Apicectomia
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Recent papers in Apicectomia
RESUMO A cirurgia parendodôntica constitui uma alternativa na permanência do dente na cavidade bucal exercendo suas funções tendo como finalidade resolver problemas que não puderam ser solucionados pelo tratamento endodôntico convencional... more
RESUMO A cirurgia parendodôntica constitui uma alternativa na permanência do dente na cavidade bucal exercendo suas funções tendo como finalidade resolver problemas que não puderam ser solucionados pelo tratamento endodôntico convencional ou quando este não é possível. A obturação do canal radicular simultânea ao ato cirúrgico está indicada quando não se consegue conter o exsudato persistente por meio da medicação intracanal, impedindo a obturação dos canais radiculares. O objetivo do estudo foi relatar um caso de caso de apicectomia e obturação simultânea nos dentes 31 e 32, com acompanhamento de 18 meses. Paciente do sexo feminino, 28 anos, fez uso de aparelho ortodôntico por 5 anos, sem histórico de trauma, compareceu ao consultório com sintomatologia dolorosa aguda e constante na região anterior de mandíbula e presença de edema. Clinicamente, foi observado escurecimento da coroa do dente 32 e, radiograficamente, lesão periapical de, aproximadamente, 15 mm, envolvendo o seu ápice, estendendo-se para a região do 31. Ambos os elementos responderam negativamente ao teste de sensibilidade ao frio. Após o diagnóstico clínico de abscesso agudo, foi realizada a abertura coronária, pela qual houve drenagem de exsudato purulento via canal. Após instrumentação dos canais, a medicação de escolha foi o hidróxido de cálcio (Calen PMCC). A cada 30 dias, foi realizada troca da medicação (Calen) durante 4 meses e a drenagem do exsudato no dente 32 persistiu, impedindo a obturação do canal. Assim, o plano de tratamento proposto foi a apicectomia e a obturação simultânea para ambos os canais, após curetagem da lesão periapical. O diagnóstico histopatológico foi de granuloma periapical. Após o procedimento cirúrgico, foi realizado enxerto ósseo. Após 18 meses, verificou-se reparo ósseo e manutenção das estruturas dentais e alveolares. Conclui-se que apicectomia seguida de obturação simultânea ao ato cirúrgico pode solucionar problemas de infecções endodônticas periapicais persistentes e permitir a manutenção das funções dentárias.
Descritores: Apicectomia. Cirurgia bucal. Endodontia. Granuloma. Obturação Retrógrada. Preparo de canal radicular.
Parendodontic surgery is an alternative for functional tooth preservation in oral cavity, it aims to solve situations that could not be solved through regular endodontic treatment or whenever it’s not possible. Root canal filling simultaneously with surgery procedure is indicated when intracanal medication cannot hold resistant exudate or blocking root canal filling. This paper aims to report a simultaneous apicectomy and filling case for teeth 31 and 32, for 18 month monitoring period. Female patient, 28 years old, made use of braces for 5 years, no trauma records, visited the dental office feeling an acute and continuous painful symptomatology in the anterior region of the mandible and swelling. Clinically, a darkening in tooth 32 crown was observed, through x-ray examination it was observed periapical lesion of approximately 15 mm, enveloping its apex, extending to tooth 31 region. Both elements responded negatively to the cold sensitivity test. After being clinically diagnosed with acute abscess, the coronary opening was undertaken, whereby there was a by canal purulent exudate drainage. After canal instrumentation, calcium hydroxide (Calen PMCC) was the medication choice. Each 30 days, medication (Calen) change was made during 4 months and the exudate drainage from tooth 32 persisted, impairing root canal filling. Thus, the treatment procedure proposed was apicectomy and simultaneous filling for both canals, after a curettage from periapical lesion. Granuloma periapical was the histopathological diagnose. After surgical procedure, it was performed a bone graft. Upon 18 months, both bone healing or alveolar and teeth structure preservation had been verified. It was thus concluded that apicectomy followed by simultaneous filling during surgical procedure may solve persistent periapical endodontic infections and it allows dental function preservation.
Descriptors: Apicoectomy. Surgery, Oral. Endodontics. Granuloma. Retrograde obturation. Root Canal Preparation
Descritores: Apicectomia. Cirurgia bucal. Endodontia. Granuloma. Obturação Retrógrada. Preparo de canal radicular.
Parendodontic surgery is an alternative for functional tooth preservation in oral cavity, it aims to solve situations that could not be solved through regular endodontic treatment or whenever it’s not possible. Root canal filling simultaneously with surgery procedure is indicated when intracanal medication cannot hold resistant exudate or blocking root canal filling. This paper aims to report a simultaneous apicectomy and filling case for teeth 31 and 32, for 18 month monitoring period. Female patient, 28 years old, made use of braces for 5 years, no trauma records, visited the dental office feeling an acute and continuous painful symptomatology in the anterior region of the mandible and swelling. Clinically, a darkening in tooth 32 crown was observed, through x-ray examination it was observed periapical lesion of approximately 15 mm, enveloping its apex, extending to tooth 31 region. Both elements responded negatively to the cold sensitivity test. After being clinically diagnosed with acute abscess, the coronary opening was undertaken, whereby there was a by canal purulent exudate drainage. After canal instrumentation, calcium hydroxide (Calen PMCC) was the medication choice. Each 30 days, medication (Calen) change was made during 4 months and the exudate drainage from tooth 32 persisted, impairing root canal filling. Thus, the treatment procedure proposed was apicectomy and simultaneous filling for both canals, after a curettage from periapical lesion. Granuloma periapical was the histopathological diagnose. After surgical procedure, it was performed a bone graft. Upon 18 months, both bone healing or alveolar and teeth structure preservation had been verified. It was thus concluded that apicectomy followed by simultaneous filling during surgical procedure may solve persistent periapical endodontic infections and it allows dental function preservation.
Descriptors: Apicoectomy. Surgery, Oral. Endodontics. Granuloma. Retrograde obturation. Root Canal Preparation