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AIM: To evaluate the effectiveness of five instruments used for irrigant agitation during the removal of calcium hydroxide [Ca(OH)2 ] paste in simulated internal root resorption (IRR) cavities created in extracted maxillary central incisors. METHODOLOGY: Seventy maxillary central incisors with a single canal were selected. The canals were accessed and instrumented with Reciproc R50, then the roots were split in the bucco-lingual direction and the halves separated. Simulated IRR cavities were created, in both halves of the roots, 5 mm from the apex with a spherical bur. The specimens were reconstructed with cyanoacrylate glue and allocated into seven groups: negative control - no treatment; positive control - filled with Ca(OH)2 without performing any irrigation protocol; the other groups were divided according to the instrument used for irrigant agitation, namely: Ultrasonic, EndoActivator® , EDDY® , XP-endo® Finisher and XP-endo® Shaper. The specimens were cleaved and analysed using optical microscopy and scanning electron microscopy, to compare the Ca(OH)2 remnants between them. Then, the IRR cavities created by the burs were cleaned and subjected to a protocol of demineralization with 20% nitric acid, the roots reconstructed, and the irrigant agitation methods, as well as the microscopic analysis was repeated. Analysis of the images of Ca(OH)2 remaining in the simulated IRR cavities after irrigation was performed by two calibrated examiners based on a previously established scoring system. The data were statistically compared by Kruskal-Wallis test, Mann-Whitney U-test and Wilcoxon tests, with the significance level set at 5%. RESULTS: There was a significant difference in the effectiveness of the instruments in relation to the cavity creation method (bur vs. bur/acid) and evaluation method (optical microscopy and scanning electron microscopy) (P < 0.05). The XP-endo® Finisher and EDDY® groups were associated with significantly more effective removal of Ca(OH)2 when the IRR cavities were created using the acid protocol and analysed by scanning electron microscopy. CONCLUSION: None of the instruments tested were able to completely remove the Ca(OH)2 paste from the simulated IRR cavities; however, the EDDY® and XP-endo® Finisher removed more Ca(OH)2 in the bur/acid cavity creation method analysed by scanning electron microscopy.

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Internal root resorption has been described as a resorptive defect of the internal aspect of the root following necrosis of odontoblasts as a result of chronic inflammation and bacterial invasion of the pulp tissue. Successful treatment outcome depends on early diagnosis, removal of the cause, proper treatment of the resorbed root. The present case report demonstrates the use of biodentine for the management of internal resorption.he aim of this study was to evaluate the efficacy of different lengths of time of passive ultrasonic irrigation (PUI) in removing calcium hydroxide (CH) paste from root canal, using scanning electron microscopy and energy dispersive spectrometry (SEM/EDS).

RESUMO

Internal root resorption (IRR) is a rare pulp disease. Its etiology involves late pulpal inflammations and trauma, among others. IRR may also show some symptoms, and is usually detected by X-rays. However, its diagnosis is significantly improved by the use of cone beam computed tomography (CBCT). The objective of this case report was to account for the diagnosis and management of an internal root resorption without perforation. The patient, a 26-year-old male, went to the School of Dentistry at Universidad Andres Bello, Concepción, without having symptoms in the tooth 1.1. Anamnesis revealed the presence of previous symptoms. CBCT examination showed absence of bowl-shaped calcified dentin tissue on the inner walls of the root canal with apical lesion but without perforation of surrounding tissues. Endodontic treatment was performed using the following methods: irrigation of the root canal with 2 percent chlorhexidine (CHX) using a Max-i-probe cannula and simultaneous cavitation of the irrigant Then calcium hydroxide (CH) was applied as intracanal medication for a week and Schilder’s technique for vertical compaction was used. The patient was checked after one week and then after six months. He did not have any symptoms. Early diagnosis using modern imaging equipment, appropriate use of ultrasound for chemomechanical debridement and thermoplastic filling techniques contribute to a more favorable prognosis of patients with internal root resorption...

La reabsorción radicular interna (RRI) es una condición pulpar poco común, cuyo origen etiológico incluye procesos inflamatorios tardíos de la pulpa, traumatismos, entre otros; por otra parte ésta podría presentar sintomatología. Generalmente es detectada por hallazgo radiográfico, sin embargo, requiere de un mejor método de diagnóstico por imagen como es la tomografía computarizada cone beam (TCCB). El objetivo de este reporte de caso fue detallar el diagnóstico y manejo de una reabsorción radicular interna sin perforación. El paciente de sexo masculino, 26 años de edad acudió a la Facultad de Odontología de la Universidad Andrés Bello sede Concepción, sin presentar síntomas en el diente 1.1. La anamnesis refirió presencia de sintomatología con anterioridad. La evaluación mediante la TCCB demostró ausencia de tejido dentinario calcificado en forma de cuenco en las paredes internas del conducto radicular con presencia de lesión apical sin evidenciar perforación hacia tejidos circundantes. Se realizó el tratamiento endodóntico, usando los siguientes métodos: el conducto radicular se irrigó con Clorhexidina (CHX) al 2 por ciento usando cánula Max-i-probe y simultáneamente fue realizada la cavitación del irrigante, luego se colocó Hidróxido de Calcio (HC) como medicación intraconducto por una semana. Se usó la técnica de compactación vertical de Schilder más un control del paciente a la semana y a los 6 meses. El paciente no presentó sintomatología. El diagnóstico temprano mediante herramientas imaginológicas contemporáneas, la utilización del ultrasonido para el desbridamiento químico-mecánico y las técnicas de obturación termoplásticas usadas acorde al caso hacen que las piezas con reabsorción radicular interna tengan un pronóstico más favorable...

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Internal root resorptions are usually non-symptomatic and are discovered occasionally throughperiapical radiographs, revealing a very defined and regular outline. These resorptions are progressive,and eventually perforate the periodontium. The present work describes the treatment of a clinicalcase of internal root resorption with periodontal communication, outlining the interrelation betweenperiodontal surgery and endodontic therapy.

As reabsorções internas são normalmente assintomáticas e descobertas ocasionalmente atravésde radiografias periapicais, onde revelam um contorno bem definido e regular. Estasreabsorções são progressivas e eventualmente perfuram o periodonto. O presente trabalhodescreve o tratamento de um caso clínico de reabsorção radicular interna com comunicaçãoperiodontal onde se fizeram necessárias a inter-relação entre a cirurgia periodontal e a terapiaendodôntica convencional.

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El Blanqueamiento Dental Interno es un procedimiento que busca mejorar la estética del paciente al aclarar el esmalte de dientes que presenten una cantidad considerable de pigmentos debidos a diversas causas tanto intrínsecas como extrínsecas. La reabsorción cervical externa es una de las desventajas del procedimiento utilizado para hacer más claro el esmalte dental y su mayor factor desencadenante son las acciones química y física de los materiales utilizados durante el procedimiento. Este estudio piloto y experimental tuvo como objetivo observar una posible vía de comunicación entre la cámara pulpar y la raíz dental y se realizó midiendo la microfiltración del agente blanqueador ocurrida a través de dos materiales selladores del tratamiento de conductos. Se realizó un procedimiento endodóntico convencional y estandarizado a 16 premolares uniradiculares, los cuales fueron divididos en 3 grupos experimentales; Grupo I: 4 dientes control (2 sellados con resina fluida y 2 con un ionómero de vidrio) Grupo II: 6 dientes sellados inmediatamente después de la endodoncia (3 sellados con resina fluida y 3 con un ionómero de vidrio), Grupo III: 6 dientes sellados una semana después de la endodoncia (3 sellados con resina fluida y 3 con un ionómero de vidrio). A los Grupos II y III se les realizó un procedimiento de blanqueamiento interno con Perborato de Sodio y Peróxido de Hidrógeno al 30, al cabo del mismo, todos los dientes fueron teñidos con Azul de Metileno, inmersos en resina epóxica, cortados longitudinalmente con un micrótomo para, finalmente, analizar la mitad más conveniente en un microscopio estereoscópico. Se encontró que a través de todos los dientes hubo microfiltración del agente blanqueador hacia la raíz, excepto en un diente que fue sellado con ionómero pero ocho días después de terminada la endodoncia.

Internal dental whitening is a procedure to improve patient´s aestethetic through removal of crown surface stains. External cervical resorption is one of the main disadventages and consequence of dental withening. This pilot study looked for a possible communication between the pulpar camera and the root surface by measuring microfiltration of the bleaching agent among two endodontic sealing materials.16 single rooted premolars were studied using standard and conventional endodontic treatment. There was tree experimental groups. Group 1 was a 4 teeth sealed 2 with glass ionomer and the rest (2 teeth) with fluid resin. Group 2 contained 6 teeth sealed inmediately after endodontic treatment, 3 with fluid resin and the rest with galls ionomer. Group 3 was composed by 6 teeth sealed one week after endodontic treatment sealed 3 with fluid resin ans another 3 with glass ionomer. Teeth groups 2 and 3 were exposed to internal bleaching with sodium perborate and 30 hydrogen peroxide all teeth specimens were stained with methylene blue and after embebed under epoxic resin and cotted with microtome and analised under the stereoscophic microscope. The conclusion, all teeth showed dye percolation of the bleachy agent towards the root, with one tooth exception sealend with glass ionomer belong to the group in wich the procedure was performed one week after endodontic treatment.

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