-percha e de um dos cimentos testados (Endométhasone, Sealer 26 e cimento não-radiopaco), e um defeito de ponta a ponta foi simulado em metade dos espécimes de cada grupo (n=8). As imagens radiográficas vestíbulo-linguais obtidas foram aleatoriamente interpretadas quanto à existência de defeitos por um radiologista e um endodontista. As diferenças em sensibilidade e especificidade entre os grupos e examinadores foram comparadas respectivamente usando-se os testes Exato de Fisher e McNemar ajustados ao nível de significância de 5 por cento. Ambos os cimentos radiopacos ocasionaram uma redução significativa da sensibilidade na parte cervical das obturações. O uso do Endométhasone aumentou os valores de especificidade para as porções cervical e apical das obturações dos canais radiculares. Concluiu-se que os cimentos testados influenciaram de maneira distinta a percepção radiográfica de obturações endodônticas executadas com condensação lateral.
Asunto(s)
Humanos , Adaptación Marginal Dental/normas , Cavidad Pulpar , Radiografía Dental/normas , Materiales de Obturación del Conducto Radicular/química , Obturación del Conducto Radicular/normas , Bismuto/química , Diente Canino , Hidróxido de Calcio/química , Combinación de Medicamentos , Dexametasona/química , Formaldehído/química , Hidrocortisona/química , Maxilar , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Estadísticas no Paramétricas , Timol/análogos & derivados , Timol/químicaRESUMEN
This study compared the coronal and apical leakage of AH Plus with gutta-percha to that of Epiphany with Resilon. Twenty-four single rooted teeth were instrumented and divided into 2 groups according to the solutions for smear layer removal and the obturation materials employed: Group A - 17% EDTA-T and AH Plus with gutta-percha; Group B - primer and Epiphany with Resilon. The Group B specimens were light-cured in the coronal area for 20 s. The external root surfaces were covered with a double layer of ethyl cyanoacrylate, except for the apical foramen and the cavity access. The teeth were immersed in 0.5% methylene blue for 48 h. The specimens were rinsed, dried and axially split for dye penetration measurement with the ImageLab 2.3 software. The t-test showed no significant differences for coronal leakage between the groups, but there were significant differences for apical leakage between the groups (P < 0.05). AH Plus with gutta-percha and Epiphany with Resilon provided the same coronal seal, whereas Epiphany with Resilon provided the best apical seal.
Asunto(s)
Recubrimiento Dental Adhesivo , Filtración Dental/prevención & control , Materiales de Obturación del Conducto Radicular/química , Obturación del Conducto Radicular/métodos , Gutapercha , Humanos , Obturación del Conducto Radicular/normas , Preparación del Conducto Radicular , Capa de Barro Dentinario , Ápice del DienteRESUMEN
El odontólogo debe considerar las condiciones biológicas, sistémicas, psicológicas, socioeconómicas y culturales que presentan los adultos mayores para poder ofrecerles las mejores estrategias para su atención. La terapia endodóntica de este grupo etario presenta algunas diferencias con el tratamiento de los pacientes jóvenes. Como ejemplo de esas diferencias se puede señalar que su sintomatología es menos severa, atípica y vaga. Del mismo modo, en cada etapa del tratamiento se producen diferencias específicas que se deben conocer, para poder orecer a estas personas una terapia endodóntica adecuada.
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano de 80 o más Años , Cuidado Dental para Ancianos/normas , Odontología Geriátrica/tendencias , Tratamiento del Conducto Radicular/métodos , Anestesia Dental/normas , Enfermedades Periodontales/diagnóstico , Obturación del Conducto Radicular/normas , Preparación del Conducto Radicular/normas , Pulpectomía/normas , Caries Radicular , Resultado del TratamientoRESUMEN
The aim of this study was to assess the prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults. A total of 1,372 periapical radiographs of endodontically treated teeth were analyzed based on the quality of root filling, status of coronal restoration and presence of posts associated with apical periodontitis (AP). Data were analyzed statistically using odds ratio, confidence intervals and chi-square test. The prevalence of AP with adequate endodontic treatment was low (16.5%). This percentage dropped to 12.1% in cases with adequate root filling and adequate coronal restoration. Teeth with adequate endodontic treatment and poor coronal restoration had an AP prevalence of 27.9%. AP increased to 71.7% in teeth with poor endodontic treatment associated with poor coronal restoration. When poor endodontic treatment was combined with adequate coronal restoration, AP prevalence was 61.8%. The prevalence of AP was low when associated with high technical quality of root canal treatment. Poor coronal restoration increased the risk of AP even when endodontic treatment was adequate (OR=2.80; 95%CI=1.87-4.22). The presence of intracanal posts had no influence on AP prevalence.
Asunto(s)
Periodontitis Periapical/epidemiología , Tratamiento del Conducto Radicular/estadística & datos numéricos , Adolescente , Adulto , Brasil/epidemiología , Estudios Transversales , Restauración Dental Permanente/normas , Restauración Dental Permanente/estadística & datos numéricos , Estudios Epidemiológicos , Humanos , Persona de Mediana Edad , Técnica de Perno Muñón/normas , Técnica de Perno Muñón/estadística & datos numéricos , Prevalencia , Radiografía de Mordida Lateral , Factores de Riesgo , Materiales de Obturación del Conducto Radicular/normas , Materiales de Obturación del Conducto Radicular/uso terapéutico , Obturación del Conducto Radicular/normas , Obturación del Conducto Radicular/estadística & datos numéricos , Tratamiento del Conducto Radicular/normas , Adulto JovenRESUMEN
The aim of this study was to assess the prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults. A total of 1,372 periapical radiographs of endodontically treated teeth were analyzed based on the quality of root filling, status of coronal restoration and presence of posts associated with apical periodontitis (AP). Data were analyzed statistically using odds ratio, confidence intervals and chi-square test. The prevalence of AP with adequate endodontic treatment was low (16.5 percent). This percentage dropped to 12.1 percent in cases with adequate root filling and adequate coronal restoration. Teeth with adequate endodontic treatment and poor coronal restoration had an AP prevalence of 27.9 percent. AP increased to 71.7 percent in teeth with poor endodontic treatment associated with poor coronal restoration. When poor endodontic treatment was combined with adequate coronal restoration, AP prevalence was 61.8 percent. The prevalence of AP was low when associated with high technical quality of root canal treatment. Poor coronal restoration increased the risk of AP even when endodontic treatment was adequate (OR=2.80; 95 percentCI=1.87-4.22). The presence of intracanal posts had no influence on AP prevalence.
O objetivo deste estudo foi avaliar a prevalência e os fatores de risco da periodontite apical (PA) em dentes com tratamento endodôntico em seleta população adulta do Brasil. Um total de 1.372 radiografias periapicais de dentes com tratamento endodôntico foi analisado, considerando-se a qualidade da obturação, o estado da restauração coronária e a presença de pinos intrarradiculares, associados com a PA. Os dados foram analisados estatisticamente empregando-se odds ratio, intervalos de confiança e teste do qui-quadrado. A prevalência de PA associada a tratamento endodôntico adequado foi baixa (16,5 por cento). Este número reduziu-se a 12,1 por cento quando se considerou obturação e restauração coronária adequadas. Os dentes com tratamento endodôntico adequado, porém com restauração coronária inadequada apresentaram prevalência de PA igual a 27,9 por cento. A PA aumentou para 71,7 por cento nos dentes com tratamento endodôntico e restauração coronária inadequados. Quando o tratamento endodôntico inadequado foi combinado com restaurações coronárias adequadas encontrou-se 61,8 por cento de PA. A prevalência de PA foi baixa quando associada com a elevada qualidade técnica do tratamento endodôntico. A restauração coronária deficiente aumentou o risco de PA mesmo na presença de adequado tratamento endodôntico. A presença de pinos intrarradiculares não influenciou a prevalência de PA.
Asunto(s)
Adolescente , Adulto , Humanos , Persona de Mediana Edad , Adulto Joven , Periodontitis Periapical/epidemiología , Tratamiento del Conducto Radicular/estadística & datos numéricos , Brasil/epidemiología , Estudios Transversales , Restauración Dental Permanente/normas , Restauración Dental Permanente/estadística & datos numéricos , Estudios Epidemiológicos , Prevalencia , Técnica de Perno Muñón/normas , Técnica de Perno Muñón/estadística & datos numéricos , Radiografía de Mordida Lateral , Factores de Riesgo , Materiales de Obturación del Conducto Radicular/normas , Materiales de Obturación del Conducto Radicular/uso terapéutico , Obturación del Conducto Radicular/normas , Obturación del Conducto Radicular/estadística & datos numéricos , Tratamiento del Conducto Radicular/normas , Adulto JovenRESUMEN
This study compared the coronal and apical leakage of AH Plus with gutta-percha to that of Epiphany with Resilon. Twenty-four single rooted teeth were instrumented and divided into 2 groups according to the solutions for smear layer removal and the obturation materials employed: Group A - 17 percent EDTA-T and AH Plus with gutta-percha; Group B - primer and Epiphany with Resilon. The Group B specimens were light-cured in the coronal area for 20 s. The external root surfaces were covered with a double layer of ethyl cyanoacrylate, except for the apical foramen and the cavity access. The teeth were immersed in 0.5 percent methylene blue for 48 h. The specimens were rinsed, dried and axially split for dye penetration measurement with the ImageLab 2.3 software. The t-test showed no significant differences for coronal leakage between the groups, but there were significant differences for apical leakage between the groups (P < 0.05). AH Plus with gutta-percha and Epiphany with Resilon provided the same coronal seal, whereas Epiphany with Resilon provided the best apical seal.
Asunto(s)
Humanos , Recubrimiento Dental Adhesivo , Filtración Dental/prevención & control , Materiales de Obturación del Conducto Radicular/química , Obturación del Conducto Radicular/métodos , Gutapercha , Preparación del Conducto Radicular , Obturación del Conducto Radicular/normas , Capa de Barro Dentinario , Ápice del DienteRESUMEN
O objetivo deste estudo foi avaliar a qualidade das obturações dos canais radiculares realizados por estudantes de graduação em Odontologia. A amostra foi constituída por 156 canais radiculares obturados e analisados através de radiografias periapicais. Compuseram a análise dentes uni e multirradiculares com tratamento endodôntico concluído há pelo menos dois anos. As radiografias foram avaliadas por três endodontistas calibrados. A condição periapical foi classificada como tendo ou não presença de lesão. Já a qualidade da obturação radicular foi determinada através de dois parâmetros: a relação do comprimento da obturação com a extensão do canal e a qualidade da condensação do material obturador. Os resultados mostraram que 75 canais (48%) foram classificados como tendo qualidade de tratamento satisfatória. Em 101 canais radiculares (64,5%), observou-se a presença de lâmina dura, caracterizando, portanto, uma condição periapical normal.
The aim of this study was to evaluate the periapical condition and the quality of root canal fillings accomplished by undergraduat estudents. The sample was constituted by 156 filled root canals of one-root and multi-root teeth whose treatment conclusion had happened at least two years before. Periapical radiographies were evaluated by three calibrated endodontists. The periapical condition was classified as having or not having periapical lesion. The quality of the root filling was determined using two parameters: the relationship between the length of the filling with the extension of the canal and the quality of the condensation of the filling material. The results showed that 75 (48%) root canals were classified as possessing satisfactory treatment quality. In 101 root canals (64.5%), the presence of hard layer was observed, characterizing a normal periapical condition.
Asunto(s)
Humanos , Obturación del Conducto Radicular/normas , Tejido Periapical , Radiografía Dental , Estudiantes de OdontologíaRESUMEN
A avaliação dos resultados dos tratamentos endodônticos é parte integrante do plano de tratamento. Com isso, este trabalho teve a proposta de avaliar a imagem radiográfica das obturações endodônticas de 70 radiografias periapicais de boca completa dos pacientes encaminhados a clínica de Radiologia da Faculdade de Odontologia da Universidade Federal de Juiz de Fora-MG (UFJF). Os resultados demonstraram que, dos 217 dentes analisados, baseados nos critérios propostos por Gutmann (1992), 56,69% foram radiograficamente considerados como tratamento de sucesso.
The evaluation of the results of the endodontic treatments is important component of the treatment plan. This work has the purpose of evaluating the radiographic image of the root canal fillings of 70 periapical full mouth radiographs of the patients of the clinic of Radiology of the Dental School of the Federal University of Juiz de Fora-MG (UFJF). The results demonstrate that, of the 217 analyzed teeth, based on the criteria proposed by Gutmann (1992), 56,69% were radiographically considered as successful treatment.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Obturación del Conducto Radicular/normas , Radiografía Dental , Factores de Edad , Factores SexualesRESUMEN
The aim of this study was to radiographically investigate the presence of root canal ramifications found after endodontic treatment, and to determine any relationship between their presence and the type of the auxiliary chemical substance used. The study evaluated 1,470 endodontic treatments performed by final year undergraduate students at the Dental School of Piracicaba, State University of Campinas (UNICAMP), SP, Brazil, during the period from 1998 to 2000. The X-rays taken during treatment were evaluated in order to establish the presence of ramifications of the root canal system. The initial X-ray did not show the presence of any canal ramifications. After filling, X-rays showed only 3 ramification types: 3.06% of lateral canals, 2.99% of apical deltas, and 0.1% of interradicular canals. The maxillary premolars showed the highest number of lateral canals (n = 13), followed by mandibular premolars (n = 10) and maxillary incisors (n = 10). Apical deltas were mostly found in mandibular molars (n = 14), followed by maxillary incisors (n = 9). Only mandibular molars had interradicular canals. The detection of ramifications increased with the use of EDTA. However, no statistically significant relationship was found between the type of auxiliary chemical substance used and the number of root canal ramifications detected after root canal filling. It was concluded that the frequency of root canal ramifications found radiographically was low in treatments performed by undergraduate students.