Conventional endodontic retreatment and / or endodontic surgery?
Autor: Ms. Vitor Hugo | Publicado: 2010-11-15T07:15:00-08:00


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 Second Estrela et al. (2001) in determining success in endodontics fulfills  criteria, involving clinical examination, radiographic examination and  histopathological analysis.&nbsp; The  professional resources available to the longitudinal control, based  solely on clinical features (signs and symptoms) and radiographic  features. &nbsp;Already  the second Bender et al, there are some clinical and radiographic  criteria representative of endodontic treatment success: 1. No pain and edema,2. Lack of drainage and closure of fistula, 3. Teeth function in normal physiology, 4. Disappearance of periapical bone rarefaction.  According  to Friedman and Stabholtz, endodontic point of view, every time there  is a failure, the choice rests on two basic tenets: periradicular  surgery or conventional endodontic retreatment, which, when properly  prescribed, provide a good prognosis.&nbsp; Since  the choice of either option depends on factors such as access to the  channel, location and anatomic position of the tooth; involvement with  prosthetic pieces, quality of endodontic treatment performed previously,  and periodontal involvement. &nbsp; Lopes et al. (2004) state that retreatment should be given when initial treatment: Upon  radiographic examination, provide inadequate filling; By means of  clinical examination, provide exposure of filling a root canal to the  oral environment for more than 60 days,&nbsp; And failure or clinical examination and radiographs.  Even  within the third clinical indication: Persistence of symptoms;  discomfort to percussion and palpation; fistula or swelling, mobility,  inability to chew.&nbsp; Radiographically,  the presence of periapical bone rarefaction in areas previously  lacking, including lateral rarefactions; periodontal ligament space  increased by more than 2mm; bone repair in the absence of a  periradicular rarefaction, an increase of a radiolucent area, no  formation of new lamina dura, and evidence of a progression re root  resorption. 
 Case Study: 
 History: Woman, 27, was referred to our clinic due to the presence of a fistula in the region of tooth 12.&nbsp;Absence of spontaneous pain and also to percussion. 
&nbsp;Radiographically,  observed the presence of previous endodontic treatment, with lack of  filling material in the apical and lateral condensation disabilities.&nbsp; Radiolucency suggesting chronic periapical abscess.  17/06/2008 17/06/2008   Proposed treatment: endodontic retreatment&nbsp; with exchanges monthly calcium hydroxide paste.    17/06/2008 17/06/2008  Removal procedure: with Gates-Glidden drills 4, 3, 2 and 1 through the middle third. Apical hand files, 40, 35 and 30. &nbsp;Manual retooling final file 70.  Hypochlorite solution with 5.25%.   Medication Used: calcium hydroxide, iodoform (3:1) and CMCP, saline vehicle. 
   07/10/2008 07/10/2008    04/11/2008 04/11/2008  Obturation Technique: Lateral condensation with sealer Endofill (Dentsply).    2/12/2008 2/12/2008    2/12/2008 2/12/2008    8/07/2009 8/07/2009