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We report the challenges faced in the treatment of a large cystic lesion in the anterior maxilla. A 32-year-old woman presented herself to the urgency service, complaining about discomfort in the region of nonvital tooth #22. Endodontic treatment was started and the patient reported to the oral medicine discipline of the authors’ institution. Imaging and clinical examination revealed a large cystic lesion involving the hard palate, nasal cavity, and the anterior portion of the maxillary sinus. A cystic decompression was performed along with an incisional biopsy that led to a histopathologic diagnosis of periapical cyst. A second surgical approach tried to enucleate the lesion but the ostium of decompression remained open, thereby impairing bone formation. A third approach was performed along with allogeneic particulate bone graft and reabsorbable membrane barrier positioning. Radiographic follow-up showed the graft integration and good recovery of the lesion after 4 months of follow-up care.

Objective: This study aims at studying the influence of hypercementosis over root and root canal morphology us-ing different methods of observation (clearing technique, radiography, stereomicroscopy and optical microscopy). Methods: 130 teeth were selected for morphological com-parative evaluation; all teeth were previously radiographed and stereomicroscopically evaluated. Out of these, 60 teeth with hypercementosis and 30 without it were selected for clearing technique evaluation. The analysis was based on aspects such as: type of hypercementosis; root canal num-ber and configuration; root surface and presence of apical foramen and apical deltas. The remaining 20 teeth with hy-percementosis were microscopically compared to 20 teeth with normal root formation by means of the Hematoxylin and Eosin (H.E.) staining technique, so as to study the ce-mentum deposition pattern and morphological aspects of the root canal. The evaluation was performed by two ex-aminers and submitted to Kappa agreement test. The data obtained was compared through non-parametric Kruskal-Wallis one-way analysis of variance test, and the Dunn test was applied for individual comparisons. Results: The root clearing examination showed higher frequency of club shaped hypercementosis (65%) followed by focal hyperce-mentosis (35%). Teeth with hypercementosis showed sig-nificant increase in the presence of apical deltas (53.3%). A higher frequency of root canal constrictions (55%), and changes in the original root canal path (46.6%) were also observed. Microscopic evaluation supports the influence of hypercementosis over the morphological characteristics of root apical third formation. Conclusions: These findings show the existence of a complex root canal anatomy at the apical third of teeth with hypercementosis, which may hinder root canal treatment.Keywords: Hypercementosis. Dental pulp cavity. Endodontics.

Made available in DSpace on 2021-07-14T10:29:48Z (GMT). No. of bitstreams: 0 Previous issue date: 2003-09. Added 1 bitstream(s) on 2021-07-14T11:31:42Z : No. of bitstreams: 1 S1678-77572003000300006.pdf: 450696 bytes, checksum: 4049c019def05cf97d25601916fe2dc2 (MD5) OBJETIVO: comparar a qualidade da obturação e a diferença de profundidade de penetração, no interior do canal radicular, dos espaçadores digitais (Finger Spreader), limas tipo Kerr, Flexofile e Nitiflex, quando utilizados como espaçadores, durante a obturação pela Técnica da Condensação Lateral Ativa. MATERIAL E MÉTODOS: foram utilizados 40 dentes molares permanentes humanos, extraídos, instrumentados pela Técnica de Goerig Modificada e divididos em quatro grupos. No grupo I foi utilizado o espaçador digital C; no grupo II, lima tipo Kerr; no grupo III, lima Flexofile e, no grupo IV, lima Nitiflex, todos com diâmetro (D1) ou diâmetro da ponta correspondente ao diâmetro de uma lima 30 (0,30mm), para abertura de espaço para colocação dos cones secundários, durante a Técnica da Condensação Lateral Ativa. Avaliou-se e submeteu-se à análise estatística (Kruskal-Wallis e teste de Dunn) a qualidade radiográfica da obturação e a profundidade de penetração dos instrumentos. RESULTADOS E CONCLUSÃO: quanto à análise radiográfica da qualidade da obturação, o grupo II foi o que apresentou o melhor resultado, seguido dos grupos I, IV e III, respectivamente. Em relação à profundidade de penetração dos instrumentos, o grupo IV aproximou-se mais da distância desejada, ou seja, 1 milímetro aquém do comprimento de trabalho, seguido, respectivamente, dos grupos II, III e I. PURPOSE: the purpose of this study was to compare the quality of the obturation and the difference of penetration depth inside the root canal of the instruments Finger Spreader, file type Kerr, Flexofile and Nitiflex when used as spreaders during the filling by Active Lateral Condensation Technique. MATERIAL AND METHOD: 40 extracted permanent human teeth were instrumented by the Modified Goerig Technique and divided in four groups. In the group I the finger spreader was used; in the group II, files type Kerr was used; in the group III, files Flexofile was used and, in the group IV, files Nitiflex, all number 30, for space opening for placement of the secondary cones, during the Technique of Active Lateral Condensation. The radiographic quality of the obturation and the depth of penetration of the instruments was evaluated and analysed statisticaly (Kruskal-Wallis and Dunn's Test). RESULTS AND CONCLUSION: with relationship to the radiograph analysis of the quality of the filling, the group II was what it presented the best result, followed by the groups I, IV and III, respectively. In relation to the depth of penetration of the instruments, the group IV approached more the desired distance, or, 1 millimeter less than the length of the work, followed, respectively, by groups II, III and I. Universidade de São Paulo, Faculdade de Odontologia de Bauru Universidade Estadual Paulista, Faculdade de Odontologia Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais Universidade Estadual Paulista, Faculdade de Odontologia

Objective: To evaluate the effectiveness of the NaviTip FX, brush-covered irrigation needle, in removing calcium hydroxide from the root canal. Study Design: Thirty single-rooted teeth were randomly divided into three groups: A - irrigation with a hypodermic needle inserted as far as possible without binding and activation with #30 K-type file; B - Irrigation with a hypodermic needle without activation; C - irrigation with NaviTip FX needle. Sodium hypoclorite 1% was used in irrigation. The root canals were examined trough scanning electron microscopy. Calcium hydroxide removal was recorded at 1, 5, and 10mm from the working length (WL) and the data were analysed using one-way ANOVA test (p

The purpose of this study was to evaluate morphological characteristics of teeth with hypercementosis that are relevant to endodontic practice. Twenty-eight extracted teeth with hypercementosis had their root apexes analyzed by scanning electron microscopy (SEM). The teeth were divided according to tooth groups and type of hypercementosis. The following aspects were examined under SEM: the contour and regularity of the root surface; presence of resorption; presence and number of apical foramina, and the diameter of the main foramen. The progression of club shape hypercementosis was directly associated with the presence of foramina and apical foramen obstruction. Cases of focal hypercementosis presented foramina on the surface, even when sidelong located in the root. Circular cementum hyperplasia form was present in 2 out of 3 residual roots, which was the highest proportion among the tooth types. The detection of a large number of foramina in the apical third of teeth with hypercementosis or even the possible existence of apical foramen obliteration contributes to understand the difficulties faced during endodontic treatment of these cases.