scholarly journals Removal of fractured endodontic NiTi file in the apical third of the root canal using an alternative approach. A case report

2021 ◽  
Vol 10 (3) ◽  
pp. e13810313097
Author(s):  
Caroline Loureiro ◽  
Flávia Alfredo Plazza ◽  
Rogério de Castilho Jacinto ◽  
Luciano Tavares Angelo Cintra ◽  
João Eduardo Gomes-Filho

This case report presents an alternative approach for the removal of a fractured endodontic instrument from the apical third of the root canal. A 52-years-old female patient was referred for specialized endodontic treatment of the maxillary left first molar due to the presence of a periapical lesion and root canal calcification. After clinical and radiographic examination, the calcification was confirmed. During biomechanical preparation, the fracture of a size 25/.06 NiTi reciprocating file (ProDesign R) occurred in the apical third of the palatine canal. The patient was informed about the complication and agreed with the attempt to remove the fragment. Firstly, a slight wear of the dentinal walls around the fragment was made using ultrasonic inserts under magnification. Then, a customized extractor was made using a hypodermic needle and a handling file whose mechanism is similar to the removal method previously described by Masserann. For this, the hypodermic needle was inserted in the root canal and the handling file was adapted in the needle lumen, with the function of fixing the fragment and removing it from the canal through the opposite movement performed by the fractured file. After associating the technique with a hypodermic needle and using ultrasound and an operating microscope to perform the procedure, the fragment was successfully removed. The association of techniques to remove fragments using only items already present in the endodontic arsenal can eliminate the need for surgical treatment and improve the prognosis of endodontic treatment through a safe, simple and cost-effective method that can be performed in the endodontic clinical routine.

2015 ◽  
Vol 18 (2) ◽  
pp. 115
Author(s):  
Lauren Grandi Dos Santos ◽  
Amanda Nunes Gallas ◽  
Josué Martos ◽  
Luiz Fernando Machado Silveira

The C-shape configuration in molars it’s an anatomical variation that difficult the diagnosis and treatment. The aim of this study was to report a case of C-shape endodontic configuration in mandibular second molar. The radiographic examination of one patient revealed the extent of caries in the mesial aspect of mandibular second molar, without the presence of periapical lesion and was clinically noted the C-shape configuration of the root canal, extending from the mesiobuccal to the distal canal. Endodontic therapy was performed and after the root canal obturation with gutta-percha cones and endodontic cement the tooth was restored. We conclude that the anatomical condition in C-shape, although it brings many difficulties for the endodontic treatment, does not preclude the tooth rehabilitation.


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.


2021 ◽  
Vol 10 (12) ◽  
pp. e139101220061
Author(s):  
Ana Paula Fernandes Ribeiro ◽  
Julia Guerra de Andrade ◽  
Heitor César Maia ◽  
Caroline Loureiro ◽  
Gladiston Willian Lobo Rodrigues ◽  
...  

This study aims to report the clinical case of a 16 years-old male patient, who attended a private office reporting that at an accident suffered at the age of 10 years-old, which caused extrusive dislocation in both teeth 11 and 21. At that time, the teeth were repositioned, without an adequate follow-up. Upon physical and radiographic examination, the following features were observed: presence of recurrent sinus tract on the vestibular surface, area of ​​external cervical resorption, and a periapical lesion on tooth 21. Endodontic treatments (necropulpectomy) were performed on teeth 11 and 21, with the placement of a root canal dressing of calcium hydroxide and subsequent root canal filling. In addition, soft tissue flap folding was performed to treat the resorption area and to seal it with glass ionomer cement. A 7 months follow-up radiograph shows stabilization in the process of the tooth resorption and remission of the periapical lesion. In conclusion, the endodontic treatment with intracanal medication, and the sealing of the resorption area were successful to preserve the traumatized tooth. In addition, it is noteworthy that following up with the patient after the trauma episode is essential to monitor the pulp vitality of the tooth involved.


2020 ◽  
Vol 2 ◽  
pp. 120-123
Author(s):  
Munish Singla ◽  
Iyana Garg ◽  
Vandana Goyal ◽  
Harleen Kaur ◽  
Litik Mittal

Sterilization of root canal space is foremost for the success of the endodontic treatment which is usually carried out with intracanal irrigants and medicaments. Triple antibiotic paste (metronidazole, ciprofloxacin, and minocycline) is used to achieve sterilization and healing of periradicular area. In the present case report, the triple antibiotic paste was used for non-surgical management of periapical lesion for 3 weeks. After 3 weeks, the tooth became asymptomatic that was then obturated. Hence, it is confirmed that conventional root canal treatment, along with intracanal medicaments (triple antibiotic paste), can non-surgically manage the periapical lesions and further promotes healing.


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.


2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Roopadevi Garlapati ◽  
Bhuvan Shome Venigalla ◽  
Jayaprakash D. Patil ◽  
Thumu Jayaprakash ◽  
C. H. Krishna Chaitanya ◽  
...  

Dental traumatic injuries may affect the teeth and alveolar bone directly or indirectly. Pulpal necrosis and chronic and apical periodontitis with cystic changes are the most common sequelae of the dental traumatic injuries, if the teeth are not treated immediately. This case report focuses on the conventional and surgical management of mandibular central incisors. A twenty-four-year-old male patient presented with pain in the mandibular central incisors. Radiographic examination revealed mandibular central incisors with dumbbell shaped periapical lesion. After root canal treatment, parendodontic surgery was performed for mandibular central incisors. After one-year recall examination, the teeth were asymptomatic and periapical lesion had healed.


2016 ◽  
Vol 1 (1) ◽  
pp. 46
Author(s):  
Asri Riany Putri ◽  
Diatri Nari Ratih

Gigi premolar maksila merupakan gigi yang mendapat tekanan pengunyahan besar dan rentan mengalami fraktur terutama setelah dilakukan perawatan saluran akar (PSA). Gigi yang telah dilakukan PSA akan menjadi sangat rapuh dan rentan fraktur karena telah kehilangan kelembaban dan banyak jaringan kerasnya. Gigi premolar juga mendapat tekanan pengunyahan yang besar karena bentuk dan letaknya yang lebih dekat dengan aksis horizontal transversal. Penggunaan parallel self-threading dowel dan mahkota penuh porselen fusi metal akan mendistribusikan beban pengunyahan keseluruh bagian akar dan meningkatkan ketahanannya terhadap fraktur. Tujuan laporan kasus ini adalah untuk menunjukkan keberhasilan penggunaan parallel self-threading dowel dengan mahkota penuh porselen fusi metal sebagai restorasi pasca PSA pada gigi premolar kedua maksila nekrosis pulpa dengan lesi periapikal. Pasien wanita berusia 30 tahun dirujuk untuk PSA pada gigi premolar kedua kanan maksila nekrosis pulpa dengan lesi periapikal. Pasien merasakan sakit saat gigi digunakan untuk makan. Perkusi dan palpasi positif namun mobilitas normal. Pemeriksaan radiografik menunjukkan gambaran radiopak yang telah mengenai ruang pulpa dan radiolusensi pada periapikal gigi. PSA dan restorasi mahkota penuh dilakukan dengan parallel self-threading dowel. Parallel self-threading dowel dan mahkota penuh PFM sebagai restorasi akhir menunjukkan keberhasilan perawatan pada gigi premolar kedua maksila pasca PSA. ABSTRACT: Porcelain Fused to Metal Crown with Parallel Self-Threading Dowel Post Root Canal Treatment On Maxillary Premolar. Maxillary premolar teeth have great chewing forces and prone to fracture, especially after root canal treatment (RCT). Teeth that have RCT done will be very brittle and fracture prone because it has lost moisture and lost most of its hard tissue. Premolars also receive great chewing forces because its shape and location are closer to the horizontal transverse axis. The use of parallel self-threading dowel and full porcelain fused to metal crowns will distribute the load of mastication throughout the roots and improve resistance to fracture. The aim of this case report was to demonstrate the success of the use of parallel self-threading dowel with full porcelain fused to metal crown restoration aftera RCT on maxillary second premolar with pulp necrosis and periapical lesion. A 30-year-old female patient was referred for RCT on the maxillary right second premolar with pulp necrosis and periapical lesion. Patient felt pain when the tooth was used to eat. There was tenderness to percussion and palpation but the mobility was normal. A radiographic examination showed radiopaque image that entered pulp chamber and periapical radiolucency on tooth. RCT and full crown restoration with parallel self-threading dowel had been performed. Parallel self-threading dowel and full porcelain fused to metal crown as the final restoration after RCT on the maxillary second premolar showed a successful treatment outcome.


2015 ◽  
Vol 18 (1) ◽  
pp. 17 ◽  
Author(s):  
Cari Maristela Pieper ◽  
Eliseu Aldrighi Münchow ◽  
Evandro Piva

<span>Periradicular lesions occur in non-vital teeth as the result of a chronic aggression by the presence of microorganisms into the root canal, which may appear as a radiolucent lesion in the radiographic exam; treatment varies according to surgical or nonsurgical methods. This case report describes the regression of a periradicular lesion using a nonsurgical endodontic treatment in association with intracanal calcium hydroxide-based medicament. After patient examination and radiographic analysis, a 13 mm (in maximum diameter) radiolucent lesion was observed in tooth number 12. The endodontic treatment was done and Calen-CMCP (S.S. White Artigos Dentários Ltda., Rio de Janeiro, RJ, Brazil) was placed into the root canal, which was changed after every two weeks during two months. It was observed a progressive centrifugal regression of the lesion after every renewing of the medicament. In addition, after six-year follow-up the tooth was still free of re-infection and bone tissue was completely regenerated. In conclusion, calcium hydroxide therapy can conservatively stimulate the regression of large periradicular lesions.</span>


2021 ◽  
Vol 33 (3) ◽  
pp. 262
Author(s):  
Diatri Nariratih ◽  
Hendra Dian Adhita Dharsono

ABSTRAKPendahuluan: Penatalaksanaan kasus penyakit pulpa yang disertai dengan lesi periapikal dapat dilakukan dengan perawatan saluran akar tanpa intervensi bedah. Preparasi biomekanis pada perawatan endodontik non-bedah dapat mengeliminasi bakteri dari saluran akar dan mencegah terjadinya infeksi berulang setelah dilakukannya obturasi. Kompleksitas anatomi menyebabkan keterbatasan preparasi biomekanis saluran akar, sehingga perawatan dapat mengalami kegagalan. Variasi anatomi saluran akar pada gigi molar pertama rahang atas umumnya terdapat pada bagian palatal akar mesiobukal yang disebut sebagai saluran akar mesiobukal kedua dengan insidensi 94%. Saluran akar mesiobukal kedua berukuran lebih sempit dan dangkal dibandingkan saluran akar mesiobukal pertama, sehingga dibutuhkan beberapa metode untuk menentukan lokasi orifis tersebut. Tujuan laporan kasus ini adalah membahas mengenai penatalaksanaan non-bedah gigi pasca perawatan endodontik parsial yang disertai dengan lesi periapikal. Laporan kasus: Pasien perempuan berusia 28 tahun datang dengan keluhan gigi belakang kiri atas sakit berdenyut sejak 1 bulan, gigi tersebut pernah dirawat saluran akarnya beberapa tahun sebelumnya. Pemeriksaan klinis menunjukkan terdapat tambalan permanen pada gigi 26. Pemeriksaan radiografis menunjukkan adanya gambaran radiopak pada email mesio-oklusal hingga mencapai dasar kamar pulpa, pelebaran ligamen periodontal, terputusnya lamina dura, serta lesi periapikal pada akar mesial dan palatal. Preparasi akses dilakukan pada gigi 26, dilanjutkan dengan penentuan lokasi orifis mesiobukal kedua. Empat saluran akar dipreparasi menggunakan instrumen rotary nickel titanium dengan teknik crown down dan dilakukan obturasi teknik kondensasi lateral. Restorasi definitif berupa mahkota penuh porselen. Simpulan: Lesi periapikal sembuh setelah dilakukan preparasi pada saluran akar mesiobukal kedua sehingga pengetahuan mengenai anatomi dan variasi internal saluran akar gigi sangat penting dalam keberhasilan perawatan endodontik non-bedah.Kata kunci: Perawatan endodontik non-bedah; previously initiated therapy; lesi periapical; mesiobukal kedua  ABSTRACTIntroduction: The management of pulp disease cases accompanied by periapical lesions can be done by root canal treatment without surgical intervention. Biomechanical preparations for non-surgical endodontic treatment can eliminate bacteria from the root canal and prevent re-infection after obturation. However, the complexity of the anatomy limits the biomechanical preparation of the root canal so that treatment can fail. Anatomical variations of the root canal in the maxillary first molars are generally found in the palatal part of the mesiobuccal root, which is the second mesiobuccal root canal with an incidence of 94%. The second mesiobuccal root canal is narrower and shallower than the first mesiobuccal root canal, so several methods are needed to determine the location of the orifice. The purpose of this case report was to discuss the non-surgical management of teeth after partial endodontic treatment accompanied by periapical lesions. Case report: A 28-year-old female patient complained of throbbing pain in the left upper back tooth for one month. The tooth had had its root canal treated several years before. Clinical examination revealed permanent fillings on tooth 26. Radiographic examination showed the radiopaque appearance of mesio-occlusal enamel to the floor of the pulp chamber, widening of the periodontal ligament, rupture of the lamina dura, and periapical lesions of the mesial and palatal roots. Access preparation was performed on tooth 26, followed by the determination of the location of the second mesiobuccal orifice. Four root canals were prepared using a rotary nickel titanium instrument with a crown down technique and obturation with lateral condensation technique. The definitive restoration is a full porcelain crown. Conclusions: Periapical lesions healed after preparation of the second mesiobuccal root canal. This result proves that knowledge of the anatomy and internal variations of the root canal is fundamental in the success of non-surgical endodontic treatment.Keywords: Non-surgical endodontic treatment; previously initiated therapy; periapical lesions; second mesiobuccal canal


2010 ◽  
Vol 11 (2) ◽  
pp. 78-84 ◽  
Author(s):  
Carlos Aguiar ◽  
Daniela Mendes ◽  
Andréa Câmara ◽  
Jose Figueiredo

Abstract Aim The purpose of this case report is to describe a nonsurgical endodontic treatment of a mandibular left second premolar with two separate roots and three distinct root canals. Background In endodontics, the possible existence of extra canals must be considered before endodontic treatment is instituted. A wide morphological variation of the root canal system is known to exist. Case Description A 36-year-old male patient was referred for endodontic treatment on the left mandibular second premolar. Radiographic examination of the involved tooth revealed an unusual, complex root canal anato my. There was an irregular root morphology consisting of two distinct roots and three canals. Summary This case report describes the successful nonsurgical endodontic treatment of a mandibular left second premolar with two separate roots and three distinct root canals filled using size 35 Thermafil guttapercha carriers and AH Plus sealer. On the one-year follow-up radiograph, the tooth was asymptomatic, confirming adequate healing with no complications. Clinical Significance Even in a tooth with an extremely complex root canal morphology, conventional endodontic treatment without surgical intervention can result in adequate healing without any complications. Citation Aguiar C, Mendes D, Câmara A, Figueiredo J. Endodontic Treatment of a Mandibular Second Premolar with Three Root Canals. J Contemp Dent Pract [Internet]. 2010 March; 11(2):078-084. Available from: http://www.thejcdp. com/journal/view/volume11-issue2-aguiar.


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