Eugenia Pilar Consoli Lizzi

The purpose of this investigation was to establish a clinical diagnosis of the cause of instrument fracture and to evaluate its impact on fragment removal success. One hundred cases of fractured endodontic instruments were analyzed to determine the relationship between fracture cause (flexion, torsion, or combined) and removal outcomes. A diagnostic protocol was developed to classify the fracture mechanism based on radiographic findings, clinical observations, and instrument-related parameters. Fragment length, intracanal location, and removal time were recorded. Torsion was the most frequent cause (54%), followed by combined fracture (33%) and flexion (13%). Flexion-related fragments were significantly longer, located in more accessible areas, and exhibited lower mechanical retention, resulting in shorter removal times (mean: 19.62 min). In contrast, torsion-related fragments were shorter, showed greater retention, and required longer removal times (mean: 32.98 min). Statistical analysis demonstrated a significant association between fracture cause, fragment location, and removal time. The fracture mechanism may serve as a predictive clinical factor for fragment removal difficulty. Early identification of this parameter can improve treatment planning and optimize clinical resource management.

El propósito de esta publicación es presentar la resolución ortógrada de dos casos clínicos inusuales en los que perforaciones radiculares fueron tratadas erróneamente como conductos radiculares, con obturación endodóntica directa en el espacio periodontal. Las piezas dentarias tratadas correspondieron a dos pacientes derivadas a la Cátedra de Endodoncia de la Facultad de Odontología de la Universidad de Buenos Aires. En ambos casos, la inspección radiográfica y clínica reveló la presencia de gutapercha en perforaciones radiculares, sin el tratamiento del conducto real. Los procedimientos realizados incluyeron remoción ortógrada del material obturador mediante tracción pasiva con micropinzas bajo magnificación, localización y tratamiento del conducto original, y sellado del defecto con el material más adecuado, según la localización de la perforación. Ambos tratamientos fueron completados en una sola sesión. Ambos casos destacan la importancia de la correcta identificación del sistema de conductos, el uso de magnificación y la selección adecuada de materiales.

Portigliatti R, et al. Restor Dent Endod. 2024 Sep;49:e35. https://doi.org/10.5395/rde.2024.49.e35

The aim of the present study was to evaluate the presence of maxillary first and second molars with a C-shaped canal system in an Argentine subpopulation, and to classify them. Materials and Method: Of the 332 CBCTs initially evaluated, 120 met the selection criteria. Once the presence of a C-shaped canal system had been established, the teeth were classified following Martins et al. Data were expressed as absolute frequencies, percentages with of 95% confidence intervals, according to the score test. Comparisons were analyzed by Chi-square test and Fisher’ exact test, with 5% significance level. Results: It was found that 5 out of 120 first molars (4%) and 17 out of 152 second molars (11%) had a C-shaped canal system. Regarding the classification applied, of 5 C-shaped first molars, 2 corresponded to type E2 (40%), 2 corresponded to type C (40%), and 1 corresponded to type B1 (20%). Of 17 C-shaped second molars, 4 resembled a type A (24%), 7 resembled a type B1 (41%), 5 resembled a type B2 (29%), and 1 resembled a type C (6%). UC1 and UC2 configurations were the most common at all levels except apical level. Conclusion: The prevalence of C-shaped canal system pattern in maxillary first and second molars was estimated for the first time in an Argentine subpopulation, in vivo. Knowledge of these data should help clinicians during endodontic treatment. Keywords: maxillary molars - C-shaped root canal - cone-beam computed tomography

Resolution of Odontogenic Sinus Pathosis by Endodontic Microsurgery

In the field of anthropology, discrete traits are considered as minimal epigenetic variations. However, they can elicit complications in endodontic therapy. Thorough understanding of root canal morphology is essential to achieving predictable results in endodontic practice, and may be attained by using cone-beam computed tomography (CBCT) scans. The aim of the present study was to research the internal root anatomy of maxillary central and lateral incisors in vivo and quantify its variation in a population of the Autonomous City of Buenos Aires, Argentina. A total 697 CBCT scans from a pre-existing database were observed, and the configuration type for each tooth was determined according to Vertucci’s classification. The data were described by absolute frequencies and percentages with 95% confidence intervals (CI). The CI was estimated by the Wilson Score method.Chi-square test (χ2 ) was used for comparing frequencies, with a 5% significance level. 238 CBCT scans met the inclusion criteria, resulting in 761 teeth assessed. Vertucci Type I configuration was observed in 760 teeth (99.9%) and the Type II was found in only one tooth (0.1%), in which the anatomy was compatible with dens in dente. When differences were analyzed according to sex, all the teeth in all women had Vertucci Type I configuration. In men, all maxillary central incisors were Vertucci Type I. Of 151 maxillary lateral incisors, 150 had Vertucci Type I configuration (99.3%) and 1 had Type II (0.7%). Conclusions: Maxillary incisor internal root anatomy prevalence was estimated from CBCT scans for the first time in an Argentine population. 99.9% of the sample presented Vertucci Type I configuration, and 0.1% had Vertucci Type II configuration. The clinical finding of maxillary incisors with anatomical complexity should be considered as a possibility in endodontic practice.