Please activate JavaScript!
Please install Adobe Flash Player, click here for download

Dental Tribune Middle East & Africa No. 1, 2018

A2 ENDO TRIBUNE Dental Tribune Middle East & Africa Edition | 1/2018 Drilling treatment using the new MTA Repair HP Clinical Case Report By Prof. Dr. Fábio Duarte da Costa Aznar, Brazil Female patient, 47 years old, present- ed with a clinical picture of extensive iatrogenic perforation of the furca- tion region of the dental element 36 (Figs. 1 and 2), associated with radio- graphic bone loss, vestibular fistula and pain on palpation. The patient reported history of having been pre- viously subjected to an urgent inter- vention in this tooth by other pro- fessional, as it presented acute pain characteristic of pulpitis. Fig. 1-2: Initial clinical and radiographic appearance of teeth 36 Fig. 3: Obturation of root canals. Figs. 4-5: Clinical and radiographic appearance of drilling filling with MTA Repair HP. Fig. 6: Drilling region protection sealed with glass ionomer cement. Fig. 7: Follow-up X-ray after two months. The tooth was submitted to endo- dontic therapy, and after the initial approach with the patient, anesthe- sia was given, followed by preparing absolute isolation. Subsequently, the coronary access was performed, where it was possible to clinically verify the presence of pulp necrosis and perforation. A disinfecting pen- etration of root canals (crown-down) was performed using as irrigator agent NaOCl to 5%, and the odon- tometry determined by the use of foraminal locator. The preparation was carried out by Reciproc system (VDW/Germany), and as irrigator agent was employed NaOCl 2.5% as- sociated with ultrasonic activation performed with straight inserts (Ir- risonic/Helse/Brazil). Next, the drilling was treated, with its cleaning and the regularization, em- ploying ultrasonic diamond insert (E7D/Helse/Brazil). As a complement to the intra-channel decontamina- tion process and the furcation re- gion, a biweekly exchange of Calci- um Hydroxide (Ultracal/Ultradent/ USA) was held, observing remission of all symptoms. The obturation was performed using the thermomechanical Hybrid Tag- ger technique (Fig. 3), by employing GutaCondensor (Maillefer/Switzer- land), TP gutta-percha cones (Dent- sply/Brazil) and MTA-based sealer Fillapex (Angelus/Brazil) (Fig. 4). Af- ter thermo compaction, the obtura- tion cutting was performed, as well as vertical condensation using cold pusher; and again the region of the perforation was cleaned and filled with Calcium Hydroxide. After 15 days, again, we proceeded to seal the drilled region, and ini- tially verified the proper possibility of drying the area. The filling of the drilled region was carried out with the use of MTA Repair HP (Angelus/ Brazil), previously prepared as rec- ommended by the manufacturer, and it was inserted using an MTA Ap- plicator (Angelus/Brazil). Clinical and radiographic criteria were used to de- termine the correct filling using the material (Figs. 4 and 5); and the glass ionomer cement (Vitremer/3M/ USA) used for the protection of the sealed region (Fig. 6). After the tem- porary restoration, radiographically it was observed proper sealing of furcation region by MTA Repair HP, as well as no postoperative complica- tions. Follow up was conducted after two months, observing bone neoforma- tion in the furcation region and ab- sence of symptoms (Fig. 7). Prof. Dr. Fábio Duarte da Costa Aznar, Brazil He is a specialist in En- dodontics HRAC (Cen- trinho)/USP/Bauru. Doctor of Applied Dental Sciences - Den- tal School by Bauru Q University of São Paulo. Additionally, Prof. Dr. Fábio is the Co- ordinator of Specialization Course in Endodontics Facoph/Bauru-SP, FACESC/ Chapecó-SC, FAIPE/Goiânia-GO, GOE/ Macapá-AM, Funorte/Ji-Paraná-RO. Irrigating the root canal A Case Report By Dr Vittorio Franco, UK and Italy The patient reported on in this ar- ticle is a student in dentistry and his parents are both dentists. They referred their son to a good endo- dontist, who then referred the case to me. As always, peers are more than welcome in either of my practices, in Rome and London, so when I treated this case, I had three dentists watching me, a future dentist on the chair, placing a great deal of pressure on me. The 22-year-old male patient had a history of trauma to his maxillary incisors and arrived at my practice with symptoms related to tooth #21. The tooth, opened in an emer- gency by the patient’s mother, was tender when prodded, with a mod- erate level of sensitivity on the re- spective buccal gingiva. Sensitivity tests were negative for the other central incisor (tooth #12 was positive), and a periapical radiograph showed radiolucency in the periapical areas of both of the central incisors. The apices of these teeth were quite wide and the length of teeth appeared to ÿPage A3 Fig. 1: Pre-operative radiograph. Fig. 2: Intraoperative radiograph of apical plug of tooth #21 Fig. 3: Post-operative radiograph

Pages Overview