Resumo O objetivo foi avaliar as propriedades físico-químicas e a penetrabilidade nos túbulos dentinários da solução de hipoclorito de cálcio [Ca(OCl)2], com ou sem surfactantes. Os surfactantes cloreto de benzalcônio, cetrimida, Tween 80 e Triton X-100 foram misturados em diferentes concentrações com a solução de hipoclorito de sódio (NaOCl), Ca(OCl)2 e água destilada (controle). Uma vez determinada a concentração micelar crítica (CMC) dos surfactantes em Ca(OCl)2 e NaOCl, foram avaliados o pH, cloro livre, tensão superficial e íons de cálcio livre. A penetrabilidade nos túbulos dentinários de NaOCl e Ca(OCl)2, com ou sem cloreto de benzalcônio e Triton X-100 [surfactantes que promoveram a menor tensão superficial de [Ca(OCl)2] foi avaliada utilizando pré-molares humanos corados com cristal violeta. Os testes estatísticos foram ANOVA de uma via e pós-teste de Tukey, Kruskal-Wallis e pós-teste de Dunn, ANOVA de duas vias e pós-teste de Bonferroni, e teste t; dependendo do ensaio. A adição de surfactantes reduziu a tensão superficial do NaOCl e Ca(OCl)2, e não alterou o pH ou cloro livre das soluções. A adição de todos os surfactantes aumentou a disponibilidade de íons de cálcio livre de Ca(OCl)2, principalmente o cloreto de benzalcônio. Ca(OCl)2 apresentou menor penetrabilidade nos túbulos dentinários do que NaOCl, e a adição de surfactantes não aumentou a penetrabilidade de Ca(OCl)2, mas aumentou a penetrabilidade de NaOCl. Pode-se concluir que a adição de surfactantes no Ca(OCl)2 não aumentou a penetrabilidade nos túbulos dentinários, mas promoveu menor tensão superficial, sem alterar os valores de pH ou cloro livre, e maior disponibilidade de íons de cálcio livre em Ca(OCl)2.

Abstract The aim was to assess the physicochemical properties and the penetration into dentinal tubules of calcium hypochlorite solution [Ca(OCl)2], with or without surfactants. The surfactants benzalkonium chloride, cetrimide, Tween 80 and Triton X-100 were mixed at different concentrations with sodium hypochlorite solution (NaOCl), Ca(OCl)2 and distilled water (control). Once the critical micellar concentration (CMC) of the surfactants in Ca(OCl)2 and NaOCl was determined, pH, free chlorine, surface tension and free calcium ions were evaluated. The penetration into dentinal tubules of NaOCl and Ca(OCl)2, with or without benzalkonium chloride and Triton X-100 [surfactants that promoted the lowest surface tension of Ca(OCl)2], was assessed using human premolars stained with crystal violet. The statistical tests were one-way ANOVA and Tukey’s post-test, Kruskal-Wallis and Dunn’s post-test, two-way ANOVA and Bonferroni’s post-test, and t-test; depending on the assay. The addition of surfactants reduced the surface tension of NaOCl and Ca(OCl)2, and did not alter the pH or the free available chlorine of either solution. The addition of all surfactants increased the availability of free calcium ions in Ca(OCl)2, especially benzalkonium chloride. Ca(OCl)2 exhibited lower penetration into dentinal tubules than NaOCl, and the addition of surfactants did not improve the penetration of Ca(OCl)2, but did increase the penetration of NaOCl. It can be concluded that the addition of surfactants to Ca(OCl)2 did not increase the penetration into dentinal tubules, but it did promote lower surface tension, without changing the pH or free available chlorine values, and higher availability of free calcium ions in Ca(OCl)2.

Abstract Objective: To assess the effects of different peracetic acid (PAA) formulations on smear layer (SL) removal, dentine erosion, cytotoxicity, and antibiofilm activity. Methodology: SL removal and dentine erosion were assessed using 90 premolars, distributed into six groups, according to final irrigation: PAA formulations (1% Sigma, 1% Bacterend OX, 1% Arposept, and 0.09-0.15% Anioxyde), 17% ethylenediaminetetraacetic acid (EDTA), and water (control). Cytotoxicity was assessed by methyl-thiazol-tetrazolium (MTT) and neutral red assays. Antibacterial and antibiofilm effectiveness was evaluated against Enterococcus faecalis. For cytotoxicity and antibiofilm activity assessment, the 2.5% NaOCl was also included. Results: EDTA, Sigma, and Bacterend OX removed more SL than Arposept, Anioxyde, and water (p<0.05). EDTA caused more severe dentine erosion than Sigma and Bacterend OX (p<0.05). Sigma and Bacterend OX had higher cytotoxicity than the other solutions (p<0.05). NaOCl, Bacterend OX, Sigma, and Anioxyde significantly reduced E. faecalis colony-forming units (CFU) (p<0.05). The 2.5% NaOCl solution promoted greater biofilm biomass reduction (p<0.05) than the other solutions. All PAA formulations promoted greater biomass reduction than 17% EDTA (p<0.05). Conclusions: Although Sigma and Bacterend OX had higher cytotoxicity, they had a SL removal capability similar to that of EDTA, were as effective as NaOCl against E. faecalis biofilm, and promoted less dentine erosion than EDTA. Arposept and Anioxyde failed to remove the SL, had lower cytotoxicity, and showed less bacterial activity than NaOCl.

ABSTRACT Two patients attended at the Endodontics Department to evaluate teeth 35 and 46. Both teeth had a history of post placement in a recent endodontic treatment in tooth 46, and 3 months ago in tooth 35, with evident large perforations in the middle third of their roots. In both cases, perforation sealing was recommended. The posts were removed and white MTA Angelus (Angelus, Londrina, PR, Brazil) was placed in the perforations of both cases. Finally, the root canals were obturated using the continuous wave technique. The 6-month, 2-year and 6-years follow-ups (tooth 35), and 3-month, 1-year and 3-year follow-ups (tooth 46) showed a favorable evolution. It can be concluded that the application of MTA in iatrogenic perforations promoted good results, allowing the maintenance of the teeth in function.

RESUMEN Dos pacientes acudieron al departamento de Endodoncia para evaluar las piezas dentarias 35 y 46. Ambas piezas tenían antecedente de colocación de poste en un tratamiento endodóntico reciente en la pieza 46, y hacía 3 meses en la pieza 35, con perforaciones de gran tamaño, evidentes en el tercio medio radicular. En ambos casos se recomendó el sellado de perforaciones. Se retiraron los postes y se colocó MTA Angelus blanco (Angelus, Londrina, PR, Brasil) en las perforaciones de ambos casos. Finalmente, los conductos radiculares se obturaron utilizando la técnica de onda continua. Los controles de 6 meses, 2 años y 6 años (pieza 35) y los controles de 3 meses, 1 año y 3 años (pieza 46) mostraron una evolución favorable. Se puede concluir que la aplicación de MTA en perforaciones iatrogénicas promueve buenos resultados, permitiendo el mantenimiento de los dientes en función dentro de la cavidad oral.

ABSTRACT: Orthognathic surgery is performed for the correction of craniofacial discrepancies. However, complications, such as tooth discoloration are possible. This case report presents two patients who underwent bilateral sagittal split ramus osteotomy associated with segmental Le Fort I osteotomy and genioplasty. During surgeries, the apical region of anterior teeth was accidentally injured in both cases. After three-week surgery follow-up, the injured teeth showed a change in color to dark pink. In both teeth, the root canal treatment was performed followed by the non vital tooth bleaching. Three sessions were necessary to achieve a significant color change of the teeth. The two-year follow-up showed that both teeth preserved an acceptable color. It was concluded that tooth discoloration after orthognathic surgery is a possible complication, which could be overcome following a conservative approach. Additionally, patients should be informed preoperatively.

RESUMEN: La cirugía ortognática es comúnmente realizada para corregir las discrepancias cráneo-faciales. Sin embargo, se pueden producir complicaciones tales como la pigmentación dentaria. Este reporte de casos presenta a dos pacientes que fueron sometidos osteotomía sagital bilateral de la rama mandibular asociada a osteotomía segmentaria Le Fort I y genioplastía. Durante la fase quirúrgica, la región apical de dientes anteriores fueron accidentalmente dañados en ambos casos. Después de tres semanas de seguimiento de la cirugía, los dientes afectados mostraron un cambio de color a rosado oscuro. Se realizó el tratamiento de conductos seguido de aclaramiento interno en ambas piezas dentarias. Fueron necesarias tres sesiones para lograr un cambio de color significativo. El seguimiento de dos años mostró que ambos dientess conservaron un color aceptable. En conclusión, la pigmentación dentaria después de la cirugía ortognática es una posible complicación, sin embargo, puede ser tratada por medio de un enfoque conservador. Además, los pacientes deben ser informados antes de la cirugía.

Abstract The aim of this study was to assess the influence of micro-computed tomography (micro-CT) voxel size on dentinal microcrack detection after root canal preparation using rotary heat-treated nickel-titanium files. Curved mesial root canals (n = 24) of mandibular molars were prepared using ProDesign Logic 30/.05 (PDL) or HyFlex EDM 25/.08 (HEDM). The specimens were scanned by micro-CT at 5 μm voxel size before and after root canal preparation. The percentage of microcracks was evaluated in images at 5, 10 and 20 μm voxel size, by two examiners at two moments. The Kappa and McNemar tests (α = 0.05) were used. The percentage of dentinal microcracks was similar before and after PDL and HEDM preparations, at 10 and 20 μm (p > 0.05). HEDM showed a higher percentage of dentinal microcracks in the middle third at 5 μm after preparation (p < 0.05). The detection of dentinal microcracks before and after instrumentation using PDL was more accurate at 5 μm than at 20 μm, in all thirds (p < 0.05). Within the limitations of this ex vivo study, as expected, the results showed that different resolutions influence the micro-CT analysis of microcracks. The highest accuracy in detecting microcracks was observed for analyses performed at 5 μm voxel size. HyFlex EDM caused even more microcracks to develop in the middle third, detectable only by visualization of images made at 5 μm voxel size.

Resumo Este estudo teve como objetivo avaliar as propriedades físico-químicas de um material reparador disponível no mercado brasileiro, BioMTA, em comparação com outros dois materiais atualmente em uso (Biodentine e MTA Angelus). O tempo de presa inicial foi avaliado usando a agulha de Gillmore. O pH foi medido com um pH-metro após 24 h, 3, 7, 14 e 21 dias. A radiopacidade foi determinada aplicando a equivalência em milímetros de alumínio (mm Al) de radiografias oclusais digitalizadas. A solubilidade foi determinada após imersão em água por 7 dias. Os dados foram analisados por meio dos testes ANOVA de uma via e Tukey (a=0,05). O tempo de presa inicial do BioMTA (5,2 min) foi menor do que os outros materiais (p<0,05). Todos os materiais apresentaram pH alcalino aos 21 dias. Às 24 h, o BioMTA foi o material mais alcalino (p<0,05); e aos 3, 7, 14 e 21 dias não houve diferença entre BioMTA e Biodentine (p>0,05), sendo ambos mais alcalinos que MTA Angelus (p<0,05). A radiopacidade do BioMTA (4,2 mm Al) foi significativamente maior em comparação ao Biodentine (p<0,05) e menor que o MTA Angelus (p<0,05). A solubilidade dos materiais foi de -4,2%, -1,6% e 4,1% para BioMTA, MTA Angelus e Biodentine, respectivamente, havendo diferença significativa entre eles (p<0,05). Portanto, pode-se concluir que o BioMTA apresentou um menor tempo de presa, pH alcalino, uma alta radiopacidade e um ganho em massa.

Abstract This study aimed to assess the physicochemical properties of a repair material in the Brazilian market, BioMTA, in comparison to other two materials currently in use (Biodentine and MTA Angelus). The initial setting time was evaluated using Gillmore needle. The pH was measured with a pH-meter after 24 h, 3, 7, 14 and 21 days. The radiopacity was determined using the equivalence in millimeters of aluminum (mm Al) from digitized occlusal radiographs. Solubility was determined after immersion in water for 7 days. The data were analyzed by one-way ANOVA and Tukey tests (a=0.05). The BioMTA initial setting time (5.2 min) was lower than the other materials (p<0.05). All materials showed an alkaline pH at 21 days. At 24 h, BioMTA was the most alkaline material (p<0.05); and at 3, 7, 14 and 21 days there was no difference between BioMTA and Biodentine (p>0.05), both being more alkaline than MTA Angelus (p<0.05). The radiopacity of BioMTA (4.2 mm Al) was significantly higher compared to Biodentine (p<0.05) and lower than MTA Angelus (p<0.05). The solubility of the materials was -4.2%, -1.6% and 4.1% for BioMTA, MTA Angelus and Biodentine, respectively, with a significant difference between them (p<0.05). Therefore, it can be concluded that BioMTA displayed a shorter setting time, an alkaline pH, a higher radiopacity, and a gain in mass.

Abstract The aims of the present study were to compare conventional radiography, radiographs digitized with a scanner or photographic camera, and digital radiography, used to evaluate the radiopacity of endodontic materials, and to compare the accuracy of linear and quadratic models used to convert radiopacity values to equivalent millimeters of aluminum (mm Al). Specimens of AH Plus, Endofill, Biodentine and BioMTA materials (n = 8) were radiographed next to an aluminum step-wedge using radiographic films and digital radiography systems (FONA CMOS sensor, Kodak CMOS sensor and photosensitive phosphor plate-PSP). Conventional radiographs were digitized using a scanner or photographic digital camera. Digital images of all the radiographic systems were evaluated using dedicated software. Optical density units (ODU) of the specimens and the aluminum step-wedge were evaluated by a photo-densitometer (PTDM), used in conventional radiographs. The radiopacity in equivalent mm Al of the materials was determined by linear and quadratic models, and the coefficients of determination (R2) values were calculated for each model. Radiopacity of the materials ranged from -9% to 25% for digital systems and digitized radiographs, compared to the PTDM (p < 0.05). The R2 values of the quadratic model were higher than those of the linear model. In conclusion, the FONA CMOS sensor showed the lowest radiopacity variability of the methodologies used, compared with the PTDM, except for the BioMTA group (higher than PTDM). The quadratic model showed higher R2 values than the linear model, thus indicating better accuracy and possible adoption to evaluate the radiopacity of endodontic materials.

Resumo Para a seleção do irrigante endodôntico deve-se considerar os possíveis efeitos citotóxicos. O objetivo foi avaliar os efeitos do hipoclorito de cálcio [Ca(OCl)2] e do cloridrato de octenidina (OCT) em células L929 e do ligamento periodontal humano (hPDL). As células foram expostas a diferentes doses das soluções: Ca(OCl)2 2,5% e 5%, OCT 0,1%, hipoclorito de sódio (NaOCl) 2,5% e clorexidina (CHX) 2%. A viabilidade celular foi avaliada pelos ensaios de metil-tiazol-tetrazólio (MTT) e vermelho neutro (NR), e a proliferação/migração pelo teste de cicatrização. Os resultados foram analisados por ANOVA de duas vias e Bonferroni (α=0,05). Os ensaios MTT e NR mostraram que OCT 0,1% foi menos citotóxico nas células do hPDL (p<0,05), seguido da CHX 2% e Ca(OCl)2 2,5% (p<0,05). Não houve diferença entre NaOCl 2,5% e Ca(OCl)2 5% (p>0,05). No entanto, estas soluções foram mais citotóxicas que as demais. O resultado foi o mesmo nas células L929, exceto que não houve diferença significativa entre CHX 2% e Ca(OCl)2 2,5% (p>0,05). A proliferação/migração das células L929 e do hPDL às 24 h nos grupos OCT 0,1%, CHX 2%, e Ca(OCl)2 2,5% foi maior que nos grupos Ca(OCl)2 5% e NaOCl 2,5% (p<0,05). Concluiu-se que OCT foi menos citotóxico que CHX, Ca(OCl)2 e NaOCl. Ca(OCl)2 2,5 e 5% apresentaram citotoxicidade menor ou similar ao NaOCl 2,5%, respectivamente. Os grupos OCT, CHX e Ca(OCl)2 2,5% apresentaram maior proliferação/migração celular do que os grupos do Ca(OCl)2 5% e NaOCl 2,5%. Portanto, OCT e Ca(OCl)2 têm potencial para serem utilizados como irrigantes endodônticos.

Abstract The aim of this study was to assess cytotoxicity and cell migration of calcium hypochlorite [Ca(OCl)2] and octenidine hydrochloride - OCT (Octenisept®, Schülke & Mayr, Norderstedt, Germany) in L929 and human periodontal ligament (hPDL) cells. The cells were exposed to different doses of different solutions: 2.5% and 5% Ca(OCl)2, 0.1% OCT, 2.5% NaOCl and 2% CHX for 10 min. Cell viability was assessed by methyl-thiazol-tetrazolium (MTT) and neutral red (NR) assays, and cell migration was determined by wound-healing assay. Statistical analysis was performed by two-way ANOVA and Bonferroni tests (α=0.05). The MTT and NR assays revealed that 0.1% OCT was less cytotoxic in hPDL cells (p<0.05), followed by 2% CHX and 2.5% Ca(OCl)2 (p<0.05). There was no significant difference between 2.5% NaOCl and 5% Ca(OCl)2 (p>0.05), but these solutions showed greater cytotoxicity than the others. The result was the same for L929 cells, except that there was no significant difference between 2% CHX and 2.5% Ca(OCl)2 (p>0.05). Wound-healing assay in L929 and hPDL cells showed that cell migration of 0.1% OCT, 2% CHX and 2.5% Ca(OCl)2 groups was higher than 5% Ca(OCl)2 and 2.5% NaOCl groups at 24 h (p<0.05). In conclusion, 0.1% OCT had lower cytotoxicity in tested cell lines than CHX, Ca(OCl)2 and NaOCl. Cell migration was higher for 0.1% OCT, 2% CHX and 2.5% Ca(OCl)2. Therefore, in terms of cytotoxicity, OCT and Ca(OCl)2 have the potential to be used as root canal irrigants.

Objectives: To describe the macroscopic, microscopic characteristics and material characterization of nickel titanium (NiTi) ProTaper Universal system scompared to similar instruments of dubious origin. Material and methods: Macroscopic analysis was performed using macro photography of the boxes and files. For microscopic analysis, S1 and F1 files were used, which were sectioned and analyzed by scanning electron microscopy comparing active parts and cross-sections at 300-550X magnification. Additionally, the characterization of fragments was performed by energy dispersive x-ray microanalysis (EDX). Results: Macroscopic analysis showed that boxes differed in design and specifications. File shanks showed differences in shape, color, finish. The active part of some files showed differences in diameter, shape and finish. Microscopic analysis indicated that adulterated files showed less sharp cutting angles and absence of triangular convexities. By EDX, comparing the chemical composition of the instruments, it was shown that both instruments have a composition Ni-Ti like. Conclusions: The major differences between ProTaper Universal system and its counterpart adulterated, were presented in macroscopic analysis. Microscopic analysis showed differences mainly in cross-section configuration.

Objetivos: Describir las características macroscópicas, microscópicas y la caracterización del material de instrumentos rotatorios de Níquel-Titanio (NiTi), ProTaper Universal, en comparación con instrumentos similares de dudosa procedencia. Material y métodos: El análisis macroscópico se realizó por medio de fotografía macro de las cajas e instrumentos. Para el análisis microscópico, se utilizaron los instrumentos S1 y F1, los cuales fueron seccionados y analizados a través de Microscopía electrónica de barrido comparando las partes activas y las secciones transversales con una magnificación de 300 a 550X. Adicionalmente, se realizó la caracterización de los fragmentos, a través de microanálisis por dispersión de energías de rayos-X (EDX). Resultados: Al análisis macroscópico, las cajas de los sistemas presentaron diferencias en el diseño y especificaciones, los vástagos de los instrumentos presentaron diferencias de forma, color y acabado, y las partes activas de algunos instrumentos, presentaron diferencias de diámetro, forma y acabado. Al análisis microscópico, los instrumentos adulterados presentaron ángulos de corte menos afilados y ausencia de convexidades triangulares. Al comparar la composición química de los instrumentos, el análisis EDX mostró que ambos instrumentos tienen una composición Ni-Ti similar. Conclusiones: Las mayores diferencias entre el sistema ProTaper Universal y su homólogo adulterado se presentaron en el análisis macroscópico. El análisis microscópico presentó diferencias principalmente en el formato de la sección transversal.

Resumo O objetivo deste trabalho foi avaliar in vitro a citotoxicidade em fibroblastos do ligamento periodontal humano de três cimentos de retrobturação: MTA Angelus(r), EndoSequence Root Repair Material Putty(r) e Super EBA(r). Uma cultura de fibroblastos primários do ligamento periodontal humano foi obtida anteriormente a fim de avaliar a citotoxicidade dos três extratos dos cimentos de retrobturação após 2 e 7 dias de endurecimento. As diluições em série destes extratos (1:1, 1:2, 1:4 e 1:8) foram avaliados em 1, 3 e 7 dias empregando o ensaio colorimétrico metil-tiazol-tetrazólio (MTT). A viabilidade celular foi calculada em base da porcentagem do grupo de controle negativo, que representou 100% de viabilidade de células. As análises estatísticas foram realizadas com o teste t, ANOVA e teste de Kruskal-Wallis a um nível de significância de 5%. Verificou-se que a principal diferença entre os cimentos de retrobturação estava nas diluições mais elevadas (p<0,05) e houve um comportamento semelhante nas diluições mais baixas (p>0,05). A viabilidade celular dos fibroblastos do ligamento periodontal humano foi superior para MTA Angelus(r) de 2 dias de endurecimento (p<0,05), em comparação com os outros materiais de retrobturação. Não houve diferença significante entre MTA Angelus(r) e EndoSequence Root Repair Material Putty(r) de 7 dias de endurecimento. Super EBA(r) mostrou a menor percentagem da viabilidade celular nas diluições mais altas (p<0,05). Portanto, os cimentos de retrobturação MTA Angelus(r) e EndoSequence Root Repair Material Putty(r) foram menos citotóxicos na diluição mais alta (1:1) em comparação com Super EBA(r).

Abstract The aim of this study was to evaluate in vitro the cytotoxicity on human periodontal ligament fibroblasts of three root-end filling materials: MTA Angelus(r), EndoSequence Root Repair Material Putty(r) and Super EBA(r). A primary culture of human periodontal ligament fibroblasts was previously obtained in order to evaluate the cytotoxicity of the three extracts from the root-end filling materials after 2 and 7 days of setting. Serial dilutions of these extracts (1:1, 1:2, 1:4 and 1:8) were evaluated at 1, 3 and 7 days using the methyl-thiazol-tetrazolium (MTT) colorimetric assay. Cell viability was evaluated as percentage of the negative control group, which represented 100% cell viability. Statistical analyses were done with t-test, ANOVA and Kruskal-Wallis test at a significance level of 5%. It was found that the main difference among root-end filling materials was in the higher dilutions (p<0.05), but there was a similar behavior in lower dilutions (p>0.05). Cell viability of MTA Angelus(r) was superior for 2-day setting (p<0.05), compared with the other two root-end fillings. There were no statistically significant differences between 7-day set MTA Angelus(r) and EndoSequence Root Repair Material Putty(r). Super EBA(r) showed the lowest percentage of cell viability at higher dilutions (p<0.05). Therefore, MTA Angelus(r) and EndoSequence Root Repair Material Putty(r) were less cytotoxic in the highest dilution (1:1) compared with Super EBA(r).

The apical area is a highly vascular region, and exhibits a tendency to hemorrhage, especially in presence ofgranulation tissue that usually is present in periradicular pathologies. This is highly important for the clinician, because only with a dry fi eld can be obtained a visible operative fi eld that allows a suitable surgery. It is necessary to assess pre-surgical and surgical considerations such as medical history, as well as tissue manipulation before the election of a hemostatic agent. Hemostatic agents have characteristics that make them particularly very different from each other, both presentation and clinical management. The aim of this review is to describe and discuss the most common hemostatic agents available and their impact on contemporary apical surgery.

La zona periapical es una región altamente vascularizada, y exhibe una gran tendencia a la hemorragia, especialmente en presencia de tejido granulomatoso, que suele acompañar las patologías perirradiculares. Esto representa para el clínico un aspecto de suma importancia, ya que solo mediante un campo seco se obtendrá un campo operatorio efectivamente visible que le permita intervenir adecuadamente. Es necesario evaluar consideraciones pre-quirúrgicas y quirúrgicas tales como la historia médica del paciente, así como la manipulación de los tejidos antes de la elección del agente hemostático que se opte por conveniente. Los agentes hemostáticos presentan características que los hacen particularmente muy distintos unos de otros, tanto en su presentación como en su manejo operatorio. La presente revisión bibliográfica describirá y analizará los principales agentes hemostáticos que se encuentran actualmente disponibles en el mercado y su impacto en la cirugía periapical contemporánea.

A conservative philosophy is the most important in contemporary dental practice. It involves not only the conservation of tooth structure, but also the preservation of the surrounding tissues. Intentional replantation is indicated in cases where a proper root canal is extremely difficult, or when an apical surgery may be compromised for various reasons. This literature review will address the indications, contraindications, and technical principles of this paraendodontic surgical procedure. Also, will discuss its feasibility as conservative option before tooth extraction.

La filosofía conservadora es lo más importante en la práctica odontológica contemporánea. No sólo implica la conservación de la estructura dentaria, sino también la preservación de los tejidos circundantes. El reimplante intencional está indicado en casos donde realizar un tratamiento de conductos de manera adecuada es sumamente difícil, o cuando una cirugía apical puede verse comprometida por distintos motivos. La presente revisión bibliográfica abordará las indicaciones, contra indicaciones, principios y técnica de este procedimiento quirúrgico para-endodóntico. Asimismo, se discutirá su conveniencia como opción conservadora antes de la extracción dentaria.