The distribution of chewing pressure in intact tooth is from crown, across the root dentin and ends in periodontal ligament. Endodontic treatment procedure is dental procedure that is necessary when the pulp tissue is irreversible damaged, because of dental caries, dental disease or traumatic injury. When the dental structure is weakened, there is a possibility of crown or root fracture. The root vertical fracture is the third most common reason for tooth extraction in endodontic treated tooth. Endodontic procedure is successful when all the steps of dental procedure is completed.The objective of this study was to estimate whether the low taper of endodontic instrument decreases the possibility of tooth fracture and increase the percentage of tooth fracture resistance.To complete the aim of this study, were analyzed total number of 84 surveys, 42 of them were used for detail analysis. The electronic research was done using the databases as: Pub Med (Medline), Embase, Medscape, Web of Science and Cochrane Library. This study is based on review on published articles written in English language, reporting results related to the use of different intensity of conicity in endodontic treatment and the influence to tooth fracture resistance. Other inclusion criteria as date parameter of the articles was set from 2000 until 2022.The research examined in this review is of in vitro studies and FEA analysis. Some results of this research have shown that fracture resistance in endodontic treated tooth depends of quantity of dental structure. In many reviewed studies the evaluated levels of fracture, have been found to be significantly lover in groups of teeth that are endodontic treated with lover conicity, compared with the other groups of teeth that are endodontic treated with high percentage of conicity. Also, The FEA method has been successfully used in endodontics, where it has proven with the in vitro methods of study.
The technique with socket shield is used like not total extraction therapy which is based on preserving segment from one of the sides on the root from the tooth that is going to be extracted. The main use of this technique is in cases for implant placement that is combined with grafting bone. The goal of this technique is to preserve as much as possible tissue from the periodontal ligament and also to spare the gingival tissue from unnecessary damaging during the therapy. Indications for this technique are : 1. To support and to preserve buccofacial bone part of extraction socket in cases that require immediate implants.2. Socket shield technique is indicated in cases with vertical fractures of teeth that are without any pathology of the pulpal tissue, where the bone tissue sparing and also attractive look are a main goal.3. To preserve the papilla between the placed dental implants. In spite of that to have a full success of this therapy is required to have enough bone tissue that will allow stability of the future implant and also absence of any kind of infection. The advantages from application of this technique are many, such as prevention from resorption of the lamellar bone, high aesthetics results, improved primary stability of the future implant, minimal invasiveness during the procedure, prevention from forming a connective tissue with the implant, low cost compared with other procedures etc. There are also disadvantages such as possibility of displacement of the buccal lamellar bone. The purpose of this study is to analyze the efficiency of this socket shield approach in immediate implant treatment. This study was based on Narrative review on published surveys, using PubMed, Medscape, Webmd, Mdconsult, Emedicine data bases. The preservation of the whole attachment apparatus of the tooth to maintain complete preservation of the alveolar bone tissue, makes the socket shield approach a very good technique that results with high level efficiency. The clinical outcomes from different studies is believed for this technique to be the best approach for alveolar ridge sparing in the future and also to use as less material as possible.
In cases with periapical lesions, there are two types of treatment modalities: noninvasive and invasive. The first one noninvasive is also known as nonsurgical or endodontic treatment. The second one – invasive method is surgical approach. In some cases, there is a need for combination of both aproaches. In everydays clinical treatment, the first choice is less invasive method and has better outcomes. Treatment of some periapical lesions (like cysts) are a theme of discussion and we do not have best option to treat them. The patient should make the definitive decision about the treatment. The doctor should inform him about the advantages and disadvantages of endodontic-noninvasive and surgical-invasive procedure. The therapeutic modalities for these pathologies are a wide range of treatment from endodontic treatment to different surgical options. We like to find out and present the best way about healing the periapical lesion. We wanted to know whenever surgical or non-surgical approach is better, and if using them might improve healing of those pathologies. The aim was clear and to reach it, we make an electronic search of medical and dental literature. We searched the following electronic databases: PubMed and Embase Ovid. Inclusion and exclusion criteria were used to reach the aim of this review study. We place restriction about language (only those articles that are written on English) and publication date (articles that are not older than 2010 year). We excluded duplicate article. We searched the references of the studies that we included for those review. We searched by hand the reference list of the studies and journals in the fields of endodontics and oral surgery. Every periapical lesion should firstly begin with good performed endodontic treatment. In some cases, there is a need for surgical approach of periapical pathologies because the endodontic treatment is not successful. Some cases might fail because of multipurpose factors such as: foreign body reaction, the size of the periapical lesion, biofilm, oral health and oral hygiene. A surgical approach is an option in cases when periapical lesion is large. Marsupialization might be the adequate option of treatment for those lesions in some cases. In cases with postoperative periapical lesion there is a need for surgical retrograde treatment. The procedure can be performed with hand endodontic instruments to make mechanical treatment of the root canal especially the part that is untreated. The advantages, disadvantages and modalities of treatment of periapical lesions are discussed in this review. According to these review there is no evidence that the first approach leads to better results compared to the second approach. This conclusion is based on electronic research of the literature database and clinical trials. There are several options for treatment to eliminate the clinical problems of periapical lesions but furder research is necessary. This review article is about the benefits of both approaches, and to determinate the best treatment modalities of cases with periapical pathologies, healing and postoperative quality of dental life.
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