scholarly journals Possibilities of endodontic therapy of endodonic-periodontal lesions

2009 ◽  
Vol 137 (7-8) ◽  
pp. 351-356
Author(s):  
Jelena Neskovic ◽  
Slavoljub Zivkovic

Intoduction. Endoperiodontal lesions are frequent in clinical practice and may require complex therapy. It is very important to determine differential diagnosis and the origin of the lesion, because the treatment plan is based on aetiology and stadium of the development of the lesion. Objective. The aim of this clinical study was to analyze the efficacy of endodontic treatment in different types of endodontic- periodontal lesions. Methods. Thirty patients and 42 teeth with diagnosed endoperiodontal lesions were included in the study and divided in two groups. Vital pulp therapy was applied to 18 vital teeth where the diagnosis was perio-endodontic lesions. The therapy of infected canal system was applied to 24 teeth with endodontic- periodontal or combined lesions. Standard endodontic procedure consisted of cleaning and shaping of the root canal system and between sessions filling with calcium-hydroxide paste. Obturation was made by lateral compact of the guttapercha and Apexit paste. Efficiency was evaluated clinically and radiographically three, six and twelve months later. Results. Radiographic and clinical follow-up showed a significant radiographic improvement and absence of subjective symptoms in a very high percentage of the treated vital and avital teeth. The results of this study showed that in the observation period of 12 months endodontic therapy was successful in 88.89% of vital teeth, and in the group of avital teeth the percentage was 91.67%. Conclusion. Endodontic treatment of the endoperiodontal lesions was sufficient and it was the basic condition to achieve a complete healing of endodontic-periodontal lesions. Such therapy ensures significant improvement or even complete healing of both types of lesions, of endodontic and periodontal origin.

Nova Scientia ◽  
2018 ◽  
Vol 10 (21) ◽  
pp. 379-390
Author(s):  
Oscar David Jurado Patrón ◽  
Andrés Vargas López ◽  
Elma María Vega Lizama ◽  
Gabriel Alvarado Cárdenas ◽  
María Eugenia López Villanueva ◽  
...  

Introduction: The radiographic control of the root canal treatment can evaluate the healing of the periapical lesions. The objective of this study was to determinate the characteristics of the radiographic healing that was observed after one year, during follow-up sessions; so, the healing of the lesions according to the periapical pathology at the beginning of the treatment and the causes of failure of the endodontic treatments were recorded.Method: This is a prospective, observational, descriptive and longitudinal study, carried out in patients who attended control one year after endodontic treatment through the Periapical Index (PAI).Results: A total of 395 teeth of patients who underwent endodontic treatment one year prior to data collection, 87 presented radiogaphically observable periapical lesions; of these, 40 (45.97%) attended the control at one year. The frequency of cases in which some degree of radiographic healing was observed one year after treatment was 97.46%. The pathology with more cases of complete healing was periodontitis with sinus tract. In general, 84.61% of the cases decreased two levels in their PAI after one year. The 100% of the cases of failure presented vertical root fractures.Conclusion: The frequency of periapical healing after endodontic treatment is high. The main cause for the failure of the treatments documented in this study was the lack of coronal restoration that caused vertical fractures.


2020 ◽  
Author(s):  
Momina Anis Motiwala ◽  
Saqib Habib ◽  
Robia Ghafoor ◽  
Seema Irfan

BACKGROUND Various intracanal medicaments have been used in cases of chronic apical periodontitis for appropriate disinfection of the root canal system to eliminate microbes specially from the inaccessible areas. Caclcium Hydroxide (CH) is the most common intracanal medicament available in various forms, but its effectiveness with or without iodoform using microbial culture is unknown. OBJECTIVE To compare the anti-microbial efficacy of Calcipex and Metapex in endodontic treatment of teeth presenting with chronic apical periodontitis METHODS 60 single rooted teeth of patients with diagnosis of chronic apical periodontitis were selected and the canals were debrided chemo-mechanically. The patients were randomized into two groups: Calcipex and Metapex. The first sample (S1) for bacterial culture was taken before placement of intracanal medicament and the second sample (S2) was taken after 7 days, before final obturation from the canal and sent to lab for culture. Colony Forming Unit (CFU) will be evaluated. Paired t-test will be used to assess difference bet¬ween antimicrobial efficacies within the group of medicaments. Independent sample t-test will be used to assess antimicrobial efficacies between groups. Level of significance will be kept at 0.05. RESULTS The results wil be shared upon completion of study. CONCLUSIONS There is no risk involved in this study as the study is based on routine procedure of endodontic treatment. It will be a benefit for future patients which will help us to decide which intracanal medicament is more effective to use in infected canals. CLINICALTRIAL NCT04336709


2019 ◽  
Vol 7 (2) ◽  
pp. 47 ◽  
Author(s):  
Mario Dioguardi ◽  
Giovanni Di Gioia ◽  
Gaetano Illuzzi ◽  
Claudia Arena ◽  
Vito Carlo Alberto Caponio ◽  
...  

The primary objective of endodontic therapy is to create a biologically acceptable environment within the root canal system that allows for the healing and maintenance of the health of the peri-radicular tissue. Bacteria are one of the main causes of pulp problems, and they have different methods of penetrating and invading the endodontic space such as through carious lesions, traumatic pulp exposures, and fractures. The types of bacteria found range from facultative anaerobes to aerobes, up to the most resistant species able to survive in nutrient-free environments; the bacterial species Enterococcus faecalis belongs to this last group. Enterococcus faecalis is considered one of the main causes of recurring apical periodontal lesions following endodontic treatment, with persistent lesions occurring even after re-treatment. The review presented in this paper was performed in accordance with the PRISMA protocol and covers articles from the related scientific literature that were sourced from PubMed, Scopus, and Google Scholar using the following terms as keywords: “endodontic treatment”, “endodontic bacteria”, “microbial endodontic”, and “endodontic failure”. Only the articles considered most relevant for the purposes of this paper were read in full and taken into consideration for the following review. The results show that Enterococcus faecalis, Actinomycetes, and Propionibacterium propionicum are the species most frequently involved in persistent radicular and extra-radicular infections.


2016 ◽  
Vol 144 (3-4) ◽  
pp. 174-180 ◽  
Author(s):  
Jelena Neskovic ◽  
Slavoljub Zivkovic ◽  
Milica Medojevic ◽  
Milos Maksimovic

Introduction. Endodontic retreatment is a complex intervention that requires detailed analysis of possible reasons for failure, and flawless practical execution of the procedure. Objective. The aim of the study was to assess the outcome of endodontic retreatment based on clinical and radiographic criteria after a two-year observation period. Methods. Clinical study included 49 teeth indicated for endodontic retreatment based on periapical index (PAI). All teeth were divided into two groups. Group I comprised teeth without any periapical lesion (PAI score of 1 and 2) while Group II consisted of teeth with visible periapical radiolucency (PAI score of 3, 4, and 5). Endodontic retreatment was completed in two visits with inter-appointment medication of 2% chlorhexidine and calcium hydroxide for two weeks. Outcome of endodontic retreatment was evaluated 12-24 months after final obturation. Results. Endodontic retreatment was successful in 93.3% in Group I after 24 months. In Group II, successful treatment and complete healing was found in 52.9% of teeth, whereas 14.7% of teeth showed only partial healing. However, clinical symptomatology was not present in any of the cases. Considering the absence of clinical signs and subjective symptoms, retreatment was successful in 67.6% of cases where chronic periapical inflammation was present. Conclusion. Endodontic retreatment was successful in high percentage in teeth with and without periapical lesions.


2020 ◽  
Vol 9 (6) ◽  
pp. 152-155
Author(s):  
Saiyad Shah Alam ◽  
Waseem Ahmad ◽  
Md Rizwanullah ◽  
Mohammad Muzammil

Introduction: A wound can be defined as the discontinuity in skin or mucus membrane. Healing is nothing but neogranulation in the depth and neo-epithelialization at the edges of the wound which ultimately results in the complete repair of such discontinuity. This case report deals with a patient of traumatic large wound at the heel who receives Unani management for wound healing. He was diagnosed as avulsion of pad of right heel with type-II diabetes mellitus. The treatment plan included mechanical debridement, cleaning with solution of alum powder (Sufuf-e-zaaj/alusol) and dressing with Marham-e-raal. The patient was advised to continue oral hypoglycemic agent with subcutaneous injection of insulin. On 85th day of treatment, the wound was healed by almost 98% and on subsequent 1st and 2nd follow up, each with a gap of 15 days, no recurrence of wound was recorded. Methodology: A male patient of traumatic wound was taken into study and given Unani management plan which included debridement, cleaning and washing with solution of Alum powder (Alusol)/ or, in Unani, Sufuf-e-zaaj and dressing of the wound with Marham-e-raal with full aseptic precautions for a period of about 3 months. Discussion: Wound healing is credited to muhallil(anti-inflammatory), daf’eta’ffun (antimicrobial), mujaffif (desiccant) and mundamil (wound healing) properties of Marham-e-raal due to presence of several phytoconstituents like camphor, linalool, borneol, cineole, terpenoids, Bergenin, Phenols and flavonoids, hopeaphenol, Oligostilbenoids, Monoterpenes, kaempferol, Quercetin and Catechin. Result: The wound completely healed at the end of 3 months with no recurrence noted on the 15th day of follow up after complete healing.


2021 ◽  
Vol 67 (2) ◽  
pp. 101-106
Author(s):  
Sanziana Adina Scarlatescu ◽  
◽  
Irina Gheorghiu ◽  
George Nicola ◽  
Andrei O. Al Aloul ◽  
...  

The objectives of root canal treatment are to prevent the apical parodontitis, to heal the acute or cronic apical periodontits and to maintain the results, keeping the teeth on the arch in a functional stage. Thus, accuratelly elimination of soft and hard tissues (cleaning and shaping of the root canal system), disinfection and complete, homogeneous and tridimensional filling of the root canal system are very important to successful endodontic treatment. Modern concepts in endodontic treatment rely on technological progress and therefore many cases are successfully fulfilled, but the practitioner may be put in front of procedural erorrs both during and after endodontic treatment. Apical blockage, ledging, zipping, stripping, perforations in the floor of the pulp canal chamber or root canals perforations are the most common errors, but in many clinical situations they can be prevented and even surpassed once happened.


2020 ◽  
Vol 18 (1) ◽  
pp. 27-30
Author(s):  
S. N. Razumova ◽  
A. S. Brago ◽  
Haydar Barakat ◽  
L. M. Khaskhanova ◽  
R. M. Bragunova

The success of endodontic treatment depends on many factors. The most important of them are the knowledge and manual skills of the dentist.Materials and methods. We analyzed the condition of teeth after endodontic treatment in 300 patients aged 20 to 70 years. Were studied 300 images of CBCT, the number of treated teeth and the number of cases of unsuccessful endodontic treatment was analyzed.Results. According to CBCT data, high-quality obturation of the root canal system was observed in 1335 (75%) endodontically treated teeth. The reasons for successful endodontic treatment are under-sealing of the root canal (16%), removal of material beyond the apex (5.6%), and missed root canals (3.4%).Conclusion. Clinical dental patient examination revealed that maxillary and mandibular molars most often undergo endodontic treatment.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Claudio Maniglia-Ferreira ◽  
Fabio de Almeida Gomes ◽  
Marcelo de Morais Vitoriano ◽  
Francisco de Assis Silva Lima

This case report described the endodontic treatment and decompression of an extensive lesion in the anterior region of the mandible, detected during clinical and radiographic examination, in a patient with a complaint of slight tenderness to palpation in the area of mandibular right lateral incisor and canine. These teeth had been accessed without proper clinical evaluation, and their pulp tissues were exposed. The periodontal tissues were healthy, with no signs of inflammation or fistula. On radiographic examination, a radiolucent lesion with well-defined borders was seen extending from the distal root of mandibular left second premolar to the mesial root of mandibular right second premolar. Central and lateral mandibular left incisors were unresponsive to thermal pulp testing and exhibited coronal discoloration, consistent with a diagnosis of pulp necrosis. Due to persistent discharge from the root canal system during endodontic procedures despite application of intracanal medicament (calcium hydroxide paste), the decision was made to biopsy and decompress the lesion and conclude endodontic treatment. Histopathologic examination revealed a periapical granuloma. After endodontic treatment of the involved teeth, at 4-year clinical and radiographic follow-up, the affected region was almost completely repaired.


Author(s):  
Suyanne Pimentel LIMA ◽  
Erick Thiago de SOUSA ◽  
Marcílio Oliveira MELO ◽  
Markelane Santana SILVA

ABSTRACT This article describes the application of Photodynamic Therapy as an aid to the endodontic treatment performed on a permanent tooth iatrogenically perforated and with pulp necrosis. After clinical and radiographic examination, the coronary access, curettage of the drilling area and mechanized preparation with the Reciproc System were performed. The drilling area was sealed with Mineral Trioxide Aggregate after prior alkalinization and decontamination by a calcium hydroxide buffer. After successive intracanal medication changes, the remission of the fistula, a clinical sign of endodontic infection, was not observed. Photodynamic therapy was then performed to reduce bacterial load in the root canal system, which resulted in fistula suppression. Then, it was possible to end the treatment with the obturation of the ducts by the Tagger Hybrid thermomechanical technique. After a year of proservation, the tooth presents no symptomatology and it is concluded that the Photodynamic Therapy was an effective solution in this case.


2020 ◽  
Vol 37 (1) ◽  
pp. 35-40
Author(s):  
Laura Sasser

Pulp debridement and disinfection in the pulp cavity is a critical step in achieving a successful root canal therapy. Microorganisms remaining in the root canal system after endodontic treatment are a main cause of root canal failure. The challenges faced in endodontic disinfection include the complex anatomy of the root canal system, the existence of a biofilm within the root canal, and the creation of a problematic smear layer during instrumentation of the canal. Historically, sodium hypochlorite and ethylenediaminetetraacetic acid have been utilized as irrigants and still remain as the most effective disinfectants due to their synergistic abilities to eradicate microorganisms, dissolve necrotic debris, and remove the smear layer and biofilm. This article addresses challenges in endodontic disinfection, objectives of endodontic irrigants, properties of an ideal irrigant, currently used irrigants, and irrigant delivery systems utilized in veterinary dentistry.


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