RESUMO
Introdução: a ciência endodôntica tem como objetivo a manutenção do elemento dentário em função no sistema estomatognático, por meio de procedimentos de sanificação, modelagem e obturação dos condutos radiculares. Porém, o sucesso do tratamento pode estar comprometido devido à presença de obliterações parciais ou totais da cavidade pulpar, que dificultam ou, até mesmo, impedem o procedimento. Recentemente, os avanços tecnológicos possibilitaram a transposição dessas barreiras com a confecção de um guia que permite o acesso retilíneo e direciona ao forame apical do canal obliterado. Métodos: o presente estudo descreve o uso do guia endodôntico em um paciente do sexo masculino, de 54 anos de idade, diagnosticado com necrose pulpar no elemento #14, com obliteração do conduto palatino. Resultados: o sucesso do tratamento pôde ser observado após seis meses de controle radiográfico e ausência de sintomatologia. Conclusões: o tratamento endodôntico de canais calcificados por meio da Endodontia guiada demonstrou ser uma abordagem clinicamente viável para localizar canais radiculares obliterados e prevenir acidentes e complicações nos dentes que não podem ser acessados de forma previsível por meio da terapia endodôntica tradicional (AU).
Introduction: Endodontic science aims to maintain the dental element in function in the stomatognathic system, through procedures of sanification, modeling and obturation of the root conduits. However, the success of the treatment may be compromised due to the presence of partial or total obliterations of the pulp cavity, which hinder and even impede the procedure. Recently, the technological advance made it possible to transpose these barriers with the creation of a guide that allows rectilinear access and directs to the apical foramen of the obliterated canal. Methods: The present study describes the use of the endodontic guide in a 54-year-old male patient, diagnosed with pulp necrosis in element 14, with obliteration of the palatine conduit. Results: The success of the treatment could be observed after six months of radiographic control and absence of symptomatology. Conclusions: Endodontic treatment of calcified canals through guided endodontics demonstrates a clinically viable approach to locate obliterated root canals and prevent accidents and complications in teeth that cannot be predictably accessed through traditional endodontic therapy (AU).
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Sistema Estomatognático , Necrose da Polpa Dentária , Ápice Dentário , Terapêutica , Cavidade Pulpar , EndodontiaRESUMO
Melanotic neuroectodermal tumor of infancy (MNTI) is a rare condition that occurs normally in the anterior maxilla of infants aged <1 year. The use of clinical and imaging tools for MNTI is extremely important to prevent problems with function as well as the aesthetic features in a breastfeeding child. Brazil is a multiethnic country with a poor epidemiological policy and little data to track the incidence of certain diseases, including MNTI. It is important to study this pathology with ethnicity as a factor to improve the current epidemiological programs and establish better post-treatment management. This paper describes a case of a 2-month-old male of African-indigenous descent and Brazilian Amazon residency, who presented to our unit in 2009 with a history of an expanding mass involving the anterior maxilla. Clinical and computerized tomography scans were used to diagnose the mass as MNTI, which was removed by total excision. A biopsy later confirmed the MNTI diagnosis.
Assuntos
População Negra , Indígenas Sul-Americanos , Neoplasias Maxilares/diagnóstico , Neoplasias Maxilares/etnologia , Tumor Neuroectodérmico Melanótico/diagnóstico , Tumor Neuroectodérmico Melanótico/etnologia , Brasil/epidemiologia , Humanos , Lactente , Masculino , Neoplasias Maxilares/diagnóstico por imagem , Neoplasias Maxilares/cirurgia , Tumor Neuroectodérmico Melanótico/diagnóstico por imagem , Tumor Neuroectodérmico Melanótico/cirurgia , Procedimentos Cirúrgicos Bucais , Tomografia Computadorizada por Raios XRESUMO
Progressive Hemifacial Atrophy, also known as Parry-Romberg Syndrome, is an uncommon degenerative and poorly understood condition. It is characterized by a slow and progressive atrophy affecting one side of the face. The incidence and the cause of this alteration is unknown. A cerebral disturbance of fat metabolism has been proposed as a primary cause. This can be the result of a trophic malformation of Cervical Sympathetic Nervous System. Possible factors that are involved in the pathogenesis include trauma, viral infections, heredity, endocrine disturbances and auto-immunity, among others. The most common complications that appear in association to this health disorder are: trigeminal neuritis, facial paresthesia, severe headache and epilepsy, being this last one the most frequent complication of the Central Nervous System. Characteristically, the atrophy progresses slowly for several years and, soon after, it become stable. Now, plastic surgery with graft of autogenous fat can be performed, after stabilization of the disease, to correct the deformity. Orthodontic treatment can help in the correction of any associated malformation. The objective of this work is, through the presentation of a clinical case, to accomplish a literature review concerning general characteristics, etiology, physiopathology, differential diagnosis and treatment of progressive hemifacial atrophy.