Sample records for apicoectomy

  1. Apical leakage following CO2 laser apicoectomy and conventional amalgam retrofilling: a comparative study in vitro

    NASA Astrophysics Data System (ADS)

    Pinheiro, Antonio L. B.; Cavalcanti, P. H. H. A.; Brugnera, Aldo, Jr.


    To perform this study, 40 extracted single rooted human teeth were used to compare dye leakage between apicoectomy following amalgam retrofill and apicoectomy using CO2 laser irradiation. All the 40 teeth were endodontically treated and than were separate in two groups of 20 teeth each. A bur was used to ressect the apexes of the sample of group I followed by silver amalgam retrofill. the 20 teeth of group II had their apexes ressected with a Carbon Dioxide laser beam. All the samples were submerged into a methylene blue dye solution, washed, longitudinally sectioned and graded upon the level of leakage by two separate examiners. The result showed a perfect concordance between both examiners and also, a non significant difference on the level of leakage in the two groups.

  2. A case of a benign cementoblastoma treated by enucleation and apicoectomy.


    Gulses, Aydin; Bayar, Gurkan Rasit; Aydin, Cumhur; Sencimen, Metin


    Cementoblastoma is a rare, benign, odontogenic neoplasm of ectomesenchymal origin, representing less than 6% of all odontogenic tumors. Despite its well-known typical features, there are still controversies regarding the management of the condition. This article presents the case of a benign cementoblastoma in a 17-year-old girl. The lesion was typical and associated with the mandibular right first molar. Endodontic treatment of the involved tooth, enucleation of the cementoblastoma, and apicoectomy of the affected roots were performed. Removal of the tumor while preserving the associated tooth resulted in normal osseous healing and no evidence of recurrence after one year. Based on the findings of the current report, it can be suggested that, in properly selected cases, it is possible to remove cementoblastomas that affect molars without extracting the involved teeth. PMID:23220315

  3. Healing of experimental apical periodontitis after apicoectomy using different sealing materials on the resected root end.


    Otani, Kaori; Sugaya, Tsutomu; Tomita, Mahito; Hasegawa, Yukiko; Miyaji, Hirofumi; Tenkumo, Taichi; Tanaka, Saori; Motoki, Youji; Takanawa, Yasuhiro; Kawanami, Masamitsu


    This study evaluated apical periodontal healing after root-end sealing using 4-META/MMA-TBB resin (SB), and root-end filling using reinforced zinc oxide eugenol cement (EBA) or mineral trioxide aggregate (MTA) when root canal infection persisted. Apical periodontitis was induced in mandibular premolars of beagles by contaminating the root canals with dental plaque. After 1 month, in the SB group, SB was applied to the resected surface following apicoectomy. In the EBA and MTA groups, a root-end cavity was prepared and filled with EBA or MTA. In the control group, the root-end was not filled. Fourteen weeks after surgery, histological and radiographic analyses in a beagle model were performed. The bone defect area in the SB, EBA and MTA groups was significantly smaller than that in the control group. The result indicated that root-end sealing using SB and root-end filling using EBA or MTA are significantly better than control. PMID:21778612

  4. Evaluation of Er:YAG, CO2, and Nd:YAG lasers on apical dentine permeability after apicoectomies

    NASA Astrophysics Data System (ADS)

    Careli de Castro, Fabiana; Gariba Silva, Ricardo; Marchesan, Melissa A.; Zanin, Fatima; Brugnera, Aldo, Jr.; Pecora, Jesus D.


    Apicoectomy is a surgical procedure that consists of radicular apex resection, eliminating periapical lesion. This study evaluated the effect of CO2 and Nd:YAG lasers on root dentine permeability after apicoectomy with Er:YAG laser. Forty-four single-rooted teeth, obtained from the Endodontic Laboratory stock from the Faculty of Dentistry of Ribeirao Preto, University of Sao Paulo, were used. The teeth were instrumented with the step-back technique, irrigated with 1.0% sodium hypochlorite and sealed with Sealer 26 (Dentsply, Brazil; lateral condensation. The samples were divided into four groups of 11 teeth each that had the root sectioned 2mm from the apex: G1 - roots were sectioned with a 4138 diamond bur with cooling; G2 - roots were sectioned with pulsed Er:YAG laser at the following parameters: 15 Hz and 250 mJ; G3 - roots were sectioned with pulsed Er:YAG laser and Nd:YAG laser (10 Hz, 100 mJ, and 1 W) was app0lied on the sectioned surface; G4 - roots were sectioned with pulsed Er:YAG laser and CO2 laser (5 W, 10 seconds ON and 20 seconds OFF) was applied to the sectioned surface. The teeth were then impermeabilized with cyanoacrylate and placed in 0.5% methylene blue for 7 days. The proximal surface of the samples was removed for exposure of the sealed root canal and dye penetration was measured by means of microscopic evaluation. The results showed a statistically significant difference at the level of 1%. We conclude that all treatments presented microleakage and can placed in increasing order: Er:YAG (G2), Bur (G1), Er:YAG + Nd:YAG (G3); Er:YAG laser presented the lowest microleakage values, showing its viability for clinical use in apicoectomies.

  5. Successful treatment of chronic periapical osteomyelitis in a Parma wallaby (Macropus parma) using comprehensive endodontic therapy with apicoectomy.


    Kilgallon, Conor P; Bicknese, Beth; Fagan, David A


    Although necrobacillosis remains a common condition of captive macropods, there have been limited reports of successful treatment modalities by which it can be treated. Comprehensive endodontic therapy with apicoectomy has been used reliably in human and domestic animal dentistry. This report describes a case of periapical osteomyelitis involving a mandibular incisor in a Parma wallaby (Macropus parma) that was successfully treated using these techniques in conjunction with low-level laser therapy at 810 nm, which was used for decontamination of the pulp cavity, anti-inflammatory, and biostimulatory effects. PMID:21370653

  6. [Retrograde obturation with MTA Cement and Super-EBA after apicoectomy. Sealing ability of MTA and Super-EBA in dye penetration tests].


    Schultz, Christoph B; Westhauser, Patrick; Nideröst, Beatrice; Klaus, W Grätz


    The present in vitro study investigated the sealing of retrograde fillings compounded of two different cements in consideration of cracking after root-end preparation of resected dental roots using diamond-coated ultrasonic retrotips. Root-end cavities were prepared in 32 resected roots using diamond-coated ultrasonic retrotips. The samples were divided into two groups. The first group was filled using zinc-oxide cement (Super-EBA-Cement), the second with mineral-trioxide-aggregate (Pro Root MTA). After resection, root-end preparation and retrograde filling, the samples were analysed using macro-zoom photography and scanning electron microscopy. The sealing quality of the filling materials was detected through dye penetration test. The average degree of penetration of the samples filled with Super-EBA-Cement was 2.19 and of the samples filled with Pro Root MTA 0.44 respectively. Accordingly the sealing of Pro Root MTA in vitro is superior to the sealing of Super-EBA-Cement. Retrograde conditioning of resected roots with ultrasonic retrotips represents an efficient and sparing alternative to conventional root-end preparation techniques. PMID:15960453

  7. Traditional endodontic surgery versus modern technique: a 5-year controlled clinical trial.


    Tortorici, Silvia; Difalco, Paolo; Caradonna, Luigi; Tetè, Stefano


    In this study, we compared outcomes of traditional apicoectomy versus modern apicoectomy, by means of a controlled clinical trial with a 5-year follow-up. The study investigated 938 teeth in 843 patients. On the basis of the procedure performed, the teeth were grouped in 3 groups. Differences between the groups were the method of osteotomy (type of instruments used), type of preparation of retrograde cavity (different apicoectomy angles and instruments used for root-end preparation), and root-end filling material used (gray mineral trioxide aggregate or silver amalgam). Outcome (tooth healing) was estimated after 1 and 5 years, postoperatively. Clinical success rates after 1 year were 67% (306 teeth), 90% (186 teeth), and 94% (256 teeth) according to traditional apicoectomy (group 1), modern microsurgical apicoectomy using burns for osteotomy (group 2) or using piezo-osteotomy (group 3), respectively. After 1 year, group comparison results were statistically significant (P < 0.0001). Linear trend test was also statistically significant (P < 0.0001), pointing out larger healing from group 1 to group 3. After 5 years, teeth were classified into 2 groups on the basis of root-end filling material used. Clinical success was 90.8% (197 teeth) in the silver amalgam group versus 96% (309 teeth) in the mineral trioxide aggregate group (P < 0.00214). Multiple logistic regression analysis found that surgical technique was independently associated to tooth healing. In conclusion, modern apicoectomy resulted in a probability of success more than 5 times higher (odds ratio, 5.20 [95% confidence interval, 3.94-6.92]; P < 0.001) compared with the traditional technique. PMID:24469371

  8. [Nonsurgical retreatment of lateral radiopacity after surgical treatment].


    Arias de Luxan, A


    A case report is presented of an upper central incisor with incomplete endodontic procedure evidencing a radiolucent image that was treated by apicoectomy and retroamalgam. A year later the periapical lesion had healed completely but a new lateral radiolucency is observed. A reentry of the canal is performed eliminating the old obturating material, biomechanical preparation and obturation with sealer and thermo gutta-percha. The lesion was cured in nine months. PMID:1964068

  9. An innovative approach for rubber dam isolation of root end tip: A case report

    PubMed Central

    Mittal, Sunandan; Kumar, Tarun; Mittal, Shifali; Sharma, Jyotika


    The success of an apicoectomy with a retrofilling is dependent upon obtaining an acceptable apical seal. The placement of the variously approved retrograde materials requires adequate access, visibility, lighting, and a sterile dry environment. There are instances, however, in which it is difficult to use the rubber dam. One such instance is during retrograde filling. This case report highlights an innovative technique for rubber dam isolation of root end retrograde filling. PMID:26069419

  10. Sealing ability of MTA and amalgam in different root-end preparations and resection bevel angles: an in vitro evaluation using marginal dye leakage.


    Post, Letícia Kirst; Lima, Fábio Garcia; Xavier, Cristina Braga; Demarco, Flávio Fernando; Gerhardt-Oliveira, Marília


    This in vitro study evaluated the effect of different apicoectomy angles, instruments used in root-end preparation, and dental materials used in retrofilling on apical sealing. Root ends were resected at 45 or 90 degrees in 80 single-rooted teeth. For each type of apicoectomy, root-end cavities were prepared with either a round carbide #2 bur or an S12/90D ultrasonic tip. The root-end cavities in each subgroup (apicoectomy + root-end preparation) were filled with silver amalgam without zinc (Am) or with gray mineral trioxide aggregate -Angelus (MTA), and the specimens were immediately immersed in 0.2% rhodamine B for 24 h. Sealing was evaluated based on the dyed cross-sectional dentin area. Data were analyzed statistically by the Kruskal-Wallis test at 5% significance level. No group showed complete sealing of root-end areas. The only significant factor affecting microleakage was dental material, with MTA exhibiting less leakage. PMID:21180797

  11. Reasons for Apical Surgery Treatment in an Underserved New York City Population.


    Hasselgren, Gunnar; Patel, Pratik; Alhassany, Hashim; Kunzel, Carol


    Endodontic retreatment often involves remaking restorations. The total cost may steer the treatment towards surgery. The aim of this study was to retrospectively record the reasons for performing apical surgery in an economically deprived patient population. The clinical reasons (59%) for apical surgery were most common, but the nonclinical (financial) reasons (41%) emerged as a major cause. The finding that 41% of the apicoectomies were performed because of nonclinical constraints is a high figure and may not reflect the situation generally. Still, economic factors potentially play a major role in the selection of surgical versus nonsurgical endodontic retreatment. PMID:27348949

  12. [A new method for combined auto-alloplastic tooth reimplantation with a parallel A1203-ceramic root].


    Kirschner, H; Bolz, U; Enomoto, S; Hüttemann, R W; Meinel, W; Sturm, J


    The operative procedure for partially replacing the root with A12O3 ceramic represents a good possibility for preserving teeth in which the pulpa is devitalized. The method used in connection with the well known autoplastic reimplantation not only presents an alternative to the traditional apicoectomy but also provides additional stabilization of the tooth by lengthing the root with cocotostabile and biocompatible A1203 ceramic. The method was tested in humans and monkeys. Argumentation was based on histological examination via light microscopy. PMID:100304

  13. Effect of the CO2 laser on the microleakage of conventional and laser apicetomized teeth retrofilled with glass ionomer: in vitro study

    NASA Astrophysics Data System (ADS)

    Pinheiro, Antonio L. B.; Martorelli, Sergio B. F.


    There is a need for further improvement on the level of apical sealing. The use of lasers on apical surgery is still not fully understood, however some good results have been reported. The aim of this study was to assess the effect of the use of the CO2 laser following conventional apicoectomy and retrofilling with glass ionomer using different combinations of power and types of emission 'In Vitro.' Seventy extracted human upper anterior teeth were used on this study. The teeth after conventional apicoectomy were retrofilled with VitremerTM. The samples were randomized into seven groups of 10, Group I acted as negative control. Groups II, III and IV were lased on defocused mode with superpulsed CO2 laser on CW with power output of 0,5; 3 and 7 Watts during 5 seconds respectively. Groups V, VI e VII were lased on defocused mode with continuous emission on CW mode with power output of 1, 10 and 20 Watts during 5 seconds respectively. All specimens were immersed on 2% Methylene Blue solution during 48 h, washed in running tap water and longitudinally sectioned. Three calibrated examiners regarding apical infiltration graded the samples. The results showed difference between groups, where Group II showed smaller level of apical infiltration. It is concluded that improving on apical sealing is better achieved by using 0.5 W on superpulsed on CW.

  14. An ambiguous asymptomatic swelling in the maxillary anterior region—A case report

    PubMed Central

    Surej Kumar, L.K.; Manuel, Suvy; Nair, Bindu J.; Nair S, Vinod


    Introduction Glandular odontogenic cyst is a rare and recently recognized type of developmental odontogenic cyst. Being odontogenic in origin, because of the pluripotentiality of the odontogenic epithelium it can show glandular or salivary features. Presentation of a case A 46 year old female patient was referred to the Oral and Maxillofacial Surgery department with chief complaint of painless swelling in the right anterior region of maxilla, radiographically associated with teeth 12, 13. Mucosa over the swelling was slightly bluish in colour and no associated palatal swelling was seen. No incidence of trauma was reported and involved teeth were not mobile. Discussion Although we have many differential diagnoses, our working diagnosis was a periapical cyst, so conventional treatment of root canal treatment, cyst enucleation, and apicoectomy was planned. Conclusion Here we present a case which was initially misdiagnosed and mismanaged but on subsequent histopathologic examination revealed the final diagnosis. PMID:27093689

  15. Progression of periapical cystic lesion after incomplete endodontic treatment.


    Huh, Jong-Ki; Yang, Dong-Kyu; Jeon, Kug-Jin; Shin, Su-Jung


    We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment. PMID:27200282

  16. Endodontic Microsurgical Treatment of a Three-rooted Mandibular First Molar with Separate Distolingual Root: Report of One Case.


    Wang, Han Guo; Xu, Ning; Yu, Qing


    The separate distolingual (DL) roots of three-rooted mandibular first molars are thought to be too difficult for performing apical surgery. This article represents microsurgical treatment of a three-rooted mandibular first molar with a separate DL root. The procedure includes incision and flap retraction, osteotomy, apicoectomy, retropreparation and retrofilling of the root canal, using micro instruments, ultrasonic retrotips and mineral trioxide aggregate (MTA) under a dental operating microscope. Two mm in length of apical root resection, 2 mm in depth of root canal retropreparation with a personalised ultrasonic retrotip, and 2 mm in length of retrofilling with MTA are the key points for accomplishment of apical surgery on separate DL roots. The case was followed up for 15 months after surgery. Clinical and radiographic examinations revealed complete healing of periapical tissue. Separate DL roots of three-rooted mandibular first molars can be treated by endodontic microsurgery with modifications from standard protocol. PMID:27622221

  17. Progression of periapical cystic lesion after incomplete endodontic treatment

    PubMed Central

    Yang, Dong-Kyu; Jeon, Kug-Jin


    We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment. PMID:27200282

  18. Multidisciplinary approach for the treatment of a complicated crown-root fracture in a young patient: a case report.


    de Castro, José Carlos Monteiro; Poi, Wilson Roberto; Pedrini, Denise; Tiveron, Adelisa Rodolfo Ferreira; Brandini, Daniela Atili; de Castro, Mara Antônio Monteiro


    Crown-root fractures in permanent teeth cause esthetic and functional problems. This paper reports the case of a complicated crown-root fracture in the maxillary right central incisor of a young patient who was treated with a multidisciplinary approach in two phases. A modified Widman flap, root canal therapy, glass fiber post cementation, and adhesive tooth fragment reattachment were performed shortly after an accident. Satisfactory esthetic and functional outcomes were obtained. However, the patient did not attend follow-up visits and returned after 7 years. During this second phase, the clinical and radiographic examination showed stability and adaptation of the fragment and good periodontal health conditions, but crown darkening and a radiolucent image associated with the root apex of the fractured tooth were also observed. The periapical lesion was surgically removed by apicoectomy, and the esthetics were recovered with a direct composite resin veneer on the traumatized tooth. PMID:21909497

  19. Extranodal large B cell lymphoma of the anterior maxilla. Case report and review of literature.


    Webber, Brian; Webber, Mariel; Keinan, David


    In the oral cavity, lymphoproliferative disorders can manifest in various ways, often as an extranodal externalization. In the case presented here, it was a B cell lymphoma originating in the periapical bone of the anterior maxilla. X-ray revealed a periapical radiolucency associated with an intact tooth with no decay, fillings or history of trauma. The tooth tested non-vital. After root canal treatment, an apicoectomy was performed with a biopsy. The most common diagnosis would be of dental etiology. The pathology report revealed a non-Hodgkin's B cell lymphoma. Most often, this disease appears as localized dental or oral pathology. Non-specific signs and symptoms present in association with lymphoproliferative disorders include lymphadenopathy, trismus, pain, swelling, sinusitis, fever, sepsis, prosthetic instability and paresthesia. Early detection results in decreased morbidity and a better prognosis for the patient. PMID:25707167

  20. A study of the apical microleakage of a gallium alloy as a retrograde filling material.


    Hosoya, N; Lautenschlager, E P; Greener, E H


    The feasibility of utilizing mercury-free Gallium alloy GF for retrograde filling was investigated by comparing apical microleakage in 184 extracted human teeth. The teeth were divided into four experimental and two control groups. Three experimental groups were apical cavity retrofillings with the Gallium alloy GF, a mercury-containing amalgam, and a glass ionomer. The fourth experimental group was filled with gutta-percha and heat-burnished after apicoectomy. After 24 h, 1 wk, 4 wk, and 12 wk immersion in dye solution, the roots were vertically sectioned, and the deepest point of dye penetration was recorded. The glass ionomer showed the least leakage, followed by the amalgam group and the gallium group (no significant difference). The gutta-percha heat-burnished group displayed the greatest leakage. Gallium alloy GF was shown to have an equivalent sealing potential to dental amalgam for a retrograde filling material. PMID:8537788

  1. Orthodontic treatment of a mandibular incisor fenestration resulting from a broken retainer.


    Farret, Marcel M; Farret, Milton M B; da Luz Vieira, Gustavo; Assaf, Jamal Hassan; de Lima, Eduardo Martinelli S


    This article describes the orthodontic relapse with mandibular incisor fenestration in a 36-year-old man who had undergone orthodontic treatment 21 years previously. The patient reported that his mandibular 3 × 3 bonded retainer had been partially debonded and broken 4 years earlier. The mandibular left lateral incisor remained bonded to the retainer and received the entire load of the incisors; consequently, there was extreme labial movement of the root, resulting in dental avulsion. As part of the treatment, the root was repositioned lingually using a titanium-molybdenum segmented archwire for 8 months, followed by endodontic treatment, an apicoectomy, and 4 months of alignment and leveling of both arches. The treatment outcomes were excellent, and the tooth remained stable, with good integrity of the mesial, distal, and lingual alveolar bones and periodontal ligament. The 1-year follow-up showed good stability of the results. PMID:26232842

  2. Eggshell Derived Hydroxyapatite as Bone Graft Substitute in the Healing of Maxillary Cystic Bone Defects: A Preliminary Report

    PubMed Central

    Kattimani, Vivekanand S; Chakravarthi, P Srinivas; Kanumuru, Narasimha Reddy; Subbarao, Vummidisetti V; Sidharthan, A; Kumar, T S Sampath; Prasad, L Krishna


    Background: Since ancient times, use of graft materials to promote healing of defects of bone is wellknown. Traditionally, missing bone is replaced with material from either patient or donor. Multiple sources of bone grafts have been used to graft bone defects to stimulate bone healing. Hydroxyapatite is naturally occurring mineral component of bone, which is osteoconductive. This versatile biomaterial is derived from many sources. The aim of this study is to evaluate the efficacy of eggshell derived hydroxyapatite (EHA) in the bone regeneration of human maxillary cystic bone defects secondary to cystic removal/apicoectomy and compare the material properties of EHA in vitro. Materials and Methods: A total of eight maxillary bone defects were grafted after cystic enucleation and/or apicoectomy in the year 2008 and completed the study at 1 year. The patients were followed-up 2 weeks after surgery for signs and symptoms of infection or any other complications that may have been related to surgical procedure. Follow-up radiographs were obtained immediately after surgery followed by 1, 2, and 3 months to assess the efficacy of EHA in bone healing. Physicochemical characterization of the EHA was carried out in comparison with synthetic hydroxyapatite (SHA), also compared the biocompatibility of EHA using in vitro cytotoxicity test. Results: By the end of the 8th week, the defects grafted with EHA showed complete bone formation. However, bone formation in non-grafted sites was insignificant. The values of density measurements were equal or more than that of surrounding normal bone. These results indicate that the osseous regeneration of the bone defect filled with EHA is significant. EHA showed the superior material properties in comparison with SHA. Conclusion: EHA is a versatile novel bone graft substitute that yielded promising results. Because of its biocompatibility, lack of disease transfer risks, ease of use and unlimited availability, EHA remains a viable choice

  3. Laser-assisted oral surgery in general practice

    NASA Astrophysics Data System (ADS)

    McCauley, Mark C.


    This presentation will demonstrate and discuss any surgical applications of the Argon dental laser. This presentation will also increase the awareness and basic understanding of the physical principals of the Argon laser. The wavelength of the Argon laser is specifically absorbed by red pigments such a hemoglobin which is abundant in oral soft tissue. The result is a sharp clean incision with minimal thermal damage to adjacent healthy tissue. Preprosthetic procedures such as full arch vestibuloplasty, labial and lingual frenectomy, and epulis fissuratum removal will be demonstrated. Other soft tissue management procedures such as minor periodontal pocket elimination surgery (gingivectomy), removal of hyperplastic granulation tissue from around poorly maintained implants, and the removal of granulation and/or cystic tissue from the apex of teeth undergoing endodontic (apicoec-tomy) surgery will also be demonstrated and discussed. Provided basic oral surgery protocol is followed, surgical procedures utilizing the Argon laser can be accomplished with minimal bleeding, minimal trauma and with minimal post-operative discomfort.

  4. Recurrent squamous odontogenic tumor: A case report and review of the literature

    PubMed Central



    Squamous odontogenic tumors (SOTs) are benign, locally infiltrative neoplasms that localize to the periodontium. In total, <50 cases have been reported since the first description of SOTs in 1975. Although the exact etiology of SOTs is unknown, the tumors are considered to derive from the epithelial cell rests of Malassez. SOTs are characterized by radiological and clinical signs and symptoms, including pain with increased sensitivity in the affected area, bone expansion and increased tooth mobility. The present study describes the case of a patient that experienced numerous SOT recurrences and also discusses recommendations for treatment. A locally invasive mandibular SOT was identified in a Caucasian 41-year-old female patient. The treatment involved recommended conservative surgery, including local curettage. In addition, 49 cases published in the literature were reviewed to assess the treatment strategies. The present patient experienced two recurrences of the tumor during the 6-year follow-up period. Ultimately, the vitality of the adjacent teeth was compromised. An apicoectomy with a small amount of resection of the marginal bone was necessary. In >50% of the reported cases of SOT in the literature the adjacent teeth were extracted. The present case of SOT and the associated literature were also discussed. It was concluded that the treatment of choice appears to be a conservative surgical removal, but the successful management of SOTs often requires the removal of the adjacent teeth. PMID:26722231

  5. Dental complications and management of patients on bisphosphonate therapy: A review article

    PubMed Central

    Kalra, Sandeep; Jain, Veena


    Bisphosphonates are group of drugs that inhibit bone resorption and are used to treat a range of pathologies including Paget's disease, osteoporosis, multiple myeloma and metastasis associated with breast or prostate cancer. The most common complication in patients on bisphosphonate therapy is osteonecrosis of jaw (ONJ) which can occur after any surgical dental procedure and the risk for the development of osteonecrosis of jaw is higher in patients receiving intravenous bisphosphonate therapy than in patients receiving oral bisphosphonate therapy. Typical presentation is in the form of non-extraction socket, presence of exposed bone, gingival swelling or purulent discharge, when local debridement and antibiotics are ineffective. At present, there is no effective treatment for bisphosphonate induced osteonecrosis, so prevention is extremely important. Maximum precautions should be taken in patients who are at the risk of development of ONJ especially when any dental surgical procedure like extractions, retrograde apicoectomies, periodontal surgery and implant placement is contemplated. Dentists and oral or maxillofacial surgeon must keep up to date with the latest approaches or guidelines to prevention and the risk factors, particularly when treating patients who are on bisphosphonates, or who will be taking bisphosphonates. PMID:25737876

  6. Mandibular nerve paresthesia caused by endodontic treatment.


    Gallas-Torreira, M Mercedes; Reboiras-López, M Dolores; García-García, Abel; Gándara-Rey, José


    The paresthesias of the inferior dental nerve consists of a complication that can occur after performing various dental procedures such as cystectomies, extraction of impacted teeth, apicoectomies, endodontic treatments, local anesthetic deposition, preprosthetic or implantologic surgery. The possible mechanisms of nervous lesions are mechanical, chemical and thermal. Mechanical injury includes compression, stretching, partial or total resection and laceration. The lesion can cause a discontinuity to the nerve with Wallerian degeneration of the distal and integrated fibers of the covering (axonotmesis) or can cause the total sectioning of the nerve (neurotmesis). Chemical trauma can be due to certain toxic components of the endodontic filling materials (paraformaldehyde, corticoids or eugenol) and irrigating solutions (sodium hypochlorite) or local anesthetics. Thermal injury is a consequence of bone overheating during the execution of surgical techniques. We present a clinical case of paresthesia of the inferior dental nerve after the introduction of a gutta-percha point in the mandibular canal during the performance of a root canal therapy of the inferior first molar. The etiology and the treatment of this endodontic complication are described. PMID:12937392

  7. Ambulatory oral surgery: 1-year experience with 11 680 patients from Zagreb district, Croatia

    PubMed Central

    Jokić, Dražen; Macan, Darko; Perić, Berislav; Tadić, Marinka; Biočić, Josip; Đanić, Petar; Brajdić, Davor


    Aim To examine the types and frequencies of oral surgery diagnoses and ambulatory oral surgical treatments during one year period at the Department of Oral Surgery, University Hospital Dubrava in Zagreb, Croatia. Methods Sociodemographic and clinical data on 11 680 ambulatory patients, treated between January 1 and of December 31, 2011 were retrieved from the hospital database using a specific protocol. The obtained data were subsequently analyzed in order to assess the frequency of diagnoses and differences in sex and age. Results The most common ambulatory procedure was tooth extraction (37.67%) and the most common procedure in ambulatory operating room was alveolectomy (57.25%). The test of proportions showed that significantly more extractions (P < 0.001) and intraoral incisions (P < 0.001) were performed among male patients, whereas significantly more alveolectomies and apicoectomies were performed among female patients (P < 0.001). A greater prevalence of periodontal disease was found in patients residing in Zagreb than in patients residing in rural areas. Conclusion The data from this study may be useful for planning of ambulatory oral surgery services, budgeting, and sustaining quality improvement, enhancing oral surgical curricula, training and education of primary health care doctors and oral surgery specialists, and promoting patients’ awareness of the importance of oral health. PMID:23444246

  8. Multidisciplinary Treatment of a Fenestration-type Defect.


    Travassos, Rafael; Soares, Bruno; Bhandi, Shilpa H; Silva, Monica Barros da; Bandéca, Matheus Coelho; Mouchrek, José Carlos Elias; Silva, Vanessa Camila da; Benatti, Bruno Braga


    The case report aimed at treating a fenestration-type defect with multidisciplinary conventional and advanced surgical techniques. Fenestrations are isolated areas in which the exposed root surface is covered only by the periosteum and gingiva, but the remaining cortical bone remains intact. Root coverage is indicated in cases of root hypersensitivity, treatment of shallow caries lesions, cervical abrasions, and esthetic and cosmetic needs. In this case report, after proper hygiene instruction and dental biofilm control, a fenestration-type defect was treated using guided tissue regeneration (anorganic bovine matrix and resorbable membrane) and a connective tissue grafts, associated to an endodontic apicoectomy. After reevaluation, the remaining gingival recession was treated with a second gingival connective tissue graft covered with q double papillae type in order to reconstruct the periodontal tissues of the involved tooth. In this clinical case, the interaction between the different areas of dentistry has made it possible to correct a fenestration-type defect, following procedures based on scientific evidence, restoring periodontal health, esthetics, self-esteem, and meeting the patient's expectations regarding her initial complaint. This case report shows the important role of interdisciplinary approach to treating a patient with a complex periodontal defect that required different types of knowledge and abilities to achieve the best results based on the current status of dentistry possibilities. PMID:26067739

  9. Laser scanning dental probe for endodontic root canal treatment

    NASA Astrophysics Data System (ADS)

    Blank, Molly A. B.; Friedrich, Michal; Hamilton, Jeffrey D.; Lee, Peggy; Berg, Joel; Seibel, Eric J.


    Complications that arise during endodontic procedures pose serious threats to the long-term integrity and health of the tooth. Potential complexities of root canals include residual pulpal tissue, cracks, mesial-buccal 2 and accessory canals. In the case of a failed root canal, a successful apicoectomy can be jeopardized by isthmuses, accessory canals, and root microfracture. Confirming diagnosis using a small imaging probe would allow proper treatment and prevent retreatment of endodontic procedures. An ultrathin and flexible laser scanning endoscope of 1.2 to 1.6mm outer diameter was used in vitro to image extracted teeth with varied root configurations. Teeth were opened using a conventional bur and high speed drill. Imaging within the opened access cavity clarified the location of the roots where canal filing would initiate. Although radiographs are commonly used to determine the root canal size, position, and shape, the limited 2D image perspective leaves ambiguity that could be clarified if used in conjunction with a direct visual imaging tool. Direct visualization may avoid difficulties in locating the root canal and reduce the number of radiographs needed. A transillumination imaging device with the separated illumination and light collection functions rendered cracks visible in the prepared teeth that were otherwise indiscernible using reflected visible light. Our work demonstrates that a small diameter endoscope with high spatial resolution may significantly increase the efficiency and success of endodontic procedures.

  10. Sealing ability of MTA used as a root end filling material: effect of the sonic and ultrasonic condensation.


    Bernabé, Pedro Felício Estrada; Gomes-Filho, João Eduardo; Bernabé, Daniel Galera; Nery, Mauro Juvenal; Otoboni-Filho, José Arlindo; Dezan-Jr, Eloi; Cintra, Luciano Tavares Angelo


    Despite the excellent properties of mineral trioxide aggregate (MTA), the condensation technique may have some influence in its sealing ability. The purpose of this study was to compare the sealing ability of sonic and ultrasonic setting of MTA. Thirty-four extracted human teeth had their canals prepared and filled with Sealapex sealer and gutta-percha using the active lateral condensation technique. The teeth were rendered waterproof and apicoectomy performed at 3 mm from the apex. Root-end cavities (3.0 mm deep and 1.4 mm diameter) were prepared with diamond ultrasonic tips. The root-end cavities were filled with Pro-Root MTA® with ultrasonic vibration, sonic vibration or no vibration. The positive control group did not receive any material while the negative control group was totally rendered waterproof. After material set, the specimens were immersed in Rodhamine B for 24 h, under vacuum in the first 15 min, then washed, dried and split longitudinally for evaluating the infiltration at the dentin/material interface. Data were analyzed using ANOVA and Tukey's tests at 5% significance level. Sonic vibration promoted the lowest infiltration values (p<0.05). It was concluded that sonic vibration could be considered an efficient aid to improve the sealing ability of MTA when used as root-end filling material. PMID:23780366

  11. Lasers in endodontics: an overview

    NASA Astrophysics Data System (ADS)

    Frentzen, Matthias; Braun, Andreas; Koort, Hans J.


    The interest in endodontic use of dental laser systems is increasing. Developing laser technology and a better understanding of laser effects widened the spectrum of possible endodontic indications. Various laser systems including excimer-, argon+-, diode-, Nd:YAG-, Er:YAG- and CO2-lasers are used in pulp diagnosis, treatment of hypersensitivity, pulp capping, sterilization of root canals, root canal shaping and obturation or apicoectomy. With the development of new delivery systems - thin and flexible fibers - for many different wavelengths laser applications in endodontics may increase. Since laser devices are still relatively costly, access to them is limited. Most of the clinical applications are laser assisted procedures such as the removing of pulp remnants and debris or disinfection of infected root canals. The essential question is whether a laser can provide improved treatment over conventional care. To perform laser therapy in endodontics today different laser types with adopted wavelengths and pulse widths are needed, each specific to a particular application. Looking into the future we will need endodontic laser equipment providing optimal laser parameters for different treatment modalities. Nevertheless, the quantity of research reports from the last decade promises a genuine future for lasers in endodontics.

  12. SEM investigation of Er:YAG laser apical preparation

    NASA Astrophysics Data System (ADS)

    Bǎlǎbuc, Cosmin; Todea, Carmen; Locovei, Cosmin; RǎduÅ£ǎ, Aurel


    Endodontic surgery involves the incision and flap elevation, the access to the root tip, its resection, the cavity retrograde preparation and filling it with biocompatible material that provides a good seal of the apex[1]. Apicoectomy is compulsory in endodontic surgery. The final stage involves the root retropreparation and the carrying out of the retrograde obturation. In order to perform the retrograde preparation the endodontist can use various tools such as lowspeed conventional handpieces, sonic and ultrasonic equipment. The ideal depth of the preparation should be 3 mm, exceeding this value may affect the long-term success of the obturation [2]. Resection at the depth of 3 mm reduces apical ramifications by 98% and lateral root canals by 93%. The ultrasonic retropreparation has numerous advantages compared to the dental drill. Firstly, the cavity will be in the axis of the tooth which implies a minimum destruction of the root canal morphology. The preparations are precise, and the cutting pattern is perpendicular to the long axis of the root, the advantage being the reduction in the number of dentinal tubules exposed at the resected area [3]. Therefore, the retrograde filling is the procedure when an inert and non-toxic material is compacted in the apically created cavity.[4,5]. The Er:YAG laser is the most common wavelength indicated for dental hard tissue preparation. Its natural selectivity offers a significant advantage compared to the conventional hard tissue preparation [6-9].The purpose of this in vitro study was to investigate the quality of Er:YAG laser apical third preparation using Scanning Electron Microscopy (SEM), in comparison with the conventional ultrasonic method.

  13. Evaluation of apical preparations performed with ultrasonic diamond and stainless steel tips at different intensities using a scanning electron microscope in endodontic surgery

    PubMed Central

    Rodríguez-Martos, Ramón; Castellanos-Cosano, Lizett; Serrera-Figallo, María A.; Segura-Egea, Juan J.; Gutierrez-Perez, Jose L.


    Objective: The objective of our study is to analyse (with the help of scanning electron microscopes) the quality of the dental root surface and the appearance of dental cracks after performing apical preparations using two diffe-rent types of ultrasonic tips. Study design: We used 32 single-rooted teeth that underwent a root canal and apical resection. Afterwards, the teeth were divided into 4 groups of 8 teeth each, with preparations of the apical cavities in the following manner: Group 1: stainless steel ultrasonic tip at 33KHz. Group 2: stainless steel ultrasonic tip at 30KHz. Group 3: diamond ultrasonic tip at 30KHz. Group 4: diamond ultrasonic tip at 33 KHz. The quality of the root surface and the presence of cracks were evaluated by one single observer using a scanning electron microscope. Results: All of the teeth in our study had cracks after the apical preparations. The mean number of cracks per tooth ranged between 6.1±1.9 (group 1) and 3.5±2.4 (group 4), with a significantly higher number found in the groups that used stainless steel tips (P=.03). The types of cracks produced involved: 8 complete cracks (4.5%), 167 incomplete cracks (94.4%), and 2 intradentinal cracks (1.1%), with no significant differences observed between the different frequencies used for each group. Conclusions: Stainless steel ultrasonic tips provoked a larger number of cracks than diamond tips. The frequency of vibration used did not have any effect on the number of cracks found. Key words:Apicoectomy, scanning electron microscope, therapeutic ultrasound, endodontic surgery, dentinal crack. PMID:22926471

  14. Apices of maxillary premolars observed by swept source optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Ebihara, Arata; Iino, Yoshiko; Yoshioka, Toshihiko; Hanada, Takahiro; Sunakawa, Mitsuhiro; Sumi, Yasunori; Suda, Hideaki


    Apicoectomy is performed for the management of apical periodontitis when orthograde root canal treatment is not possible or is ineffective. Prior to the surgery, cone beam computed tomography (CBCT) examination is often performed to evaluate the lesion and the adjacent tissues. During the surgical procedure, the root apex is resected and the resected surface is usually observed under dental operating microscope (DOM). However, it is difficult to evaluate the details and the subsurface structure of the root using CBCT and DOM. A new diagnostic system, swept source optical coherence tomography (SS-OCT), has been developed to observe the subsurface anatomical structure. The aim of this study was to observe resected apical root canals of human maxillary premolars using SS-OCT and compare the findings with those observed using CBCT and DOM. Six extracted human maxillary premolars were used. After microfocus computed tomography (Micro CT; for gold standard) and CBCT scanning of the root, 1 mm of the apex was cut perpendicular to the long axis of the tooth. Each resected surface was treated with EDTA, irrigated with saline solution, and stained with methylene blue dye. The resected surface was observed with DOM and SS-OCT. This sequence was repeated three times. The number of root canals was counted and statistically evaluated. There was no significant difference in the accuracy of detecting root canals among CBCT, DOM and SS-OCT (p > 0.05, Wilcoxon test). Because SS-OCT can be used in real time during surgery, it would be a useful tool for observing resected apical root canals.

  15. Scanning electron microscopy reveals severe external root resorption in the large periapical lesion.


    Ookubo, Kensuke; Ookubo, Atsushi; Tsujimoto, Masaki; Sugimoto, Kouji; Yamada, Shizuka; Hayashi, Yoshihiko


    The present study was designed to investigate the relationships between clinicopathological findings and the resorptive conditions of root apices of teeth with periodontitis. The samples included 21 root apices with large periapical radiolucent lesions. The preoperative computed tomography (CT) and intraoperative findings were correlated with the presence, extension, and the progression pattern of periapical resorption using a scanning electron microscope. The subjects' age, gender, chief complaint, type of tooth, percussion test results, size of periapical lesion using CT, and intraoperative findings were recorded. All apicoectomies were performed under an operative microscope for endodontic microsurgery. A significant large size was observed in cystic lesions compared with granulomatous lesions. The cementum surface at the periphery of the lesion was covered with globular structures (2-3 μm in diameter). Cementum resorption started as small defect formations at the surface. As the defect formation progressed, a lamellar structure appeared at the resorption area, and the size of globular structures became smaller than that of globules at the surface. Further resorption produced typical lacuna formation, which was particularly observed in fracture cases. The most morphologically severe destructive pattern of dentin resorption was observed in large cystic lesions. This study is the first report to elucidate the relationships between three clinical types of undesirable periapical lesions: (1) undertreatment, (2) periapical fracture, (3) macro-level resorption, and the microstructure of external root resorption including from small defects at the cementum surface to a significant destructive pattern inside the dentin. Microsc. Res. Tech. 79:495-500, 2016. © 2016 Wiley Periodicals, Inc. PMID:26957368