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Pirani C, Camilleri J. Effectiveness of root canal filling materials and techniques for treatment of apical periodontitis: A systematic review. Int Endod J 2023; 56 Suppl 3:436-454. [PMID: 35735776 DOI: 10.1111/iej.13787] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Apical periodontitis (AP) is an inflammatory disease of the apical periodontium as sequelae of pulp death. It is managed by disinfection and filling of the root canal space. OBJECTIVES The aim of this systematic review was to investigate whether obturation techniques and materials used for root canal filling led to the management of AP. METHODS A systematic review protocol was written following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist and registered on the international prospective register of systematic reviews (PROSPERO; CRD42021260275) including two populations, interventions, comparisons, outcomes and time (PICOT) for the research questions querying the effectiveness of obturation techniques (PICOT 1) and materials (PICOT 2) for the management of AP. Electronic searches were conducted on PubMed, ScienceDirect, Scopus and Embase search engines. Searches on International Endodontic Journal, Journal of Endodontics, Clinical Oral Investigations, Journal of Dental Research and Journal of Dentistry websites were also conducted, until May 2021. Both primary (tooth survival) and secondary outcomes were evaluated. The risk of bias was assessed by Cochrane RoB2 for the randomized and ROBINS-I for the nonrandomized trials. RESULTS The search strategy identified 1652 studies, with 1600 excluded on the title and abstract screening, leaving 52 studies for full-text screening. In total, 10 studies met the inclusion criteria. The obturation technique and materials used did not affect the outcome of AP. Vertical compaction resulted in faster resolution of periapical lesions. The oral health-related quality of life of patients treated with lateral condensation exhibited poorer outcomes compared with single matched cone after 6 months of recall. DISCUSSION The inclusion and exclusion criteria used for this systematic review enabled the capture of all the literature available on the effect of obturation techniques and materials on the outcome of AP. The data were heterogenous, and a number of articles investigating obturation techniques had no information on the materials and techniques used as they looked at the quality of fill. CONCLUSIONS Included studies did not find any difference between different procedures (PICOT 1) and materials (PICOT 2). The risk of bias was high, thus the findings should be interpreted with caution. REGISTRATION PROSPERO registration number: CRD42021260275.
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Affiliation(s)
- Chiara Pirani
- Department of Biomedical and Neuromotor Sciences (DIBINEM), School of Dentistry, Endodontic Clinical Section, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Josette Camilleri
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Koçer A, Dönmez Özkan H, Turk T. Postoperative pain intensity and incidence following single visit root canal treatment with different obturation techniques: a randomized clinical trial. PeerJ 2022; 10:e13756. [PMID: 35915749 PMCID: PMC9338753 DOI: 10.7717/peerj.13756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/28/2022] [Indexed: 01/17/2023] Open
Abstract
Background There are few studies in the literature about the effect of obturation techniques on postoperative pain. Besides, GuttaFlow2 was used for the first time in this study regarding postoperative pain. This study aimed to compare the postoperative pain levels and incidence following single-visit root canal treatment with different canal filling techniques; cold lateral compaction (CLC), thermoplasticised solid-core carrier (GuttaCore) based filling and cold free-flow compaction (GuttaFlow2) technique. Methods The patients (n = 93) having single-rooted teeth with a single canal diagnosed with asymptomatic irreversible pulpitis or single-rooted vital teeth with a single canal requiring endodontic treatment because of prosthetic reasons were enrolled in this study. Patients were randomized into three groups (n = 31) according to the obturation technique. A single operator performed all the treatments in a single visit. Data on obturation levels, postoperative pain and analgesic intake frequency were recorded at postoperative 6, 12 and 24 h and daily afterward until the 7th day. Postoperative pain was measured by visual analogue scale (VAS). The date were statistically analyzed with chi-squared tests (for the analyses of the categorical data), the nonparametric Kruskal-Wallis test (for the comparisons of VAS score) and with the Friedman test (for the assessments of the changes in VAS scores over time). Results The GuttaCore group recorded the higher pain levels, except first 12 h, on the other hand, the GuttaFlow2 group recorded the lower pain levels at all time periods. Significant differences occurred among the groups during the first 4 days (p < 0.05), except at 12 h (p = 0.054). The patients in the CLC and GuttaFlow2 groups did not need to use the prescribed analgesic; however, one patient in the GuttaCore group used it once. Conclusions Postoperative pain levels following root canal therapy were affected by the obturation technique especially first 4 days following obturation.
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Affiliation(s)
- Aliye Koçer
- Department of Endodontics, Aydın Adnan Menderes University, Efeler, Aydın, Türkiye
| | - Hicran Dönmez Özkan
- Department of Endodontics, Aydın Adnan Menderes University, Efeler, Aydın, Türkiye
| | - Tugba Turk
- Department of Endodontics, Ege University, Bornova, İzmir, Türkiye
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Sponchiado Junior EC, Vieira WDA, Normando AGC, Pereira JV, Ferraz CCR, Almeida JFA, Marciano MA, Gomes BP, de-Jesus-Soares A. Calcium Silicate-Based Sealers Do Not Reduce the Risk and Intensity of Postoperative Pain after Root Canal Treatment when Compared with Epoxy Resin-Based Sealers: A Systematic Review and Meta-Analysis. Eur J Dent 2021; 15:347-359. [PMID: 33759149 PMCID: PMC8184314 DOI: 10.1055/s-0041-1724157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This review aims to evaluate whether root canal obturation with calcium silicate-based (CSB) sealers reduces the risk and intensity of endodontic postoperative pain when compared to epoxy resin-based (ERB) sealers. The review was registered at PROSPERO (CRD42020169255). Two independent reviewers conducted an electronic search in PubMed, Scopus, EMBASE, Web of Science, Cochrane Library and LILACS until November 2020 and included only randomized clinical trials with adult health participants undergoing root canal treatment. After selection, the JBI Critical Appraisal tool was used to assess the risk of bias. A fixed-effect meta-analysis was performed to summarize the results of pain risk and pain intensity at time intervals of 24 and 48 hours. Finally, the certainty of evidence was assessed using the GRADE approach. The search resulted in 1,206 records, of which five studies (n = 421 patients) met the eligibility criteria and presented moderate to low risk of bias. There was no significant difference between groups in the risk of pain in the first 24 hours (relative risk or RR = 0.83, 95% confidence interval or CI: 0.60, 1.16, I 2 =) or 48 hours (RR = 0.56, 95% CI: 0.26, 1.21, I 2 =). Silicate-based sealers led to lower pain intensity only at 48 hours (mean and standard deviation = 0.37, 95% CI: 0.69, 0.05). All analyses revealed low heterogeneity (I 2 < 25%). The evidence presented moderate level of certainty. Currently available evidence has shown that there is no difference between CSB and ERB sealers in the risk or intensity of postoperative pain.
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Affiliation(s)
- Emílio Carlos Sponchiado Junior
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
- Division of Endodontics, Dental School, Federal University of Amazonas, Manaus, Amazonas, Brazil
| | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Ana Gabriela Costa Normando
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Juliana Vianna Pereira
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
- Division of Endodontics, Dental School, Federal University of Amazonas, Manaus, Amazonas, Brazil
| | - Caio Cezar Randi Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - José Flávio A. Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Marina Angélica Marciano
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Brenda P.F.A. Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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Javidi M, Zarei M, Ashrafpour E, Gharechahi M, Bagheri H. Post-treatment Flare-up Incidence after Using Nano Zinc Oxide Eugenol Sealer in Mandibular First Molars with Irreversible Pulpitis. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2020; 21:307-313. [PMID: 33344681 PMCID: PMC7737921 DOI: 10.30476/dentjods.2020.83231.1041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Statement of the Problem: Some patients may report moderate-to-severe pain and/or swelling following root canal treatment, which is undesirable for both the patient and dentist and may require an unscheduled emergency visit by patients to relieve their symptoms. Purpose: The aim of this study was to evaluate the post-treatment flare-up incidence following application of nano zinc oxide-eugenol (NZOE) sealer in mandibular first molars with irreversible pulpitis. Materials and Method: This single-blinded study was performed on 60 patients having mandibular first molars with irreversible pulpitis. After signing the written consent form, the patients were randomly divided into two groups considering their age range (20-34 and 35-50 years). Individuals without systemic diseases and with a first mandibular molar diagnosed with irreversible pulpitis due to caries, no sinus track and abscess, normal periapical radiographic appearance, no spontaneous pre-treatment pain, not taken any medication for at least 8 hours before the treatment visit were included in this study. Patients of both sexes with age range of 20 to 50 years were selected. In order to obturate the root canal space, AH26 sealer was used in the one group and the synthesized NZOE was applied in another group. The patients were then given questionnaires to report the severity of pain and presence of swelling during 6, 18, 24, and 48 hours of follow-up. The data was analyzed using SPSS v.19 software applying repeated measures ANOVA. The significance level was set at 0.05. Results: The severity of pain was significantly lower in NZOE group at 24 hours post-treatment (p= 0.003). Patients reported no symptoms of swelling in any group. Conclusion: NZOE sealer manifested satisfactory results and could be regarded as a promising substitute to routine sealers since patients may experience less pain during the first hours after receiving root canal therapy.
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Affiliation(s)
- Maryam Javidi
- Dept. of Endodontics, Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mina Zarei
- Dept. of Endodontics, Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Ashrafpour
- Postgraduate Dept. of Endodontics, Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Gharechahi
- Dept. of Endodontics, Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Bagheri
- Dept. of Dental Material, Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Athkuri S, Mandava J, Chalasani U, Ravi RC, Munagapati VK, Chennareddy AR. Effect of different obturating techniques and sealers on the removal of filling materials during endodontic retreatment. J Conserv Dent 2020; 22:578-582. [PMID: 33088069 PMCID: PMC7542081 DOI: 10.4103/jcd.jcd_241_19] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 04/03/2020] [Accepted: 04/15/2020] [Indexed: 11/15/2022] Open
Abstract
Background: Adequate removal of previous root filling materials is an important objective during endodontic retreatment. Aim: This study was aimed to evaluate the influence of obturation quality and sealer type on the removal of root filling materials during endodontic retreatment using micro-computed tomography (μ-CT). Materials and Methods: Ninety extracted mandibular premolars were randomly assigned to two groups (n = 45) based on the type of sealer (AH Plus and BioRoot RCS) and three sub-groups based on the obturating technique used, i.e., cold lateral condensation, warm vertical compaction, and thermoplasticized injectable techniques. Specimens were scanned using μ-CT before and after retreatment to assess the amount of filling material, and time taken for removal was recorded. Statistical Analysis: Data were analyzed using two-way analysis of variance and Tukey's multiple post hoc test at 5% significance level. Results: Filling debris percentage and retreatment time were not significantly affected by the type of sealer (P ≥ 0.05). The percentage of remaining filling material was higher in teeth obturated with thermoplasticized technique (P < 0.05). Significantly more filling material debris was observed in apical third (P < 0.05). Conclusions: The type of obturating technique used for initial root canal treatment has influenced the amount of remaining filling material and retreatment time. Retreatability of the BioRoot RCS sealer was similar to the AH Plus sealer.
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Affiliation(s)
- Srividya Athkuri
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Jyothi Mandava
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Uma Chalasani
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Ravi Chandra Ravi
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Vamsi Krishna Munagapati
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Anusha Reddy Chennareddy
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
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Castagnola R, Minciacchi I, Rupe C, Marigo L, Grande NM, Contaldo M, Pesce A, Lajolo C. The Outcome of Primary Root Canal Treatment in Postirradiated Patients: A Case Series. J Endod 2020; 46:551-556. [PMID: 32088010 DOI: 10.1016/j.joen.2019.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/08/2019] [Accepted: 12/21/2019] [Indexed: 12/25/2022]
Abstract
Osteoradionecrosis (ORN) of the jaw is considered the most severe long-term adverse effect that can occur in radiation therapy patients. Teeth extractions and dental diseases are the main risk factors for ORN in irradiated patients. The aim of this case series was to evaluate the outcome of primary root canal treatments performed on patients who underwent head and neck radiotherapy and to evaluate any ORN related to the endodontic treatment. In this case series, primary root canal therapies (absence of radiolucency) were performed on 10 teeth of 8 patients who underwent radiotherapy for head and neck cancers. Radiation doses to the periapical area were calculated using the radiotherapy planning computed tomographic scan. After a 277-day mean follow-up, all patients were asymptomatic, no teeth showed periapical radiolucency, and no ORN was observed. Even if a limitation of buccal opening occurred after radiotherapy and complicated the endodontic procedures, root canal therapy seemed to be safe and a valid alternative to tooth extraction.
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Affiliation(s)
- Raffaella Castagnola
- Department of Operative Dentistry and Endodontics, "Fondazione Policlinico Universitario A. Gemelli IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Irene Minciacchi
- Department of Operative Dentistry and Endodontics, "Fondazione Policlinico Universitario A. Gemelli IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cosimo Rupe
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Marigo
- Department of Operative Dentistry and Endodontics, "Fondazione Policlinico Universitario A. Gemelli IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicola Maria Grande
- Department of Operative Dentistry and Endodontics, "Fondazione Policlinico Universitario A. Gemelli IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania L. Vanvitelli, Naples, Italy
| | - Adele Pesce
- Department of Radiation Oncology, "Fondazione Policlinico Universitario A. Gemelli IRCCS," Institute of Radiology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlo Lajolo
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
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Albuquerque PP, Hungaro Duarte MA, Pelegrine RA, Kato AS, Stringheta CP, Duque JA, Bueno CEDS. Influence of foraminal enlargement on the apical extrusion of filling material: Volumetric analysis using micro‐computed tomography. AUST ENDOD J 2020; 46:210-216. [DOI: 10.1111/aej.12394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 10/13/2019] [Accepted: 12/27/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry, Endodontics and Dental Materials School of Dentistry of Bauru University of São Paulo Bauru Brazil
| | - Rina Andréa Pelegrine
- Faculdade São Leopoldo Mandic Instituto de Pesquisas São Leopoldo Mandic Campinas Brazil
| | - Augusto Shoji Kato
- Faculdade São Leopoldo Mandic Instituto de Pesquisas São Leopoldo Mandic Campinas Brazil
| | | | - Jussaro Alves Duque
- Department of Restorative Dentistry, Endodontics and Dental Materials School of Dentistry of Bauru University of São Paulo Bauru Brazil
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Post-obturation pain following the use of carrier-based system with AH Plus or iRoot SP sealers: a randomized controlled clinical trial. Clin Oral Investig 2018; 23:3053-3061. [DOI: 10.1007/s00784-018-2721-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/17/2018] [Indexed: 12/23/2022]
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Ramugade MM, Sagale AA. A Review of Medicolegal Considerations of Endodontic Practice for General Dental Practitioners. J Int Soc Prev Community Dent 2018; 8:283-288. [PMID: 30123758 PMCID: PMC6071360 DOI: 10.4103/jispcd.jispcd_206_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 06/29/2018] [Indexed: 01/04/2023] Open
Abstract
Treating a live human being to their health has been considered as a noble profession since the ancient times. Doctors are duty bound by their professional ethics to provide the best treatment to their patients. Endodontics is the specialty branch of the dental science of saving natural teeth in the oral cavity. During endodontic procedures, a mishap can occur any time in a day-to-day practice and may be treated as negligence which in turn ends into some legal complications. To prevent and tackle such future medicolegal issues related to endodontic treatment, the knowledge of the legal aspect of such clinical situation is necessary.
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Affiliation(s)
- Manoj Mahadeo Ramugade
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Apurva Anil Sagale
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
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Wong AWY, Zhang S, Li SKY, Zhang C, Chu CH. Clinical studies on core-carrier obturation: a systematic review and meta-analysis. BMC Oral Health 2017; 17:167. [PMID: 29284463 PMCID: PMC5747112 DOI: 10.1186/s12903-017-0459-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 12/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This systematic review aimed to evaluate the clinical performance of core-carrier obturation in endodontic treatment. METHODS Keywords of "(core carrier OR Thermafil) OR (cold lateral condensation OR lateral condensation) OR (warm vertical condensation OR vertical condensation) AND (obturation OR root canal filling) AND clinical study" were searched for all obtainable publications up to year 2017 in the databases of PubMed, ScienceDirect, EMBASE, Scopus and Web of Science. The success rate, short-term postoperative pain, overfilling and adaptation of core-carrier obturation from clinical studies were selected. Reviews, laboratory studies, animal studies and irrelevant reports were excluded. RESULTS 1349 relevant articles were identified with 149 duplicated articles removed and 1173 irrelevant articles were excluded after screening. The titles and abstracts of the 19 identified articles were screened in the systematic review. The full texts of remaining articles were retrieved with data extracted for meta-analysis on the success rate, postoperative pain, overfilling and adaptation of obturation. The pooled success rate of core-carrier obturation was 83% (95% CI: 69%-91%). The pooled incidence of 1-day and 7-day short-term postoperative pain were 35% (95% CI: 15%-62%) and 6% (95% CI: 1-35%). The pooled proportion of teeth with overfilling and adequate adaptation of the obturation material were 31% (95% CI: 18%-50%) and 85% (95% CI: 75%-91%), respectively. CONCLUSIONS The success rate of endodontic treatment using core-carrier obturation was 83%. Short-term postoperative pain was not uncommon (24%). Most teeth (85%) had adequate adaptation using core-carrier obturation material, but a considerable amount of teeth (31%) had overfilling.
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Affiliation(s)
- Amy Wai-Yee Wong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Shinan Zhang
- School of Stomatology, Kunming Medical University, Yunnan, China
| | | | - Chengfei Zhang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China. .,3B53A, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China.
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Pirani C, Iacono F, Gatto MR, Fitzgibbon RM, Chersoni S, Shemesh H, Prati C. Outcome of secondary root canal treatment filled with Thermafil: a 5-year follow-up of retrospective cohort study. Clin Oral Investig 2017; 22:1363-1373. [PMID: 28993900 DOI: 10.1007/s00784-017-2229-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 09/27/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The aim of the present retrospective cohort study was to assess the 5-year outcome and survival of secondary root canal treatments (2°RCT), exploring the influence of pre-, intra-, and post-operative variables. MATERIALS AND METHODS One hundred thirty-two endodontically retreated teeth were radiographically and clinically re-examined after 5 years. 2°RCT had been performed during a Masters program following standardized protocols and filled with AH Plus/Thermafil (TF). Pre-, intra-, and post-operative data were collected. The 5-year outcome was blindly evaluated and categorized as healed/diseased on the basis of the periapical index. Bivariate analysis and chi-square test evaluated the association between outcome and 31 demographic/clinical parameters. Multilevel analysis was performed at both patient and tooth level. Statistical significance was calculated at 5% level. RESULTS At 5-year evaluation, survival rate was 80% with 7.5% lost for endodontic reasons. Eighty-three percent of the teeth were classified as healed. Multilevel analysis identified significant predictors of increased survival: female gender (p = 0.012), absence of a pre-operative metal post (p = 0.017), conservative apical preparation (diameter size < #35) (p = 0.039), teeth restored with a crown (p = 0.009), and final PAI (after 5 years) ≤ 2 (p = 0.001). Multilevel analysis identified as predictor healing: not being a smoker (p = 0.048) and conservative apical preparation < size #35 (p = 0.037). CONCLUSIONS Outcome of 2°RCT filled with Thermafil was successful at 5 years, showing a high rate of survived and healed teeth comparable to that reported previously for other obturation techniques. CLINICAL RELEVANCE Present findings confirm 2°RCT as a valid therapeutic option to retain natural teeth.
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Affiliation(s)
- Chiara Pirani
- Department of Biomedical and Neuromotor Sciences (DIBINEM), School of Dentistry, Endodontic Clinical Section, Master in Clinical Endodontology, Alma Mater Studiorum University of Bologna, Via San Vitale 59, 40125, Bologna, Italy.
| | - Francesco Iacono
- Department of Biomedical and Neuromotor Sciences (DIBINEM), School of Dentistry, Endodontic Clinical Section, Master in Clinical Endodontology, Alma Mater Studiorum University of Bologna, Via San Vitale 59, 40125, Bologna, Italy
| | - Maria Rosaria Gatto
- Department of Biomedical and Neuromotor Sciences (DIBINEM), School of Dentistry, Endodontic Clinical Section, Master in Clinical Endodontology, Alma Mater Studiorum University of Bologna, Via San Vitale 59, 40125, Bologna, Italy
| | - Raquel Michelle Fitzgibbon
- Department of Biomedical and Neuromotor Sciences (DIBINEM), School of Dentistry, Endodontic Clinical Section, Master in Clinical Endodontology, Alma Mater Studiorum University of Bologna, Via San Vitale 59, 40125, Bologna, Italy
| | - Stefano Chersoni
- Department of Biomedical and Neuromotor Sciences (DIBINEM), School of Dentistry, Endodontic Clinical Section, Master in Clinical Endodontology, Alma Mater Studiorum University of Bologna, Via San Vitale 59, 40125, Bologna, Italy
| | - Hagay Shemesh
- Endodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Carlo Prati
- Department of Biomedical and Neuromotor Sciences (DIBINEM), School of Dentistry, Endodontic Clinical Section, Master in Clinical Endodontology, Alma Mater Studiorum University of Bologna, Via San Vitale 59, 40125, Bologna, Italy
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12
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Pirani C, Friedman S, Gatto MR, Iacono F, Tinarelli V, Gandolfi MG, Prati C. Survival and periapical health after root canal treatment with carrier-based root fillings: five-year retrospective assessment. Int Endod J 2017; 51 Suppl 3:e178-e188. [DOI: 10.1111/iej.12757] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 02/15/2017] [Indexed: 11/30/2022]
Affiliation(s)
- C. Pirani
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - S. Friedman
- Faculty of Dentistry; University of Toronto; Toronto Ontario Canada
| | - M. R. Gatto
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - F. Iacono
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - V. Tinarelli
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - M. G. Gandolfi
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - C. Prati
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
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Dalopoulou A, Economides N, Evangelidis V. Extrusion of Root Canal Sealer in Periapical Tissues - Report of Two Cases with Different Treatment Management and Literature Review. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Summary
Background: Extrusion of root canal sealers may cause damage to the surrounding anatomic structures. Clinical symptoms like pain, swelling and paresthesia or anesthesia may be present. The purpose of this presentation is to describe two cases of root canal sealer penetration into periapical tissues. A different treatment management was followed in each case.
Case reports: A 55 year-old man underwent root canal retreatment of the right mandibular first molar tooth due to a periapical lesion. Postoperative periapical radiographs revealed the presence of root canal sealer (AH26) beyond the apex in the distal root in proximity to the mandibular canal. The patient reported pain for the next 7 days. Radiographic examination after 1 year showed complete healing of the periapical area and a small absorption of the root canal sealer. A 42 year-old woman was referred complained of swelling and pain in the area of the right maxillary first incisor. Radiographic examination showed extrusion of root canal sealer in the periapical area associated with a periapical lesion. Surgical intervention was decided upon, which included removal of the sealer, apicoectomy of the tooth and retrograde filling with MTA. After 1 year, complete healing of the area was observed.
Conclusion: In conclusion, cases of root canal sealer extrusion, surgical treatment should be decided on only in association with clinical symptoms or with radiographic evidence of increasing periapical lesion.
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Affiliation(s)
- Athina Dalopoulou
- Undergraduate student, Aristotle University, Dental School, Thessaloniki, Greece
| | - Nikolaos Economides
- Associate Professor, Aristotle University, Dental School, Thessaloniki, Greece
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Physicochemical Properties of Epoxy Resin-Based and Bioceramic-Based Root Canal Sealers. Bioinorg Chem Appl 2017; 2017:2582849. [PMID: 28210204 PMCID: PMC5292198 DOI: 10.1155/2017/2582849] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 12/08/2016] [Indexed: 11/26/2022] Open
Abstract
Three bioceramic sealers (EndoSequence BC sealer, EndoSeal MTA, and MTA Fillapex) and three epoxy resin-based sealers (AH-Plus, AD Seal, and Radic-Sealer) were tested to evaluate the physicochemical properties: flow, final setting time, radiopacity, dimensional stability, and pH change. The one-way ANOVA and Tukey's post hoc test were used to analyze the data (P = 0.05). The MTA Fillapex sealer had a highest flow and the BC Sealer presented a flow significantly lower than the others (P < 0.05). The BC Sealer and MTA Fillapex samples were not set in humid incubator condition even after one month. EndoSeal MTA had the longest setting time among the measurable materials and Radic-Sealer and AD Seal showed shorter setting time than the AH-Plus (P < 0.05). AH-Plus and EndoSeal MTA showed statistically higher values and MTA Fillapex showed statistically lower radiopacity (P < 0.05). BC Sealer showed the highest alkaline pH in all evaluation periods. Set samples of 3 epoxy resin-based sealers and EndoSeal MTA presented a significant increase of pH over experimental time for 4 weeks. In conclusion, the bioceramic sealer and epoxy resin-based sealers showed clinical acceptable physicochemical properties, but BC Sealer and MTA Fillapex were not set completely.
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Pirani C, Tinarelli V, Gatto M, Iacono F, Gandolfi M, Prati C. Prognosis of root canal treatments filled with Thermafil system: a 5-year retrospective study. GIORNALE ITALIANO DI ENDODONZIA 2016. [DOI: 10.1016/j.gien.2016.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Kandemir Demirci G, Çalışkan MK. A Prospective Randomized Comparative Study of Cold Lateral Condensation Versus Core/Gutta-percha in Teeth with Periapical Lesions. J Endod 2015; 42:206-10. [PMID: 26686053 DOI: 10.1016/j.joen.2015.10.022] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/23/2015] [Accepted: 10/30/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study was to compare the outcome of root canal treatment using either Thermafil (TF; Dentsply Maillefer, Ballaigues, Switzerland) or the cold lateral condensation (CLC) obturation technique in teeth with periapical lesions and to investigate the influence on postoperative pain and treatment outcomes. METHODS After standardized root canal preparation technique, 112 teeth were obturated with either the TF or the CLC technique during 2 sessions by single operator. Postoperative pain, obturation length, and treatment outcomes were recorded. The teeth were reviewed clinically and radiographically for 2 years. RESULTS Although there were no significant differences between the techniques in the incidence of postoperative pain at 24 hours (P > .05), the incidence of pain was significantly higher in the TF group than in the CLC group at 48 hours (P < .05). During the 2-year follow-up period, there was no statistically significant difference in the success rate of the teeth treated with TF (96.4%) in comparison with those treated with CLC (98.2%) (P > .05). CONCLUSIONS In this study, the outcome of the root canal treatment of teeth using the TF and CLC techniques revealed that these techniques are useful for root canal obturation.
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Bürklein S, Grund C, Schäfer E. Relationship between Root Apices and the Mandibular Canal: A Cone-beam Computed Tomographic Analysis in a German Population. J Endod 2015; 41:1696-700. [DOI: 10.1016/j.joen.2015.06.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 05/29/2015] [Accepted: 06/25/2015] [Indexed: 10/23/2022]
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Sant'Anna-Junior A, Guerreiro-Tanomaru JM, Martelo RB, Silva GFD, Tanomaru Filho M. Filling of simulated lateral canals with gutta-percha or thermoplastic polymer by warm vertical compaction. Braz Oral Res 2015; 29:56. [PMID: 25885024 DOI: 10.1590/1807-3107bor-2015.vol29.0056] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 01/08/2015] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the ability of gutta-percha and a thermoplastic synthetic polymer (Resilon) to fill simulated lateral canals, using warm vertical compaction. Forty-five single-rooted human teeth were prepared using the rotary crown-down technique. Artificial lateral canals were made at 2, 5, and 8 mm from the working length (WL) in each root. The specimens were divided into three groups (n = 15), according to the filling material: Dentsply gutta-percha (GD), Odous gutta-percha (GO), and Resilon cones (RE). The root canals were obturated using warm vertical compaction, without endodontic sealer. The specimens were subjected to a tooth decalcification and clearing procedure. Filling of the lateral canals was analyzed by digital radiography and digital photographs, using the Image Tool software. The data were subjected to the Kruskal-Wallis and Dunn tests at 5% significance. RE had the best filling ability in all root thirds (p < 0.05), with similar results for GO in the coronal third. In the middle and apical thirds, GD and GO had similar results (p > 0.05). Resilon may be used as an alternative to gutta-percha as a solid core filling material for use with the warm vertical compaction technique. The study findings point to the potential benefit of the warm vertical compaction technique for filling lateral canals, and the study provides further information about using Resilon and gutta-percha as materials for the warm vertical compaction technique.
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Affiliation(s)
- Arnaldo Sant'Anna-Junior
- Department of Restorative Dentistry, Araraquara School of Dentistry, Universidade Estadual Paulista, Araraquara, SP, Brazil
| | | | - Roberta Bosso Martelo
- Department of Restorative Dentistry, Araraquara School of Dentistry, Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Guilherme Ferreira da Silva
- Department of Restorative Dentistry, Araraquara School of Dentistry, Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Mário Tanomaru Filho
- Department of Restorative Dentistry, Araraquara School of Dentistry, Universidade Estadual Paulista, Araraquara, SP, Brazil
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Physicochemical properties and surfaces morphologies evaluation of MTA FillApex and AH plus. ScientificWorldJournal 2014; 2014:589732. [PMID: 24883413 PMCID: PMC4032737 DOI: 10.1155/2014/589732] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 04/07/2014] [Indexed: 11/17/2022] Open
Abstract
The solubility, pH, electrical conductivity, and radiopacity of AH Plus and MTA FillApex were evaluated. In addition, the surfaces morphologies of the sealers were analyzed by using scanning electron microscopy. For pH test, the samples were immersed in distilled water at different periods of time. The same solution was used for electrical conductivity measurement. The solubility and radiopacity were evaluated according to ANSI/ADA. Statistical analyses were carried out at 5% level of significance. MTA FillApex presented higher mean value for solubility and electrical conductivity. No significant difference was observed in the mean values for pH reading. AH Plus presented higher radiopacity mean values. MTA FillApex presented an external surface with porosities and a wide range of sizes. In conclusion, the materials fulfill the ANSI/ADA requirements when considering the radiopacity and solubility. AH Plus revealed a compact and homogeneous surface with more regular aspects and equal particle sizes.
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Brooks JK, Kleinman JW. Retrieval of extensive gutta-percha extruded into the maxillary sinus: use of 3-dimensional cone-beam computed tomography. J Endod 2013; 39:1189-93. [PMID: 23953297 DOI: 10.1016/j.joen.2013.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 03/12/2013] [Accepted: 04/03/2013] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Close proximity of the maxillary sinus to the roots of maxillary teeth can predispose to the inadvertent deposition of endodontic products into the maxillary sinus. One such material is thermoplasticized injectable gutta-percha, which has gained popularity of late. As a consequence of overfilling, some patients warrant surgical retrieval. METHODS A case report of extreme overextension of gutta-percha within the maxillary sinus after endodontic retreatment on tooth #14 was provided. The distobuccal and palatal canals had been obturated with gutta-percha master cones and backfilled with thermoplasticized injectable warm gutta-percha. The mesiobuccal canal had only been filled with thermoplasticized injectable warm gutta-percha, the origin of the extrusion. Imagery with 3-dimensional cone-beam computed tomography was performed for localization of the gutta-percha. RESULTS The patient underwent a Caldwell-Luc approach for removal of the extruded material. The gutta-percha was successfully removed intact, and the patient had an unremarkable postoperative course. However, the patient continues to have mild tenderness in the sinus region. CONCLUSIONS The featured case exemplified the consequence of overinstrumentation and ensuing inadequate apical stop. In these situations, the obturation of a maxillary tooth with thermoplasticized injectable gutta-percha, without master cones, can potentially result in overfilling and deposition into the antrum. Use of 3-dimensional cone-beam computed tomography could enhance endodontic diagnosis, serve as an aid for visualization of foreign materials within the sinus and contiguous soft tissue structures, and improve clinical outcome.
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Affiliation(s)
- John K Brooks
- Department of Oncology and Diagnostic Sciences, University of Maryland Dental School, Baltimore, Maryland 21201-1586, USA.
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