Title LOM INSTUMENTA KAO KOMPLIKACIJA ENDODONTSKE TERAPIJE
Title (english) INSTUMENT FRACTURE AS ROOT CANAL TREATMENT COMPLICATION
Author Petra Ošo
Mentor Alen Braut (mentor)
Committee member Alen Braut (predsjednik povjerenstva)
Committee member Ivana Brekalo-Pršo (član povjerenstva)
Committee member Jelena Prpić (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Endodontics and Restorative Dentistry) Rijeka
Defense date and country 2020-07-24, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Dental Medicine Endodonics and Restorative Dentistry
Abstract Većina se DDM-a susretne s nekom od komplikacija tijekom ili nakon endodontske terapije. Lom
instrumenta u korijenskom kanalu složena je komplikacija koja od DDM-a zahtijeva poznavanje
etioloških čimbenika, terapijskih mogućnosti, kao i prognostičke kriterije.
NiTi instrumenti zbog svojih su elastičnih svojstava široko primijenjeni u mnogim granama
dentalne medicine, pa tako i endodonciji. Usprkos brojnim kvalitetama NiTi legure, ni ovi
instrumenti nisu otporni na lom. Štoviše, lom NiTi je češći od loma instrumenata od nehrđajućeg
čelika. Razlog se pripisuje torzijskom i fleksijskom zamoru, dok je okretni moment uzrok loma
ručnih čeličnih instrumenata. Etiologija loma instrumenta je multifaktorijalna i opisani su brojni
etiološki čimbenici koji imaju utjecaj na nastanak loma. Utjecaj DDM-a nepravilnom upotrebom
te anatomija zuba i endodontskog prostora smatraju se najvažnijima. Učestalost loma je povećana
kod kutnjaka, zakrivljenih korijenskih kanala, malog promjera i u apikalnoj trećini korijenskih
kanala.
Terapijski se postupci mogu podijeliti na nekirurške i kirurške. Nekiruški uključuju ostavljanje
instrumenta, njegovo zaobilaženje ili uklanjanje, a najčešći kirurški je apikotomija. Prvi izbor u
liječenju ove komplikacije je uklanjanje instrumenta. Najučinkovitiji način uklanjanja je
ultrazvučna tehnika kojom se odstranjuje dentin oko odlomljenog fragmenta i vibracijama ispere
iz korijenskog kanala. Nepovoljan utjecaj na dugoročnu prognozu zuba ima postojanje infekcije,
odlomljeni fragment izvan apikalnog otvora, ostavljanje instrumenta i neprimjereno trajno
punjenje korijenskih kanala. Odsustvo patoloških procesa i potpuno uklanjanje ili zaobilaženje
fragmenta osigurat će povoljnu prognozu zuba, koji se mora redovito kontrolirati.
Abstract (english) Dentists may encounter complications in any stage or after endodontic treatment. Intracanal
endodontic instrument fracture with separation is a problematic incident and it requires
knowledge on the contributing factors such as etiology, treatment options, and impact of
fractured instrument on tooth prognosis.
Highly flexible NiTi instruments have become important appliances for root canal preparation.
Despite superior qualities of NiTi files, they fail as a result of cyclical flexural fatigue and
torsional failure, while stainless steel file fractures are associated with torque. Reasons for
fracture are multifactorial, but most important ones are the operator's skill and experience, the
number of uses of the instrument, tooth type, and canal configuration. Molar teeth and the apical
third of decreased diameter and curved canals are prone to cause instrument fracture with
separation.
The management of fractured endodontic instruments involves nonsurgical and surgical
approaches. When the nonsurgical method is chosen, the dentist may decide to leave the
fragment, bypass it, or remove it, while the most common surgical procedure is apicoectomy.
Instrument removal should always be attempted. The most commonly used removal technique is
with ultrasonic devices. The first step is to remove the dentin and create enough space around the
coronal segment for special ultrasonic tips that agitate and loosen fractured instruments. Presence
of periapical disease, fragments extruded beyond the apex, retained instruments and poor
obturation quality have been shown to have a negative impact on prognosis. On the other hand,
when there is no periapical pathology and fractured instruments are bypassed or removed, the
prognosis is more favorable.
Keywords
Komplikacije
Lom
Nehrđajući čelik
Nikal-titanska legura
Uklanjanje instrumenta.
Keywords (english)
Complications
Instrument removal
Nickel-titanium alloy
Separation
Stainless Steel.
Language croatian
URN:NBN urn:nbn:hr:184:772896
Study programme Title: Dental Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
Type of resource Text
File origin Born digital
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Terms of use
Created on 2020-11-04 09:41:04