Apicoectomy: an Elucidation to a Hitch
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Surgical Management of a Separated Endodontic Instrument Using
Review Article Clinician’s corner Images in Medicine Experimental Research Case Report Miscellaneous Letter to Editor DOI: 10.7860/JCDR/2017/25761.9991 Case Report Postgraduate Education Surgical Management of a Separated Case Series Endodontic Instrument using Second Dentistry Section Generation Platelet Concentrate and Short Communication Hydroxyapatite SL SATHEESH1, SHEFALI JAIN2, atUL CHANDRA BHUYAN3, LEKSHMY S DEVI4 ABSTRACT Fractured endodontic instrument is an unfortunate endodontic mishap which may obstruct thorough cleaning and shaping of the root canals with potential impact on the endodontic prognosis and treatment outcome. When the fractured segment lies apical to canal curvature, overzealous removal of tooth structure is required to gain access to the separated segment which in turn increases the likelihood of root fracture. In infected cases, the stage at which instrument separation occurs is crucial as root canal disinfection is jeopardized. This case report describes the surgical retrieval of a fractured endodontic file from the mesiobuccal canal of mandibular first molar by limited resection of mesial root. Second generation platelet concentrate called Platelet Rich Fibrin (PRF) and nanocrystalline hydroxyapatite and β- tricalcium phosphate bone graft was placed to fill the surgical defect as the combination enhances the regenerative effect of PRF by exerting an osteoconductive effect in the bony defect area. The clinical and radiographic examination after eighteen months revealed complete periapical healing. Keywords: Bone graft, Instrument fracture, Instrument retrieval, Periapical surgery, Platelet rich fibrin CASE REPORT symptomatic. Treatment plan was changed to periapical surgery to A 32-year-old male patient with a chief complaint of dull aching pain retrieve the fractured file from mesiobuccal canal because it was in relation to his mandibular left first molar tooth (# 19) was referred deemed likely that further attempts to remove the file could perforate to Department of Endodontics for retreatment. -
Apexification of Immature Permanent Incisors Using MTA and Calcium Hydroxide- Case Report
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 19, Issue 4 Ser.7 (April. 2020), PP 33-37 www.iosrjournals.org Apexification of Immature Permanent Incisors using MTA and Calcium hydroxide- Case Report Tanu Rajain1, Kesang Tsomu2, Ritu Namdev3 1Post Graduate Trainee 2nd year , Department of Pedodontics and Preventive Dentistry, PGIDS , Rohtak, Haryana. 2Post Graduate Trainee 3rd year , Department of Pedodontics and Preventive Dentistry, PGIDS , Rohtak, Haryana. 3Senior Professor and Head, Department of Pedodontics and Preventive Dentistry, PGIDS , Rohtak, Haryana. Corresponding Author: Dr. Tanu Rajain , Department of Pedodontics and Preventive Dentistry, Pt. B.D. Sharma PGIMS , Rohtak , Haryana- 124001, India. Abstract- In young pediatric patient the endodontic management of immature non vital permanent teeth is a great challenge to dentist. There is difficulty in debridement and obturation as the walls of the root canals are frequently divergent and open apexes are present. Apexification is a technique to generate a calcific barrier in a root with an open apex or the sustained apical development of an incomplete root in teeth with necrotic pulp. The most commonly advocated medicament is calcium hydroxide although recently considerable interest has been expressed in the use of MTA. In this case series both calcium hydroxide and MTA were used successfully for apexification procedure in teeth with open apex. Keywords- Young permanent maxillary incisor, open apex, calcium hydroxide, mineral trioxide aggregate, apexification. ----------------------------------------------------------------------------------------------------------------------------- ---------- Date of Submission: 04-04-2020 Date of Acceptance: 20-04-2020 ----------------------------------------------------------------------------------------------------------------------------- ---------- I. Introduction Dental trauma in the young adolescent patient is most common to the anterior dentition. -
June 2000 Issue the Providers' News 1 To
To: All Providers From: Provider Network Operations Date: June 21, 2000 Please Note: This newsletter contains information pertaining to Arkansas Blue Cross Blue Shield, a mutual insurance company, it’s wholly owned subsidiaries and affiliates (ABCBS). This newsletter does not pertain to Medicare. Medicare policies are outlined in the Medicare Providers’ News bulletins. If you have any questions, please feel free to call (501)378-2307 or (800)827-4814. What’s Inside? "Any five-digit Physician's Current Procedural Terminology (CPT) codes, descriptions, numeric ABCBS Fee Schedule Change 1 modifiers, instructions, guidelines, and other material are copyright 1999 American Medical Association. All Anesthesia Base Units 2 Rights Reserved." Claims Imaging and Eligibility 2 ABCBS Fee Schedule Change Reminder: Effective July 1, 2000 Arkansas Blue Cross Claims Payment Issues 3 Blue Shield is updating the fee schedule used to price professional claims. The update includes changes in the Coronary Artery Intervention 2 Relative Value Units used to calculate the maximum allowances as well as the implementation of Site-Of - CPT Code 99070 2 Service (SOS) pricing. Dental Fee Schedule 2 Under SOS pricing, a given procedure may have different allowances when provided in a setting other Electronic Filing Reminder 2 than the office. Health Advantage Referral Reminder 2 The Place Of Service reported in block 24b on the HCFA 1500 claim form indicates which allowance should be Type of Service Corrections 3 applied. An “11” in this field indicates that the service was delivered in the office setting. Any value other than Attachments “11” in block 24b will result in the application of the SOS A Guide to the HCFA - 1500 Claim Form pricing, if there is an applicable SOS allowance for that (Paper Claims) 7 service. -
Apicoectomy Treatment
INFORMED CONSENT DISCUSSION FOR APICOECTOMY TREATMENT Patient Name: Date: DIAGNOSIS: Patient’s initials required Twisted, curved, accessory or blocked canals may prevent removal of all inflamed or infected pulp/nerve during root canal treatment. Since leaving any pulp/nerve in the root canal may cause your symptoms to continue or worsen, this might require an additional procedure called an apicoectomy. Through a small opening cut in the gums and surrounding bone, any infected tissue is removed and the root canal is sealed, which is referred to as a retrofilling procedure. An apicoectomy may also be required if your symptoms continue after root canal therapy and the tooth does not heal. Benefits of Apicoectomy, Not Limited to the Following: Apicoectomy treatment is intended to help you keep your tooth, allowing you to maintain your natural bite and the healthy functioning of your jaw. This treatment has been recommended to relieve the symptoms of the diagnosis described above. Risks of Apicoectomy, Not Limited to the Following: I understand that following treatment I may experience bleeding, pain, swelling and discomfort for several days, which may be treated with pain medication. It is possible that infection may accompany treatment and must be treated with antibiotics. I will immediately contact the office if my condition worsens or if I experience fever, chills, sweats or numbness. I understand that I may receive a local anesthetic and/or other medication. In rare instances patients have a reaction to the anesthetic, which may require emergency medical attention, or find that it reduces their ability to control swallowing. This increases the chance of swallowing foreign objects during treatment. -
A Case of Periradicular Surgery: Apicoectomy and Obturation of the Apex, a Bold Act
Locurcio et al. Stomatological Dis Sci 2017;1:76-80 DOI: 10.20517/2573-0002.2016.08 Stomatological Disease and Science www.sdsjournal.com Case Report Open Access A case of periradicular surgery: apicoectomy and obturation of the apex, a bold act Lino Lucio Locurcio1, Rachel Leeson2 1Ashford & St. Peter‘s Hospitals, Ashford TW15 3AA, UK. 2Eastman Dental Hospital, London WC1X 8LD, UK. Correspondence to: Dr. Lino Lucio Locurcio, Ashford & St. Peter’s Hospitals, London Road, Ashford TW15 3AA, UK. E-mail: [email protected] How to cite this article: Locurcio LL, Leeson R. A case of periradicular surgery: apicoectomy and obturation of the apex, a bold act. Stomatological Dis Sci 2017;1:76-80. Dr. Lino Lucio Locurcio has a wide experience in oral surgery, achieved throughout his training experience in Italy. He moved to London for a Master at Eastman Dental Institute in London. In addition, Dr. Locurcio had a fellowship in craniofacial surgery at Great Ormond Street Children Hospital. At the moment he is working in London as oral surgeon and implantologist with a special interest in maxillofacial and skin cancer surgery. Besides his hospital commitments, Dr. Locurcio currently works in a private clinic in Battersea, London. ABSTRACT Article history: This paper reports a case of a recurrent periapical cyst treated with enucleation of the lesion, Received: 08-10-2016 apicoectomy, and root end obturation on a lower left first molar. In the case of conventional Accepted: 21-12-2016 root canal treatment failure, non-surgical retreatment is the preferred option in most of the Published: 29-06-2017 cases. -
Surgical Repair of Root and Tooth Perforations JOHN D
Endodontic Topics 2005, 11, 152–178 Copyright r Blackwell Munksgaard All rights reserved ENDODONTIC TOPICS 2005 1601-1538 Surgical repair of root and tooth perforations JOHN D. REGAN, DAVID E. WITHERSPOON & DEBORAH M. FOYLE A root perforation is a mechanical or pathological communication formed between the supporting periodontal apparatus of the tooth and the root canal system. Three broad categories of etiological factors exist and these are procedural mishaps, resorption and caries. The diagnosis, management and repair of root perforations require skill and creative thinking. Unfortunately, much of what has been written on the subject of root perforation repair is unsubstantiated and empirical in nature and contributes little to evidence-based support for any specific repair procedure. However, perforation repair frequently provides a very attractive and frequently successful alternative to extraction of the involved tooth. In recent years, the procedure has become more predictable owing to the development of new materials, techniques and procedures. Introduction many perforations has been facilitated by the use of improved magnification and illumination provided by A root perforation is a mechanical or pathological the use of loupes or the surgical operating microscope communication formed between the supporting per- (SOM) (9, 10, 15–28). In practice, however, the iodontal apparatus of the tooth and the root canal indications for surgical correction of root perforations system (1). Perforations result in the destruction of the are being eroded from two directions: on the one hand dentine root wall or floor along with the investing by the improved non-surgical management of perfora- cementum. This communication compromises the tions and on the other by the use of implants. -
Dr Prasad Musale (MDS, MLD)
Dr Prasad Musale (MDS, MLD) ✤ Graduate from Bharati Vidyapeeth Dental College & Hospital, Pune(1994), Postgraduate from Government Dental College & Hospital, Mumbai(1999) and Masters in Laser Dentistry from Med- ical University of Vienna, Austria(2010) ✤ Teaching experience of 19 years ✤ Core interest in Pediatric Endodontics, Microscopic Pediatric Dentistry, MID and Laser assisted Pediatric Dentistry ✤ Published more than 25 International and National scientific papers ✤ Contributed many chapters in leading Pediatric Dentistry textbooks of authors like Dr Damle and Dr Shobha Tondon. ✤ Invited as Speaker/Faculty for National and international conferences ✤ Director of “Little Ones Big Smiles” Laser and Microscope Integrated Pediatric Dentistry in Pune since 1999 PEDIATRIC ENDODONTICS VITAL AND NON-VITAL PULP THERAPY Dr Prasad Musale (MDS, MLD) Pune,India SCOPE OF PEDIATRIC ENDODONTICS # To understand the developmental and biomedical aspects of primary and permanent pulp # Comprehensive clinical and radiographic diagnosis of the pulp and periradicular lesions # Vital pulp therapy and Nonvital pulp therapy including Regenerative Endodontics # Selective surgical removal of pathological tissues resulting from pulpal pathosis # Intentional replantation and replantation of avulsed teeth # Surgical removal of tooth structure, such as root-end resection and root-end filling; hemisection, and root resection # Bleaching of discolored dentin and enamel # Retreatment of teeth previously treated endodontically # Coronal restorations by means of post -
Chapter 17.Pdf
Richard E. Walton DRAINAGE OF AN ABSCESS Irrigation PERlAPlCAL SURGERY Radiographic Verification lndications Flap Replacement and Suturing Anatomic Problems Postoperative Instructions Restorative Considerations Suture Removal and Evaluation Horizontal Root Fracture CORRECTIVE SURGERY Irretrievable Material in Canal Indications Procedural Error Procedural Errors Large Unresolved Lesions After Root Canal Resorptive Perforations Treatment Contraindications Contraindications (or Cautions) Anatomic Considerations Unidentified Cause of Treatment Failure Location of Perforation When Conventional Root Canal Treatment is Accessibility Possible Considerations Simultaneous Root Canal Treatment and Apical Surgical Approach Surgery Repair Material Anatomic Considerations Prognosis Poor Crown and Root Ratio Surgical Procedure Medical (Systemic) Complications HEALING Surgical Procedure RECALL Flap Design ADJUNCTS Semilunar lncision Light and Magnification Devices Submarginal incision Surgical Microscope Full Mucoperiosteal lncision Fiber Optics Anesthesia Guided Tissue Regeneration lncision and Reflection Bone Augmentation Periapical Exposure WHEN TO CONSIDER REFERRAL Curettage Training and Experience Root End Resection Determining the Cause of Root Canal Treatment Root End Preparation and Restoration Failure Root End-Filling Materials Surgical Difficulties Principles of Endodontic Surgery . CHAPTER 17 381 ndodontic surgery is the management or preven- tion of periradicular pathosis by a surgical approach. In general, this includes abscess drainage, -
Analysis of Clinical Studies Related to Apexification Techniques
Introduction A. Agrafioti, D.G. Giannakoulas*, C.G. Filippatos, E.G. Kontakiotis Teeth with necrotic pulp and open apex bring about several challenges to clinicians due to the lack of natural Department of Endodontics, School of Dentistry, National and apical constriction and the thin root walls that are Kapodistrian University of Athens, Athens, Greece prone to fracture [Trope, 2006, Camp, 2008]. In order *School of Dentistry, National and Kapodistrian University of to confine filling materials into the root canal space and Athens, Athens, Greece prevent overfilling, the placement of an artificial apical barrier and/or the closure of the apex are necessary email: [email protected] before obturation of the root canal system [Trope 2006]. The traditional approach to handle cases with open apex DOI: 10.23804/ejpd.2017.18.04.03 is the multiple-visit apexification treatment with the use of calcium hydroxide (CH) as intracanal medicament [Seltzer, 1988]. The frequency of changes of CH from the root canal constitutes a controversial topic as there are studies Analysis of clinical that propose that a single placement of this medicament is enough to achieve predictable outcomes [Chawla studies related 1986], whereas others claim that multiple replacements of CH could lead to a more rapid formation of a calcified to apexification tissue barrier [Abbot 1998]. The time required for the calcified tissue barrier to form varies from 5 to 20 months techniques [Sheehy and Roberts, 1996] and seems to be influenced by several factors such as opening of the apex, frequency of intracanal medication replacement, age of the patient and the presence of periapical radiolucency [Mackie et al., ABSTRACT 1988; Finucane and Kinirons, 1999; Kleier and Barr, 1991]. -
Apicoectomy of Maxillary Anterior Teeth Through a Piezoelectric Bony-Window Osteotomy: Two Case Reports Introducing a New Technique to Preserve Cortical Bone
Case report ISSN 2234-7658 (print) / ISSN 2234-7666 (online) https://doi.org/10.5395/rde.2016.41.4.310 Apicoectomy of maxillary anterior teeth through a piezoelectric bony-window osteotomy: two case reports introducing a new technique to preserve cortical bone Viola Hirsch1,2, Meetu Two case reports describing a new technique of creating a repositionable piezoelectric R. Kohli1*, Syngcuk bony window osteotomy during apicoectomy in order to preserve bone and act as an 1 autologous graft for the surgical site are described. Endodontic microsurgery of anterior Kim teeth with an intact cortical plate and large periapical lesion generally involves removal of a significant amount of healthy bone in order to enucleate the diseased 1 Department of Endodontics, tissue and manage root ends. In the reported cases, apicoectomy was performed on the University of Pennsylvania School of Dental Medicine, Philadelphia, lateral incisors of two patients. A piezoelectric device was used to create and elevate PA, USA a bony window at the surgical site, instead of drilling and destroying bone while 2Private Practice, Munich, Germany making an osteotomy with conventional burs. Routine microsurgical procedures - lesion enucleation, root-end resection, and filling - were carried out through this window preparation. The bony window was repositioned to the original site and the soft tissue sutured. The cases were re-evaluated clinically and radiographically after a period of 12 - 24 months. At follow-up, radiographic healing was observed. No additional grafting material was needed despite the extent of the lesions. The indication for this procedure is when teeth present with an intact or near-intact buccal cortical plate and a large apical lesion to preserve the bone and use it as an autologous graft. -
Treatment Options for the Compromised Tooth: a Decision Guide
Treatment Options for the Compromised Tooth: A Decision Guide www.aae.org/treatmentoptions Photo by Lindsey Frazier submitted by L. Stephen Buchanan, D.D.S. Root Amputation, Hemisection, Bicuspidization Case One Hemisection of the distal root of tooth #19. PreOp PostOp 13 mo. Recall Case Two* Hemisection of the distal root of tooth #30. PreOp PostOp Clinical Photograph * These images were published in The Color Atlas of Endodontics, Dr. William T. Johnson, p. 162, Copyright Elsevier 2002. Treatment Considerations/Prognosis Favorable Questionable Unfavorable Remaining Coronal Greater than 1.5 mm ferrule 1.0 to 1.5 mm ferrule Less than 1 mm ferrule Tooth Structure Crown Lengthening None needed If required will not Treatment required that compromise the aesthetics will affect the aesthetics or periodontal condition or further compromise the of adjacent teeth osseous tissues (support) of the adjacent teeth Endodontic Treatment Routine endodontic Nonsurgical root canal Canal calcification, complex treatment or not required retreatment required prior canal and root morphology, due to previous treatment to root resection and isolation complicate an ideal endodontic treatment result 2 American Association of Endodontists | www.aae.org Endodontic-Periodontic Lesions Case One Tooth #19 exhibiting probing to the distal apex. Treated in two steps using interim calcium hydroxide. PreOp Calcium Hydroxide PostOp 12 mo. Recall Case Two Tooth #21 exhibiting a wide, but deep probing on the mesial aspect. Treated in two steps using interim calcium hydroxide. PreOp Calcium Hydroxide PostOp 12 mo. Recall Case Three Tooth #19 with an 8 mm probing into furcation. Interim calcium hydroxide used. PreOp PostOp 12 mo. -
Diagnosis and Treatment of Endodontically Treated Teeth With
Case Report/Clinical Techniques Diagnosis and Treatment of Endodontically Treated Teeth with Vertical Root Fracture: Three Case Reports with Two-year Follow-up Senem Yigit Ozer,€ DDS, PhD,* Gulten€ Unl€ u,€ DDS, PhD,† and Yalc¸ın Deger, DDS, PhD‡ Abstract Introduction: Vertical root fracture (VRF) is an impor- vertical root fracture (VRF) manifests as a complete or incomplete fracture line tant threat to the tooth’s prognosis during and after Aextending obliquely or longitudinally through the enamel and dentin of an root canal treatment. Often the detection of these frac- endodontically treated root. VRFs usually result in extraction of the affected tooth tures occurs years later by using conventional periapical (1). Major iatrogenic and pathologic risk factors for VRFs include excessive root canal radiographs. However, recent studies have addressed preparation, overzealous lateral and vertical compaction forces during root canal the benefits of computed tomography to diagnose these filling, moisture loss in pulpless teeth, overpreparation of post space, excessive pres- problems earlier. Accurately diagnosed VRFs have been sure during post placement, and compromised tooth integrity as a result of large treated by extraction of teeth, with minimal damage to carious lesions or trauma (2). Whereas a multi-rooted tooth with VRF can be conserved the periodontal ligament, extraoral bonding of fractured by resecting the involved root, a single-rooted tooth usually has a poor prognosis, segments with an adhesive resin cement, and inten- leading to extraction in 11%–20% of cases (3). tional replantation of teeth after reconstruction. Although several methods have been used to preserve vertically fractured teeth, no Methods: The 3 case reports presented here describe specific treatment modality has been established (4–9).