This study aimed to evaluate the prevalence of mesiobuccal 2(MB2) canals not located/treated in maxillary molars and correlated their non-treatment with the presence of periradicular lesion. The study was conducted on 180 cone beam computed tomography (CBCT) scans. The 180 examinations added up to 210 teeth analyzed (140 maxillary first molars and 70 maxillary second molars). The presence of non-located/treated MB2 canals and periapical lesions in the mesiobucal(MB) root was identified by observation of the axial and subsequently of sagittal and coronal slices. Among the 210 teeth evaluated, 91.4% (n=192) had MB2 canal, while 8.6% (n=18) did not have this canal. In the first molars with presence of MB2 (n=133), periapical lesion was observed in 85.0% (n=113). Among the second molars with presence of MB2 (n=59), periapical lesion was observed in 72.9% (n=43). The presence of periapical lesion in the MB root was related to the non-location/treatment of the MB2 canal and was higher when it was an independent canal.
Conventional radiographic techniques have limitations, showing a two-dimensional image of a three-dimensional object, making it difficult to recognize the internal root anatomy in endo-dontic therapy. Cone-beam computed tomography (CBCT) is a diagnostic method that allows the visualization of all structures three-dimensionally, showing promising results compared to periapical radiographs. The objective of this study was to report two clinical cases where CBCT was fundamental to the diagnosis and a better treatment planning of the steps that were taken during the endodontic intervention. The CBCT were performed prior to the treat-ments, the volume of the exams were dynamically analyzed in specific software. The data were interpreted and together with the radiographic image and clinical examination data, the diagnosis and treatment planning were carried out. Given the report and discussion of the two clinical cases, it can be concluded that CBCT proved to be an impacting resource to support diagnosis and decision-making in the treatment of complex endodontic cases. CBCT ensured greater reliability in the diagnosis and treatment plan adopted, increasing the predictability of the endodontic therapy.
The success of an endodontic surgery depends on the removal of a persistent infection from the external apical surface and necrotic tissue or contaminated filling material within the root canal system followed to a complete filling of the root end preparation. The current concepts of surgical endodontics recommend that its execution with the use of magnification and illumination of the operating microscope, which allows an easier identification of the root apices, small ostectomies and smaller apex resection angles. The objective of this article is to report and discuss a clinical case of endodontic microsurgery where the main resources currently recommended were used to increase the success in surgical endodontics. Based on specific equipments, instruments and materials the endodontic microsurgery increases the predictability of success of the surgery. Among the main advances compared to traditional surgery we could observe less trauma to the operated region which resulted in a faster and more comfortable healing for the patient.
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