NOTAS DE
ENDODONCIA
Profesor: Dr. Ricardo Rivas Muñoz
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15.1. Prevención de accidentes 15.2. Debidos al diagnóstico incorrecto 15.2.1. En la técnica radiográfica e interpretación 15.3. Con la anestesia local 15.3.1. Fracaso con la anestesia en un diente con inflamación aguda 15.3.2. Fracaso con la anestesia por infiltración 15.3.3. Fracaso con la anestesia regional 15.4. Con el Aislamiento con dique de hule 15.4.1. Falta de estructura dentaria para colocar la grapa
15.5. Durante el acceso a la cámara pulpar 15.5.1. Dificultad para identificar y remover todo el tejido carioso o estructura dental debilitada 15.5.2. Dificultad para establecer un acceso adecuado a cámara y conductos 15.5.3. Perforación de la cámara pulpar por encima de la cresta ósea 15.5.4. Perforación de la cámara pulpar por debajo de la cresta ósea o en furca 15.5.5. Angulación de la corona en relación con la raíz 15.5.6. Preparación del acceso a través de una corona total artificial 15.6. Localización y penetración a conductos delgados y calcificados. 15.6.1. Localización del orificio de entrada 15.6.2. Perforación del diente al buscar el orificio de entrada 15.6.3. Penetrar o explorar un conducto muy delgado o calcificado
15.7. Durante la limpieza y conformación de conductos 15.7.1. El instrumento ya no llega a la longitud de trabajo 15.7.2. Escalones 15.7.3. Fractura de instrumentos dentro del conducto radicular 15.7.4. Rasgar o transportar el foramen apical 15.7.5. Adelgazamiento o perforación lateral de la raíz 15.7.6. Sobreinstrumentación
15.8. Durante la obturación 15.8.1. La punta maestra no llega hasta la conductometría 15.8.2. Los conos de gutapercha se han vuelto quebradizos 15.9. Después de la obturación 15.9.1. Sobreextensión. Sobreobturación
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REGRESAR A LA SECCIÓN DE ACCIDENTES DURANTE LA LIMPIEZA Y CONFORMACIÓN
RESUMEN DEL ARTÍCULO CITADO:
Performance of techniques used for re-attachment of endodontically treated crown fractured teeth
Alessandro Dourado Loguercio, Gilmara Leski, Daiana Sossmeier
Abstract
Objectives: The aim of this study was to compare the fracture strength of three techniques used to re-attach tooth fragments in sound and endodontically treated fractured teeth with or without fiber post placement. Material and methods: Ninety human lower incisors were randomly divided into three groups of 30 teeth each. In group A teeth were not subjected to endodontic treatment; while teeth from groups B and C were endodontically treated and the pulp chamber restored with a composite resin. All teeth were fractured by an axial load applied to the buccal area in order to obtain tooth fragments. Teeth from each group were then divided into three subgroups, according to the re-attachment technique: bonded-only, buccal-chamfer and circumferential chamfer. Before the re-attachment procedures, fiber posts were placed in teeth from group C using dual cure resin luting cement (Duo-Link). All teeth (groups A–C) had the fragments re-attached using a same dual cure resin luting cement. In the bonded-only group, no additional preparation was made. After re-attachment of the fragment, teeth from groups buccal and circumferential chamfer groups had a 1.0mm depth chamfer placed in the fracture line either on buccal surfaceor along the buccal and lingual surfaces, respectively. Increments of microhybid composite resin (Tetric Ceram) were used in subgroups buccal chamfer and circumferential chamfer to restore the chamfer. The specimens were loaded until fracture in the same pre-determined area. The force required to detach each fragment was recorded and the data was subjected to a three-way analysis of variance where factors Group and Re-attachment technique are independent measures and Time of fracture is a repeated measure factor (first and second) and Tukey’s test (a = 0.05). Results: The main factors Re-attachment technique ( p = 0.04) and Time of fracture ( p = 0.02) were statistically significant. The buccal and circumferential chamfer techniques were statistically similar ( p > 0.05) and superior to the bonded-only group ( p < 0.05). The first time of fracture was statistically superior to second time of fracture ( p < 0.001). Conclusions: The use of fiber post is not necessary for the reinforcement of the tooth structure in re-attachment of endodontically treated teeth. When bonding a fractured fragment, the buccal or circumferential re-attachment techniques should be preferable in comparison with the simple re-attachment without any additional preparation. None of the techniques used for re-attachment restored the fracture strength of the intact teeth
Dourado Loguercio A., et al. PERFORMANCE OF TECHNIQUES USED FOR RE-ATTACHMENT OF ENDODONTICALLY TREATED CROWN FRACTURED TEETH. Journal of Dentistry 2008;36:249-255. Disponible en www.sciencedirect.com
Investigado por Claudia Margarita Camacho Álvarez, Alumna del grupo 2622-2008, FES Iztacala, UNAM
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