Endodontic treatment in tooth with pulp necrosis and periapical lesion with Reciproc Blue and XP-Endo Finisher instruments: case report

Authors

DOI:

https://doi.org/10.33448/rsd-v10i13.20823

Keywords:

Endodontics; Dentistry; Primary endodontic infection.

Abstract

The objective of the endodontic treatment is to prevento r eliminate apical periodontitis by means of cleaning, shaping and filling the root canals. Chemomechanical preparation is recognized as one of the most important step for microbial reduction within the root canals. In order to overcome anatomical challenges, especially in cases of curvatures, novel heat treatments to endodontic instrument alloys have been proposed to increase its flexibility. The aim of the present clinical case report is to describe the endodontic procedures performed with Reciproc Blue and XP-Endo Finisher files in an upper lateral incisor with pulp necrosis and presence of periapical lesion. Male patient was referred to the Postgraduate Clinic of the Piracicaba Dental School - UNICAMP seeking endodontic treatment. The clinical examination revealed negative response to the pulp sensitivity cold testing. Radiographically, the presence of restoration on the mesial surface and the presence of periapical lesion were observed. Endodontic treatment was undertaken under magnification by using an operating microscope. After local anesthesia and cavity access, endodontic treatment was performed using Reciproc Blue instruments, with the crown-down technique. Patency and foraminal enlargement were performed. The instrumentation level was determined at 1 mm beyond the apical foramen. 2% chlorhexidine gel was used as auxiliary chemical substance and sterile saline solution as an irrigating solution. At the end of the chemical-mechanical preparation, final rinse was performed with 3mL of 17% EDTA, under agitation with the XP-Endo Finisher instrument for 1 minute. Then, the root canal was filled using the single cone technique using medium gutta-percha and endodontic cement (Endomethasone). The gutta-percha cut was performed with a thermoplasticizer instrument, 2 mm below the cementoenamel junction. Coronary sealing was performed by placing coltosol at the entrance of the root canals, followed by the insertion of light-curing composite resin using the incremental technique.

References

Arruda-Vasconcelos, R., Barbosa-Ribeiro, M., Louzada, L. M., Mantovani, G. D., & Gomes, B. P. (2019). Apically Extruded Debris Using Passive Ultrasonic Irrigation Associated with Different Root Canal Irrigants. Braz Dent J. 30 (4):363-367.

Arruda-Vasconcelos, R., Louzada, L. M., Feres, M., Tomson, P. L., Cooper, P. R & Gomes, B. P. F. A. (2021). Investigation of microbial profile, levels of endotoxin and lipoteichoic acid in teeth with symptomatic irreversible pulpitis: a clinical study. Int Endod J. 54 (1):46-60.

Aveiro, E., Chiarelli-Neto, V. M., de-Jesus-Soares, A., Zaia, A. A., Ferraz, C. C. R., Almeida, J. F. A., Marciano, M. A., Feres, M., & Gomes, B. P. F. A. (2020). Efficacy of reciprocating and ultrasonic activation of 6% sodium hypochlorite in the reduction of microbial content and virulence factors in teeth with primary endodontic infection. Int Endod J. 53 (5):604-618.

Bao, P., Shen, Y., Lin, J., & Haapasalo, M. (2017). In vitro efficacy of XP-endo Finisher with 2 different protocols on biofilm removal from apical root canals. J Endod. 43 (2):321-5.

Barbosa-Ribeiro, M., Arruda-Vasconcelos, R., de-Jesus-Soares, A., Zaia, A. A., Ferraz, C. C. R., Almeida, J. F. A & Gomes, B. P. F. A. (2019). Effectiveness of calcium hydroxide-based intracanal medication on infectious/inflammatory contents in teeth with post-treatment apical periodontitis. Clin Oral Investig. 23 (6):2759-2766.

Barbosa-Ribeiro, M., Arruda-Vasconcelos, R., Fabretti, F. L., Silva, E. J. N. L., De-Deus G., & Gomes, B. P. F. A. (2018). Evaluation of Apically Extruded Debris Using Positive and Negative Pressure Irrigation Systems in Association with Different Irrigants. Braz Dent J. 29 (2):184-188.

Barbosa-Ribeiro, M., Arruda-Vasconcelos, R., Louzada, L. M., Dos-Santos, D. G, Andreote, F. D., & Gomes, B. P. F. A. (2021). Microbiological analysis of endodontically treated teeth with apical periodontitis before and after endodontic retreatment. Clin Oral Investig. 25 (4):2017-2027.

Benatti O., Valdrighi L., Biral R.R., Pupo J. (1985). A histological study of the effect of diameter enlargement of the apical portion of the root canal. J Endod. 11:428-434.

Carvalho, M. C., Zuolo, M. L., Arruda-Vasconcelos, R., Marinho, A. C. S., Louzada, L. M., Francisco, P. A., Pecorari, V. G. A., & Gomes, B. P. F. A. (2019). Effectiveness of XP-Endo Finisher in the reduction of bacterial load in oval-shaped root canals. Braz Oral Res. 33 (1): 021.

De Deus, Q. D. Endodontia. (5a ed.), MEDSI, 1992.

De-Deus, G., Silva, E. J., Vieira, V. T., Belladonna, F. G., Elias, C. N., Plotino, G & Grande, N. M. (2017). Blue Thermomechanical Treatment Optimizes Fatigue Resistance and Flexibility of the Reciproc Files. J Endod. 43 (3):462-466.

Gomes, B. P., Vianna, M. E., Zaia, A. A., Almeida, J. F & Souza-Filho, F. J., Ferraz, C. C. (2013). Chlorhexidine in endodontics. Braz Dent J. 24 (2):89-102.

Herrera, D. R., Martinho, F. C., de-Jesus-Soares, A., Zaia, A. A., Ferraz, C. C. R., Almeida, J. F. A & Gomes, B. P. F. A. (2017). Clinical efficacy of EDTA ultrasonic activation in the reduction of endotoxins and cultivable bacteria Int Endod J. 50 (10):933-940.

Kakehashi, S., Stanley, H. R & Fitzgerald, R. J. (1965). The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 20:340-9.

Keleş, A., Alcin, H., Kamalak, A & Versiani, M. A. (2014). Oval-shaped canal retreatment with self-adjusting file: a micro-computed tomography study. Clin Oral Investig. 18 (4):1147-1153.

Lopes, H. P & Siqueira Jr, F. J. Endodontia: Biologia e técnica. (4a ed.), Editora Elsevier. 2015.

Louzada, L. M., Arruda-Vasconcelos, R., Duque, T. M., Casarin, R. C. V., Feres, M & Gomes, B. P. F. A. (2020). Clinical Investigation of Microbial Profile and Levels of Endotoxins and Lipoteichoic Acid at Different Phases of the Endodontic Treatment in Teeth with Vital Pulp and Associated Periodontal Disease. J Endod. 46 (6):736-747.

Martinho, F. C., Leite, F. R. M., Arruda-Vasconcelos, R., Louzada, L. M., Darveau, R. P & Gomes, B. P. F. A. (2021) Influence of Bacterial Profiles in Cytokine and Clinical Features of Endodontic Disease. J Endod. 47 (8):1265-1271.

Marton, I. J & Kiss, C. (2014). Overlapping protective and destructive regulatory pathways in apical periodontitis. J Endod. 40(1):155-163.

Neves, M. A. S., Provenzano, J. C., Roças, I. N & Siqueira, J. F. (2016). Clinical antibacterial effectiveness of root canal preparation with reciprocating single-instrument or continuously rotating multi-instrument systems. J Endod. 42 (1):25-9.

Ray, H. A & Trope, M. (1995). Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J. 28 (1):12-8.

Sonoda TN. (2011). Avaliação prospectiva da sintomatologia clínica pós-operatória de tratamentos endodônticos realizados em sessão única com patência e ampliação do forame apical. [Dissertação]. Campinas: Centro de Pesquisa São Leopoldo Mandic.

Teves, A., Blanco, D., Casaretto, M., Torres, J., Alvarado, D. E., Coaguila-Llerena, H., Faria, G & Jaramillo, D. E. (2021). Multispecies biofilm removal by XP-endo Finisher and passive ultrasonic irrigation: A scanning electron microscopy study. Aust Endod J. doi: 10.1111/aej.12549. Epub ahead of print.

Versiani, M. A., Leoni, G. B., Steier, L., De-Deus, G., Tassani, S., Pécora, JD & De Sousa-Neto, M. D. (2013). Micro-computed tomography study of oval-shaped canals prepared with the self-adjusting file, Reciproc, WaveOne, and ProTaper universal systems. J Endod. 39 (8):1060-6.

Versiani, M. A., Pécora, J. D & De-Sousa-Neto, M. D. (2011). Flat-oval root canal preparation with self-adjusting file instrument: a micro-computed tomography study. J Endod. 37 (7):1002-7.

Published

17/10/2021

How to Cite

LOUZADA, L. M. .; ALVES-SILVA, E. G. .; LEMOS, B. I. N. .; BARBOS-RIBEIRO, M.; NOGUEIRA, A. V. de S. .; GOMES, B. P. F. de A. .; ARRUDA-VASCONCELOS, R. Endodontic treatment in tooth with pulp necrosis and periapical lesion with Reciproc Blue and XP-Endo Finisher instruments: case report. Research, Society and Development, [S. l.], v. 10, n. 13, p. e406101320823, 2021. DOI: 10.33448/rsd-v10i13.20823. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/20823. Acesso em: 23 nov. 2024.

Issue

Section

Health Sciences