Endodontic Surgery Associated with Guided Tissue Regeneration Technique: Case Report
DOI:
https://doi.org/10.17921/2447-8938.2019v21n4p336-41Resumo
Abstract
Non-surgical endodontic retreatment should always be the first option for reintervention when the initial endodontic treatment fails. The surgical treatment, called periradicular surgery, will be the procedure of choice when there is no success after the conventional endodontic retreatment. The purpose of this article is to describe clinical case of endodontic surgery, associated with guided tissue regeneration (GTR). A male patient, 24 years old, was referred for endodontic surgery on tooth 12 after two unsuccessful endodontic interventions. During the surgery, osteotomy, lesion curettage, apicectomy, retrograde obturation with Mineral Trioxide Aggregate (MTA), and filling of the bone failure with lyophilized bone and reabsorbable collagen membrane were performed. After six months of follow-up, the patient did not present any type of painful symptomatology. The endodontic surgery, associated with a technique of guided tissue regeneration, was efficient to solve this clinical case.
Keywords: Endodontics. Apicoectomy. Guided Tissue Regeneration.
Resumo
O retratamento endodôntico não cirúrgico deve sempre ser a primeira opção de reintervenção quando o tratamento endodôntico inicial falha. Já o tratamento cirúrgico, ou cirurgia parendodôntica, será o procedimento de escolha quando não há sucesso após o retratamento endodôntico convencional. O objetivo deste artigo é descrever um caso clínico de cirurgia parendodôntica, associada à regeneração tecidual guiada (RTG). O paciente, gênero masculino, 24 anos, foi encaminhado para cirurgia parendodôntica no dente 12 após duas intervenções endodônticas sem sucesso. Durante a cirurgia foram realizadas manobras de osteotomia, curetagem da lesão, apicectomia, obturação retrógrada com Mineral Trióxido Agregado (MTA), além de preenchimento da falha óssea com osso liofilizado e membrana de colágeno reabsorvível. Após seis meses de acompanhamento do caso, o paciente não apresentou nenhum tipo de sintomatologia dolorosa. A cirurgia parendodôntica, associada à técnica de regeneração tecidual guiada, foi eficiente para solucionar este caso clínico.
Palavras-chave: Endodontia. Apicectomia. Regeneração Tecidual Guiada.
Referências
Pirani C, Chersoni S, Montebugnoli L, Prati C. Long-term outcome of non-surgical root canal treatment: a retrospective analysis. Odontology 2015;103(2):185-93 doi: 10.1007/s10266-014-0159-0.
Tabassum S, Khan FR. Failure of endodontic treatment: the usual suspects. Eur J Dent 2016;10(1):144-7 doi: 10.4103/1305-7456.175682.
Siqueira JF Jr. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J 2001;34(1):1-10 doi: 10.1046/j.1365-2591.2001.00396.x
Karunakaran JV, Abraham CS, Karthik AK, Jayaprakash N. Successful nonsurgical management of periapical lesions of endodontic origin: a conservative orthograde approach. J Pharm Bioallied Sci 2017;9:S246-S251 doi: 10.4103/jpbs.JPBS_100_17.
Öğütlü F, Karaca İ. Clinical and radiographic outcomes of apical surgery: a clinical study. J Maxillofac Oral Surg 2018;17(1):75-83 doi: 10.1007/s12663-017-1008-9.
Deng Y, Zhu X, Yang J, Jiang H, Yan P. The effect of regeneration techniques on periapical surgery with different protocols for different lesion types: a meta-analysis. J Oral Maxillofac Surg 2016;74(2):239-46 doi: 10.1016/j.joms.2015.10.007.
Tsesis I, Rosen E, Tamse A, Taschieri S, Del Fabbro M. Effect of guided tissue regeneration on the outcome of surgical endodontic treatment: a systematic review and meta-analysis. J Endod 2011;37(8):1039-45 doi: 10.1016/j.joen.2011.05.016.
Gutmann JL, Harrison JW. Posterior endodontic surgery: anatomical considerations and clinical techniques. Int Endod J 1985;18(1):8-34 doi: 10.1111/j.1365-2591.1985.tb00415.x.
von Arx T. Apical surgery: A review of current techniques and outcome. Saudi Dent J 2011;23(1):9-15 doi: 10.1016/j.sdentj.2010.10.004.
Pop I. Oral surgery: part 2. Endodontic surgery. Br Dent J 2013;215(6):279-86 doi: 10.1038/sj.bdj.2013.876.
Lin YC, Lee YY, Ho YC, Hsieh YC, Lai YL, Lee SY. Treatment of large apical lesions with mucosal fenestration: a clinical study with long-term evaluation. J Endod 2015;41(4):563-7 doi: 10.1016/j.joen.2014.11.020.
Torabinejad M, Watson TF, Pitt Ford TR. Sealing ability of a mineral trioxide aggregate when used as a root end filling material. J Endod 1993 Dec;19(12):591-5 doi: 10.1016/S0099-2399(06)80271-2
Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod 2009;35(7):930-7 doi: 10.1016/j.joen.2009.04.023.
Villa-Machado PA, Botero-Ramírez X, Tobón-Arroyave SI. Retrospective follow-up assessment of prognostic variables associated with the outcome of periradicular surgery. Int Endod J 2013;46(11):1063-76 doi: 10.1111/iej.12100.
Lieblich SE. Current concepts of periapical surgery. Oral Maxillofac Surg Clin North Am. 2015;27(3):383-92 doi: 10.1016/j.coms.2015.04.009
Velvart P, Peters CI. Soft tissue management in endodontic surgery. J Endod 2005;31(1):4-16 doi: 10.1097/01.DON.000014532.08454.5c
Gagliani M, Taschieri S, Molinari R. Ultrasonic root-end preparation: influence of cutting angle on the apical seal. J Endod 1998;24(11):726-30 doi: 10.1016/S0099-2399(98)80162-3
Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part I: chemical, physical, and antibacterial properties. J Endod 2010;36(1):16-27 doi: 10.1016/j.joen.2009.09.006.
Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part III: Clinical applications, drawbacks, and mechanism of action. J Endod 2010;36(3):400-13 doi: 10.1016/j.joen.2009.09.009.
Jain A, Ponnappa KC, Yadav P, Rao Y, Relhan N, Gupta P, et al. Comparison of the root end sealing ability of four different retrograde filling materials in teeth with root apices resected at different angles - an invitro study. J Clin Diagn Res 2016;10(1):ZC14-7 doi: 10.7860/JCDR/2016/15437.7042.
Chi CS, Andrade DB, Kim SG, Solomon CS. Guided tissue regeneration in endodontic surgery by using a bioactive resorbable membrane. J Endod 2015;41(4):559-62 doi: 10.1016/j.joen.2014.10.018.
Calişkan MK. Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review. Int Endod J 2004;37(6):408-16 doi: 10.1111/j.1365-2591.2004.00809.x.
Lin LM, Ricucci D, Lin J, Rosenberg PA. Nonsurgical root canal therapy of large cyst-like inflammatory periapical lesions and inflammatory apical cysts. J Endod 2009;35(5):607-15. doi: 10.1016/j.joen.2009.02.012.
Sánchez-Torres A, Sánchez-Garcés MÁ, Gay-Escoda C. Materials and prognostic factors of bone regeneration in periapical surgery: a systematic review. Med Oral Patol Oral Cir Bucal 2014;19(4):e419-25 doi: 10.4317/medoral.19453.
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