Root canal transportation can lead to treatment failure. A large number of methodologies for assessing root canal preparation have been tried in the past. This study compared two methods for apical transportation measurement: digitised images of longitudinal root sections and radiographs. Sixty upper molar mesiobuccal root canals prepared for endodontic treatment were assessed. The results did not demonstrate statistically significant differences between the two imaging methods used to evaluate root canal transportation. The two methods were proven to be equally reliable.
Objetivos: O presente estudo teve como objetivo relatar a análise de um prontuário de paciente submetido ao tratamento de uma queimadura por hipoclorito de sódio em mucosa oral devido à extravasamento de hipoclorito de sódio durante o tratamento endodôntico. Materiais e Métodos: Através da análise de prontuários de pacientes atendidos na disciplina de Estágio Supervisionado do Complexo Odontológico da FSG Centro Universitário entre os anos de 2017 e 2018, selecionou-se um prontuário de um paciente que sofreu queimadura acidental devido ao extravasamento de hipoclorito de sódio. Resultados: O extravasamento de hipoclorito resultou numa lesão por queimadura na lingual do elemento 45. Como medidas, o paciente foi orientado a usar medicação sistêmica, medicamento Ad-Muc® associado a bochechos com clorexidina a 0,12% e sessões de laserterapia de baixa intensidade. Conclusão: O presente relato destaca os problemas associados ao extravasamento acidental de solução irrigadora à base de hipoclorito de sódio. O adequado diagnóstico, juntamente com a conduta adotada, associando medicação sistêmica, tópica e realização de laserterapia, neste caso, se mostrou efetiva.Descritores: Endodontia; Hipoclorito de Sódio; Acidentes.ReferênciasNoites R, Carvalho MF, Vaz IP. Complicações que podem surgir durante o uso do hipoclorito de sódio no tratamento endodôntico. Rev Port Estomatol Cir Maxilofac. 2009; 50(1):53-56.Salum G, Barros Filho S, Rangel LFGO, Rosa RH, dos Santos SSF, Leão MVP. Hipersensibilidade ao hipoclorito de sódio em intervenções endodônticas. Rev Odontol Univ São Paulo. 2012;24(3):200-8.Borin G, Becker AN, Oliveira EPM. A história do hipoclorito de sódio e a sua importância como substância auxiliar no preparo químico mecânico de canais radiculares. Rev Endod Pesq Ensino On Line. 2007;3(5):1-5.Witton R, Brennan PA. Severe tissue damage and neurologic defict following extravasation of sodium hypochlorite solution during routine endodontic treatment. Br Dent J. 2005; 198(12):749-50.Bramante CM, Duque JA, Cavenago BC, Vivan RR, Bramante AS, Andrade FB, Duarte MAH. Use of a 660-nm laser to aid in the healing of necrotic alveolar mucosa caused by extruded sodium hypochlorite: a case report. J Endod. 2015;41(11):1899-902.Tenore G, Palaia G, Ciolfi C, Mohsen M, Battisti A, Romeu U. Subcutaneous emphysema during root canal therapy: endodontic accident by sodium hypoclorite. Ann Stomatol (Roma). 2017; 8(3):117-122.Hulsmann M, Hahn W. Complications during root canal irrigation – literature review and case reports. Int Endod J. 2000;33(3):186-93.Silva JPM, Boijink D. Acidente com hipoclorito de sódio durante tratamento endodôntico: Análise de prontuário. Rev Odontol Araçatuba. 2019;40(1):25-8.Ribeiro MS, Silva DFT, Zezell DM, Nunez SC. Laser de baixa intensidade. A Odontologia e o laser. São Paulo: Quintessense; 2004.Azzi VJB, Di Pietro SN. Aplicação da laserterapia no tratamento de queimaduras: uma revisão sistemática. Rev Bras Terap e Saúde. 2012;3(1):15-26.Graça BP. O Hipoclorito de sódio em Endodontia [dissertação]. Porto: Faculdade de Ciências da Saúde/Universidade Fernando Pessoa; 2014.Gursoy UK, Bostanci V, Kosger HH. Palatal mucosa necrosis because of accidental sodium hypochlorite injection instead of anaesthetic solution. Int Endod J. 2006;39(2):157-61.Freitas RPA, Barcelos APM, Nóbrega BM, Macedo AB, Oliveira AR, Ramos AMO et al. Laserterapia e microcorrente na cicatrização de queimadura em ratos: terapias associadas ou isoladas?. Fisioter Pesqui. 2013;20(1):24-30.Prockt AP, Takahashi A, Pagnoncelli RM. Uso de terapia com laser de baixa intensidade na cirurgia bucomaxilofacial. Rev Port Estomatol Cir Maxilofac. 2008;49(4):247-55.Noba C, Mello-Moura ACV, Gimenez T, Tedesco TK, Moura-Netto C. Laser for bone healing after oral surgery: systematic review. Lasers med Sci. 2018;33(3):667-74.Rocha Júnior AM, Oliveira RG, Farias RE, Andrade LCF, Aarestrup FM. Modulação da proliferação fibroblástica e da resposta inflamatória pela terapia a laser de baixa intensidade no processo de reparo tecidual. An Bras Dermatol. 2006;81(2):150-56.Soares RG, Dagnese C, Irala LED, Salles AA, Limongi O. Injeção acidental de hipoclorito de sódio na região periapical durante tratamento endodôntico: relato de caso. RSBO. 2006; 4(1):17-21.Doherty MAH, Thomas MBM, Dummer PMH. Sodium hypochlorite accident – a complication of poor access cavity design. Dent Update. 2009;36(1):7-12.
The temporomandibular joint (TMJ) poses challenges in the therapeutics and diagnosis due to its anatomical and physiological complexities. TMJ pain and dysfunction are common occurrences and may result from a variety of etiological factors, both of traumatic and nontraumatic nature, categorized as muscle dysfunctions and arthrogenic dysfunctions. The syndrome comprising the symptoms produced by these factors bears some resemblance to muscle and arthrogenic conditions and is collectively called TMJ disorder (TMD). [1,2] While clinical evaluation methods are loosely based on inspection, palpation, and performance tests, imaging examinations afford more consistent details in the investigation process and make the differential diagnosis of TMD easier. More specifically, due to its high-resolution capabilities and efficiency, with no side effects, magnetic A B S T R A C T Context: Imaging examinations afford more consistent details than clinical evaluation in the investigation process and make the differential diagnosis of temporomandibular joint (TMJ) disorders (TMDs) easier. Aims: This study aimed to check agreement among professionals from different fields of work evaluating TMDs using magnetic resonance imaging (MRI) and based on ten diagnoses criteria: Position, shape and recapture of joint disk, joint mobility, degenerative changes, bone changes, condyle position, effusion, intramedullary edema, and avascular necrosis. Methods: An oral and maxillofacial radiologist, a medical radiologist, and a dental surgeon specialized in TMD and orofacial pain interpreted 152 MRI taken from 76 patients. A scenario simulating daily activities was devised, which neither calibration nor discussion of criteria was assessed. Interobserver agreement was measured using the Kappa coefficient. Results: Poor agreement was observed in avascular necrosis; a slight agreement was recorded in form and position of the joint disk, condyle position, effusion; fair agreement in TMJ mobility and disk recapture; moderate to almost perfect agreement in condylar changes, degenerative changes, and intramedullary edema. Conclusion: Professionals from different areas that interpret TMJ disorders using MRI did not agree on the diagnoses, especially for the soft-tissue changes.
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