No abstract

This study evaluated the accuracy of three electronic apex locators (Root ZX, Novapex, and Justy II) in root canal length determinations using different apical file sizes, considering the apical constriction (AC) and the major foramen (MF) as anatomic references. The diameter of the apical foramina of 40 single-rooted teeth was determined by direct visual measurement and the master apical file was established. Electronic measurements were then performed using 3 instruments: the selected master apical file (adjusted file), one size smaller (intermediate file), and two sizes smaller (misfit file). The distances from the tip of files fixed in the canals to the MF and to the AC were measured digitally. Precision at AC and at MF for the misfit, intermediate and adjusted apical files was as follows: 80%/88%/83% and 78%/83%/95% (Root ZX); 80%/85%/80% and 68%/73%/73% (Novapex); and 78%/80%/78% and 65%/78%/70% (Justy II). Considering the mean discrepancies, statistically significant differences were found only for the adjusted file at MF, with Root ZX presenting the best results at MF. The chi-square test showed significant differences between the acceptable measurements at AC and at MF for the Justy II and Novapex (± 0.5 mm) regardless of file adjustment. Under the conditions of the present study, all devices provided acceptable electronic measurements regardless of file adjustment, except for Root ZX which had its performance improved significantly when the precisely fit apical file was used. Justy II and Novapex provided electronic measurements nearest to the AC.

No abstract

The present report describes the endodontic treatment of an Oehlers type II dens invaginatus in a maxillary lateral incisor with 5 root canals, an extremely rare condition. Apical periodontitis and related symptoms were noted. Cone-beam computed tomography was used to aid the diagnosis, reveal tooth morphology, and assist in canal location. The pulp chamber was carefully accessed, and the root canals were explored under magnification. All root canals were prepared with an R25 Reciproc Blue system and sodium hypochlorite (NaOCl) irrigation. After initial preparation, a self-adjusting file (SAF) with NaOCl and ethylenediaminetetraacetic acid was used to complement the disinfection. Additionally, calcium hydroxide medication was applied. Vertical compaction was used to fill the canals with a calcium silicate-based endodontic sealer and gutta-percha. After 12 months, the patient exhibited healing of the periapical region, absence of symptoms, and normal dental function. In conclusion, this nonsurgical treatment protocol was successful in promoting the cure of apical periodontitis. Both complementary disinfection with an SAF and use of calcium hydroxide medication should be considered when choosing the best treatment approach for dens invaginatus with very complex anatomy.

Introdução: A perfuração radicular é um acidente caracterizado pela comunicação entre o espaço pulpar ou canal radicular com os tecidos periodontais de sustentação do elemento dentário. Este tipo de complicação pode acontecer em virtude de cáries extensas, reabsorções radiculares ou ainda devido ao uso incorreto de brocas e outros instrumentos endodônticos. O presente estudo teve como objetivo relatar um caso clínico em que foi realizado o tratamento endodôntico de um elemento dental com perfuração radicular, utilizado o MTA para o selamento da perfuração. Relato de caso: Paciente do sexo masculino, 29 anos, foi encaminhado para a clínica de especialização para continuação e tratamento endodôntico. Ao exame radiográfico observou-se espessamento do espaço do ligamento periodontal na região apical e área radiolúcida na região coronária sugestiva de perfuração radicular, confirmada clinicamente e com o uso do localizador eletrônico foraminal. Na primeira sessão foi realizado o preparo químico-cirúrgico e uso de medicação intracanal. Na sessão seguinte foi realizado o fechamento da perfuração radicular com o uso de MTA cinza e sem seguida a obturação do canal. Considerações finais: Uma conduta clínica adequada, com a utilização de tecnologia e equipamentos que auxiliam no diagnóstico bem como o uso de materiais mais indicados para o tratamento de perfurações radiculares são fundamentais para a obtenção de resultados clínicos favoráveis.