Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-09-12, 09:26:18 | version 1.38.0
| industry report lasers in endodontics Case 2 (Figs. 3a & b) A 46-year-old woman with missing restorations on the mandibular right first and second premolars complained of toothache. The fracture of the crowns was a result of secondary caries at the cervical portion of premolars. A large apical lesion was observed around the root of the first premolar. A prosthdontic treatment of splinted crowns on the mandibular right first and second premolars with crown lengthening and cast posts was planned due to the patient’s desire to retain teeth. All symptoms subsided after end- odontic treatment was completed. There was radio- graphic evidence of sealer in the apical ramifications. Case 3 (Figs. 4a–c) A 40-year-old woman sought treatment for a labial sinus tract related to the maxillary right first premolar. Extensive pulpal calcification was noticed on the peri- apical radiograph. The gutta-percha cone indicated that the labial sinus tract which appears to originate from a lateral canal. A dilaceration of the apical third and calcification of the canal made access difficult, resulting in a perforation on the mesial aspect of the root. The working length was adjusted and the canal was obturated to this point. A lateral canal was filled with sealer on the distal aspect of the root. The patient returned for follow-up in two weeks. The sinus tract healed and she was asymptomatic. Discussion Microbial infection is considered a major cause of endodontic failure. Several studies reported that peri- apical lesions did not develop without bacteria, al- though pulp tissue had been devitalised6,23; therefore, thorough disinfection is strongly recommended be- fore obturation is performed. The complexity and variability of the root canal system make it difficult to achieve ideal goals of endodontic treatment. A laser system which transmits energy through a flexible and Fig. 3a Fig. 3b Fig. 3: Comparison of periapical radiographs before (a) and post Case presentation treatment (b). Dental restorations of Case 1 (Figs. 2a–e) mandibular right first and second premolars were lost due to secondary caries. Periapical radiolucency around the root of mandibular right first was seen (a). One-month post treatment. Accessory canals were identified by sealer (b). A 45-year-old woman sought treatment for severe pain associated with a mandibular left canine. Clini- cally there was severe vertical mobility and cuspal interference existed when the patient moved her mandible in lateral excursion. Radiographic examina- tion revealed a radiolucent lesion extending along the mesial aspect of the root. Before beginning access opening, the canine was splinted to the mandibular left, lateral incisor and first premolar, and the occlu- sion was adjusted to eliminate lateral interference. Purulent exudate was drained not only from the periodontal pocket, but also from the canal orifice after the chamber was opened. An accessory canal mimicking a bifurcated apical canal was sealed. At the ten-month recall, bone density was increased around the root and no inflammatory signs were observed in the periodontal pocket. Fig. 4: Comparison of periapical radiographs before treatment (a, b) and two-week post treatment (c). Severe canal calcification with apical root dilaceration of maxillary right first premolar was observed (a). Insertion of a gutta-percha cone into the labial sinus tract for diagnosis. The tip of the gutta- percha cone pointed to the lateral surface of the root instead of the root apex (b). A lateral canal was identified by sealer (c). 38 roots 3 2017 Fig. 4a Fig. 4b Fig. 4c