scholarly journals Apical Surgery: Therapeutic Option for Endodontic Failure

2018 ◽  
Vol 20 (3) ◽  
pp. 185
Author(s):  
Paulo Otávio Carmo Souza ◽  
Carolina Ferrari Piloni de Oliveira ◽  
Iussif Mamede-Neto ◽  
Amin De Macedo Mamede Sulaimen ◽  
Pedro Luís Alves de Lima ◽  
...  
Keyword(s):  
Root Canal ◽  
Therapeutic Option ◽  
Treatment Plan ◽  
Tomographic Images ◽  
Apical Surgery ◽  
Root Canal Retreatment ◽  
Periapical Granuloma ◽  
History Of ◽  
Endodontic Retreatment

AbstractThe aim of this study is present a surgical solution of the case of endodontic root canal failure caused by overfilling, with a history of endodontic retreatment and aesthetic rehabilitation with porcelain veneers. Patient C.F.P.L, 50 years old, female, was looking for treatment complaining of pain. Previous endodontic treatment was reported on tooth 11, and root canal retreatment after 6 months due to the persistence of painful symptomatology. Later, the patient carried out aesthetic rehabilitation with porcelain veneers, and approximately 6 months later the vitro pain related to the tooth 11 occurred again. Radiographic and tomographic images showed obturation of the root canal of the tooth 11 associated with diffuse hypodense area in the periapical region, with overextended endodontic material. The probable clinical diagnosis was symptomatic traumatic apical periodontitis, and apical surgery was proposed as treatment plan. After infiltrative anesthesia, a Newmann incision and split flap were performed, followed by osteotomy with micro-chisel and curettage of the lesion. An apicectomy was performed with Zecrya drill, followed by retro cavity with diamond ultrasonic tip and retrograde obturation with white MTA. After 2 years of follow-up bone neoformation and absence of symptomatology were observed, tooth in function and preservation of aesthetic rehabilitation harmony. Apical surgery is a therapeutic alternative with favorable prognosis for the treatment of endodontic failure, provided that it is correctly indicated and with a wellexecuted surgical protocol.Keywords: Apicectomy. Periapical Periodontitis. Periapical Granuloma. ResumoO objetivo deste estudo é apresentar a resolução cirúrgica de um caso de insucesso endodôntico ocasionado pela sobre obturação do canal radicular, com histórico de retratamento endodôntico e reabilitação estética com facetas cerâmicas. Paciente C.F.P.L, 50 anos, gênero feminino, procurou atendimento odontológico queixando-se de dor. Foi relatado tratamento endodôntico prévio no dente 11, e retratamento do canal radicular após 6 meses devido à persistência de sintomatologia dolorosa. Posteriormente, a paciente passou por reabilitação estética com facetas cerâmicas e, aproximadamente 6 meses após, houve o reaparecimento de dor espontânea relacionada ao dente 11. As imagens radiográficas e tomográficas revelaram obturação do canal radicular do dente 11 associado à área hipodensa difusa na região periapical, com extravasamento de material obturador. O diagnóstico clínico provável foi de periodontite apical sintomática traumática, e plano de tratamento proposto uma cirurgia parendodôntica. Posterior a anestesia infiltrativa, realizou-se incisão do tipo Newmann e retalho dividido, seguido de osteotomia com micro cinzel e curetagen da lesão. A apicectomia foi realizada com broca Zecrya, seguida da confecção da retrocavidade com ponta ultrassônica diamantada e obturação retrógrada com MTA branco. Após 2 anos de proservação foi observada neoformação óssea e ausência de sintomatologia, dente em função e preservação da harmonia da reabilitação estética. A cirurgia parendodôntica é uma alternativa terapêutica com prognóstico favorável para o tratamento do insucesso endodôntico, desde que corretamente indicada e com protocolo cirúrgico bem executado.Palavras-chave: Apicectomia. Periodontite Periapical. Granuloma Periapical.

scholarly journals Conventional Endodontic Retreatment of Persistent Pain on Previously Treated Tooth in an Elderly Patient: A Case Report

2021 ◽  
Vol 55 (8) ◽  
Author(s):  
Nina Dhaniar ◽  
Hermawan Adi Praja ◽  
Ratih Mahanani Santoso ◽  
Cendranata Wibawa Ongkowijoyo ◽  
Widya Saraswati
Keyword(s):  
Elderly Patient ◽  
Root Canal ◽  
Persistent Pain ◽  
Endodontic Treatment ◽  
Root Canal Treatment ◽  
Favorable Result ◽  
Root Canal Retreatment ◽  
Previously Treated ◽  
Endodontic Retreatment

Clinical evaluation for a successful root canal treatment is assessed by various criteria, which are clinical, histopathological, and radiographical criteria. Therefore, failure of endodontic treatment can be described as a recurrence of clinical symptoms, with the presence of a periapical radiolucency or both. Failure factors in the treatment are frequently related to persistent infection. Conventional endodontic retreatment is indicated for symptomatic previously treated teeth or asymptomatic teeth with inadequately done initial endodontic treatment to avoid potential recurrence. Endodontic retreatment in elderly patients is a great challenge because the clinician has to reassure both the physical and psychological factors of the patient to determine whether to save a tooth or perform an extraction. Some difficulties may also be found in root canal retreatment, including finding the root canal hole or root canal blockage found in parts of the root canal that have not been repaired in the previous treatment. A 60-year-old female patient came with the chief complaint of recurrent pain, and subjective discomfort in the maxillary left central incisor. The patient had anxiety about the dental treatment. The tooth had a history of root canal treatment four months ago. The clinical examination showed a positive response to the percussion test. The radiographical analysis showed a root canal underfilling, 2-3 mm short of length from the apex. The tooth was diagnosed as a previously treated tooth with symptomatic apical periodontitis. Endodontic retreatment was performed based on the patient’s clinical condition and consent, followed by composite restoration. The clinical and radiographic re-evaluation after four weeks of follow-up revealed an excellent condition. This favorable result showed that a conventional retreatment plan of persistent pain on the previously treated tooth in an elderly patient led to progressive healing, and a longer follow-up was advised.

Nonsurgical Endodontik Retreatment of Maxillary First Premolar

DENTA ◽  
2017 ◽  
Vol 11 (1) ◽  
pp. 88
Author(s):  
Yongki Hadinata W ◽  
Karlina Samadi
Keyword(s):  
Root Canal ◽  
Radiographic Examination ◽  
Periapical Lesion ◽  
First Choice ◽  
Periapical Abscess ◽  
Dental Hospital ◽  
Conservative Dentistry ◽  
Previously Treated ◽  
Endodontic Retreatment

<p><strong><em>Background :</em></strong><em> There are some factors can cause endodontic failure such as inadequate in cleaning or shaping step, non hermetic obturation, or poor restoration, which can cause bacteria multiply. <strong>Purpose :</strong> To report the management of endodontic failure with nonsurgical treatment. <strong>Case :</strong> 46-year-old woman came to Airlangga Dental Hospital Conservative Dentistry Department to treat her upper right tooth which show symptomatic pain in the last 2 weeks. The tooth has been treated and crowned with porcelain fused to metal about 10 years ago. Clinical examination show the presence of fistula on premolar buccal gingiva, react to percussion.  Radiographic examination show not hermetic obturation in one root canal and radiolucency in the periapical area. The diagnosis for maxillary first premolar is previously treated tooth with chronic periapical abscess.. <strong>Treatment :</strong> Crown and post was removed from the tooth, and endodontic retreatment was done. Follow up 6 months after the retreatment show no reaction to percussion, and radiographic examination show no enlargement periapical lesion. <strong>Conclusion :</strong> Nonsurgical endodontic retreatment always become the first choice to resolve endodontic failure for previously treated tooth.</em></p><p><strong><em>Keywords :</em></strong><em> endodontic failure, maxillary first premolar, nonsurgical endodontic retreatment</em></p><p><strong><em>Correspondence:</em></strong><em> Yongki Hadinata W., drg. PPDGS Ilmu Konservasi Gigi Fakultas Kedokteran Gigi Universitas Airlangga, Surabaya. Jl. Mayjen. Prof. Dr. Moestopo No. 47, Surabaya.</em></p>

Persistent Apical Periodontitis: Bacterial Taxonomic Analysis and Treatment Through Intentional Replantation

2020 ◽  
Author(s):  
Fernando Eduardo Coria-Valdiosera
Keyword(s):  
Antibiotic Therapy ◽  
Root Canal ◽  
Resistance Mechanisms ◽  
Apical Periodontitis ◽  
Infectious Process ◽  
Identification Of Bacteria ◽  
The Right ◽  
Apical Lesions ◽  
Endodontic Retreatment

Introduction: The microorganisms own different resistance mechanisms that allow them to resist the chemo-mechanical cleanliness of root canal and antibiotic therapies causing the persistence of apical lesions. Methods: This clinical case describes a male patient diagnosed with pulp necrosis in the right lower central incisor due to trauma, which developed apical periodontitis manifesting itself extra orally. Root canal treatment along with antibiotic therapy was performed, but because the infectious process persisted, endodontic retreatment and a new antibiotic therapy were carried out, however, the clinical evolution was not favorable. For this reason, the intentional replantation was chosen as the outright treatment, performing apicectomy and curettage of the periapical lesion, from which the isolation and taxonomic study of microorganisms were carried out, with the respective antibiogram. Results: In the 10-day clinical follow-up, the extraoral infectious process disappeared almost completely and 6 months later, a complete repair of the bone tissue was observed on the tomography. Conclusion: A better understanding of the persistence of apical periodontitis was achieved by taxonomic identification of bacteria and the intentional replantation allowed to remove the apical biofilm gaining an excellent wound healing.

scholarly journals Radicular Perforation Repair with Mineral Trioxide Aggregate: A Case Report with 10-Year Follow-up

2016 ◽  
Vol 10 (1) ◽  
pp. 733-738 ◽  
Author(s):  
Leopoldo Cosme-Silva ◽  
Breno Carnevalli ◽  
Vivien Thiemy Sakai ◽  
Naiana Viana Viola ◽  
Leon Franco de Carvalho ◽  
...  
Keyword(s):  
Case Report ◽  
Root Canal ◽  
Mineral Trioxide Aggregate ◽  
Radiographic Examination ◽  
Root Canal Filling ◽  
Second Molar ◽  
Iatrogenic Perforation ◽  
Iatrogenic Complications ◽  
Root Canal Retreatment

Background: Iatrogenic complications such as accidental perforation of the root or the floor of the pulp chamber may occur. Case Report: Patient was referred for root canal retreatment of the mandibular left second molar with periapical lesion evidenced through radiographic examination. During post removal, iatrogenic perforation occurred at the mesial face of the distal root. After clinical localization of the perforation and bleeding control, MTA was applied. In a second appointment, the root canal filling was removed and the chemical-surgical retreatment of the canals was performed, followed by the obturation with gutta-percha and sealer. Patient returned after three days reporting no pain. After 6 months, 3, 7 and 10 years of follow-up. Conclusion: Absence of pain, normal periodontal probing and lack of radiolucent area at the region of perforation and the periapices were detected, which evidenced the successful repair of the tooth.

scholarly journals Chondrosternal Arthritis in Infant: An Unusual Entity

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Athina Nikolarakou ◽  
Dana Dumitriu ◽  
Pierre-Louis Docquier
Keyword(s):  
Clinical Symptoms ◽  
Therapeutic Option ◽  
White Blood Cells ◽  
Laboratory Data ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
History Of ◽  
Local Tenderness ◽  
Wait And See

Primary arthritis of chondrosternal joint is very rare and occurs in infants less than 18 months of age. Presentation is most often subacute but may be acute. Child presents with a parasternal mass with history of fever and/or local signs of infection. Clinical symptoms vary from a painless noninflammatory to a painful mass with local tenderness and swelling, while fever may be absent. Laboratory data show low or marginally raised levels of white blood cells and C-reactive protein, reflecting, respectively, the subacute or acute character of the infection. It is a self-limiting affection due to the adequate immune response of the patient. Evolution is generally good without antibiotherapy with a progressive spontaneous healing. A wait-and-see approach with close follow-up in the first weeks is the best therapeutic option.

scholarly journals The reform of Italian forensic psychiatric hospitals and its impact on risk assessment and management

2018 ◽  
Author(s):  
Vittorio De Luca ◽  
Pieritalo Maria Pompili ◽  
Giovanna Paoletti ◽  
Valeria Bianchini ◽  
Federica Franchi ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Treatment Plan ◽  
Psychiatric Hospitals ◽  
Assessment Tools ◽  
Residential Home ◽  
Security Measures ◽  
Lazio Region ◽  
History Of ◽  
Forensic Psychiatric

Italy has a consolidated history of de-institutionalization, and it was the first country to completely dismantle psychiatric hospitals, in order to create small psychiatric inwards closer to the community (i.e. in general hospitals). Nevertheless, it took the nation nearly 40 years to end the process from the beginning of de-institutionalization, definitely closing all of the forensic hospitals, which was not addressed by the first Italian psychiatric reform. This paper describes the establishment of new facilities substituting old forensic hospitals, called Residences for the Execution of Security Measures (REMS), which are a paradigm shift in terms of community-based residential home, and are mainly focused on treatment and risk assessment, rather than custodial practices. The use of modern assessment tools, such as the Aggressive Incident Scale (AIS) and the Hamilton Anatomy of Risk Management (HARM), is crucial in order to point out the focus and consistent instruments of the treatment plan. A preliminary analysis of data from the first 2 years of activity, considering severely ill patients who have been treated for more than 12 months, is then described for two REMSs in the Lazio region, close to Rome. Encouraging results suggest that further research is needed in order to assess clinical elements responsible for a better outcome, and to detect follow-up measures of violence or criminal relapse after discharge.

Topical Tacrolimus in the Treatment of Erosive Pustular Dermatosis of the Scalp

2007 ◽  
Vol 11 (6) ◽  
pp. 222-225 ◽  
Author(s):  
Marta J. Cenkowski ◽  
Shane Silver
Keyword(s):  
Light Exposure ◽  
Therapeutic Option ◽  
Rare Condition ◽  
Initial Therapy ◽  
Topical Steroids ◽  
Topical Tacrolimus ◽  
History Of ◽  
Prevention Of Relapse

Background: Erosive pustular dermatosis of the scalp (EPDS) is a rare condition characterized by chronic, sterile, pustular erosions leading to scarring alopecia. Although the etiology is unknown, it appears to be associated with ultraviolet light exposure and trauma. Histologic findings include nonspecific atrophy of the epidermis and chronic inflammation. Case History: A 71-year-old female presented with a 1-year history of a boggy, erythematous, friable plaque on the vertex of her scalp. A diagnosis of EPDS was made based on presentation, negative cultures, and histologic findings. Initial therapy with intralesional and topical steroids and oral antibiotics resolved the inflamed plaques; however, steroid-induced atrophy became prominent after 5 months of use. The treatment was discontinued, resulting in recurrence of disease. Topical tacrolimus 0.1% ointment was initiated, which has been successfully controlling the lesions with reversal of skin atrophy and clinical evidence of hair growth. Conclusion: This is the fourth reported case of the successful treatment of EPDS with topical tacrolimus for the resolution of atrophy and the prevention of relapse of inflammation. Although its long-term use warrants close follow-up for side effects, tacrolimus may constitute a novel therapeutic option for the treatment of EPDS.

scholarly journals Treatment of Atypical Bifid Mandibular Condyle Associated with Ankylosis of the Temporomandibular Joint

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Katheleen Miranda ◽  
André Sander Carneiro ◽  
Jennifer Tsi Gerber ◽  
Suyany Gabriely Weiss ◽  
Leandro Eduardo Klüppel ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Treatment Plan ◽  
Mandibular Condyle ◽  
Mouth Opening ◽  
Facial Asymmetry ◽  
Lateral Deviation ◽  
Tmj Ankylosis ◽  
History Of ◽  
The Right

Introduction. The bifid mandibular condyle (BMC) is an unusual temporomandibular joint (TMJ) disorder with controversial etiology. The association of this entity with ankylosis is rare. Objective. The objective of the present study is to report a case of BMC with associated TMJ ankylosis in a patient with no history of trauma and/or infection. Case Report. A 17-year-old male patient sought care reporting pain on the right TMJ region and mastication difficulty due to a severe limitation of mouth opening. In the clinic and imaging examinations, a 15 mm mouth opening and BMC associated with ankylotic mass of the right TMJ were observed, besides a facial asymmetry with chin deviation to the right. The proposed treatment plan was condylectomy on the right side, bilateral coronectomy, and genioplasty, so the chin lateral deviation could be corrected, under general anesthesia. The patient remains under clinical and imaging follow-up of two years with functional stability and no signs of relapse of the ankylosis. Conclusion. The association of BMC with ankylosis is an atypical entity which must be diagnosed and treated early to prevent aesthetic and functional damages to the patient.

scholarly journals Interleukin-2 may induce prolonged remissions in advanced acute myelogenous leukemia

Blood ◽  
1994 ◽  
Vol 84 (7) ◽  
pp. 2158-2163 ◽  
Author(s):  
G Meloni ◽  
R Foa ◽  
M Vignetti ◽  
A Guarini ◽  
S Fenu ◽  
...  
Keyword(s):  
Acute Myelogenous Leukemia ◽  
Residual Disease ◽  
Therapeutic Option ◽  
Interleukin 2 ◽  
Myelogenous Leukemia ◽  
High Dose ◽  
Antileukemic Effect ◽  
Acute Myelogenous ◽  
History Of

Abstract The administration of interleukin-2 (IL-2) may induce complete remissions in acute myelogenous leukemia (AML) patients with a low proportion of residual bone marrow (BM) blasts. To confirm this preliminary observation, we treated 14 AML patients with advanced disease and with a residual BM blastosis that ranged between 7% and 24% with repeated 5-day cycles of high-dose recombinant IL-2 administered by daily continuous intravenous infusion. Patients who responded have been subsequently submitted to a monthly maintenance scheme with subcutaneous IL-2 at lower doses. While using this schedule and closely monitoring clinical and laboratory conditions, side effects were acceptable and no toxic deaths recorded. Eight of the 14 patients treated with high-dose IL-2 obtained a complete remission (CR). Five remain in persistent CR (four in third CR and one in fourth CR) after a median follow-up time of 32 months (14, 30, 32, 33, and 68 months, respectively). In all five patients, the IL-2-induced remission is the longest in the natural history of the disease. These findings show that IL-2 displays an antileukemic effect in AML with limited residual disease, and suggest that IL-2 should be considered a therapeutic option for resistant or relapsed AML patients.

Ex juvantibus approach for chronic posterior laryngitis: results of short-term pantoprazole therapy

1999 ◽  
Vol 113 (8) ◽  
pp. 734-739 ◽  
Author(s):  
Walter Habermann ◽  
Andreas Eherer ◽  
Franz Lindbichler ◽  
Johann Raith ◽  
Gerhard Friedrich
Keyword(s):  
Side Effects ◽  
Proton Pump ◽  
Case History ◽  
Therapeutic Option ◽  
Short Term ◽  
Globus Pharyngeus ◽  
Symptom Questionnaire ◽  
History Of ◽  
Pharyngeal Reflux

AbstractThe aim of this study was to investigate whether patients with chronic posterior laryngitis and symptoms of gastro-pharyngeal reflux benefit from a six-week therapy with pantoprozole. Twenty-nine out-patients with voice disorders (case history of at least two months) and simultaneous symptoms of gastropharyngeal reflux were recruited for this study. At the entry to the study a symptom questionnaire and a videolaryngo/stroboscopy were completed. The symptom questionnaire and the video-laryngo/stroboscopy were repeated after the six weeks of therapy with pantoprazole 40 mg once a day and again six weeks and three months after this follow-up, during which time the patient was without therapy.Hoarseness, globus pharyngeus, sore throat, heartburn, and coughing were the symptoms which showed a significant (p<0.05) recovery at the follow-ups (mean of hoarseness index: 7.28 to 0.92; mean of globus pharyngeus index: 3.14 to 0.58; mean of heartburn index: 2.86 to 0.5; mean of cough index: 1.72 to 0.25; mean of throat soreness index: 1.72 to 0.15). Laryngoscopy scores of the posterior laryngeal region, the glottic and the supraglottic region showed statistically significant improvement (p<0.05) after the treatment with pantoprazole. The therapeutic effect exceeded the drug administration until the last follow-up (after three months). The medication was tolerated without side-effects in all patients.A primary (ex juvantibus) therapy with proton pump inhibitors seems to be a therapeutic option for patients with long-lasting chronic inflammation of the larynx not responding to common therapy. In this case a six-week course of treatment has been shown to be sufficient.

Sign in / Sign up

Export Citation Format

Share Document