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Patel SR, Jarad F, Moawad E, Boland A, Greenhalgh J, Liu M, Maden M. The tooth survival of non-surgical root-filled posterior teeth and the associated prognostic tooth-related factors: A systematic review and meta-analysis. Int Endod J 2024. [PMID: 38949036 DOI: 10.1111/iej.14116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/28/2024] [Accepted: 06/18/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Analysis of the survival of root-filled posterior teeth and the associated prognostic tooth-related factors will enable clinicians to predict the outcome of root canal treatment. OBJECTIVES To investigate (i) the survival of root-filled posterior teeth and (ii) the tooth-related factors that may affect their survival. METHODS Randomized controlled trials, comparative studies and observational studies assessing survival rates of root-filled posterior teeth with a minimum 4-year follow-up period were identified through an electronic search of the following databases up to January 2023: The Cochrane Central Register of Controlled Trials, Medline via PubMed, the Cochrane Database of Systematic Reviews, Embase, Web of Science and NIHR centre for reviews and dissemination. Two reviewers (SP and ML) independently selected the final studies based on pre-defined inclusion criteria. The Newcastle Ottawa Scale and the Cochrane Risk of Bias Tool for Randomized Trials were used to assess the risk of bias. Pooled weighted survival rates were analysed using a random effects meta-analysis model using DerSimonean and Laird methods. Descriptive analysis of studies describing any prognostic tooth-related factors was conducted. RESULTS Of the 72 studies identified, data from 20 studies were included in the survival meta-analysis, and data from 13 of these studies were included in the descriptive analysis of tooth-related factors; 12 studies were retrospective, 7 were prospective, and one was a randomized control trial. The pooled survival rates at 4-7 years and 8-20 years of root-filled posterior teeth regardless of tooth type was 91% (95% CI, 0.85; 0.95) and 87% (95% CI, 0.77; 0.93), respectively. The prognostic tooth-related factors mentioned in the included studies were (i) remaining coronal tooth structure, (ii) ferrule, (iii) crown-to-root ratio (iv) tooth type and location (v) periodontal disease (vi) proximal contacts and (vii) cracks. CONCLUSIONS The meta-analysis suggests that root canal treatment has a high medium to long term survival outcome. The narrative summary identified 7 factors that affect tooth survival. However, there is a paucity of evidence, and more research is needed in this area. REGISTRATION PROSPERO Registration: CRD42021227213.
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Affiliation(s)
- S R Patel
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - F Jarad
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - E Moawad
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - A Boland
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
| | - J Greenhalgh
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
| | - Maria Liu
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
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Eliyas S, Shah K, Dhamecha N, Jayaram T, Yusuf A, Jasani V, Kaur N. GIRFT and Measuring Outcomes in MCNs: endodontics in 646 teeth treated in Tier 2 (Primary Care) and Tier 3 (Secondary Care) settings in England. Prim Dent J 2024; 13:36-52. [PMID: 38888078 DOI: 10.1177/20501684241230799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
AIM This paper aims to assess the complexity, quality and outcome of endodontic treatment provided in Managed Clinical Networks (MCNs) in England to understand if we are "getting it right first time" (GIRFT). METHODS In a convenient sample of endodontic treatments provided between May 2011 and April 2017, the complexity of teeth treated, the quality of treatment procedure, the radiographic appearance of root fillings, as well as clinical and radiographic healing were retrospectively assessed using records taken as part of treatment. Trained, calibrated examiners independently scored radiographs using previously published scoring systems. RESULTS 646 teeth were followed up for 24.7 months (standard deviation [SD] 17.08). The average age of those patients treated was 46.7 years (SD 15.38) with 48.3% being male. Of teeth treated, 70.4% were of complexity level 3. 88.2% of teeth were asymptomatic, and 80% demonstrated complete radiographic healing. Procedural errors inhibited achieving correct working length and taper, with more voids within root canal fillings. When patency filing was reported as being carried out, complete radiographic healing was more likely. CONCLUSIONS It is possible to collate outcome data in the NHS system, especially if there is provision for ongoing follow up and time allocated for collection of data. Endodontic treatment provided within primary and secondary care settings are of high quality, with outcomes being better with single operators carrying out high volumes of endodontic treatment.
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Affiliation(s)
- Shiyana Eliyas
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Kewal Shah
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Nalin Dhamecha
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Tapasya Jayaram
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Aaron Yusuf
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Vishal Jasani
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Nirvair Kaur
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
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Chen X, Liu SQ, Wang XX, Liu W, Zhou X, Wang X. Effect of Orthodontic Treatment on the Outcomes of Endodontically Treated Teeth: A Cone-Beam Computed Tomography Analysis. J Endod 2024:S0099-2399(24)00282-6. [PMID: 38763483 DOI: 10.1016/j.joen.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 04/22/2024] [Accepted: 05/03/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Often there is the need of moving endodontically treated teeth. Orthodontic movement may have no effect on the prognosis of teeth with root canal treatment (RCT). To verify this subject, we evaluated the effect of orthodontic movement on the prognosis of RCT teeth using cone-beam computed tomography (CBCT) and further explored the influence of orthodontic movement on the prognosis of RCT teeth with and without apical periodontitis (AP). METHODS This retrospective study was conducted by evaluating 169 RCT teeth of 100 patients who had undergone fixed orthodontic treatment. AP was assessed and classified using the CBCT periapical index. Univariate analysis of RCT outcome was performed for the total RCT group, RCT without AP group and RCT with AP group. Multivariate logistic regression was performed for the total RCT group and RCT without AP group, respectively, but not for the RCT with AP group. Variables related to the prognosis of RCT were included, such as age, gender, tooth position, RCT quality, coronal restoration quality, periodontal condition, orthodontic traction distance, and orthodontic rotation angle. RESULTS The orthodontic traction distance and rotation angle were not significantly correlated to the RCT outcomes, regardless of the presence of AP. Among the total RCT group, teeth with unqualified RCT (odds ratio = 3.42, P = .004) and inadequate coronal restoration (odds ratio = 4.40, P = .031) had a lower success rate. Of the 97 RCT teeth without AP, unqualified RCT was a risk factor for treatment failure (odds ratio = 3.55, P = .041). Of the 72 RCT teeth with AP, the univariate analysis showed that RCT quality were significantly related to the outcome (P = .042). CONCLUSIONS Orthodontic movement had no effect on the prognosis of RCT teeth regardless of the presence of AP.
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Affiliation(s)
- Xue Chen
- Department of Stomatology, Peking University Third Hospital, Beijing, China
| | - Shao-Qing Liu
- Department of Stomatology, Peking University Third Hospital, Beijing, China
| | - Xiao-Xiao Wang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Wei Liu
- Department of Stomatology, Peking University Third Hospital, Beijing, China
| | - Xin Zhou
- Department of Stomatology, Peking University Third Hospital, Beijing, China
| | - Xiao Wang
- Department of Stomatology, Peking University Third Hospital, Beijing, China.
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Zhao J, Wu S, Huang Y, Zhao Y, Liu H, Jiang Q, Shen Y, Chen M. Comparation of the effectiveness of conventional needle irrigation and photon-induced photoacoustic streaming with sodium hypochorite in the treatment of teeth with apical periodontitis: a randomized clinical trial. BMC Oral Health 2024; 24:293. [PMID: 38431616 PMCID: PMC10909256 DOI: 10.1186/s12903-024-04055-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
Photon-initiated photoacoustic streaming (PIPS) with an Er: YAG laser has been introduced in root canal treatment to improve irrigation and facilitate the removal of bacteria in the root canal system. This study aimed to compare the antibacterial effectiveness of two different root canal irrigation techniques, conventional needle irrigation (CNI) and PIPS, using 1% sodium hypochlorite (NaOCl), in the treatment of teeth with apical periodontitis. Sixty patients with a total of sixty teeth affected by apical periodontitis were included in this study. The teeth underwent root canal therapy, and after mechanical instrumentation, they were randomly assigned to two groups (n = 30) based on the final irrigation protocol: CNI or PIPS with 1% NaOCl. Bacterial suspensions in the root canals were evaluated using Adenosine 5'-triphosphate (ATP) assay kit after mechanical instrumentation and after final irrigation. Then, a follow-up was conducted after 7 days. The results revealed that final irrigation significantly reduced ATP values in both the CNI and PIPS groups (P < 0.001). The ATP values after final irrigation was greater in the CNI group compared to the PIPS group (P < 0.001). After a 7-day follow-up, percussion tenderness and fistula were significantly resolved in both groups (P < 0.05). A multivariate linear regression model was used to identify the factors that influence post irrigation ATP values. The analysis demonstrated that pre-operative percussion tenderness (P = 0.006), the presence of a fistula (P < 0.001) and the method used in the final irrigation (P < 0.001) had a significant impact on the ATP value after final irrigation. These results indicate that employing PIPS with 1% NaOCl as the final irrigation protocol exhibited superior antibacterial effectiveness and has the potential to enhance clinical outcomes in the treatment of teeth afflicted with apical periodontitis.
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Affiliation(s)
- Jian Zhao
- Department of Endodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510182, Guangdong, China
| | - Shengxuan Wu
- Department of Endodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510182, Guangdong, China
| | - Yuting Huang
- Department of Endodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510182, Guangdong, China
| | - Yuxuan Zhao
- Department of Endodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510182, Guangdong, China
| | - He Liu
- Division of Endodontics, Faculty of Dentistry, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - Qianzhou Jiang
- Department of Endodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510182, Guangdong, China.
| | - Ya Shen
- Division of Endodontics, Faculty of Dentistry, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
| | - Minle Chen
- Department of Stomatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, Guangdong, China.
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Paljevic E, Brekalo Prso I, Hrstic JV, Pezelj-Ribaric S, Persic Bukmir R. Impact of Smoking on the Healing of Apical Periodontitis after Nonsurgical Endodontic Treatment. Eur J Dent 2024; 18:124-130. [PMID: 36977477 PMCID: PMC10959606 DOI: 10.1055/s-0043-1761451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVES The aim of this prospective study was to compare the healing of periapical bone between smokers and nonsmokers after root canal therapy. The effects of duration and intensity of smoking on the healing rate of apical periodontitis were analyzed. MATERIALS AND METHODS Fifty-five smokers were included in this study. The control group consisted of healthy nonsmokers who matched the smoker group in age and sex. Only teeth with a favorable periodontal prognosis and adequate coronal restoration were included in the study. The periapical status of treated teeth was assessed using the periapical index system at follow-ups after 6 and 12 months. STATISTICAL ANALYSIS The chi-squared test and Mann-Whitney U test were used to assess the changes in periapical index score at baseline and in subsequent time intervals between the two groups examining dichotomized and ordinal data, respectively. Multivariate logistic regression analysis was used to test the association of independent variables age, gender, tooth type, arch type, and smoking index with the outcome variable. The outcome variable was set as the presence versus absence of apical periodontitis. RESULTS The analysis at 12-month follow-up revealed a significantly higher healing rate in control group than in smokers (90.9 vs. 58.2; χ2 = 13.846; p < 0.001). Smokers had significantly higher periapical index scores than the control group (p = 0.024). The multivariate logistic regression analysis demonstrated that an increase in the value of the smoking index significantly increases the risk of apical periodontitis persistence (odds ratio [OR] =7.66; 95% confidence interval [CI]: 2.51-23.28; p < 0.001) for smoking index < 400 and (OR = 9.65; 95% CI: 1.45-64.14; p = 0.019) for smoking index 400 to 799. CONCLUSION The results from this study show a lower rate of apical periodontitis healing in a group of smokers at 1-year follow-up. Delayed periapical healing seems to be associated with the cigarette smoking exposure.
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Affiliation(s)
- Ema Paljevic
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Ivana Brekalo Prso
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
- Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Jelena Vidas Hrstic
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Sonja Pezelj-Ribaric
- Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Department of Oral Medicine, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Romana Persic Bukmir
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
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Chang Y, Choi M, Wang YB, Lee SM, Yang M, Wu BH, Fiorellini J. Risk factors associated with the survival of endodontically treated teeth: A retrospective chart review. J Am Dent Assoc 2024; 155:39-47. [PMID: 38054916 DOI: 10.1016/j.adaj.2023.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Studies on risk factors affecting tooth retention after endodontic treatment in dental school settings are limited. Understanding these factors is crucial for preserving teeth. The aim of this retrospective study was to evaluate patient- and tooth-level risk factors associated with the survival of endodontically treated teeth. METHODS Electronic health records of patients who underwent endodontic treatment at the School of Dental Medicine at the University of Pennsylvania from 2017 through 2020 were analyzed. Patient-level factors included age, sex, American Society of Anesthesiologists Physical Status Classification, smoking history, diabetes status, and amoxicillin allergy. Tooth-level factors included position, presence of restorations, and periodontal conditions with preprosthetic treatments. RESULTS The results of this study indicate that the patient-level factors significantly associated with tooth retention included age, sex, American Society of Anesthesiologists Physical Classification Status, and amoxicillin allergy. Tooth-level factors such as core buildup, full-coverage crown, healthy periodontium, and scaling and root planing were also associated with higher survival rates. Mandibular premolars had higher survival rates than mandibular molars. CONCLUSIONS This investigation revealed that the tooth retention rate of endodontically treated teeth was 96.2% after initial root canal treatment, 92.4% for nonsurgical re-treatment, and 97.8% for surgical re-treatment. PRACTICAL IMPLICATIONS The tooth retention of the endodontic treatment was associated with healthy periodontium, tooth structure, tooth position, tooth restoration, and the patient's overall health.
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de Jesus Oliveira LS, de Figueiredo FED, Dantas JA, Ribeiro MAG, Estrela C, Sousa-Neto MD, Faria-E-Silva AL. Impact XP-endo finisher on the 1-year follow-up success of posterior root canal treatments: a randomized clinical trial. Clin Oral Investig 2023; 27:7595-7603. [PMID: 37867163 DOI: 10.1007/s00784-023-05349-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE To evaluate the clinical relevance of using the XP-endo Finisher as a supplementary tool to improve the success of root canal treatment of posterior teeth with apical periodontitis, as assessed by 1-year follow-up. METHODS A randomized clinical trial was conducted with 92 posterior teeth with apical periodontitis. Root canal treatment was performed using a single reciprocating file, with or without the supplementary use of the XP-endo Finisher. The status of apical periodontitis was assessed using the periapical index (PAI) at baseline and 1 year follow-up. Changes on PAI indicated that the lesions were healed, healing, or not healed. Successful treatments were defined as healed or healing lesions without clinical symptoms. Chi-square analysis and logistic regression were used for data analysis (α = 0.05). RESULTS There was no significant difference in the distribution of healing status between the XP-endo Finisher group and the control group (p = 0.690). The success rates were also similar, with 81% in the XP-endo Finisher group and 78% in the control group. However, gender had a significant impact on success rates, with higher rates observed in females. CONCLUSIONS The use of the XP-endo Finisher file as a supplementary tool did not affect the success rate of root canal treatment in posterior teeth with apical periodontitis. The findings indicate that the XP-endo Finisher file has limited clinical relevance in improving treatment outcomes for root canal treatment in posterior teeth with apical periodontitis. CLINICAL TRIAL REGISTRATION The study protocol was registered in the Brazilian Clinical Trials Registry under identification number RBR-76w7cj (June 19, 2018).
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Affiliation(s)
- Ludmila Smith de Jesus Oliveira
- Graduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Fabricio Eneas Diniz de Figueiredo
- Graduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Janaina Araújo Dantas
- Department of Dentistry, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Maria Amália Gonzaga Ribeiro
- Department of Dentistry, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Av. Universitária, s/n - Setor Leste Universitário, Goiânia, GO, 74605-020, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, SP, 14020-904, Brazil
| | - André Luis Faria-E-Silva
- Graduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil.
- Department of Dentistry, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil.
- Departamento de Odontologia, Campus da Saúde, Universidade Federal de Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil.
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Williams-Beecher C, Basrani B, Desai S, Cardoso EOC, Tenenbaum HC, Azarpazhooh A. A Retrospective Study on Endodontic Treatment Outcomes in Patients with Special Needs. J Endod 2023:S0099-2399(23)00241-8. [PMID: 37164169 DOI: 10.1016/j.joen.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/12/2023]
Abstract
INTRODUCTION Outcomes of endodontic treatment in patients with special needs are not fully understood, leading to reluctance in performing endodontic treatment. METHODS This retrospective cohort study evaluated the periapical healing and tooth survival in patients with special needs who had permanent teeth endodontically treated in a hospital setting between 1998 to 2019. Data characterization was performed using univariate analyses. Logistic and Cox regression analyses (P<0.05) were performed to identify the odds ratio (OR) and hazard ratio (HR) of the potential prognostic factors, respectively. These predictors were chosen from previous outcome studies in the general population and patients with special needs. RESULTS 61 patients (108 teeth) met the inclusion criteria. Most common treatment modality was initial therapy with 81.5% of cases being managed without a need for general anesthesia. Healing rate for initial endodontic treatment was 89.9% and was affected by no restoration at follow-up (OR=0.15, 95%CI:0.12, 0.71, P=0.02). After a mean follow up of 79.36±59.6 months, the survival rate was 73% and was correlated with gender (HR for males = 0.3; 95% CI, 0.1-0.6; P <0.05) and age (HR for patients >45 years = 3.7; 95% CI, 1.7-8.2; P<0.05). The most common reason for tooth extraction was unrestorable tooth fracture. CONCLUSIONS Endodontic therapy without a need for general anesthesia is a viable treatment option for patients with special needs. If the overall patient condition permits, then treatment can be administered by community dentists rather than waiting for a patient to be seen in a hospital setting.
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Affiliation(s)
| | - B Basrani
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - S Desai
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - E O C Cardoso
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - H C Tenenbaum
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - A Azarpazhooh
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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9
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Gulabivala K, Ng YL. Factors that affect the outcomes of root canal treatment and retreatment-A reframing of the principles. Int Endod J 2023; 56 Suppl 2:82-115. [PMID: 36710532 DOI: 10.1111/iej.13897] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023]
Abstract
This paper undertakes a broad and comprehensive synthesis of relevant clinical, biological, biomechanical, technical and healthcare services data to understand the factors affecting outcomes of periapical healing after root canal (re)treatment. The medical and dental evidence-based era (1980-present) is contextualized with the earlier evidence drive in endodontics (1911-1940) triggered by the focal infection era. The current evidence-based approach has a sharper focus on evidence quality and derivation of practice guidelines. Contrary views question whether guideline-driven, or expertise-development-driven endeavours would best serve outcome improvement in society. The endodontic discipline functions in a broad healthcare framework and sustains industrial, economic and trend pressures that may be deemed to influence outcomes. The nature of root canal treatment and the challenges in determining the factors that affect its outcomes is discussed. The factors potentially affecting periapical healing after root canal treatment are classified into pre-operative, intra-operative and postoperative groups. These categories subsume multiple elements with interactive influences, creating a complex picture, further confounded by some apparently surprising, counter-intuitive and contradictory findings. The technical versus biological conundrum in root canal treatment continues to cause cognitive dissonance. However, due reflection and cross-discipline-synthesis resolve the apparent data conflicts into a very simple, consistent and plausible picture of how root canal treatment works and the key factors that affect periapical healing. Root canal retreatment is considered mainly in the context of its differences from primary treatment as the majority of factors influencing outcomes are common to both. The exceptional difference is that retreatments have a proportionately reduced probability of healing by virtue of compromised apical root canal ramification access or modified host/infection interactions. Root canal (re)treatment outcomes are dominantly influenced by the nature of prior dynamic host/infection interaction (pre-operative patient factors) and how the direction of this dynamic is influenced by two factors: (1) the active efficacy of the operators' root canal treatment protocol to sustain a microbial ecological shift (intra-operative treatment factors) and dampen periapical inflammation; and (2) the passive ability of the functional tooth (and its restoration margin) to maintain its integrity to resist infection reversal (postoperative restorative factors).
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Affiliation(s)
- Kishor Gulabivala
- Unit of Endodontology, Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, UK
| | - Yuan Ling Ng
- Unit of Endodontology, Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, UK
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10
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Coşar M, Kandemir Demirci G, Çalışkan MK. The effect of two different root canal sealers on treatment outcome and post-obturation pain in single-visit root canal treatment: A prospective randomized clinical trial. Int Endod J 2023; 56:318-330. [PMID: 36385378 DOI: 10.1111/iej.13870] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
Abstract
AIM This randomized clinical trial aimed to evaluate and compare the effect of mineral trioxide aggregate (MTA)-based bioceramic- and resin-based sealers on the incidence and intensity of post-obturation pain and treatment outcome in asymptomatic vital molar teeth in single-visit root canal treatment. METHODOLOGY One hundred asymptomatic mandibular molar teeth with vital pulp were randomly assigned into two groups according to the sealer used: MTA Fillapex or AH Plus sealer. WaveOne Gold instruments were used for root canal preparations. Root canals were obturated with WaveOne Gold gutta-percha cones corresponding in size and taper to the last instrument used. MTA Fillapex was used in the first group and AH Plus was used in the second group as the root canal sealer. The effects of age, gender, tooth types and the level of root canal filling on the treatment outcome were evaluated after 1 and 2 years. Postoperative pain at 6, 12, 24, 48, 72 h, 4, 5, 6, 7 and 30 days after root canal treatment was measured with the Numerical Rating Scale. Chi-square test was used for the treatment outcome and Mann-Whitney U, chi-Square and Spearman correlation analyses were used for postoperative pain. α = .05 was the level of significance. RESULTS Twelve patients did not complete the 2-year follow-up and the study finished with 88 patients. In the MTA Fillapex group 41 correct, one short, two extruded, and in the AH Plus group 40 correct, one short and three extruded root canal fillings were detected. No significant differences were observed between the first- and second-year treatment outcomes between the groups (p > .05).There was no association between age, gender, tooth number, root canal filling length and the treatment success in all evaluated teeth (p > .05). The differences between the groups in terms of postoperative pain incidence and intensity at all time-points were not significant (p > .05). There was no correlation between the age and postoperative pain (p > .05), but pain was statistically higher in women (p < .05). CONCLUSIONS Mineral trioxide aggregate Fillapex showed similar success rate and post-obturation pain incidence and intensity as AH Plus sealer and can be used as a root canal sealer in asymptomatic mandibular molars with irreversible pulpitis.
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Affiliation(s)
- Melis Coşar
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
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11
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Nagendrababu V, Vinothkumar TS, El-Karim I, Rossi-Fedele G, Doğramaci EJ, Dummer PMH, Duncan HF. DENTAL PATIENT-REPORTED OUTCOMES IN ENDODONTICS - A NARRATIVE REVIEW. J Evid Based Dent Pract 2023; 23:101805. [PMID: 36914302 DOI: 10.1016/j.jebdp.2022.101805] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/11/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022]
Abstract
Recently in oral health care settings, the focus of assessing treatment outcomes has shifted from the perspective of the clinician towards that of the patient. Endodontology is a specialty of dentistry concerned with the prevention and treatment of pulp and periapical diseases. Research in endodontology and its associated treatment outcomes have focused mainly on clinician-reported outcomes (CROs) and not dental patient-reported outcomes (dPROs). As a result, there is a need to emphasize the importance and relevance of dPROs to researchers and clinicians. The aim of this review is to present an overview of dPROs and dPROMs within endodontics in an attempt to create a better understanding of the patient experience, highlight the need to place the patient at the center of treatment, enhance patient care and encourage more research into dPROs. The key dPROs following endodontic treatment include pain, tenderness, tooth function, need for further intervention, adverse effects (exacerbation of symptoms, tooth discoloration) and Oral Health-Related Quality of Life. dPROs are important following endodontic treatment because they assist clinicians and patients when they discuss and select the most appropriate management options, help clinicians make decisions on pre-operative assessment, prevention and treatment, and improve the methodology and design of future clinical studies. Clinicians and researchers in endodontology should prioritize patient welfare and undertake routine analyses of dPROs using appropriate and robust measures. Due to the lack of agreement over the reporting and definition of endodontic treatment outcomes, a comprehensive project to define a ``Core Outcome Set for Endodontic Treatment Methods (COSET)'' is currently ongoing. In the future, a new and exclusive assessment tool should be developed to reflect the viewpoints of patients receiving endodontic treatment more accurately.
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Affiliation(s)
- Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE.
| | - Thilla Sekar Vinothkumar
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia; Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Ikhlas El-Karim
- School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | | | - Esma J Doğramaci
- Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
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12
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Jiang J, Sun J, Huang Z, Bi Z, Yu G, Yang J, Wang Y. The state of the art and future trends of root canal files from the perspective of patent analysis: a study design. Biomed Eng Online 2022; 21:90. [PMID: 36566212 PMCID: PMC9789667 DOI: 10.1186/s12938-022-01060-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/14/2022] [Indexed: 12/25/2022] Open
Abstract
The goal of this review is to present a detailed and comprehensive description of the published work from the past decade regarding methods of improved material, geometric design, and additional functions in root canal files. The main improved methods of files and the most common technologies were further addressed, underlining their advantages and main limitations. Online databases (the Derwent Innovations Index) were consulted on this topic. Published work from 2010 to 2022 was collected and analyzed the relevant papers were chosen for inclusion in this review. The patent map classified the latest phase of the root canal files based on the analysis of the number of patents. The performance of the root canal files, such as materials. Directly affects the quality of the root canal therapy. We provided a thorough review of advances in the field of root canal files. In particular, three categories of improved methods were examined and compared, including material-based methods, geometry-based methods, and those based on additional functions. To understand this state of the art of different improved methods of root canal files, we conducted a literature analysis and a series of comparisons between different methods. The features and limitations of each method of root canal files were further discussed. Finally, we identified promising research directions in advancing the methods for the improved performance of root canal files. There is no perfect technology for all material/geometric design/additional functions, capable alone of fulfilling all the specificity and necessities of every patient. Although it is very promising, the material of the files remains understudied, and further work is required to make material science a pervasive technology in root canal therapy, and contribute to endodontic and periapical diseases by assisting in the subsequent development of root canal files.
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Affiliation(s)
- Jingang Jiang
- grid.411994.00000 0000 8621 1394Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, 150080 Heilongjiang People’s Republic of China ,grid.19373.3f0000 0001 0193 3564State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin, 150001 Heilongjiang People’s Republic of China
| | - Jianpeng Sun
- grid.411994.00000 0000 8621 1394Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, 150080 Heilongjiang People’s Republic of China
| | - Zhiyuan Huang
- grid.19373.3f0000 0001 0193 3564State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin, 150001 Heilongjiang People’s Republic of China
| | - Zhuming Bi
- grid.503846.c0000 0000 8951 1659Department of Civil and Mechanical Engineering, Purdue University Fort Wayne, West Lafayette, 46805 USA
| | - Guang Yu
- grid.12527.330000 0001 0662 3178Department of Mechanical Engineering, Tsinghua University, Beijing, 100084 People’s Republic of China
| | - Jingwen Yang
- grid.11135.370000 0001 2256 9319National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School of Stomatology, Beijing, 100081 People’s Republic of China ,grid.11135.370000 0001 2256 9319Peking University School of Stomatology, Beijing, 100081 People’s Republic of China
| | - Yong Wang
- grid.11135.370000 0001 2256 9319National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School of Stomatology, Beijing, 100081 People’s Republic of China ,grid.11135.370000 0001 2256 9319Peking University School of Stomatology, Beijing, 100081 People’s Republic of China
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13
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Kaplan T, Kaplan SS, Sezgin GP. The effect of different irrigation and disinfection methods on post-operative pain in mandibular molars: a randomised clinical trial. BMC Oral Health 2022; 22:601. [PMID: 36514017 PMCID: PMC9746019 DOI: 10.1186/s12903-022-02651-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND To examine post-operative pain (PP) after conventional irrigation and sonic activation methods, with and without laser disinfection in mandibular molars. METHODS Eighty patients with symptomatic apical periodontitis were included in this randomized clinical study. There were four study groups. In group 1, conventional irrigation only was applied. In group 2, a sonic irrigation activation system (EDDY (VDW, Munich, Germany)), was applied. In groups 3 and 4, irradiation with a 980-nm diode laser was performed, following irrigation with the conventional method and sonic irrigation activation system, respectively. The patients were instructed to record their PP and analgesic intake using a numerical rating scale 8, 24, 48 h and 7 days post-procedure. A chi-square test, Fisher's exact chi-square test and Fisher-Freeman-Halton exact test were used to assess qualitative data. Inter-group and intra-group parameters were assessed using the Kruskal-Wallis test and Wilcoxon's test at a significance level of p < 0.05. RESULTS There was no statistically significant difference among the groups in terms of age, sex, pre-operative pain, PP and analgesic intake (p > 0.05). CONCLUSIONS The use of sonic irrigation activation system in the final irrigation protocol and irradiation with the 980-nm diode laser did not significantly reduce PP levels and analgesic intake.
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Affiliation(s)
- Tuna Kaplan
- Department of Endodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - Sema Sönmez Kaplan
- Department of Endodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey.
| | - Güzide Pelin Sezgin
- Department of Endodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey
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14
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Burns LE, Kim J, Wu Y, Alzwaideh R, McGowan R, Sigurdsson A. Outcomes of Primary Root Canal Therapy: An updated Systematic Review of Longitudinal Clinical Studies Published between 2003 and 2020. Int Endod J 2022; 55:714-731. [PMID: 35334111 PMCID: PMC9322405 DOI: 10.1111/iej.13736] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/17/2022] [Accepted: 03/22/2022] [Indexed: 12/04/2022]
Abstract
Background A comprehensive effort to evaluate outcomes of primary root canal therapy (RCT) between 1966 and 2002 was published by Ng et al. (2007, International Endodontic Journal, 40, 921; 2008, International Endodontic Journal, 41, 6). Changes in endodontic materials and treatment methods warrant an updated analysis of outcomes. Objectives This study aimed to (1) quantify the success rates of primary RCT published between 2003 and 2020; and (2) investigate the influence of some characteristics known/suspected to be associated with treatment outcomes. Methods An electronic search was performed in the following databases (01‐01‐2003 to 12‐31‐2020): Pubmed, Embase, CINHAL, Cochrane and Web of Science. Included study designs were longitudinal clinical studies (randomized control trials, cohort studies, retrospective observational studies). Studies with at least twelve‐months of post‐operative review and success rates based on clinical and radiographic criteria were analysed. The terms ‘strict’ (complete resolution of periapical lesion) or ‘loose’ (reduction in size of existing periapical lesion) were used to describe the outcome criteria. Weighted, pooled success rates were calculated. Random effects meta‐regression models were used to investigate potential sources of statistical heterogeneity. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to evaluate for quality assessment of the included studies. Results Forty‐two studies were included in the review. Meta‐analyses showed that the weighted pooled success rates were estimated to be 92.6% (95% CI: 90.5%–94.8%) under ‘loose criteria’ and 82.0% (95% CI: 79.3%–84.8%) under ‘strict’ criteria. The most significant areas of study heterogeneity were year of publication and qualification of operator. The majority (64.29%) of studies were considered to be of low quality of evidence. Discussion Biological factors continue to have the most significant impact on RCT outcomes. The technological method of instrumentation had no significant effect. The quality of evidence was based primarily on study design and only randomized control trials were considered to be ‘high’ quality of evidence. Conclusions The reported success rates show improvement over time. Weighted success rates for studies with a minimum of four‐years follow‐up had better outcomes, compared to those with less than four years, when ‘strict criteria’ were used. Registration PROSPERO database (CRD42021226311).
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Affiliation(s)
- L E Burns
- New York University College of Dentistry, Department of Endodontics, New York
| | - J Kim
- New York University College of Dentistry, Department of Endodontics, New York
| | - Y Wu
- New York University Langone Health, Department of Population Health, Division of Biostatistics, New York
| | - R Alzwaideh
- New York University College of Dentistry, Department of Endodontics, New York
| | - R McGowan
- New York University, Health Sciences Library
| | - A Sigurdsson
- New York University College of Dentistry, Department of Endodontics, New York
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15
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Marconi DF, da Silva GS, Weissheimer T, Silva IA, Só GB, Jahnke LT, Skupien JA, Só MVR, da Rosa RA. Influence of the root canal filling technique on the success rate of primary endodontic treatments: a systematic review. Restor Dent Endod 2022; 47:e40. [DOI: 10.5395/rde.2022.47.e40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/18/2022] [Accepted: 08/10/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Daniel Feijolo Marconi
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Giovana Siocheta da Silva
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Theodoro Weissheimer
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Isadora Ames Silva
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Gabriel Barcelos Só
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Leonardo Thomasi Jahnke
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Jovito Adiel Skupien
- Health and Life Sciences Master’s and Dental School, Franciscan University (UFN), Santa Maria, RS, Brazil
| | - Marcus Vinicius Reis Só
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Bufersen S, Jones J, Shanmugham J, Hsu TY, Rich S, Ziyab AH, Chogle S. Survival of endodontically treated permanent teeth among children: a retrospective cohort study. BMC Oral Health 2021; 21:589. [PMID: 34798851 PMCID: PMC8603487 DOI: 10.1186/s12903-021-01952-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/03/2021] [Indexed: 11/25/2022] Open
Abstract
Background Outcome studies of nonsurgical root canal treatment (NSRCT) in permanent teeth of children are scarce. This study investigated survival and assessed the variables associated with failure of endodontically treated teeth (ETT) in 6- to 18-year-olds. Methods Records of subjects who received NSRCT at age 6–18 years at Boston University between 2007 and 2015 were assessed for the occurrence of untoward events. Kaplan–Meier survival curves were used to investigate the survival of ETT in the total sample. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated. Results The analysis included 341 patients (424 ETT). Kaplan–Meier survival curves differed according to age at treatment (log-rank P = 0.026), with survival being the lowest among the youngest age group. The estimated 5-year survival probability was 80% for 15- to 18-year-olds, 64.8% for 12- to 14-year-olds and 46.4% for 6- to 11-year-olds. Compared to age at treatment of 15–18 years, age at treatment of 6–11 years (aHR: 2.19, 95% CI 1.02–4.67) and 12–14 years (aHR: 2.02, 95% CI 1.15–3.55) was associated with an increased risk of ETT failure. In the total study sample, the estimated cumulative survival probability was 93.3% at 12 months, 88.0% at 24 months, 76.2% at 36 months, 71.0% at 48 months, and 69.1% at 60 months. Conclusions In children, ETT are more likely to survive when NSRCTs are performed at an older age.
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Affiliation(s)
- Saitah Bufersen
- Department of Endodontics, Boston University Henry M Goldman School of Dental Medicine, 635 Albany St, G200, Boston, MA, 02118, USA.
| | - Judith Jones
- Department of Endodontics, Boston University Henry M Goldman School of Dental Medicine, 635 Albany St, G200, Boston, MA, 02118, USA.,University of Detroit Mercy School of Dentistry, Detroit, MI, USA
| | - Jayapriyaa Shanmugham
- Department of Endodontics, Boston University Henry M Goldman School of Dental Medicine, 635 Albany St, G200, Boston, MA, 02118, USA
| | - Tun-Yi Hsu
- Department of Endodontics, Boston University Henry M Goldman School of Dental Medicine, 635 Albany St, G200, Boston, MA, 02118, USA
| | - Sharron Rich
- Department of Endodontics, Boston University Henry M Goldman School of Dental Medicine, 635 Albany St, G200, Boston, MA, 02118, USA
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Sami Chogle
- Department of Endodontics, Boston University Henry M Goldman School of Dental Medicine, 635 Albany St, G200, Boston, MA, 02118, USA
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Bytyqi A, Aliu X, Barani M, Stubljar D, Jukic T, Starc A, Krasniqi S. Disinfection of Infected Artificial Dental Periapical Lesions with Diode Laser: An In Vitro Study. Med Sci Monit Basic Res 2021; 27:e932492. [PMID: 34369916 PMCID: PMC8325393 DOI: 10.12659/msmbr.932492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Periapical lesions are primarily caused by infections in the root canals. The objective of this study was to assess the antibacterial effectiveness of diode laser during root canal treatment in artificial models of infected periapical lesions. Material/Methods One hundred twenty-two extracted premolar single-rooted teeth were inserted into methyl methacrylate artificial models of periapical lesions, and bacterial solutions of Enterococcus faecalis (ATCC 29212) and Streptococcus mitis (ATCC 49456) were then applied to the models. The respective diameters of lesions in the artificial models represented 3 different subgroups based on lesion size. The laser protocol used for endodontic disinfection had a power output of 1.5 W and a wavelength of 810 nm. The impact on cell viability was evaluated by flow cytometry. Results Disinfection with laser did not differ between microorganisms (P=0.137), and laser irradiation with a longer duration had better disinfecting action for both microorganisms (P<0.001). Compared with larger lesions, smaller lesions had a higher percentage of dead cells for both microorganisms (P<0.001). The percentage of dead cells in the treatment groups was significantly higher than in the control group (P<0.001). Conclusions Laser treatment had a poor, almost negligible effect on elimination of bacterial cells in large periapical lesions. Application of a laser might serve as an adjuvant method to standard irrigation with sodium hypochlorite.
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Affiliation(s)
- Agron Bytyqi
- College of Medical Sciences - Rezonanca, Pristina, Kosovo
| | - Xhevdet Aliu
- University for Business and Technology, Faculty of Dentistry, Pristina, Kosovo
| | - Merita Barani
- University for Business and Technology, Faculty of Dentistry, Pristina, Kosovo
| | - David Stubljar
- Department of Research and Development, In-Medico, Metlika, Slovenia
| | - Tomislav Jukic
- Department of Internal Medicine, History of Medicine and Medical Ethics, Faculty of Medicine Osijek, University Josip Juraj Strossmayer, Osijek, Croatia
| | - Andrej Starc
- Chair of Public Health, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Sokol Krasniqi
- Faculty of Medicine, University of Pristina, Prishtina, Kosovo
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Influence of post type on periapical status: a prospective study in a Brazilian population. Clin Oral Investig 2021; 26:781-787. [PMID: 34231058 DOI: 10.1007/s00784-021-04057-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 06/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This prospective study assessed the effect of post type used to restore endodontically treated teeth in the onset, progression, and remission of periapical lesions. MATERIALS AND METHODS One hundred and forty teeth (92 patients) were endodontically treated and received a glass fiber post or a cast metal post and a final restoration at a University Clinic by undergraduate students. All patients were followed up for a mean period of 5.1 ± 2.2 years. Periapical Index (PAI) was used for endodontic assessment. Two calibrated and blind examiners assessed the radiographs. The longevity of the endodontic treatment was analyzed using Kaplan-Meier statistics. RESULTS Of the included teeth, 67.1% received glass fiber posts while 32.9% received cast metal posts. There were 4 endodontic failures, two glass fiber posts with a PAI = 3 in the baseline and PAI = 4 in the last follow-up, and one PAI = 4 in baseline and last follow-up. One cast metal post-failure was PAI = 4 in the baseline and the last follow-up. After 9.4 years, the overall success rate of the endodontic treatment was 97.1% (p = 0.7). CONCLUSIONS The tested posts presented similar endodontic healing. Precautions taken during endodontic therapy, post cementation, and final restoration are more likely to be responsible for the success of endodontic treatment rather than a specific type of post. Clinical relevance The type of post is not related to the success of the endodontic treatment.
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Liao WC, Tsai YL, Chen KL, Blicher B, Chang SH, Yeung SY, Chang MC, Jeng JH. Cracked teeth: Distribution and survival at 6 months, 1 year and 2 years after treatment. J Formos Med Assoc 2021; 121:247-257. [PMID: 33858736 DOI: 10.1016/j.jfma.2021.03.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/15/2021] [Accepted: 03/22/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/PURPOSE The unpredictable condition of cracked teeth warrants further investigation and clinical experiences. The purpose of this study was to collect and record data on demographics, clinical characteristics, different treatment modalities and survival of cracked teeth at 6-month, 1-year and 2-year recalls. METHODS 77 cracked teeth from 65 patients were included. Data on demographics, clinical parameters, treatment modalities and recall were collected. Binomial, multinomial and chi square tests were used for statistical analysis. RESULTS Most cracked teeth occurred in patients greater than 40 years old (p < 0.01). Cracked teeth themselves were most often molars (79.22%; p < 0.01), a non-terminal tooth in the arch (62.34%; p < 0.05) and nonendodontically-treated teeth (94.81%; p < 0.01). Cracked teeth exhibited pain to percussion (63.64%, p < 0.05) or biting (74.03%; p < 0.01), and no or only positive mobility (76.62%; p < 0.01). Cracks were most often oriented in the mesiodistal direction (68.83%; p < 0.01). Higher survival rates were noted in cracked teeth lacking pre-operative pain to palpation or spontaneous pain, and with no or only positive mobility at 6-month and 1-year recalls. In vital cracked teeth, higher survival rates were noted in teeth lacking pre-operative pain to palpation and with no or only positive mobility at 2-year recalls. CONCLUSION The absence of pre-operative palpation discomfort, spontaneous pain and minimal mobility, as well as the presence of pulp vitality were associated with higher survival rates of cracked teeth at all recall times. Results are useful for diagnosis and outcomes-based treatment planning of cracked teeth.
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Affiliation(s)
- Wan-Chuen Liao
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ling Tsai
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Liang Chen
- Department of Dentistry, Chi-Mei Medical Center, Tainan, Taiwan
| | | | - Shu-Hui Chang
- School of Public Health, National Taiwan University, Taipei, Taiwan
| | - Sin-Yuet Yeung
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Mei-Chi Chang
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan; Chang Gung University of Science and Technology, Kwei-Shan, Taoyuan, Taiwan.
| | - Jiiang-Huei Jeng
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Essam O, Boyle EL, Whitworth JM, Jarad FD. The Endodontic Complexity Assessment Tool (E-CAT): A digital form for assessing root canal treatment case difficulty. Int Endod J 2021; 54:1189-1199. [PMID: 33682086 DOI: 10.1111/iej.13506] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/29/2022]
Abstract
AIMS To develop an evidence-based, valid and reliable assessment tool that educational establishments and dental practitioners may use to assess the complexity of root canal treatment (RCT) utilizing digital advancements. The study also aimed to provide a more objective definition of the term 'uncomplicated' root canal treatment as described by the Association for Dental Education in Europe (ADEE) and the European Society of Endodontology (ESE) undergraduate curriculum guidelines for Endodontology. METHODOLOGY The development process involved a narrative review of the literature to identify the complexity factors associated with root canal treatment on permanent teeth; an iterative development and analysis process to assess the weighting of these factors; and the programming of digital software to enhance the efficiency and user interface of the assessment form. Validation of the tool was sought with a panel of 35 specialist endodontists to assess clinical scenarios and assess the consensus inter-examiner agreement with the outcomes provided by the E-CAT. The inter-user and intra-user reliability studies were conducted with 15 dentists to evaluate the same clinical cases and by repeating the experiment 9 months later. The ease of use of the form was also assessed. RESULTS The E-CAT was successfully developed with a total of 19 complexity criteria and hosted on a secure server under the domain of www.e-cat.uk. The tool provides a smart interactive filtering mechanism and automatic background calculation of the risk scores. Three levels of complexity were defined: class I (uncomplicated), class II (moderately complicated) and class III (highly complicated). The consensus of the panel of endodontists had excellent agreement with the outcome of the E-CAT. The inter-user and intra-user reliability was found to be 0.80 and 0.90, respectively. The average time to assess a case was 1:36 min. CONCLUSION The E-CAT gave promising results providing an efficient and reliable platform to assess the complexity of cases undergoing root canal treatments. The study design allowed the formulation of a more objective definition to describe 'uncomplicated' root canal treatment as referred to by the ESE and ADEE guidelines. This study is advantageous for educational, public health and referral pathways.
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Affiliation(s)
- O Essam
- Department of Restorative Dentistry, School of Dentistry, University of Liverpool, Liverpool, UK
| | - E L Boyle
- Department of Restorative Dentistry, School of Dentistry, University of Liverpool, Liverpool, UK
| | - J M Whitworth
- School of Dental Sciences, Newcastle University, Newcastle-upon-Tyne, UK
| | - F D Jarad
- Department of Restorative Dentistry, School of Dentistry, University of Liverpool, Liverpool, UK
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Zhang MM, Fang GF, Chen XT, Liang YH. Four-year Outcome of Nonsurgical Root Canal Retreatment Using Cone-beam Computed Tomography: A Prospective Cohort Study. J Endod 2020; 47:382-390. [PMID: 33130061 DOI: 10.1016/j.joen.2020.10.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The purpose of this prospective study was to investigate the 4-year outcome and prognostic factors of nonsurgical root canal retreatment determined by measuring the volumetric change of periapical radiolucencies on cone-beam computed tomographic (CBCT) scans. METHODS Ninety-seven endodontically treated teeth from 80 patients diagnosed as apical periodontitis and indicated for root canal retreatment were included. Retreatment was performed by 7 endodontic specialists using a standardized treatment protocol. The teeth were reexamined clinically and radiographically 48-67 months after retreatment. The volume of preoperative and postoperative periapical radiolucencies on CBCT images was independently measured by 2 examiners. Radiographic outcome is presented in 4 categories: absence, reduction, enlargement, or unchanged. Reduction or enlargement was determined when the volumetric change of radiolucency was 20% or more. Multivariate logistic regression was performed for predictor analysis. RESULTS Sixty-two teeth (63.9%) from 50 patients returned for follow-up. Fifty-eight teeth were included in the prognostic analysis, all of which were symptom free. The 4 remaining teeth that had been extracted because of fracture were excluded. The total volume of periapical radiolucencies at 4 years postoperatively decreased by 94.6% compared with that preoperatively (P < .001), with an average reduction of 83.4% (95% confidence interval, 69.2%-97.5%). The periapical radiolucencies were determined as absence in 44 teeth (75.9%), reduction in 10 teeth (17.2%), unchanged in 1 tooth (1.7%), and enlargement in 3 teeth (5.2%). Tooth type was identified as an outcome predictor (P < .05). CONCLUSIONS The 4-year outcome of endodontic retreatment is predictable, with a significant volumetric reduction in periapical radiolucencies.
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Affiliation(s)
- Ming-Ming Zhang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Gao-Feng Fang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiao-Tong Chen
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yu-Hong Liang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China; Department of Stomatology, Peking University International Hospital, Beijing, China.
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Verma A, Yadav RK, Tikku AP, Chandra A, Verma P, Bharti R, Shakya VK. A randomized controlled trial of endodontic treatment using ultrasonic irrigation and laser activated irrigation to evaluate healing in chronic apical periodontitis. J Clin Exp Dent 2020; 12:e821-e829. [PMID: 32994870 PMCID: PMC7511050 DOI: 10.4317/jced.56368] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/24/2020] [Indexed: 11/29/2022] Open
Abstract
Background Aim of this trial was to evaluate the combined clinical and radiographic success rate of endodontic treatment using passive ultrasonic irrigation (PUI) and laser activated irrigation (LAI) as compared to conventional syringe irrigation.
Material and Methods Permanent incisors and single rooted premolars were assessed for eligibility and 69 patients were randomly divided into three treatment groups (n=23) by allocation concealment method and irrigation was performed in accordance with the allocated group. Teeth were evaluated clinically and radiographically with CBCT after 6 months and 12 months of the treatment.
Results A significant difference was observed in the radiographic healing rates among three groups (χ2=12.29, p=0.05). On comparing the final outcome among the three groups (n=19), it was found that 2 (10.5%) cases of group I(Conventional Syringe irrigation), 7 (36.8%) cases of group II (Passive ultrasonic irrigation) and 8 (42.1%) cases of group III(Laser activated irrigation) were healed while under healing category 13 (68.4%) cases of group I, 12 (63.2%) cases of group II and 11 (57.9%) of group III were observed whereas 4 (21.1%) cases were categorised as diseased in group I only.
Conclusions LAI and PUI can increase the predictability of the endodontic treatment success in cases of chronic apical periodontitis. Key words:Cone-beam computed tomography, CBCT-PAI, Irrigation, LASER, Radiographic healing, Root canal treatment, Ultrasonic.
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Affiliation(s)
- Akansha Verma
- Professor, Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, U.P., India
| | - Rakesh-Kumar Yadav
- Professor, Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, U.P., India
| | - Aseem-Prakash Tikku
- Professor, Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, U.P., India
| | - Anil Chandra
- Professor, Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, U.P., India
| | - Promila Verma
- Professor, Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, U.P., India
| | - Ramesh Bharti
- Professor, Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, U.P., India
| | - Vijay-Kumar Shakya
- Professor, Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, U.P., India
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Ince Yusufoglu S, Ugur Aydin Z, Tulumbaci F, Bayrak S. Evaluation of different Apexification treatments of teeth with immature apices and apical periodontitis on the fractal dimensions of trabecular bone. AUST ENDOD J 2020; 47:163-169. [PMID: 32902092 DOI: 10.1111/aej.12441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/08/2020] [Accepted: 08/12/2020] [Indexed: 01/22/2023]
Abstract
The aim of the present study was to investigate in the fractal dimension (FD) time-dependent changes of periapical bone after two different apexification treatments in teeth with immature apices and apical periodontitis. This study included 55 cases treated with apexification. Cases were divided into two groups: a calcium hydroxide group and a mineral trioxide aggregate group. In each case, the lesion area was evaluated by fractal analysis on periapical radiographs obtained before and 1-year after treatment via Image-J program. The FD of each region of interest on the radiographs was calculated using the fractal analysis method. The data were statistically analysed. In both groups, the FD values increased compare to initial at 1-year follow-up after treatment (P < .05). There was no statistically significant difference between the groups in terms of the time-dependent increase in FD values (P = 0.118). In the present study, time-dependent changes in FD were independent of the apexification method.
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Affiliation(s)
- Selen Ince Yusufoglu
- Faculty of Dentistry, Departments of Endodontics, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Zeliha Ugur Aydin
- Faculty of Dentistry, Departments of Endodontics, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Fatih Tulumbaci
- Faculty of Dentistry, Departments of Pedodontics, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Seval Bayrak
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Working Length Transfer in the Endodontic Clinical Practice: A Comparative Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10175824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present paper evaluated the accuracy of two different methods for transferring working length (WL) between manual endodontic instruments and nickel–titanium (NiTi) shaping files. Thirty root canals of extracted permanent teeth were used. Root canals were divided according to canal length (CL) and canal curvature (CC). The reference cusp and the root end were flattened to provide reproducible and accurate measurements. During shaping, the WL measurements were obtained with manual k-files (KF) and transferred to WaveOne (W1) NiTi reciprocating files using the traditional method with the endodontic ruler (method I) and an alternative clinical procedure based on the comparison of the instruments side by side from tip to shank (method II). For each file and each tested method, two measures were taken by two examiners using Rhino (ver. 4.0, McNeel, Seattle, WA, USA) software for a total of 360 (30 × 3 × 2 × 2) measures. Analysis of variance was performed by taking the difference in length (Delta WL, DWL) between files used for the same canal. The difference between methods I and II for WL transfer was found to be statistically significant (df = 1; F = 71.52; p < 0.001). The DWL absolute values obtained with method II were found to be closer to 0 mm (i.e., same length as corresponding KF) than those obtained with method I. Both CL (df = 2; F = 1.27; p = 0.300) and CC (df = 1; F = 2.22; p = 0.149) did not significantly influence WL measurements. With respect to WL transfer, method II seemed to better preserve the correct WL transfer between instruments during the clinical endodontic procedures.
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Outcome of Root Canal Treatments Provided by Endodontic Postgraduate Students. A Retrospective Study. J Clin Med 2020; 9:jcm9061994. [PMID: 32630443 PMCID: PMC7355894 DOI: 10.3390/jcm9061994] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/21/2020] [Accepted: 06/23/2020] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to assess the preoperative, intraoperative, and postoperative factors that influenced complete periapical healing in teeth that underwent primary root canal treatment (RCT), in patients treated by postgraduate students in endodontics. Factors were retrieved and compared with the periapical status during the follow-up visit. Healing was considered as the absence of clinical and radiological symptoms. Variables significantly associated by the chi-squared test were included in a logistic regression model (LRM). Preoperative factors associated with healing were: American Society of Anesthesiology (ASA) status (p = 0.01); the absence of preoperative pain (p = 0.04); positive response to pulp tests; when the RCT cause was caries, pain, abscess, or sinus tract; probing depth <4 mm; the absence of mobility; absence or <4 mm periapical lesion (p < 0.01). In the LRM, the factors included were: absence or <4 mm periapical lesion; probing depths <4 mm; RCT caused by caries, pain, abscess, or sinus tract; the tooth was not a bridge abutment. Postoperative factors were: teeth with direct restoration; teeth that did not act as a support for a fixed prosthetic restoration; the favorable condition of the coronal restoration (p < 0.01). In the LRM, only the status of the coronal restoration was included. Preoperative conditions and the adequate fit of the coronal restoration influenced the outcome of RCT.
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García-Guerrero C, Delgado-Rodríguez CE, Molano-González N, Pineda-Velandia GA, Marín-Zuluaga DJ, Leal-Fernandez MC, Gutmann JL. Predicting the outcome of initial non-surgical endodontic procedures by periapical status and quality of root canal filling: a cohort study. Odontology 2020; 108:697-703. [DOI: 10.1007/s10266-020-00494-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 02/05/2020] [Indexed: 10/25/2022]
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Bletsa A, Iden O, Sulo G, Berggreen E. Work experience influences treatment approaches in endodontics: a questionnaire survey among dentists in Western Norway. Acta Odontol Scand 2019; 77:617-623. [PMID: 31271077 DOI: 10.1080/00016357.2019.1631470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: To collect information on endodontic treatment procedures among dentists in the public dental service (PDS) in Western Norway and relate this information to their work experience. Materials and methods: A survey comprised of 35 questions related to personal information, frequency of endodontic treatment, endodontic procedures and treatment principles was distributed electronically to 187 dentists in PDS in two counties of Western Norway. Results: The response rate was 74%, and 130 dentists participated. Among them, 57.0% had completed their education less than 13 years ago, and almost all were below 39 years old (95%). The majority (81.0%) had graduated in Norway. Stepwise caries excavation in primary and permanent teeth and direct pulp capping in primary teeth were more frequently performed by dentists with less than 13 years from graduation. Routine use of rubber dam was high among the responders (87%). However, use of rubber dam and master-cone radiograph uptakes were more frequent among the younger dentists. The majority used rotary instrumentation systems, and almost all participants followed the current guidelines for use of antibiotics in endodontics. Conclusions: In general, dentists in PDS follow the current endodontic treatment guidelines. However, it seems that the more recently graduated dentists perform more endodontic procedures and tend to adhere more to the taught principles regarding rubber dam use and radiograph uptakes.
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Affiliation(s)
- Athanasia Bletsa
- Oral Health Center of Expertise in Western Norway-Hordaland, Bergen, Norway
| | - Ole Iden
- Oral Health Center of Expertise in Western Norway-Hordaland, Bergen, Norway
| | - Gerhard Sulo
- Oral Health Center of Expertise in Western Norway-Hordaland, Bergen, Norway
- Center for Disease Burden, The Norwegian Institute of Public Health, Bergen, Norway
| | - Ellen Berggreen
- Oral Health Center of Expertise in Western Norway-Hordaland, Bergen, Norway
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Aminoshariae A, Kulild JC. The impact of sealer extrusion on endodontic outcome: A systematic review with meta‐analysis. AUST ENDOD J 2019; 46:123-129. [DOI: 10.1111/aej.12370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Anita Aminoshariae
- Department of Endodontics School of Dental Medicine Case Western Reserve University Cleveland Ohio USA
| | - James C. Kulild
- Department of Endodontics UMKC School of Dentistry Kansas City Missouri USA
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AbdurRahman S, Abdel Aziz SM, Gawdat SI, AbdalSamad AM. Postoperative pain of patients with necrotic teeth with apical periodontitis following single visit endodontic treatment versus multiple visit endodontic treatment using triple antibiotic paste: a randomized clinical trial. F1000Res 2019; 8:1203. [PMID: 32047601 PMCID: PMC6993827 DOI: 10.12688/f1000research.19936.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2019] [Indexed: 11/20/2022] Open
Abstract
Background: A randomized clinical trial was conducted to compare the postoperative pain following endodontic treatment of necrotic teeth with apical periodontitis. Treatments were performed in multiple visits with application of triple antibiotic paste interappointment dressing or single visit without interappointment dressing. Methods: In total 44 participants were assigned randomly into two groups. Group A: multiple visit endodontic treatment with triple antibiotic paste interappointment dressing; group B: single visit endodontic treatment without interappointment dressing. Postoperative pain of participants was assessed after 24, 48, 72 hours and one week using numerical rating scale. Results: No statistically significant difference was found in postoperative pain after 24, 48, 72 hours and one week between the two groups. Conclusion: Triple antibiotic paste as an interappointment dressing in multiple visits endodontic treatment was not proved to reduce the postoperative pain compared to a single visit in patients with necrotic teeth with apical periodontitis who did not have an interappointment dressing. Trial registration: clinicaltrials.gov, NCT02947763. Date: 28th October 2016.
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Affiliation(s)
| | | | | | - Ahmed M. AbdalSamad
- Department of Oral and Maxillofacial Radiology, Cairo University, Cairo, Egypt
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Restrepo‐Restrepo FA, Cañas‐Jiménez SJ, Romero‐Albarracín RD, Villa‐Machado PA, Pérez‐Cano MI, Tobón‐Arroyave SI. Prognosis of root canal treatment in teeth with preoperative apical periodontitis: a study with cone‐beam computed tomography and digital periapical radiography. Int Endod J 2019; 52:1533-1546. [DOI: 10.1111/iej.13168] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 06/13/2019] [Indexed: 01/15/2023]
Affiliation(s)
- F. A. Restrepo‐Restrepo
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - S. J. Cañas‐Jiménez
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - R. D. Romero‐Albarracín
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - P. A. Villa‐Machado
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - M. I. Pérez‐Cano
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - S. I. Tobón‐Arroyave
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
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Sánchez Alemán JA, García-Guerrero CC. Categorización del fracaso para el tratamiento endodóntico primario. ACTA ODONTOLÓGICA COLOMBIANA 2019. [DOI: 10.15446/aoc.v9n2.76432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: caracterizar la enfermedad periapical posterior al tratamiento endodóntico primario realizado en una cohorte de individuos asistentes a las clínicas de la Especialidad en Endodoncia de la Facultad de Odontología de la Universidad Nacional de Colombia. Métodos: se realizó un estudio observacional retrospectivo en una muestra de 232 dientes con tratamiento endodóntico primario, procedentes de 155 individuos. Un análisis de frecuencia estimó la prevalencia entre la presencia de enfermedad periapical y las siguientes covariables: sexo, edad, tipo y localización del diente, diagnóstico previo, condiciones del tratamiento endodóntico, y tipo de restauración. Resultados: se registró un 24% de prevalencia de enfermedad periapical en la población observada. De este porcentaje, el 13,7% fue categorizado como EPE y el 10,3% fue categorizado como EPP. La distribución por sexo fue de 59% para mujeres y 41% para hombres, con promedio de edad de 55,8 años. La prevalencia de la enfermedad fue mayor en molares (44%) y el diagnóstico pulpar más frecuente fue necrosis pulpar (34%). El 20% de los tratamientos analizados presentó longitud de obturación corta y, de ellos, el 54,3% se asoció con aparición de la enfermedad. Conclusiones: la longitud de obturación corta resultó ser el factor que registró mayor relación clínica con la aparición de la enfermedad. Se reconoce a la EPE como el verdadero fracaso del tratamiento endodóntico primario.
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Fezai H, Al-Salehi S. The relationship between endodontic case complexity and treatment outcomes. J Dent 2019; 85:88-92. [DOI: 10.1016/j.jdent.2019.05.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/11/2019] [Accepted: 05/13/2019] [Indexed: 11/17/2022] Open
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Effects of root-end filling on the fractal dimension of the periapical bone after periapical surgery: retrospective study. Clin Oral Investig 2019; 23:3645-3651. [DOI: 10.1007/s00784-019-02967-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/16/2019] [Indexed: 12/14/2022]
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34
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Assessment of extracting molars and premolars after root canal treatment: A retrospective study. Saudi Dent J 2019; 31:487-491. [PMID: 31695297 PMCID: PMC6823745 DOI: 10.1016/j.sdentj.2019.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/24/2019] [Accepted: 04/29/2019] [Indexed: 11/25/2022] Open
Abstract
Background The loss of dentition after root canal treatment is a multifactorial entity which might differ between different teeth. The extraction can be more critical, as well as the rehabilitation options. Aim To analyze if the etiology of extracting root canal treated teeth is different between premolars and molars. Materials and methods The study included a total of 403 cases with non-surgical root canal therapy (NSRCT) and crown coverage that was referred to the oral surgery clinic for extraction. Tooth type, patient’s age, gender, time since treatment completion, and the reason for extractions were recorded and analyzed. Results The most frequently extracted teeth were molars (55.6%), followed by premolars (30.3%) and anterior teeth (14.1%). The reasons for extraction were subgingival decay (SGD) (62.5%), vertical root fractures (VRF) (25.3%), and patient demands after uncomfortableabscess discharge (12.2%). Most of the teeth survived between 13 and 36 months after NSRCT. The statistical power of 0.92 was demonstrated, and a P-value of less than 0.05 presented significant correlations. Conclusion Molars were extractedafter NSRCT due to SGD followed by premolars, which were extracted due to VRF. Special care should be taken while planning NSRCT treatment for molars, in particular, with emphasis on the importance of oral hygiene and follow-up visits.
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Divine KA, McClanahan SB, Fok A. Anatomic Analysis of Palatal Roots of Maxillary Molars Using Micro-computed Tomography. J Endod 2019; 45:724-728. [PMID: 31056296 DOI: 10.1016/j.joen.2019.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 02/26/2019] [Accepted: 03/13/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The morphology of the palatal root of maxillary first and second molars was analyzed and compared using micro-computed tomographic scanning. METHODS Forty-seven extracted maxillary molars were scanned with a micro-computed tomographic device to analyze the palatal radicular dentin dimensions, canal working width, root length, canal curvature, lateral canals, and apical constriction anatomy. Quantitative data were analyzed with mean and standard deviation for first and second molars, respectively. Comparison was made between first and second molars using an unpaired t test. RESULTS The palatal root of maxillary first molars was found to have statistically significantly thinner dentin than second molars on the palatal aspect of the root 8-11 mm from the apex, correlating to the coronal and middle thirds of the root. First molar palatal roots also had a statistically significantly wider canal mesiodistally than second molars at 13-15 mm from the apex, correlating approximately to the level of the cementoenamel junction and pulpal floor. Significant canal curvature was present. These findings suggest the need for conservative coronal flaring and instrumentation. CONCLUSIONS The absence of an apical constriction in 76.6% of the specimens highlights the importance of creating an apical seat through instrumentation to maintain obturation materials. A minimum master apical file size of 40 is recommended based on preoperative working widths in the apical 0.5-1.0 mm. A root-end resection of 3.5 mm would remove a greater majority of lateral canals.
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Affiliation(s)
- Katherine A Divine
- Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota.
| | - Scott B McClanahan
- Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota
| | - Alex Fok
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, Minnesota
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Jahreis M, Soliman S, Schubert A, Connert T, Schlagenhauf U, Krastl G, Krug R. Outcome of non‐surgical root canal treatment related to periodontitis and chronic disease medication among adults in age group of 60 years or more. Gerodontology 2019; 36:267-275. [DOI: 10.1111/ger.12407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 02/28/2019] [Accepted: 03/29/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Martin Jahreis
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
| | - Sebastian Soliman
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
| | - Alexander Schubert
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine University of Basel Basel Switzerland
| | - Ullrich Schlagenhauf
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
| | - Ralf Krug
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
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Jesus SFD, Cohenca N, Romualdo PC, Nelson-Filho P, Queiroz AMD, Sousa-Neto MD, Paula-Silva FWG, Silva LABD. Radiographic and Immunohistochemical Evaluation of Root Canal Treatment Using Different Irrigation Systems. Braz Dent J 2019; 30:123-132. [PMID: 30970054 DOI: 10.1590/0103-6440201901702] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 01/15/2019] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to evaluate the radiographic periapical repair and the synthesis of inflammatory mediators after endodontic treatment in a single session, using different irrigation protocols, in teeth with apical periodontitis. Experimental apical periodontitis were induced in dog's teeth randomly assigned into 4 groups: G1 - Irrigation by Negative Apical Pressure (n= 20); G2 - Passive Ultrasonic Irrigation (n= 20), G3 - Positive Pressure Irrigation (n= 20); G4 - apical periodontitis without treatment (n= 20). After 180 days, the animals were euthanized, the tissues removed and submitted to histotechnical processing for immunohistochemical analysis of osteopontin (OPN), tumor necrosis factor-a (TNF-a) and interleukin 1-a (IL-1a). Radiographic analysis was performed using the Periapical Index (PAI), obtained prior to and 180 days following endodontic treatment. Data were analyzed using Wilcoxon signed-rank test, Fisher's Exact test or Kruskal-Wallis test and Dunn's post-test (a = 5%). Radiographically, after endodontic treatment, apical periodontitis persisted in 35% of G1 specimens, 40% of G2 and 40% of G3 (p>0.05), although a PAI reduction was observed (p<0.05). By immunohistochemical evaluation, endodontic treatment resulted in lower synthesis of TNF-a and OPN in periapical region, compared to apical periodontitis without treatment (p<0.05). Production of IL-1 was not modulated by endodontic treatment (p>0.05). Periapical healing was observed in approximately 60% of the cases after endodontic treatment performed in a single session with lower synthesis of TNF-a and OPN in the periapical region, regardless of the irrigation protocol used.
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Affiliation(s)
- Sidinéia Feitoza de Jesus
- School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil.,Instituto Amazônia de Ensino Superior, Manaus, AM, Brazil
| | - Nestor Cohenca
- School of Dentistry, University of Washington, Seattle, WA, USA
| | | | - Paulo Nelson-Filho
- School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Manoel Damião Sousa-Neto
- School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Verma N, Sangwan P, Tewari S, Duhan J. Effect of Different Concentrations of Sodium Hypochlorite on Outcome of Primary Root Canal Treatment: A Randomized Controlled Trial. J Endod 2019; 45:357-363. [PMID: 30827769 DOI: 10.1016/j.joen.2019.01.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 11/23/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the effect of 2 different concentrations of sodium hypochlorite on healing and postoperative pain after primary endodontic treatment. METHODS One hundred mandibular molars with pulp necrosis and chronic apical periodontitis were randomly assigned to 2 treatment groups: high-concentration (HC) 5% sodium hypochlorite and low-concentration (LC) 1% sodium hypochlorite. Root canal treatment was performed using a standardized protocol. Canals were prepared using equal volumes of respective irrigants after each instrument change. After chemomechanical preparation, the final flush was performed with 5 mL 17% EDTA solution followed by 5 mL 5% or 1% sodium hypochlorite depending on the group. All patients were asked to record the degree of pain on a visual analog scale every 24 hours for 1 week. At the second visit, canals were obturated, and the teeth were restored permanently. Clinical and radiographic evaluations were performed every 3 months for 12 months. The data collected were statistically analyzed. RESULTS Eighty-six teeth were available for evaluation at the 1-year follow-up. The overall healing rate observed was 76.7%. Greater healing was observed in the HC (81.4%) group compared with the LC group (72.1%), but the difference was not statistically significant (P > .05). No significant differences in pain incidence and pain scores were found between the 2 groups (P >.05), with lower values reported in the LC group. CONCLUSIONS The use of LC or HC sodium hypochlorite did not result in a significant difference in the clinical outcome.
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Affiliation(s)
- Neha Verma
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Pankaj Sangwan
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India.
| | - Sanjay Tewari
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Jigyasa Duhan
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Valerio MS, Kirkwood KL. Sexual Dimorphism in Immunity to Oral Bacterial Diseases: Intersection of Neutrophil and Osteoclast Pathobiology. J Dent Res 2018; 97:1416-1423. [PMID: 30205018 DOI: 10.1177/0022034518798825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Sex is a biological variable that affects immune responses to bacterial and other types of infectious agents. Males and females are known to have differential oral bacterial disease burden in periodontal and endodontic disease. Understanding that there is a contribution from both sex and gender to these oral diseases, we discuss in this review recent sex-based findings that provide a pathobiological basis for differences observed between males and females. Sexual dimorphism of immune responses with respect to neutrophil trafficking and osteoclast differentiation and formation is presented as a plausible mechanism to explain the sexual differences. We also emphasize that sex, as a biological variable, should be considered in these types of oral immunologic studies.
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Affiliation(s)
- M S Valerio
- 1 Extremity Trauma and Amputation Center of Excellence, Walter Reed National Military Medical Center, Department of Defense and Department of Veterans Affairs, Bethesda, MD, USA
| | - K L Kirkwood
- 2 Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY, USA.,3 Department of Oral Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Healing of Apical Periodontitis after Nonsurgical Root Canal Treatment: The Role of Statin Intake. J Endod 2018; 44:1355-1360. [DOI: 10.1016/j.joen.2018.06.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 01/29/2023]
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Outcome of Initial Endodontic Treatment Performed, by One Specialist, in 122 Tunisian Patients: A Retrospective Study. Int J Dent 2018; 2018:3504245. [PMID: 30154847 PMCID: PMC6091415 DOI: 10.1155/2018/3504245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/11/2018] [Indexed: 01/09/2023] Open
Abstract
Objective To assess the 6- to 24-month outcome of endodontic treatments performed, by one specialist, and to identify prognostic factors that may influence initial endodontic treatment outcome (IETO). Methods One hundred and forty-six patients out of 163 were included. A number of 201 teeth were endodontically treated, and an overall number of 408 canals were obturated. Of these, 165 teeth received initial endodontic treatment (IET). The criteria of the European Society of Endodontology were used to assess the IETO. The level of significance was set at p < 0.05%. Results Apical periodontitis (AP) was present in 42.5% of all cases, with a PAI >3 in 28.5%. The success rate (SR) was 91.5%. It was significantly higher in vital teeth (97%) than in devital teeth (87.7%) (p=0.04); however, a lower SR was recorded in teeth with AP (p=0.02). The lesion healed in 60 teeth (85.7%), decreased in size in 4 teeth (5.7%), and increased in size in 6 teeth (8.5%). A higher SR was obtained when a permanent restoration was present (94%) than absent (68.7%) (p=0.005). Conclusion Within the limitations of the study, pulp and periapical status and permanent restoration are found to be strong outcome predictors.
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Chybowski EA, Glickman GN, Patel Y, Fleury A, Solomon E, He J. Clinical Outcome of Non-Surgical Root Canal Treatment Using a Single-cone Technique with Endosequence Bioceramic Sealer: A Retrospective Analysis. J Endod 2018; 44:941-945. [DOI: 10.1016/j.joen.2018.02.019] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/17/2018] [Accepted: 02/19/2018] [Indexed: 01/26/2023]
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43
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Krell KV, Caplan DJ. 12-month Success of Cracked Teeth Treated with Orthograde Root Canal Treatment. J Endod 2018; 44:543-548. [DOI: 10.1016/j.joen.2017.12.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 12/28/2017] [Accepted: 12/28/2017] [Indexed: 02/06/2023]
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44
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Survival of Endodontically Treated Roots/Teeth Based on Periapical Health and Retention: A 10-year Retrospective Cohort Study. J Endod 2017; 43:2001-2008. [DOI: 10.1016/j.joen.2017.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/12/2017] [Accepted: 08/02/2017] [Indexed: 11/21/2022]
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Chércoles-Ruiz A, Sánchez-Torres A, Gay-Escoda C. Endodontics, Endodontic Retreatment, and Apical Surgery Versus Tooth Extraction and Implant Placement: A Systematic Review. J Endod 2017; 43:679-686. [DOI: 10.1016/j.joen.2017.01.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/01/2017] [Accepted: 01/08/2017] [Indexed: 10/19/2022]
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Association of Quality of Coronal Filling with the Outcome of Endodontic Treatment: A Follow-up Study. Dent J (Basel) 2017; 5:dj5010005. [PMID: 29563411 PMCID: PMC5806991 DOI: 10.3390/dj5010005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/22/2016] [Accepted: 01/06/2017] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to assess the effect of the quality of the coronal restoration and the root filling on the success of endodontic treatment. Patients treated at Kuwait University Dental Clinics (KUDC) from 2003 to 2014 were contacted by telephone calls. Demographic data and clinical records of patients, including age, gender, the tooth number, and medical history were recorded. Each patient received clinical examination for all teeth, including assessment of the coronal filling (type, quality), root- and/or coronal fracture, and the periodontal condition around the tooth (e.g., probing depth, gingival recession); percussion and mobility tests. A periapical radiograph of the endodontic treated tooth was taken to determine the health of the periapical tissues using the periapical index. The quality of the root filling was assessed by length and density of the root filling. The mean follow-up period was 4.8 years. The overall success rate of endodontic treatment was 86%; teeth without any initial periapical lesion had a success of 93%, whereas those with such lesion had a success rate of 80%. Periapical healing was not significantly associated with either the length of root filling (p = 0.40) or the density of root filling (p = 0.099), but was statistically significantly associated with the presence of coronal filling defects (p = 0.001). This study demonstrated that inadequate coronal filling but not the quality of root filling was associated with a higher prevalence of periapical lesions.
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Comparison of Two Base Materials Regarding Their Effect on Root Canal Treatment Success in Primary Molars with Furcation Lesions. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1429286. [PMID: 27957486 PMCID: PMC5121461 DOI: 10.1155/2016/1429286] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/29/2016] [Accepted: 10/19/2016] [Indexed: 11/18/2022]
Abstract
Introduction. The aim of this study was to compare MTA with another base material, IRM, which is generally used on pulpal floor after root canal treatment, regarding their effect on the success of root canal treatment of primary teeth with furcation lesions. Materials and Methods. Fifty primary teeth with furcation lesions were divided into 2 groups. Following root canal treatment, the pulpal floor was coated with MTA in the experimental group and with IRM in the control group. Teeth were followed up considering clinical (pain, pathological mobility, tenderness to percussion and palpation, and any soft tissue pathology and sinus tract) and radiographical (pathological root resorption, reduced size or healing of existing lesion, and absence of new lesions at the interradicular or periapical area) criteria for 18 months. For the statistical analysis, Fisher's exact test and Pearson's chi-square tests were used and a p value of <0.05 was considered to be statistically significant. Results. Although there were no statistically significant differences between two groups in terms of treatment success, lesions healed significantly faster in the MTA group. Conclusion. In primary teeth with furcation lesions, usage of MTA on the pulpal floor following root canal treatment can be a better alternative since it induced faster healing.
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De-Deus G, Belladonna FG, Silva EJNL, Souza EM, Carvalhal JCA, Perez R, Lopes RT, Versiani MA. Micro-CT assessment of dentinal micro-cracks after root canal filling procedures. Int Endod J 2016; 50:895-901. [PMID: 27689844 DOI: 10.1111/iej.12706] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 09/27/2016] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the frequency of dentinal micro-cracks after root canal filling procedures with GuttaCore (GC), cold lateral compaction (CLC) and warm vertical compaction (WVC) techniques in mandibular molars using micro-computed tomographic analysis. METHODOLOGY Thirty mesial roots of mandibular molars, with a type II Vertucci's canal configuration, were prepared to working length with a Reciproc R40 instrument and randomly assigned to one of the three experimental groups (n = 10), according to the technique used for root filling: GC, CLC or WVC. The GC group was filled with a size 40 GC obturator, whilst CLC and WVC groups used conventional gutta-percha cones. AH Plus sealer was used in all groups. The specimens were scanned at an isotropic resolution of 14.25 μm before and after root canal preparation and after root filling. Then, all pre- and postoperative cross-sectional images of the roots (n = 41 660) were screened to identify the presence of dentinal defects. RESULTS Overall, 30.75% (n = 12 810) of the pre- + post-filling images displayed dentinal defects. In the GC, CLC and WVC groups, dentinal micro-cracks were observed in 18.68% (n = 2510), 15.99% (n = 2389) and 11.34% (n = 1506) of the cross-sectional images, respectively. All micro-cracks identified in the post-filling scans were also observed in the corresponding post-preparation images. CONCLUSION Root fillings in all techniques did not induce the development of new dentinal micro-cracks.
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Affiliation(s)
- G De-Deus
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - F G Belladonna
- Department of Endodontics, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - E J N L Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - E M Souza
- Department of Dentistry II, Federal University of Maranhão (UFMA), São Luís, MA, Brazil
| | - J C A Carvalhal
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - R Perez
- Department of Endodontics, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - R T Lopes
- Nuclear Engineering Program, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - M A Versiani
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
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Mittal P, Logani A, Shah N, Pandey RM. Effect of apical clearing technique on the treatment outcome of teeth with asymptomatic apical periodontitis: A randomized clinical trial. J Conserv Dent 2016; 19:396-401. [PMID: 27656054 PMCID: PMC5026095 DOI: 10.4103/0972-0707.190006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Aim: This study aims to compare the periapical healing of teeth with asymptomatic apical periodontitis treated either by conventional apical preparation (CAP) or apical clearing technique (ACT). Materials and Methods: Twenty subjects with bilateral nonvital similar teeth exhibiting comparable periapical index (PAI) score were enrolled and randomly allocated. Group I (CAP, n = 20): Apical preparation three sizes greater (master apical file [MAF]) than the first binding file at the established working length. Group II (ACT, n = 20): Apical preparation three sizes greater than the MAF that was followed by dry reaming. Root canal therapy was accomplished in single-visit for all the teeth. They were pursued radiographically at 3, 6, 9 and 12 months. Pre- and post-treatment PAI scores were compared. To ascertain the proportion of healed teeth between the two groups, McNemar Chi-square test was applied. Results: At 3, 6, and 9 months’ time interval the proportion of healed teeth for Group II (ACT) was greater in comparison to Group I (CAP) (P < 0.05). However, at 12 months follow-up period this difference was not significant (P = 0.08). Conclusion: ACT enhanced the healing kinetics. However, the long-term (12 months) radiographic outcome was similar for either technique.
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Affiliation(s)
- Priya Mittal
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Logani
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Naseem Shah
- Department of Dentistry, Hindu Rao Hospital, North Delhi Municipal Corporation Medical College, New Delhi, India
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
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Eliyas S, Briggs PFA, Harris IR, Newton JT, Gallagher JE. Development of quality measurement instruments for root canal treatment. Int Endod J 2016; 50:652-666. [DOI: 10.1111/iej.12679] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 07/13/2016] [Indexed: 11/28/2022]
Affiliation(s)
- S. Eliyas
- Population and Patient Health Division; King's College London Dental Institute; London
- St George's University Hospitals NHS Foundation Trust; London
| | | | - I. R. Harris
- Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - J. T. Newton
- Population and Patient Health Division; King's College London Dental Institute; London
| | - J. E. Gallagher
- Population and Patient Health Division; King's College London Dental Institute; London
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