scholarly journals KERUSAKAN TULANG PADA KASUS ENDODONTIK-PERIODONTAL

2021 ◽  
Vol 17 (1) ◽  
pp. 43-48
Author(s):  
Natalina - Natalina

Latar belakang. Masalah pulpa dan periodontal menyebabkan lebih dari 50% kehilangan gigi. Kasus pada laporan kasus ini merupakan lesi primer endodontik dan lesi sekunder periodontal dan secara klinis terdapat sinus tract. Kondisi ini merupakan kasus yang secara kolaborasi dikerjakan oleh bidang konservasi gigi dan bidang periodonsia untukmemdapatkan hasil yang maksimal. Kasus. Terdapat tiga kasus lesi endodonti-periodontal, dua merupakan kasus (gigi 21 dan 37) yang setelah beberapa tahun dilakukan perawatan saluran akar (PSA) mengalami pembentukan sinus tract, dan satu kasus (gigi 47) yang setelah PSA namun tidak memeperlihatkan perbaikan sinus tract yang terbentuk di gingiva. Tindakan bedah flap periodontal dilakukan untuk mencari penyebab, menghilangkan jaringan granulasi, dan memperbaiki kerusakan tulang alveolar yang terjadi. Seluruh kasus terlihat terdapat kerusakan tulang anguler di daerah furkasi pada gigi posterior (37 dan 47), dan daerah interdental pada gigi anterior (21); satu kasus (gigi 21) mengalami fenestrasi di fasial. Defek tulang anguler dan daerah fenestrasi setelah dibersihkan dari jaringan granulasi yang terinfeksi, diisi dengan graf tulang dan ditutup oleh membran pericardium sebagai guided tissue regeneration (GTR), kemudian dijahit. Kontrol 14 hari setelah tindakan bedah, sinus tract  telah hilang dan warna gingiva normal. Kesimpulan. Lesi endodontik-periodontal yang memperlihatkan sinus tract yang persisten setelah perawatan saluran akar merupakan indikasi adanya kerusakan periodontal yang kompleks. Defek periodontal kompleks bisa diperbaiki dengan tindakan bedah regeneratif.Kata kunci. Lesi endodontik-periodontal, sinus tract, defek tulang anguler, fenestrasi Abstract Background. Dental pulp and periodontal problems account for more than 50% of tooth loss. The cases in this case report were primary endodontic lesions and secondary periodontal lesions and clinically contained a sinus tract. This report is a collaborative carried out by the conservative dentistry and periodontics to obtain maximum results. Case. There were three cases of endodontic-periodontal lesions, two were cases (teeth 21 and 37) where after several years of root canal treatment had sinus tract formation, and one case (tooth 47) after endodontic treatment but did not show any improvement in the sinus tract in the gingiva. Periodontal flap surgery is performed to find the cause, remove the granulation tissue, and repair the alveolar bone damage that has occurred. All cases showed angular bone defects in the furcation areas of the posterior teeth (37 and 47), and the interdental areas of the anterior teeth (21); one case (tooth 21) had facial fenestration. Angular bone defects and areas of fenestration after cleaning of infected granulation tissue, filled with bone graft and covered by pericardial membrane as guided tissue regeneration (GTR), then sutured. Control 14 days after surgery, the sinus tract was gone and the gingival color was normal. Conclusion. Endodontic-periodontal lesions showing persistent sinus tracts after root canal treatment are indicated of complex periodontal damage. Complex periodontal defects can be corrected with regenerative surgery.Keywords. endodontic-periodontal lesions, sinus tract, angular bone defect, fenestration

2019 ◽  
Vol 13 (1) ◽  
pp. 93-100
Author(s):  
Mohammad Alwadani ◽  
Mohammed H. Mashyakhy ◽  
Amr Jali ◽  
Arwa O. Hakami ◽  
Ahmed Areshi ◽  
...  

Objectives: The intent of this study was to evaluate and compare the preferences and treatment choices between dentists and dental interns with regard to the following different treatment modalities: Root Canal Treatment (RCT) with restoration versus extraction with Implant-Supported Crown (ISC) or surgical treatment in relation to the given case scenarios. Methods: The questionnaire was presented as an online survey with a case scenario. The total number of the respondents were 165. The four clinical case scenarios included an anterior and posterior tooth having apical periodontitis, with and without previous RCT. The treatment options were as follows: RCT with restoration, extraction then implant, and surgical treatment. Results: A total of 165 dentists and dental interns were included in this study. A hundred and three 62.4% respondents were dentists, 60; 36.3% were males and 105; 63.7% were females. Most of the respondents graduated from the College of Dentistry, Jazan University (93.9%). The highest percentages and numbers for Anterior Teeth (AT) were selected in related to the RCT and restorations in the four scenarios among gender, dentists, and interns, with no considerable differences. A high percentage of RCT and restoration option was recorded for Posterior Teeth (PT) with no previous restoration and around 50% for the same treatment modality to posterior teeth with previous restorations. For Future Planning Postgraduate Studies (FPPS), it was obvious that most of the selected specialties agreed with the RCT and restorations choice. Conclusion: All dentists and interns in both genders preferred RCT with restorations over extraction, and then ISC in the AT with and without previous RCTs. In the PT with no previous RCT, the participants agreed that RCT with restorations is superior to other choices. Among the FPPS, the respondents demonstrated an absolute agreement to RCT and restorations as a treatment of choice for different scenarios. Clinical Significance: Dentists should preserve the natural teeth by RCT with restoration as the first treatment choice followed by other choices. The nonsurgical approach should always be adopted as a routine measure in PA lesions of endodontic origin. Conservative orthograde endodontic therapy demonstrates favorable outcomes with a regular periodic review and assessment of the healing process of PA lesions.


2018 ◽  
Vol 17 (2) ◽  
Author(s):  
Anisa Kusumawardani ◽  
Yunita Dewi Ardini ◽  
Taufiq Hidayat Hasan

Dens evaginatus (DE) is a developmental anomaly. It is an extra cusp or tubercle that protrudes from the occlusal surface of posterior teeth, as well as the lingual surface of anterior teeth. Tubercles are susceptible to pulp exposure from wear or fracture because of malocclusion;leading to pulpal complications early after eruption.DE may also complicate the process of daily routine oral health care. A 13-year-old girl presented to our polyclinic with sinus track at the posterior lower left buccal gingiva forthe past1 year. All 35 teeth were sound. At the lingual side, there was an accessory tooth in close relation to tooth 35 covered with supra-gingival inflammation. Electric pulp test (EPT) showed that tooth 35 was already non-vital. Intraoral periapical (IOPA) radiograph and cone beam computed tomography (CBCT) scan showed an abnormalappearing root which shows DE with radiolucency at the periapical area. Root canal treatment was performed using crown down pressureless (CDP) technique and obturation was done using lateral condensation technique. The tooth was restored using composite restoration. DE is a rare condition. It is quite a challenge for dental practitioner since the diagnosis is difficult and the treatment options are limited. In the case of DE with necrotic pulp and periapical abscess, root canal treatment is a treatment of choice. We have to accept and appreciate any gift from Allah SWT whether it is good or bad, no equal divine creation except from Allah SWT.Therefore we need to take care of our oral hygiene to prevent diseases. In every disease, there is a cure; we thus need to try to do the best to find the cure and to not easily get rid of the tooth and replace it with a denture. Early diagnosis of DE can lead to proper treatment which can result in high success rate if it is followed by adequate restoration.


Author(s):  
Liliana Artaza ◽  
Andrea Campello ◽  
Giuliana Soimu ◽  
Flávio R. F. Alves ◽  
Isabela N. Rôças ◽  
...  

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 573
Author(s):  
João Miguel Santos ◽  
Joana F. Pereira ◽  
Andréa Marques ◽  
Diana B. Sequeira ◽  
Shimon Friedman

Background and Objectives: Symptomatic irreversible pulpitis in permanent mature teeth is a common indication for nonsurgical root canal treatment (NSRCT), but contemporary studies have reported on vital pulp therapy (VPT) applied in such teeth as a less invasive treatment. This systematic review assessed the outcomes of VPT, including partial and full pulpotomy performed with hydraulic calcium silicate cements (HCSCs) in permanent mature posterior teeth diagnosed with symptomatic irreversible pulpitis. Materials and Methods: The PRISMA guidelines were followed. The search strategy included PubMed®, EMBASE, Cochrane library and grey literature electronic databases. The quality assessment of the identified studies followed the Cochrane Collaboration Risk of Bias, ROBINS-I and Newcastle–Ottawa Scale tools. Results: The search of primary databases identified 142 articles, of which 9 randomized controlled trials and 3 prospective cohort studies were selected for review. The risk-of-bias was assessed as ‘high’ or ‘serious’, ‘fair’, and ‘low’ for three, seven and two articles, respectively. One to five years after VPT using HCSCs, the success rates mostly ranged from 78 to 90%. Based on two articles, the outcomes of the VPT and NSRCT were comparable at one and five years. Despite the necessity for the intra-operative pulp assessment in VPT procedures, the majority of the studies did not fully report on this step or on the time needed to achieve hemostasis. Small sample sizes, of under 23 teeth, were reported in three studies. Conclusions: The reviewed 12 articles reported favorable outcomes of the VPT performed with HCSCs in permanent mature posterior teeth with symptomatic irreversible pulpitis, with radiographic success in the range of 81 to 90%. Two articles suggested comparable outcomes of the VPT and root canal treatment. Universal case selection and outcome criteria needs to be established for VPT when considered as an alternative to NSRCT. This evidence supports the need for further research comparing longer-term outcomes of both of the treatment modalities.


Materials ◽  
2021 ◽  
Vol 14 (10) ◽  
pp. 2661
Author(s):  
Kiche Shim ◽  
Young-Eun Jang ◽  
Yemi Kim

Background: This clinical trial aimed to compare the effects of bioceramic sealer and resin-based sealer on the incidence and intensity of postoperative pain. Methods: Patients with anterior teeth or premolars requiring root canal treatment were assigned to group 1 (n = 51). Those with molars requiring treatment were assigned to group 2 (n = 57). In groups 1En and 2En, root canals were obturated with Endoseal MTA using the single-cone technique. In groups 1AH and 2AH, the sealer used was AH Plus with the continuous wave technique. On the day of canal filling, each patient was instructed to indicate their pain intensity over the 7 day postoperative period, at rest and, while biting, using a visual analog scale. Results: There was no significant difference in the incidence or intensity of postoperative pain between the Endoseal MTA and AH Plus groups during the 7 day postoperative period (p > 0.05). Less time was needed to seal the root canals with Endoseal MTA, especially in group 2 (p < 0.05). Conclusions: Endoseal MTA and AH Plus had similar effects on the incidence and intensity of postoperative pain. The obturation time was shorter when using Endoseal MTA compared to AH Plus.


2017 ◽  
Vol 44 (1) ◽  
pp. 14-25 ◽  
Author(s):  
Pinpana Tupyota ◽  
Pattama Chailertvanitkul ◽  
Malinee Laopaiboon ◽  
Chetta Ngamjarus ◽  
Paul V. Abbott ◽  
...  

2010 ◽  
Vol 04 (04) ◽  
pp. 403-411 ◽  
Author(s):  
Gonca Cayir Keles ◽  
Mahmut Sumer ◽  
Burcu Ozkan Cetinkaya ◽  
Ferda Tutkun ◽  
S. Burcak Simsek

Objectives: The aim of this clinical trial was to evaluate the additional benefit of using guided tissue regeneration (GTR) with autogenous cortical bone (ACB) grafting versus ACB grafting alone for the regenerative treatment of intraosseous periodontal defects.Methods: Via a split-mouth design, 12 patients with chronic periodontitis (five men, seven women; mean age, 45.3±4.6 years) who had probing pocket depths (PPDs) of ≥6 mm following initial periodontal therapy were randomly assigned to two treatments in contralateral areas of the dentition: a combination of ACB grafting and GTR (with a absorbable membrane of polylactic acid) or ACB grafting alone. The compared parameters were preoperative and 6-month postoperative PPDs, clinical attachment levels (CALs), and radiographic alveolar bone heights.Results: Both treatment modalities resulted in significant changes in the postoperative measurements from the preoperative values (P<.01). The reduction in the PPDs, gain in the CALs, and gain in the radiographic alveolar bone heights were 4.58±1.08, 4.25±1.06, and 5.50±2.24 mm in the patients treated with ACB grafting and GTR and 4.92±1.00, 4.50±0.80, and 5.92±1.83 mm in those treated with ACB grafting alone, respectively. The differences between the treatments were not statistically significant (P>.05).Conclusions: Within the study limitations, both ACB grafting with GTR and ACB grafting alone lead to significant improvements in clinical and radiographic parameters at 6 months postoperatively. The combined approach does not provide any additional benefit for treating intraosseous periodontal defects. (Eur J Dent 2010;4:403-411)


2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Zahra Alizadeh Tabari ◽  
Hamed Homayouni ◽  
Tahere Pourseyediyan ◽  
Armita Arvin ◽  
Derrick Eiland ◽  
...  

Introduction. The radicular groove is a developmental groove which is usually found on the palatal or lateral aspects of the maxillary incisor teeth. The present case is a maxillary lateral incisor with a small second root and a deep radicular groove. The developmental groove caused a combined periodontal-endodontic lesion. Methods. Case was managed using a combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal treatment. After completion of root canal treatment, guided tissue regeneration (GTR) was carried out using decalcified freeze dried bone allograft (DFDBA) and a bioabsorbable collagenous membrane. Tooth also was splinted for two months. Results. After 12 months the tooth was asymptomatic. The periapical radiolucency disappeared and probing depth did not exceed 3 mm. Conclusion. Combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal regenerative treatment can be a predictable technique in treating combined endodontic-periodontal lesions caused by radicular groove.


2018 ◽  
Vol 42 (2) ◽  
pp. 146-149
Author(s):  
Fadi Said ◽  
Moti Moskovitz

Objectives: The aim of the present study was to assess the effect of calcium hydroxide as a root canal dressing material on dentin microtensile fracture strength in human primary teeth in vitro. Study design: Thirty primary anterior teeth with root canals packed with calcium hydroxide were divided into groups of ten and immersed in saline at room temperature for 7, 30 and 90 days. Ten teeth with root canals filled with sterile saline were the control group. Microtensile fracture strength was measured in Mechanical tester Lloyd testing machine. Results: There was a significant difference (P &lt; 0.05) between the fracture strength of the calcium hydroxide-filled teeth after 90 days (19.1 MPa) compared with the control (35.8 MPa). Dentin microtensile fracture strength of the calcium hydroxide-filled teeth decreased at an average of 0.142 MPa per day. Conclusion: Calcium hydroxide placed in root canals for an extended time had a significantly negative effect on root strength. Long-term success of root canal treatment in primary anterior teeth is estimated as 65% with most of the failures result from trauma recurrence. Clinical Relevance: Our results stress the need to evaluate the pros and cons of root canal treatment compared to extractions of non-vital primary incisors.


Sign in / Sign up

Export Citation Format

Share Document