El traumatismo dental trae consigo afecciones pulpares irreversibles que pueden desencadenar una necrosis del tejido pulpar. Debido a la ausencia de sintomatología en algunos casos, el proceso necrótico puede generar una lesión apical que a largo plazo puede alcanzar grandes extensiones. Para tratar este tipo de lesiones apicales de gran tamaño, es necesario un adecuado diagnóstico clínico, complementado con la evaluación tomográfica, para la localización los dientes afectados. Es posible tratar estas afecciones con un abordaje no quirúrgico, obteniendo resultados favorables. El presente reporte de caso tiene como objetivo presentar la resolución no quirúrgica de una lesión periapical extensa de origen endodóntico. / Dental trauma brings irreversible pulpal conditions that can trigger pulp tissue necrosis. Due to the absence of symptomatology in some cases, the necrotic process can generate an apical lesion that in the long term can reach large extensions. To treat this type of large apical lesions, an adequate clinical diagnosis, complemented with tomographic evaluation, are necessary to locate the affected teeth. Is possible to treat these conditions with a non-surgical approach, obtaining favorable results. This case report aims to present the non-surgical resolution of an extensive periapical lesion of endodontic origin. / Trabajo académico

Los avances tecnológicos para mejorar la calidad del tratamiento endodóntico en todos los aspectos son insuficientes si no se complementa con un adecuado tratamiento protésico. La filtración bacteriana causada por tratamientos protésicos desadaptados puede promover la migración bacteriana hacia el canal radicular y el material de obturación, en caso presente un tratamiento endodóntico. Si esta situación no es controlada, la infección podría continuar hacia los tejidos periapicales, causando un quiste periapical. Para tratar el quiste periapical será necesario identificar el diente donde se originó la infección, retratar los canales radiculares y realizar el retiro quirúrgico del quiste. Sin embargo, es posible realizar un abordaje no quirúrgico con resultados favorables. / Technological advances to improve the quality of endodontic treatment in all aspects are insufficient if they are not complemented by adequate prosthetic treatment. The bacterial cause caused by the maladaptive prosthetic treatments can promote bacterial migration towards the root canal and the filling material, in case of endodontic treatment. If this situation is not controlled, the infection could continue into the periapical tissues, causing a periapical cyst. To treat the periapical cyst, identify with the tooth where the infection originated, portray the root canals and perform the surgical removal of the cyst. However, it is possible to perform a non-surgical approach with favorable results. / Trabajo académico

Made available in DSpace on 2014-07-29T12:03:34Z (GMT). No. of bitstreams: 1 dissetacao augusto.pdf: 470357 bytes, checksum: d1f27e85a7915373969a90cec182659a (MD5) Previous issue date: 2008-11-11 / This cross-sectional study examined the prevalence of endodontically treated teeth in 1,401 Brazilian adults. Panoramic radiographs were selected at the Radiological Center of Orofacial Images (CRIOF, Cuiabá, MT, Brazil) between August 2002 and September 2007. Three independent endodontists discussed interpretation criteria and classified specimens according to the following data: presence of root canal treatment, which was defined as partially or completely filled canal space, regardless of whether filling ended at the radiographic apex or not; presence of intracanal post; and associated apical periodontitis. Odds ratio, logistic regression and a chi-square test were used for statistical analyses. Significance level was set at p<0.05. Of 29,467 teeth evaluated, 6,313 (21.4%) were treated endodontically. Endodontic treatment was most frequent in maxillary premolars and molars, whereas mandibular incisors showed the lowest prevalence. Most endodontically treated teeth were found in people aged 46 to 60 years (47.6%, p<0.001) and the prevalence increased with age in this age range. Females (61.9%, p<0.001) showed a higher prevalence of teeth with root fillings than males. The present study found a higher prevalence of endodontically treated teeth in a Brazilian adult population compared to the prevalence reported in epidemiological studies conducted in other countries. / O objetivo do estudo transversal foi avaliar a prevalência dentes tratados endodonticamente em uma população de brasileiros adultos. Um total de 1.401 radiografias panorâmicas, oriundas do banco de imagens do Centro de Radiologia e Imagens Orofacial de Cuiabá (CRIOF, Cuiabá, MT, Brazil), entre agosto de 2002 e setembro de 2007 foi analisado. Três examinadores avaliaram todas as imagens, considerando-se a presença de tratamento endodôntico, indiferente à qualidade do tratamento (presença ou ausência de retentor intra-radicular ou periodontite apical). Os dados foram estatisticamente avaliados empregando-se razão de chances (odds ratio), regressão logística e teste Qui-quadrado. A partir de 29.467 dentes avaliados, 6.313 (21,4%) eram endodonticamente tratados. Os pré-molares e molares superiores foram os dentes com maior prevalência de tratamento, enquanto os incisivos inferiores representaram o grupo de menor prevalência. Indivíduos do gênero feminino (61.9%), e com idade entre 46 a 60 anos apresentaram maior prevalência de tratamento endodôntico. O presente estudo encontrou elevada prevalência de dentes tratados endodonticamente em adultos Brasileiros comparada com outros estudos epidemiológicos.

Indiana University School of Dentistry located on the campus of Indiana University-Purdue University Indianapolis (IUPUI) / This in-vitro, prospective, randomized study microscopically compared the debridement efficacy of negative pressure irrigation with the EndoVac (Discus Dental, Culver City, CA) versus the Canal CleanMax (Maximum Dental, Inc., Secaucus, NJ). Sixty extracted human canines were instrumented using a combination of hand-instrumentation with Lexicon K-type files and rotary instrumentation with ProTaper files. All canals were irrigated with 6.0-percent sodium hypochlorite and 17- percent ethylenediaminetetraacetic acid (EDTA). However, the irrigation/aspiration techniques differed among three groups of 20 randomly selected teeth. Group one (control) was irrigated with only a 12-ml Monoject syringe via 30-gauge side-vented, closed-end needle. Group two was irrigated with the EndoVac system. Group three was irrigated similar to group one, but with the adjunct of the Canal CleanMax system. All teeth were sectioned longitudinally, and the more intact sections were divided into coronal, middle, and apical thirds. Each portion of the canal was photographed with a scanning electron microscope (SEM). The photographs were scored by two independent examiners according to relative amount of debris and/or smear layer present, as well as relative number of patent dentinal tubules. These scores were statistically analyzed using a Krustal-Wallis test and Wilcoxon Rank Sum tests to determine differences between groups. The coronal aspect of root canal walls irrigated with the EndoVac system exhibited significantly less debris and/or smear layer present when compared to the coronal aspect of root canals irrigated with only a standard 12-ml Monoject syringe equipped with 30-gauge ProRinse side-vented, closed-end needle (control). There were no other significant differences in scores between any groups at any location. For all locations combined, the EndoVac system produced significantly cleaner root canal walls as compared to the control. No significant differences were seen between the Canal CleanMax and Control or Canal CleanMax and EndoVac. This study suggested negative pressure irrigation delivery with the EndoVac system during and after hand-rotary instrumentation is more effective in removal of debris and smear layer from the coronal third and combined thirds of root canal walls compared to irrigation with a standard 12-ml Monoject syringe equipped with 30-gauge ProRinse side-vented, closed-end needle.