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Through three clinical cases, the authors demonstrate that large lesion do not compromise the teeth. Endodontic surgery could be used as the ultimate solution when classical root canal therapy fails to repair the lesion.
Retrograde filling consists in sealing endodontics system directly at the apical zone after surgical approach. This article is studying the best approach by flap surgery adapted to anatomo-pathological data of each case.
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In an in vitro study the sealing properties of materials commonly used for retrograde filling of apicectomized teeth were investigated in extracted teeth and compared with those of ionomeric vitreous cement. Materials tested included: --Heat-sealed guttapercha; --Guttapercha + phosphate cement; --Amalgam; --Standardized ceramic pins (Ulm system); and --Ionomeric vitreous cement. Sealing was established by methylene blue perfusion. Seals produced by heat-sealed guttapercha, guttapercha + phosphate cement and non-gamma-2 amalgam were found to be inferior to those obtained with ionomeric vitreous cement and standardized aluminium oxide ceramic pins.
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With Gluma a methacrylate-based resin may be chemically bonded to dentin with considerable strength. Resin may therefore be used for retrograde root fillings. Whereas a retrograde amalgam filling demands a box-like preparation, retroplast (Gluma and resin) may be applied to a slightly concave root surface. It may therefore be employed in areas normally inaccessible with amalgam technique. Retroplast can thus be used on roots of all molars and to restore root perforations, root resorptions, cracks, grooves and defects of the root. In addition on lateral canals, on extremely thin roots and to cover perforating root canal posts, this technique can also be used. Dentin/root-cement transplantation may be performed for the purpose of reattachment. The article discusses the technique and its applications with examples showing that it may result in satisfactory healing.
Gluma, an aqueous solution containing 5% glutaraldehyde and 35% HEMA, may bond resin chemically to dentin with considerable strength and without cracks. In retrograde root filling, Gluma and resin (retroplast), can adhere to a flat or slightly concave root surface, so that it may be employed to otherwise inaccessible roots. Gluma may cause toxic reactions, but properly used, it is tolerated well. Of 400 consecutive cases with retroplast, 388 were controlled (99 front teeth, 86 premolars and 203 molars) up to 1 year after operation. The healing after these was compared with a series of retrograde amalgams with the same number and distribution in the various tooth types 1 year postoperatively. The result after retroplast was 74% complete healing, 4% fibrous healing, 15% uncertain and 7% failures. After retrograde amalgam 59% complete healing, 3% fibrous healing, 30% uncertain and 8% failures. Complete healing occurred significantly more often after retroplast than after amalgam (P less than 0.00005). After retroplast significantly fewer cases with complete healing occurred in lower front teeth than in other tooth types. There were no significant differences in the occurrence of postoperative complications after retroplast and amalgam. There were two patients with serious osteitis after retroplast.
The aim of the present investigation was to compare the quality of retrograde amalgam fillings made under the control of the naked eye and that of a stereomicroscope. The 58 extracted upper incisors used for study had been divided into two groups and were filled with one of the control methods. In both groups on 25 teeth the microleakage was assessed by dye diffusion, the surfaces of the remaining 4 teeth were subjected to SEM examination. The depths and angle belonging to the stained sections of the perimeter had been measured under a stereomicroscope with a magnification of 40 and the area affected was calculated. Significantly (p less than 0.001) less area was involved in the stereomicroscopic group (1.46 +/- 0.34 mm2) than in the naked eye group (3.89 +/- 1.80 mm2). The SEM photographs demonstrated the faults which can be eliminated by the use of a stereomicroscope and showed also those which derive from the physical and chemical properties of the amalgam.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.