Odontogenic sinusitis (OS) is a highly prevalent, underappreciated and underdiagnosed disease that has been known for over 100 years. Apical periodontitis, periodontal disease and iatrogenic extrusion of foreign bodies into the sinus are the main causes of OS. Although the prevalence of sinus pathosis of dental origin is still controversial, otolaryngologists recognize that in the presence of recalcitrant sinusitis, a dental origin should be considered and properly treated. Currently, cone-beam computed tomography is the gold-standard imaging technique to assess the relationship between dental conditions, especially apical periodontitis and sinus diseases, and whenever this association is detected, patients should be seen by both a dentist and an otolaryngologist in order to achieve complete recovery. This article reviews the current concepts regarding the definitions, diagnosis and management of OS from a clinical point of view.
Objetivo: O objetivo da presente revisão de literatura foi discutir a relação entre a infecção secundária e a infecção persistente e o insucesso endodôntico. Material e Métodos: Foi realizada uma pesquisa bibliográfica abrangendo artigos de revisão e de pesquisa, a partir de buscas em bases de dados SciELO, Periodicos CAPES, PubMed e MedLine utilizando os seguintes descritores: endodontia, periodontite periapical, infecção. Foram incluídos artigos publicados no período de 1990 a 2016 e escritos nas línguas inglesa e portuguesa. Além disso, os artigos foram selecionados após a leitura do seu resumo e a verificação da adequação do mesmo ao conteúdo dessa revisão. Resultados: A literatura atual parece concordar que a desinfecção inadequada do sistema de canais radiculares e mecanismos de adaptação e resistência microbiana desempenham papel importante no insucesso endodôntico. Porém, a mesma ainda é controversa com relação ao papel do E. faecalis nesses casos de insucesso. Conclusão: Pode-se concluir, dentro das limitações do presente estudo, que o respeito às técnicas endodônticas é fundamental para obter sucesso e que novos estudos, utilizando proteômica, podem contribuir para esclarecer quais os principais micro-organismos envolvidos, bem como seu mecanismo de ação.
To assess the root canal system morphology of mandibular molars by means of micro-computed tomography, one hundred and four mandibular first molars were investigated and the following were evaluated: Vertucci's classification, the presence of lateral canals and the number of apical foramina. Mesial root canal surface area and volume were obtained by the CTAn and CTvol software. The type of root canal isthmi was classified applying the Hsu & Kim and Fan criteria. The most frequent root canal configuration was Vertucci type IV (46.2%). Lateral canals were observed in all root canal thirds and the average number of apical foramina was 3.15 ± 1.77. Regarding the presence of isthmus, Types I and II were the most prevalent, according to Hsu & Kim and Fan et al. criteria, respectively. Mesial root canals of mandibular molars showed high morphology variability.
BackgroundAn osteoma is a benign tumor of bone with unknown etiology and is considered rare, mostly restricted to the craniofacial skeleton.Case presentationThis case report describes an uncommon condylar osteoma in a 67 years old white female patient with laterognathism to the left side, limited mouth opening, aesthetic change and pain associated with the right temporomandibular joint (TMJ). The histopathological examination confirmed osteoma. The lesion was surgically excised and immediate reconstruction was carried out using a custom-made total TMJ prosthesis. The patient has been in follow-up for 2 years, with no symptoms.ConclusionsUnilateral total TMJ prosthesis can be considered to replacement of TMJ after osteoma excision with resection of the condyle.
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