scholarly journals Penatalaksanaan Gigi 36 dengan Diagnosis Nekrosis Pulpa disertai Abses Periapikal Kronis

2020 ◽  
Vol 8 (2) ◽  
pp. 90-100
Author(s):  
Ratu Amelia ◽  
Deli M

The main goal of endodontic treatment is to remove the entire microbial flora from the root canal system and promote periapical healing. Microorganisms that settle in the root system play an important role in the development and persistence of periapical lesions. Necrotic canals provide a very favorable environment for the growth of microorganisms in the root canal system. Thus, elimination of these bacteria is essential for apical and periapical healing after endodontic treatment. This case report discusses the endodontic treatment using calcium hydroxide in a necrotic pulp with chronic periapical abscess.

2015 ◽  
Vol 16 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Dilek Helvacioglu-Yigit

ABSTRACT Aim C-shaped canal system is a seldom-found root canal anatomy which displays a challenge in all stages of endodontic treatment. According to the literature, this type of canal morphology is not a common finding in the mandibular first molar teeth. Background This case report presents endodontic management of a mandibular first molar with a C-shaped canal system. Case report Root canal system was cleaned and shaped by nickel-titanium (NiTi) rotary instruments combined with selfadjusting file (SAF). Obturation was performed using warm, vertical condensation combined with the injection of warm gutta-percha. Follow-up examination 12 months later showed that the tooth was asymptomatic. The radiological findings presented no signs of periapical pathology. Clinical significance The clinician must be aware of the occurence and complexity of C-shaped canals in mandibular first molar teeth to perform a successful root canal treatment. The supplementary use of SAF after application of rotary instruments in C-shaped root canals might be a promising approach in endodontic treatment of this type of canal morphology. How to cite this article Helvacioglu-Yigit D. Endodontic Management of C-shaped Root Canal System of Mandibular First Molar by using a modified Technique of Self-adjusting File System. J Contemp Dent Pract 2015;16(1):77-80.


Author(s):  
Pardeep Mahajan ◽  
Ruma Grover ◽  
Shikha Baghi Bhandari ◽  
Prashant Monga ◽  
Vanita Keshav

Successful outcome of endodontic treatment depends on the identification of all root canals which in turn guarantee complete extirpation of pulp tissue, proper chemo-mechanical cleaning and shaping and three dimensional obturation of the root canal system with an inert filling material. However endodontic treatment can fail for many reasons, such as diagnostic errors, persistence of the infection in the root canal system, errors in debridement and shaping of the root canal systems, instrument fractures, poor restorations and extra roots or canals if not detected are the reasons for failure. Undetected extra roots or root canals have been considered as a major reason for failure of root canal treatment. Many of the challenges faced during root canal treatment may be directly attributed to an inadequate understanding of the canal morphology of teeth. A broad knowledge of both the external and internal anatomy of teeth is of great importance for adequate endodontic treatment. We present a case report of 2 roots in mandibular lateral incisor.


2014 ◽  
Vol 8 (3) ◽  
pp. 172-175 ◽  
Author(s):  
A Gupta ◽  
V Goyal ◽  
S Bala ◽  
J Duhan ◽  
S Hans

ABSTRACT The success of root canal treatment is based on total elimination of root canal content, thorough cleaning, shaping and obturation of root canal system. Calcium hydroxide is recommended as intra-canal medicament because of its antibacterial properties, tissue dissolving ability, inhibition of tooth resorption and indication of tissue repair by hard tissue formation. The present case series highlights the use of calcium hydroxide as an inter appointment endodontic dressing for management of large periapical radiolucency and periodically reviewed. Thus the non surgical healing of large periapical lesions provided favourable clinical and radiographic response.


2006 ◽  
Vol 14 (5) ◽  
pp. 334-340
Author(s):  
Sônia Regina Panzarini ◽  
Valdir Souza ◽  
Roberto Holland ◽  
Eloi Dezan Júnior

One of the primary objectives of endodontic treatment of teeth with pulp necrosis is the elimination of microorganisms from the root canal system, as effectively as possible, especially in cases with chronic periapical lesions. AIM: The purpose of this study was to analyze the response of the periapical tissue of dogs' teeth with chronic periapical lesions to endodontic treatment performed with utilization of metronidazole, calcium hydroxide, and an association of both as root canal dressings. METHODOLOGY: Forty root canals were submitted to pulpectomy and the root canals were kept exposed to the oral environment for 6 months. Then, they were submitted to biomechanical preparation and divided into 4 study groups with 10 specimens: group I - no root canal dressing; group II - calcium hydroxide; group III - metronidazole; group IV - calcium hydroxide associated to metronidazole. After 15 days, the root canals were filled with Fill Canal sealer. After 90 days, the animals were killed and the especimens processed for histological analysis. RESULTS: Calcium hydroxide dressing provided a significantly better outcome compared to other experimental groups (alpha = 0.01). Also, the results of the association of metronidazole and calcium hydroxide were similar to those observed for the metronidazole group. The worst results were obtained by the no root canal dressing group. CONCLUSION: The use of metronidazole alone or associated with Calcium hydroxide, did not improve periapical healing when compared to Calcium hydroxide dressing.


2006 ◽  
Vol 14 (5) ◽  
pp. 355-364 ◽  
Author(s):  
Janir Alves Soares ◽  
Mário Roberto Leonardo ◽  
Léa Assed Bezerra da Silva ◽  
Mário Tanomaru Filho ◽  
Izabel Yoko Ito

OBJECTIVE: The purpose of this study was to evaluate the distribution of microorganisms in the root canal system (RCS) and periapical lesions of dogs' teeth after rotary instrumentation and placement of different calcium hydroxide [Ca(OH)2]-based intracanal dressings. MATERIALS AND METHODS: Chronic periapical lesions were experimentally induced in 80 premolar roots of four dogs. Instrumentation was undertaken using the ProFile rotary system and irrigation with 5.25% sodium hypochlorite. The following Ca(OH)2-based pastes were applied for 21 days: group 1 - Calen (n=18); group 2 - Calen+CPMC (n=20); group 3 - Ca(OH)2 p.a. + anaesthetic solution (n=16) and group 4 - Ca(OH)2 p.a.+ 2% chlorhexidine digluconate (n=18). Eight root canals without endodontic treatment constituted the control group. Histological sections were obtained and stained with Brown & Brenn staining technique to evaluate the presence of microorganisms in the main root canal, ramifications of the apical delta and secondary canals, apical cementoplasts, dentinal tubules, areas of cemental resorption and periapical lesions. The results were analyzed statistically by the Mann-Whitney U test (p<0.05). RESULTS: The control group showed the highest prevalence of microorganisms in all sites evaluated. Gram-positive cocci, bacilli and filaments were the most frequent morphotypes. Similar microbial distribution patterns in the RCS and areas of cementum resorption were observed in all groups (p>0.05). The percentage of RCS sites containing microorganisms in groups 1, 2, 3, 4 and control were: 67.6%, 62.5%, 78.2%, 62.0% and 87.6%, respectively. CONCLUSION: In conclusion, the histomicrobiological analysis showed that the rotary instrumentation and the different calcium hydroxide pastes employed did not effectively eliminate the infection from the RCS and periapical lesions. However, several bacteria seen in the histological sections were probably dead or were inactivated by the biomechanical preparation and calcium hydroxide-based intracanal dressing.


2010 ◽  
Vol 04 (04) ◽  
pp. 468-474 ◽  
Author(s):  
Tahsin Yildirim ◽  
Nimet Gencoglu

Pulpal and periradicular pathosis are the result of microbial, mechanical, or chemical invasion. Microorganisms are the main irritants of pulpal and periapical tissues. The goal of the obturation is to obtain a fluid-tight seal of the root canal system from its coronal aspect through its apical extent to preserve from the irritants.. Root apices have morphological irregularities in teeth with periapical lesions. Therefore, it is more difficult to produce hermetically apical stop with conventional guttapercha obturation techniques. This case report describes the treatment and six years follow-up of the teeth with large periapical lesion using MTA as apical filling material. (Eur J Dent 2010;4:468- 474)


2019 ◽  
Vol 4 (2) ◽  
pp. 40-42
Author(s):  
Kadambari Padmanabhan ◽  

A thorough knowledge and understanding of the root canal morphology including the variations is important for the successful outcome of endodontic treatment. The success of an endodontic treatment depends on the eradication of microbes from the root-canal system and prevention of re-infection [1] . The variations in mandibular first molar involves the number of roots, the number of root canals, and morphology. Radix entomolaris and the radix paramolaris are the additional root located lingually and buccally respectively [2] . This case report discusses endodontic treatment of a mandibular first molar with a radix entomolaris and pulp stone.


2020 ◽  
Vol 9 (6) ◽  
pp. 513-516
Author(s):  
Mailon Cury Carneiro ◽  
Fernanda Angelio Da Costa ◽  
Paula Gabriela Vieira Chicora ◽  
Marcos Sergio Endo ◽  
Vanessa Cristina Veltrini

O objetivo deste trabalho é relatar um caso clínico de uma extensa lesão periapical em maxila, tratada somente por uma abordagem endodôntica não cirúrgica, com expressivo reparo periapical. Paciente do sexo feminino, 52 anos, compareceu à clínica odontológica, com a queixa principal de “cisto crescendo na boca”. Os dentes 13, 14 e 15 apresentavam-se sem vitalidade pulpar. Os exames radiográficos mostraram duas áreas radiolúcidas, uniloculares, envolvendo os ápices dos dentes 13 e 15, ambos sem sinais de intervenção endodôntica. As áreas eram sugestivas de granuloma periapical e cisto periapical inflamatório, respectivamente. Realizou-se tratamento endodôntico dos dentes 13, 14 e 15. Após 11 meses, notou-se regressão significativa da rarefação óssea periapical, não sendo necessária qualquer intervenção cirúrgica. A paciente continuará em proservação até a remissão completa da lesão. O preparo químico-mecânico, associado ao emprego de medicação intracanal, pode ser suficiente para o reparo de lesões periapicais extensas. Sugere-se que o tratamento conservador seja sempre a primeira opção em casos semelhantes, de forma a se evitar cirurgias parendodônticas invasivas desnecessárias. Descritores: Endodontia; Cisto Radicular; Tratamento Conservador. Referências Hammouti J, Chhoul H, Ramdi H. Non-surgical management of large periapical cyst like lesion: case report and litterature review. J Oral Heal Dent Sci. 2019;3(1):1–7. Mitra A, Adhikari C. Management of large periapical lesions by non surgical endodontic approach - two case reports. 2017;2(5):97–104. Al Khasawnah Q, Hassan F, Malhan D, Engelhardt M, Daghma DES, Obidat D, et al. Nonsurgical clinical management of periapical lesions using calcium hydroxide-iodoform-silicon-oil paste. Biomed Res Int. 2018;2018:1-8. Schulz M, von Arx T, Altermatt HJ, Bosshardt D. Histology of periapical lesions obtained during apical surgery. 2009;35(5):634-42. Ramachandran Nair PN, Pajarola G, Schroeder HE. Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(1):93-102. Gutmann JL, Baumgartner JC, Gluskin AH, Hartwell GR, Walton RE. Identify and define all diagnostic terms for periapical/periradicular health and disease states. JOE. 2009;35(12):1658-74. Antoh M, Hasegawa H, Kawakami T, Kage T, Chino T, Eda S. Hyperkeratosis and atypical proliferation appearing in the lining epithelium of a radicular cyst. Report of a case. J Cranio-Maxillo-Facial Surg. 1983;21(5):210-13. Natkin E, Oswald RJ, Carries LI. The relationship of lesion size to diagnosis, incidence, and treatment of periapical cysts and granulomas. Oral Surg. 1984;57(1):82-94. Rathod DM, Mulay SA. Non-surgical treatment of large periapical lesion using various formulations of calcium hydroxide & nd: yag laser. Int J Curr Res. 2017;9(8):56668-72. Rosenberg PA, Frisbie J, Lee J, Lee K, Frommer H, Kottal S, et al. Evaluation of pathologists (histopathology) and radiologists (cone beam computed tomography) differentiating radicular cysts from granulomas. J Endod. 2010;36(3):423-28. Sant’ana Filho M, Rados PV. Lesões apicais. In: Silveira JOL, Beltrão GC. Exodontia. 1Porto Alegre: Missau; 1998. cap. 22, p. 275-85. Sood N, Maheshwari N, Gothi R, Sood N. Treatment of large periapical cyst like lesion: a noninvasive approach: a report of two cases. Int J Clin Pediatr Dent. 2015;8(2):133-37. Singh U, Nagpal R, Sinha D, Tuhin, Tyagi N. Iodoform based calcium hydroxide paste (metapex):an aid for the healing of chronic periapical lesion. J Adv Res Biol Sci. 2013;6(1):63-7. Dandotikar D, Peddi R, Lakhani B, Lata K, Mathur A, Chowdary UK. Nonsurgical management of a periapical cyst: a case report. J Int Oral Health. 2013;5(3):79-84. Calişkan MK. Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review. Int Endod J. 2004;37(6):408-16.  Kanmaz F, Altunbaş D, Zan R, Akpınar KE. Nonsurgical endodontic treatment of a large periradicular lesion. Turk Endod J. 2017;2(1):21–4. Öztan MD. Endodontic treatment of teeth associated with a large periapical lesion. Int Endod J. 2002;35(1):73–8. Barroso JAY, Uchimura JYT, Endo MS, Pavan NNO, Queiroz AF. Avaliação in vitro da influência da lima patência na manutenção do comprimento de trabalho. Rev Odontol UNESP. 2017;46(2):72-6. Madhusudhana K, Surada R, Kumar CS, Lavanya A. Non-surgical management of a large periapical lesion: a case report. Ann Essences Dent. 2017;9(2):22-5. Soares J, Santos S, Silveira F, Nunes E. Nonsurgical treatment of extensive cyst-like periapical lesion of endodontic origin. Int Endod J. 2006;39(7):566-75. Mohammadi Z, Shalavi S, Yazdizadeh M. Antimicrobial activity of calcium hydroxide in endodontics: a review. Chonnam Med J. 2013;48(3):133-40. Estrela C, Bammann LL, Pimenta FC, Pécora JD. Control of microorganisms in vitro by calcium hydroxide pastes. Int Endod J. 2001;34(5):341-45. Soares JA, Brito-Júnior M, Silveira FF, Nunes E, Santos SMC. Favorable response of an extensive periapical lesion to root canal treatment. J Oral Sci. 2008;50(1):107-11.


2021 ◽  
Vol 10 (30) ◽  
pp. 2331-2333
Author(s):  
Shelly Sharma ◽  
Anshul Arora ◽  
Mandeep S. Grewal ◽  
Mamta Singla ◽  
Lakshita Singh

In-depth knowledge of the root canal system is a major prerequisite for successful endodontic treatment.1 The major aim of endodontic treatment is the eradication of infection and prevention of reinfection in canal. However endodontic treatment may fail because of incomplete knowledge about the anatomical variation of root canals. Most of the times the canal remains untreated because of the inability of the dentist to recognize its presence. For good prognosis of the root canal treatment, proper exploration, complete debridement, biomechanical preparation, and filling of root canal system must be done. Therefore, a dentist must be familiar with all the various possible canal configurations.2 Many times, failure of endodontic treatment may occur because the morphological variation of the tooth unfavourably affects the treatment. Pulpal inflammation can occur as a result of many factors like dental caries or trauma which causes tissue necrosis. Periapical tissue eradication develops in response to microbial accumulation and infiltration of their by-products in the periradicular tissues and activates host's immune reaction.3 The following case report presents the non-surgical management of mandibular central and lateral incisors, with each having two separate canals which join together to form a single canal just before exiting the apical foramen. Before starting root canal treatment, a careful radiographic examination should be done to detect the morphological variations in root canal anatomy. This paper describes two clinical cases of mandibular incisors with or without periapical lesion having two canals.


2011 ◽  
Vol 12 (5) ◽  
pp. 368-371 ◽  
Author(s):  
Matheus Melo Pithon ◽  
Deyla Duarte Vilela ◽  
Manoel Matos Neto ◽  
Alexandre Mascarenhas Villela

ABSTRACT Aim To evaluate the interference of the intracanal medication Calen® (SSWhite, São Paulo, Brazil) on the filling of simulated lateral canals. Materials and methods Twenty human anterior teeth were used. Before the endodontic filling procedures the access of cavity was made, and after this root canals were made in all the teeth to simulate the presence of lateral canals. After preparation, the teeth were randomly divided into two groups (n=10). In group I, the root canal system was filled directly after chemicalmechanical preparation; in group II, endodontic treatment was performed in multiple sessions, and after preparation the calcium hydroxide-based intracanal medication Calen® was inserted. After the period of 7 days, the root canals were vigorously irrigated and then they were filled. Next, the teeth were radiographed to verify the quality of the filling. Results The results demonstrated that the teeth treated in a single session, without calcium hydroxide medication, presented 47 canals out of 60 with radiographic evidence of filling, whereas the teeth in which intracanal medication was used, only 07 presented a radiographic image compatible with filling (p < 0.05). Conclusion The use of the calcium hydroxide-based medication Calen made it difficult to obtain a hermetic filling of the root canal system. Clinical significance The clinical significance of this work basing on the fact that once the dentist knowing that property obliteration of calcium hydroxide can be taken care when they are used in the presence of lateral canals. How to cite this article Vilela DD, Neto MM, Villela AM, Pithon MM. Evaluation of Interference of Calcium Hydroxide-based Intracanal Medication in Filling Root Canal Systems . J Contemp Dent Pract 2011;12(5):368-371.


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