Estudo in vitro das alterações morfológicas da superfície de raízes submetidas à apicectomia e írradiadas com laser de Nd:YAG

Introduction: success rates of apical surgery are variable, and there are several causes of failure related in the literature. Among them, permeability of exposed dentin at the apical surface after apicoectomies has been receiving much attention, Nd: YAG laser irradiation can decrease this permeability, but its effects on root surface are not completely known. Objectives: evaluate morphological alterations of apical surface, specially surface smoothness, after Nd: YAG non contact laser irradiation, in different powers, in vitro. Material and Methods: thirty extracted human cuspids, maintained in distilled water had its crowns removed, and were endodontically treated in standard technique. Apicoectomy performed, removing 4 mm most apical of roots, using handpiece. Teeth were divided in three groups of 10 each. Half of the area of each apical surface was irradiated with Nd:YAG laser in non contact mode, for 30 seconds. Three different powers were used- three groups of 10 each. Half of the area of each apical surface was irradiated.

Apicoectomy – A review

This review article throws a light on the background of theoretical and clinical aspects of apicoectomy procedure. Apicoectomy is also known as root resection, which means amputation of the apex of the root and is considered as a part of peiradicular surgery. The periradicular surgery is a standard oral surgical procedure which includes surgical treatment of area surrounding root and is done when conventional root canal treatment does not suffice the infection. This procedure includes three important steps to eliminate persistent endodontic pathogens: surgical debridement of pathological periradicular tissue, root-end resection (apicoectomy), and retrograde root canal obturation (root-end filling). There is a plethora of literature on the clinical studies and case reports on apicoectomy procedure; our review adds an imperative segment to this standard protocol used in pediatric endodontics and the objective is to give the reader an acquaintance about apical surgery with latest updates.

NON-SURGICAL MANAGEMENT OF A LARGE CYSTIC LESION WITH SURGICAL DECOMPRESSION: A CASE REPORT WITH 14 MONTHS FOLLOW UP

The main aim of this case report was to report the clinical efficacy of decompression for treating large periapical lesions. Tooth with large periapical cystic lesions were treated with decompression after root canal treatment. A conventional decompression technique such as aspiration/irrigation technique was used in this case. An 18-G needle with a syringe was used to aspirate the cystic lesion. Two needles were then inserted into the lesion copious saline irrigation was delivered from 1 needle and until clear saline was expressed from the other. Complete enucleation and root-end surgery was not done in the case. Healed lesions or lesions in healing were observed after 14 months. On the basis of the presented case and published case reports regarding large periapical cystic lesions, conservative decompression may be used for certain cases before or in lieu of apical surgery. Decompression enables healing of large, persistent periapical lesions after root canal treatment.

THE MAGICAL INSTRUMENT WHICH CAN POSTPONE ENDODONTIC SURGERY

The ultimate target of any endodontic treatment with periapical lesion is to induce complete bony healing of the lesion in which faster healing comprises with apical surgery but patient always wants an alternative of the surgery and this is the magical instrument which can postpone the endodontic surgery-The Apexum Device

Endodontic Surgery

Endodontic surgery straddles the specialties of endodontics and dento alveolar surgery. With the advent of the operating microscope, newer endodontic filling materials and stem cell therapy, humungous strides have been taken in this area, thus enabling transmutation of peri apical surgery into an avant-garde treatment modality, this chapter is a modest attempt to expound the various aspects of the subject from the surgeons frame of reference. Hence greater import is laid on incisions, flaps,surgical techniques, rather than restorative materials and retro cavity preparation.

Pelvic organ prolapse after laparoscopic hysterectomy compared with vaginal hysterectomy: the POP-UP study

Introduction and hypothesis The objective was to review the long-term prevalence of pelvic organ prolapse (POP) after laparoscopic hysterectomy (LH) compared with vaginal hysterectomy (VH). Methods An observational cohort study was conducted amongst women who underwent an LH or a VH for benign indications during the period 1996–2004: the POP-UP study. The prevalence of POP was inventoried by a questionnaire involving the Pelvic Floor Distress Inventory (PFDI-20) and a pelvic floor examination (POP-Q). Women were divided into groups based on route and indication of hysterectomy: LH, VH-1 (for nonprolapse), and VH-2 (prolapse). Results Four hundred and six of the 706 eligible patients (58%) returned the questionnaire and 247 underwent POP-Q examination. Sixty-eight patients (17%) received treatment for prolapse; 8% LH, 10% VH-1, and 29% VH-2 (Chi-squared test, p < 0.001). The prevalence of vaginal vault prolapse (apical surgery or ≥ stage 2 at POP-Q) was 4.4% for LH and 5.8% for VH-1 (p = 0.707); and 23% for VH-2 (VH-2 versus others, p < 0.0001). The prevalence of prolapse ≥ stage 2 in any compartment was 62% (n = 153) in total and in 42% of the LH group, 51% of the VH-1 group, and 84% of the VH-2 group (Chi-squared test, p < 0.001). A symptomatic POP (anatomical POP ≥ stage 2 with bulging) was present in 11% of the population. Conclusions No difference was found in the prevalence of POP between LH and VH for nonprolapse indications. However, POP after VH for prolapse occurs more frequently than after hysterectomy for other indications.