Consolaro Alberto, Miranda Dario Augusto Oliveira, Consolaro Renata Bianco
Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil.
Departamento de Saúde, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil.
Dental Press J Orthod. 2020 May;25(3):20-29. doi: 10.1590/2177-6709.25.3.020-029.oin. Epub 2020 Aug 19.
Endodontically treated teeth may be moved, as endodontic treatment is not a contraindication for orthodontic treatment. Apical periodontal repair begins when the periapical or pulp lesion has completely resolved. This may happen immediately after treatment if the filling material causes little or no irritation of periapical tissues, and particularly if the material is fully contained within the canal. When it leaks, a foreign body granuloma forms and persists for some months or indefinitely, depending on the composition of the filling material. Materials containing calcium hydroxide with no resin components undergo phagocytosis and disappear in some months, as macrophages gradually remove them. Materials containing resins, silicone, ionomers, zinc oxide-eugenol, bioceramics or gutta-percha remain in the site and induce the formation of foreign body granulomas. Although this does not preclude tooth movement, patients should be followed up every three months using periapical images to control the position of the material in relation to the tooth apex. "Pseudo" overfilling may be avoided if permanent filling is delayed until the time when orthodontic treatment is completed.
根管治疗后的牙齿可以移动，因为根管治疗并非正畸治疗的禁忌证。当根尖周或牙髓病变完全消退时，根尖牙周组织开始修复。如果充填材料对根尖周组织几乎没有或没有刺激，尤其是材料完全位于根管内时，治疗后可能立即发生修复。当材料渗漏时，会形成异物性肉芽肿，并持续数月或更长时间，这取决于充填材料的成分。不含树脂成分的氢氧化钙材料会被吞噬细胞吞噬，几个月内消失，因为巨噬细胞会逐渐将其清除。含树脂、硅酮、离聚物、氧化锌丁香油、生物陶瓷或牙胶的材料会留在原位并诱导异物性肉芽肿的形成。虽然这并不妨碍牙齿移动，但应每三个月使用根尖片对患者进行随访，以控制材料相对于根尖的位置。如果将永久性充填推迟到正畸治疗完成时，则可以避免“假性”超充。
