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Yoo YJ, Cho EB, Perinpanayagam H, Gu Y, Zhu Q, Noblett WC, Kum KY. Endodontic Microsurgery Outcomes over 10 Years and Associated Prognostic Factors: A Retrospective Cohort Study. J Endod 2024; 50:934-943. [PMID: 38642732 DOI: 10.1016/j.joen.2024.04.009] [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: 12/08/2023] [Revised: 03/13/2024] [Accepted: 04/13/2024] [Indexed: 04/22/2024]
Abstract
INTRODUCTION This retrospective cohort study aimed to evaluate long-term healing outcomes (10-17.5 years) after contemporary endodontic microsurgery (EMS) and identify the associated prognostic factors. METHODS Clinical and radiographic data of an EMS cohort (2006-2013) from the electronic database of the dental hospital were reviewed retrospectively by 2 independent examiners to determine their survival and healing outcomes, and potential prognostic factors were analyzed by Cox proportional hazards regression and logistic regression (α = 0.05). RESULTS Through strict inclusion and exclusion criteria and 721 EMS-treated teeth in the cohort, 309 (42.9%) were included (male = 35.0%; female = 65.0%; age = 45.83 ± 15.53 years) with a mean final follow-up of 152.26 ± 26.37 months (range, 120-211 months; median = 148 months). Clinical and radiographic assessments found an 80.5% 10-year survival rate with 63.4% of success. Collectively, tooth type, tooth mobility, preoperative lesion size, clinical crown-to-root ratio, and crown restorations at follow-up were significantly associated with long-term success and survival over 10 years. CONCLUSIONS The preoperative status and condition of the tooth including its alveolar bone support and adequate full-crown restorations may be relevant prognostic determinants of success and survival after EMS over time.
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Affiliation(s)
- Yeon-Jee Yoo
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Eun-Bee Cho
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Hiran Perinpanayagam
- Division of Endodontics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Yu Gu
- Department of Endodontics, School and Hospital of Stomatology, Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Qiang Zhu
- Division of Endodontology, University of Connecticut School of Dental Medicine, Farmington, Connecticut
| | - W Craig Noblett
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
| | - Kee-Yeon Kum
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea.
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Saiz-Pardo-Pinos AJ, Manzano-Moreno FJ, Muñoz-Soto E, González-Rodríguez MP, Romero-Olid N, Olmedo-Gaya MV. Analysis of the Prognostic Factors That Influence the Outcome of Periapical Surgery, including Biomimetic Membranes for Tissue Regeneration: A Review. Biomimetics (Basel) 2024; 9:258. [PMID: 38786468 PMCID: PMC11117633 DOI: 10.3390/biomimetics9050258] [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: 03/26/2024] [Revised: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
The objective of this study was to analyze the prognostic factors that influence the outcome of periapical surgery. A systematic search of the literature was carried out using PubMed and Scopus databases between January 2000 and December 2023 with no language limitations. The PICO question of the present systematic review was: What prognostic factors may influence the outcome of periapical surgery? The most relevant randomized controlled clinical trials (RCTs), prospective clinical trials, retrospective studies, and meta-analyses (n = 44) were selected from 134 articles. The reviewed literature evidenced that bone-lesion healing could significantly be improved by the absence of deep periodontal pockets (>4 mm), localization in anterior teeth, the absence of pain and/or preoperative symptoms, a size of bone lesion < 5 mm, the use of ultrasound, the correct placement of retrograde filling material, and the use of different biomimetic membranes for guided tissue regeneration (GTR). Some preoperative and intraoperative factors could significantly improve the prognosis of periapical surgery. However, these results were not conclusive, and further high-quality research is required.
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Affiliation(s)
| | - Francisco J. Manzano-Moreno
- Department of Stomatology, School of Dentistry, University of Granada, 18071 Granada, Spain; (M.P.G.-R.); (N.R.-O.); (M.V.O.-G.)
| | - Esther Muñoz-Soto
- Master of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain;
| | - María Paloma González-Rodríguez
- Department of Stomatology, School of Dentistry, University of Granada, 18071 Granada, Spain; (M.P.G.-R.); (N.R.-O.); (M.V.O.-G.)
| | - Nuria Romero-Olid
- Department of Stomatology, School of Dentistry, University of Granada, 18071 Granada, Spain; (M.P.G.-R.); (N.R.-O.); (M.V.O.-G.)
| | - María Victoria Olmedo-Gaya
- Department of Stomatology, School of Dentistry, University of Granada, 18071 Granada, Spain; (M.P.G.-R.); (N.R.-O.); (M.V.O.-G.)
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Dong X, Su Q, Li W, Yang J, Song D, Yang J, Xu X. The outcome of combined use of iRoot BP Plus and iRoot SP for root-end filling in endodontic microsurgery: a randomized controlled trial. Clin Oral Investig 2024; 28:188. [PMID: 38430316 DOI: 10.1007/s00784-024-05569-7] [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: 11/26/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVES Root-end filling is important for the clinical outcome of endodontic microsurgery. Our previous study showed that combined application of iRoot BP Plus Root Repair Material (BP-RRM) and iRoot SP Injectable Root Canal Sealer (SP-RCS) in root-end filling exhibited better apical sealing as compared to the application of BP-RRM alone. The aim of this randomized controlled clinical trial was to evaluate the effect of the combined use of BP-RRM and SP-RCS on the prognosis of teeth with refractory periapical diseases after endodontic microsurgery. MATERIALS AND METHODS 240 teeth with refractory periapical diseases scheduled for endodontic microsurgery were randomly divided into BP-RRM/SP-RCS group (n = 120) and BP-RRM group (n = 120). The patients were followed up at 3 months, 6 months, and 12 months after endodontic microsurgery. Pre- and post-operative clinical and radiographic examinations were performed to evaluate the treatment outcome. The 1-year success rate of endodontic microsurgery in BP-RRM/SP-RCS and BP-RRM groups was compared by Chi-square test. Factors that might impact the prognosis were further analyzed using Chi-square test or Fisher's exact test. RESULTS A total of 221 teeth completed the 12-month follow-up. The 1-year success rates of the BP-RRM/SP-RCS and BP-RRM groups were 94.5% (104/110) and 92.8% (103/111), respectively. The combined use of BP-RRM and SP-RCS achieved a clinical outcome comparable to BP-RRM alone (P = 0.784). Tooth type (P = 0.002), through-and-through/apico-marginal lesion (P = 0.049), periodontal status (P < 0.0001), and Kim's lesion classification (P < 0.0001) were critical factors associated with the 1-year success of endodontic microsurgery. CONCLUSIONS The combined use of BP-RRM and SP-RCS is a practicable method for root-end filling in endodontic microsurgery with a satisfactory 1-year clinical outcome. CLINICAL RELEVANCE The combined application of BP-RRM and SP-RCS in EMS is an effective root-end filling method with a satisfactory 1-year clinical outcome. TRIAL REGISTRATION This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100052174).
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Affiliation(s)
- Xu Dong
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Stomatology, The First People's Hospital of Liangshan Yi Autonomous Prefecture, Xichang, China
| | - Qin Su
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wen Li
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jinbo Yang
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dongzhe Song
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Yang
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Wong I, Ton A, Cassidy AJ, Fozzard N, Sharma LA, Love RM, Sharma A. A retrospective study on the prognostic factors and success, survival, and failure outcomes of treated endodontic-periodontal lesions. Clin Exp Dent Res 2024; 10:10.1002/cre2.848. [PMID: 38345476 PMCID: PMC10832312 DOI: 10.1002/cre2.848] [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: 08/30/2023] [Revised: 12/27/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES The objective of this retrospective study was to determine possible prognostic factors of endodontic-periodontal lesions and to compare success, survival, and failure outcomes of treated endodontic-periodontal lesions across different treatment modalities, demographic variables, and anatomical tooth variations. MATERIALS AND METHODS Data was collected from patient records in the patient management system (Salud, Titanium Solutions) from the Griffith University Dental Clinic between January 2008 and December 2021. The search strategy used the terms "endodontic periodontal lesion," "periodontal endodontic lesion," "endo perio lesion," "perio endo lesion," and "EPL." The 88 cases which met inclusion and exclusion criteria were analyzed. RESULTS The overall success rate was 46.6%, with 21.6% of teeth surviving and 31.8% of teeth failing. Bone loss extending to the apical third (OR = 0.3, 95% CI [0.104, 0.866]), and probing depths of 5-7 mm (OR = 0.147, 95% CI [0.034, 0.633]) and 8-10 mm (OR = 0.126, 95% CI [0.029, 0.542]) were associated with a statistically significant lower odds of success (p < .05). A history of no periodontal disease (OR = 7.705, 95% CI [1.603, 37.037]) was associated with a statistically significant higher odds of success (p < .05). CONCLUSION Practitioners should be aware of bone loss to the apical third, deep probing depths, and a history of periodontal disease as possible prognostic factors that can affect the success rate when treating endodontic-periodontal lesions. Further research with more stringent control over operator factors should be done to investigate these variables.
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Affiliation(s)
- Ingar Wong
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - An Ton
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - Amiel J. Cassidy
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - Nicolette Fozzard
- School of Pharmacy and Medical SciencesGriffith UniversitySouthportAustralia
| | | | - Robert M. Love
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - Ajay Sharma
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
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Bieszczad D, Wichlinski J, Kaczmarzyk T. Treatment-Related Factors Affecting the Success of Endodontic Microsurgery and the Influence of GTR on Radiographic Healing-A Cone-Beam Computed Tomography Study. J Clin Med 2023; 12:6382. [PMID: 37835026 PMCID: PMC10573613 DOI: 10.3390/jcm12196382] [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: 08/01/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
The primary objective of this retrospective study was to assess the correlation between treatment-related factors (resection angle, depth of retrograde filling, length of resected root and use of guided tissue regeneration-GTR) evaluated using cone-beam computed tomography (CBCT) scans and the treatment outcomes of endodontic microsurgery (EMS). The secondary purpose of this research was to evaluate the influence of the GTR technique on the radiographic healing state, taking into account the initial parameters of periapical lesions. In 161 cases, the local factors (volume of a lesion, bone destruction pattern, presence/absence of cortical bone destruction) were measured using preoperative CBCT images before undergoing EMS. At least one year after surgery, the outcome of EMS was classified as a success or a failure (based on radiographic and clinical criteria). Using postoperative CBCT, treatment-related factors (resection angle, depth of retrograde filling, and length of resected root) were measured. Additionally, the status of radiographic healing was evaluated (in accordance with modified PENN 3D criteria). Eighteen cases (11.18%) were classified as failures, and 143 were classified as successes (88.82%). Univariate analysis showed that there was no statistically significant influence of treatment-related factors on the healing outcome of EMS. An exact Fischer's test showed the significant impact of GTR on radiographic healing (P < 0.001) in apical lesions (P < 0.001), lesions with a volume between 100 mm3 and 450 mm3 (P < 0.009) and over 450 mm3 (P < 0.001), lesions with the destruction of one plate (P < 0.001), and lesions with the destruction of two plates (through and through) (P = 0.022). The use of GTR in apical lesions, lesions with volumes over 100 mm3, and lesions with the destruction of at least one plate is significantly associated with better radiographic healing.
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Affiliation(s)
- Daniel Bieszczad
- NZOZ Centrum Stomatologii s.c. Justyna Wichlinska, Jaroslaw Wichlinski, ul. 3-go Maja 16, 38-300 Gorlice, Poland; (D.B.); (J.W.)
| | - Jarosław Wichlinski
- NZOZ Centrum Stomatologii s.c. Justyna Wichlinska, Jaroslaw Wichlinski, ul. 3-go Maja 16, 38-300 Gorlice, Poland; (D.B.); (J.W.)
| | - Tomasz Kaczmarzyk
- Chair of Oral Surgery, Institute of Dentistry, Medical College, Jagiellonian University, ul. Montelupich 4, 31-155 Krakow, Poland
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Ng YL, Gulabivala K. Factors that influence the outcomes of surgical endodontic treatment. Int Endod J 2023; 56 Suppl 2:116-139. [PMID: 36710526 DOI: 10.1111/iej.13896] [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: 08/11/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023]
Abstract
Surgical endodontic treatment encompasses a broad spectrum of procedures, amongst which root-end cavity preparation and filling, retrograde root canal treatment and through-and-through endodontic surgery, may be classified under the umbrella term 'Root-end surgery'. This narrative review considers the available data on periapical healing, soft tissue healing, tooth survival and oral health-related quality of life (OHRQoL), following root-end surgery and the factors that affect its outcomes. The pooled periapical healed rate for the studies published up to 2021 was 69% (95% CI: 65%, 73%) but increased to 76% (95% CI: 66%, 86%) when only data from the 2020's studies were analysed. The prognostic factors consistently reported for periapical healing have included: pre-operative periapical lesion with complete loss of buccal plate, quality of root-end preparation, remaining thickness of apical root dentine and restorative status. Soft tissue healing of the reflected flap was found to have a positive association with periapical healing. The survival rates following root-end surgery range from 48% to 93%, with failure of periapical healing associated with root and crown fracture, being the predominant reasons for tooth extraction. The factors influencing impact of root-end surgery on patients' quality of life could not be adequately evaluated due to design flaws in the available studies. In conclusion, if root canal treatment failure due to leakage through cracks, fractures or restoration margin are excluded, the remaining cases may represent localized residual infection and inflammation at the periapex that should be amenable to predictable management with the aid of modern root-end surgery.
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Affiliation(s)
- Yuan-Ling Ng
- Unit of Endodontology, Department of Restorative Dentistry, UCL Eastman Dental Institute, London, UK
| | - Kishor Gulabivala
- Unit of Endodontology, Department of Restorative Dentistry, UCL Eastman Dental Institute, London, UK
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Baseri M, Radmand F, Milani AS, Gavgani LF, Salehnia F, Dianat O. The effect of periapical lesion size on the success rate of different endodontic treatments: a systematic review and meta-analysis. Evid Based Dent 2023; 24:43. [PMID: 36890256 DOI: 10.1038/s41432-023-00851-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/01/2022] [Indexed: 03/10/2023]
Abstract
INTRODUCTION This systematic review evaluated the effect of periapical lesion (PL) size on the success rate of different endodontic treatments, including root canal treatment (RCT), non-surgical retreatment (NSR), and apical surgery (AS). METHODS Cohorts and randomized controlled trials investigating the outcomes of endodontic treatment of permanent teeth with PL and its size were identified electronically through Web of Science, MEDLINE, Scopus, and Embase databases. Two reviewers independently conducted the study selection, data extraction, and critical appraisal process. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale and the 11-item Critical Appraisal Skills Program checklist for randomized controlled trials. The success rates of the endodontic treatments (small lesions and large lesions) were estimated using the rate ratios (RRs) with an associated 95% confidence interval (CI). RESULTS Out of 44 included studies, 42 were cohort, and 2 were randomized controlled trials. Thirty-two studies had poor quality. For the meta-analysis, five studies in RCT, 4 in NSR, and 3 in AS were considered. The RR of the endodontic treatment success in PLs was 1.04 in RCT (95% CI, 0.99-1.07), 1.11 in NSR (95% CI, 0.99-1.24), and 1.06 in AS (95% CI, 0.97-1.16). Only sub-group analysis of long-term follow-up of RCT showed a significantly higher success rate in small lesions than in large lesions. CONCLUSIONS Considering the quality of studies and variation in outcomes and size classification, our meta-analysis demonstrated that the PL size had no significant effect on the success rate of different endodontic treatments.
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Affiliation(s)
- Milad Baseri
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faraz Radmand
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Salem Milani
- Associate Professor of Endodontics, Endodontic Department, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Leili Faraji Gavgani
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Salehnia
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Omid Dianat
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
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Oztekin F, Gurgenc T, Dundar S, Ozercan IH, Yildirim TT, Eskibaglar M, Ozcan EC, Macit CK. In Vivo Evaluation of the Effects of B-Doped Strontium Apatite Nanoparticles Produced by Hydrothermal Method on Bone Repair. J Funct Biomater 2022; 13:jfb13030110. [PMID: 35997448 PMCID: PMC9397061 DOI: 10.3390/jfb13030110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/20/2022] [Accepted: 07/28/2022] [Indexed: 11/25/2022] Open
Abstract
In the present study, the structural, morphological, and in vivo biocompatibility of un-doped and boron (B)-doped strontium apatite (SrAp) nanoparticles were investigated. Biomaterials were fabricated using the hydrothermal process. The structural and morphological characterizations of the fabricated nanoparticles were performed by XRD, FT-IR, FE-SEM, and EDX. Their biocompatibility was investigated by placing them in defects in rat tibiae in vivo. The un-doped and B-doped SrAp nanoparticles were successfully fabricated. The produced nanoparticles were in the shape of nano-rods, and the dimensions of the nano-rods decreased as the B ratio increased. It was observed that the structural and morphological properties of strontium apatite nanoparticles were affected by the contribution of B. A stoichiometric Sr/P ratio of 1.67 was reached in the 5% B-doped sample (1.68). The average crystallite sizes were 34.94 nm, 39.70 nm, 44.93 nm, and 48.23 nm in un-doped, 1% B-doped, 5% B-doped, and 10% B-doped samples, respectively. The results of the in vivo experiment revealed that the new bone formation and osteoblast density were higher in the groups with SrAp nanoparticles doped with different concentrations of B than in the control group, in which the open defects were untreated. It was observed that this biocompatibility and the new bone formation were especially elevated in the B groups, which added high levels of strontium were added. The osteoblast density was higher in the group in which the strontium element was placed in the opened bone defect compared with the control group. However, although new bone formation was slightly higher in the strontium group than in the control group, the difference was not statistically significant. Furthermore, the strontium group had the highest amount of fibrotic tissue formation. The produced nanoparticles can be used in dental and orthopedic applications as biomaterials.
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Affiliation(s)
- Faruk Oztekin
- Department of Endodontics, Faculty of Dentistry, Firat University, Elazig 23100, Turkey;
- Correspondence:
| | - Turan Gurgenc
- Faculty of Technology, Firat University, Elazig 23100, Turkey;
| | - Serkan Dundar
- Department of Periodontology, Faculty of Dentistry, Firat University, Elazig 23100, Turkey; (S.D.); (T.T.Y.)
| | | | - Tuba Talo Yildirim
- Department of Periodontology, Faculty of Dentistry, Firat University, Elazig 23100, Turkey; (S.D.); (T.T.Y.)
| | - Mehmet Eskibaglar
- Department of Endodontics, Faculty of Dentistry, Firat University, Elazig 23100, Turkey;
| | - Erhan Cahit Ozcan
- Department of Esthetic, Plastic and Reconstructive Surgery, Faculty of Medicine, Firat University, Elazig 23100, Turkey;
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Bieszczad D, Wichlinski J, Kaczmarzyk T. Factors Affecting the Success of Endodontic Microsurgery: A Cone-Beam Computed Tomography Study. J Clin Med 2022; 11:jcm11143991. [PMID: 35887756 PMCID: PMC9323724 DOI: 10.3390/jcm11143991] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/23/2022] [Accepted: 07/01/2022] [Indexed: 02/06/2023] Open
Abstract
The purpose of this retrospective study was to verify preoperative local parameters of periapical lesions evaluated on cone-beam computed tomography (CBCT) scans as a potential prognostic factor in endodontic microsurgery (EMS). Among 89 cases, local factors (dimensions of lesion, bone destruction pattern, presence/absence of cortical bone destruction, height of buccal bone plate, apical extend of root canal filling, presence/absence of communication with anatomical cavities, type of lesion restriction) were measured on preoperative CBCT images before EMS. At least one year after surgery, the outcome of EMS was classified as a success or a failure. Ten cases (11.24%) were classified as a failure and 79 as a success (88.76%). Symptomatic lesions (OR = 0.088 (95% CI 0.011-0.731); p = 0.024), apicomarginal lesions (OR = 0.092 (0.021-0.402); p = 0.001) and an association with molar teeth (OR = 0.153 (0.032-0.732); p = 0.019) were found as negative predictive factors in the univariate analysis, whereas large apicocoronal dimension (OR = 0.664 (0.477-0.926); p = 0.016), apicomarginal lesions (OR = 0.058 (0.006-0.55); p = 0.013), and an association with molar teeth (OR = 0.047 (0.003-0.869); p = 0.04) were identified as negative predictive factors in the multivariate analysis model. Symptomatic lesions, apicomarginal lesions, lesions associated with molar teeth and large apicocoronal dimensions are significantly associated with the failure of EMS.
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Affiliation(s)
- Daniel Bieszczad
- NZOZ Centrum Stomatologii s.c. Justyna Wichlinska, Jaroslaw Wichlinski, ul. 3-go Maja 16, 38-300 Gorlice, Poland; (D.B.); (J.W.)
| | - Jaroslaw Wichlinski
- NZOZ Centrum Stomatologii s.c. Justyna Wichlinska, Jaroslaw Wichlinski, ul. 3-go Maja 16, 38-300 Gorlice, Poland; (D.B.); (J.W.)
| | - Tomasz Kaczmarzyk
- Department of Oral Surgery, Jagiellonian University Medical College, ul. Montelupich 4, 31-155 Krakow, Poland
- Correspondence:
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Shah PK, El Karim IA, Duncan HF, Nagendrababu V, Chong BS. Outcomes reporting in systematic reviews on surgical endodontics: A scoping review for the development of a core outcome set. Int Endod J 2022; 55:811-832. [PMID: 35553439 DOI: 10.1111/iej.13763] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Evidence-informed decision-making in healthcare relies on the translation of research results to everyday clinical practice. A fundamental requirement is that the validity of any healthcare intervention must be supported by the resultant favourable treatment outcome. Unfortunately, differences in study design and the outcome measures evaluated often make it challenging to synthesise the available research evidence required for secondary research analysis and guideline development. Core outcome sets (COS) are defined as an agreed standardised set of outcomes which should be measured and reported as a minimum in all clinical trials on a specific topic. The benefits of COS include less heterogeneity, a reduction in the risk of reporting bias, ensuring all trials contribute data to facilitate meta-analyses, and given the engagement of key stakeholders, it also increases the chances that clinically-relevant outcomes are identified. The recognition of the need for COS for assessing endodontic treatment outcomes lead to the development of Core Outcome Sets for Endodontic Treatment modalities (COSET) protocol, which is registered (No. 1879) on the Core Outcome Measures in Effectiveness Trials (COMET) website. OBJECTIVES The objectives of this scoping review are to: (1) identify the outcomes assessed in studies evaluating surgical endodontic procedures; (2) report on the method of assessment used to measure the outcomes; (3) and assess selective reporting bias in the included studies. The data obtained will be used to inform the development of COS for surgical endodontics. METHODS A structured literature search of electronic databases and the grey literature was conducted to identify systematic reviews on periradicular surgery (PS), intentional replantation (IR) and tooth/root resection (RR), published between January 1990 and December 2020. Two independent reviewers were involved in the literature selection, data extraction and the appraisal of the studies identified. The type of intervention, outcomes measured, type of outcomes reported (clinician- or patient-reported), outcome measurement method, and follow-up period, were recorded using a standardised form. RESULTS Twenty-six systematic reviews consisting of 19 studies for PS, three studies for IR and four studies for RR were selected for inclusion. Outcome measures identified for PS and IR included pain, swelling, mobility and tenderness, outcomes related to periodontal/soft tissue healing (including sinus tract), periradicular healing, tooth survival, life impact (including Oral-Health-Related-Quality-of-Life), resource use and/or adverse effects. For RR, in addition to tooth survival, endodontic complications, and adverse effects, the outcome measures were primarily periodontal-related, including pocket depth reduction, attachment gain, periodontal disease, and periodontic-endodontic lesions. The majority of outcome measures for PS, IR, and RR were assessed clinically, radiologically and/or via patient history. Specific tools such as rating scales (Visual Analog Scale, Verbal rating Scale, Numerical Rating Scale, and other scales) were used for the assessment of pain, swelling, and tenderness, and validated questionnaires were used for the assessment of oral health-related quality of life. The range of follow-up periods were variable, dependent on the outcome measure and the type of intervention. CONCLUSIONS Outcome measures, method of assessment and follow-up periods for PS, IR and RR were identified and categorised to help standardise the reporting of outcomes for future research studies. Additional outcome measures that were not reported, but may be considered in the COSET consensus process include loss of root-end filling material, number of clinic visits, surgery-related dental anxiety and muco-gingival aesthetic-related measures, such as scarring, black triangles, root surface exposure, and tissue discolouration.
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Affiliation(s)
- Pratik Kamalkant Shah
- Institute of Dentistry, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Ikhlas A El Karim
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Henry Fergus Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Bun San Chong
- Institute of Dentistry, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
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Prognostic Factors in Endodontic Surgery Using an Endoscope: A 1 Year Retrospective Cohort Study. MATERIALS 2022; 15:ma15093353. [PMID: 35591687 PMCID: PMC9103390 DOI: 10.3390/ma15093353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/22/2022] [Accepted: 05/05/2022] [Indexed: 12/12/2022]
Abstract
This retrospective study clarified the success rate of endoscopic endodontic surgeries and identified predictors accounting for successful surgeries. In this retrospective study, 242 patients (90 males, 152 females) who underwent endoscopic endodontic surgery at a single general hospital and were diagnosed through follow-up one year later were included. Risk factors were categorized into attributes, general health, anatomy, and surgery. Then, the correlation coefficient was calculated for the success or failure of endodontic surgery for each variable, the odds ratio was calculated for the upper variable, and factors related to the surgical prognosis factor were identified. The success rate of endodontic surgery was 95.3%, showing that it was a highly predictable treatment. The top three correlation coefficients were post, age, and perilesional sclerotic signs. Among them, the presence of posts was the highest, compared with the odds ratio, which was 9.592. This retrospective study revealed the success rate and risk factors accounting for endoscopic endodontic surgeries. Among the selected clinical variables, the presence of posts was the most decisive risk factor determining the success of endodontic surgeries.
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12
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Nagy E, Braunitzer G, Gryschka DG, Barrak I, Antal MA. Accuracy of digitally planned, guided apicoectomy with a conventional trephine and a custom-made endodontic trephine: An in vitro comparative study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:388-394. [PMID: 34601166 DOI: 10.1016/j.jormas.2021.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/27/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Static guided trephine apicoectomy has been developed as a less invasive and more accurate alternative to conventional freehand apicoectomy with drills. Overpenetration is a frequent issue with this procedure, which deteriorates accuracy and raises safety concerns. A safety improvement to address this problem is presented. MATERIALS AND METHODS Guided apicoectomies were performed in porcine mandibles with either a conventional bone trephine or a custom-made endo-trephine with built-in depth control. The deviation of the apical endpoint of the trephine from the digital surgical plan was analyzed. Overpenetration frequency was recorded. RESULTS Procedures performed with the custom trephine were significantly more accurate both along the x-axis and globally, but no significant difference was found for the y and z axes. Overpenetration frequency was 70% in the conventional trephine group versus 38% in the stop trephine group. CONCLUSION The results indicate that the lack of physical depth control can interfere with the accuracy (and safety) of these procedures to a significant extent, as visual cues (such as the depth markings on a conventional trephine) are insufficient to prevent overpenetration. Our results show that custom-made trephines with a built-in stop offer an optimal solution for this problem.
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Affiliation(s)
- Eszter Nagy
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | | | - Dániel Gerhard Gryschka
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Ibrahim Barrak
- Faculty of Medicine, Department of Oral and Maxillofacial Surgery, University of Szeged, Szeged, Hungary
| | - Mark Adam Antal
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary; Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE.
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Alsubait S, Alhathlol N, Alqedairi A, Alfawaz H. A micro-computed tomographic evaluation of retreatability of BioRoot RCS in comparison with AH Plus. AUST ENDOD J 2021; 47:222-227. [PMID: 33119208 DOI: 10.1111/aej.12456] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/24/2020] [Accepted: 10/02/2020] [Indexed: 12/28/2022]
Abstract
This study compared the retreatability of filling material from canals filled with BioRoot RCS (Septodont, Saint-Maur-des-Fosses, France) and AH Plus (Dentsply DeTrey, Konstanz, Germany) combined with gutta-percha using micro-computed tomography for evaluation. Thirty-four mandibular premolars were divided into two groups according to the sealer used. Thirty days after obturation, canals were retreated with a ProTaper Universal retreatment system (Dentsply Maillefer, Ballaigues, Switzerland) followed by passive ultrasonic irrigation (PUI). The time taken for retreatment was recorded. The roots were scanned after obturation, after retreatment and after PUI. Data were analysed using the Mann-Whitney and Wilcoxon tests. Canals filled with BioRoot RCS exhibited significantly less remaining filling material than canals filled with AH Plus (P < 0.05). The addition of PUI resulted in a significant decrease in the residual material in both groups (P < 0.05). A significantly shorter retreatment time was reported for the AH Plus group than the BioRoot RCS group (P < 0.05).
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Affiliation(s)
- Sara Alsubait
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nuha Alhathlol
- Endodontic Residency Program, Saudi Commission for Health Specialist, Riyadh, Saudi Arabia
- Department of Clinical Dental Sciences, College of Dentistry, Princess Norah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdullah Alqedairi
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hussam Alfawaz
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Bardales-Alcocer J, Ramírez-Salomón M, Vega-Lizama E, López-Villanueva M, Alvarado-Cárdenas G, Serota KS, Ramírez-Wong J. Endodontic Retreatment Using Dynamic Navigation: A Case Report. J Endod 2021; 47:1007-1013. [PMID: 33745944 DOI: 10.1016/j.joen.2021.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/27/2021] [Accepted: 03/08/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Dynamic navigation systems are used in dental implantology to optimize the accuracy of dental implant placement. METHODS A 30-year-old man was seen at the endodontic clinic of the Universidad Autónoma de Yucatán for pain in the left maxillary lateral incisor. A previously treated tooth with symptomatic apical periodontitis was diagnosed. The patient accepted treatment, and after signing an informed consent form, minimally invasive coronal access was performed through a zirconia crown. Then a post removal was performed with an ultrasonic tip to 2 mm before the apical gutta-percha limit, and the removal of material was completed manually with a K-file. RESULTS This case report demonstrates the use of dynamic navigation to remove a post from under a zirconia crown for the retreatment of a failing root canal procedure. The removal of fiber posts from endodontically treated teeth can present a unique challenge for clinicians. Numerous techniques and instrument kits are recommended for the removal of fiber posts, but the risk of excessive root structure damage is a major concern because the ability to differentiate the color difference between peripheral dentin and a bonded fiber post can complicate the accuracy of the removal. CONCLUSIONS The dynamic navigation system enabled minimally invasive removal of the fiber post with a high degree of accuracy, thus ensuring that there was no unnecessary removal of root structure. Dynamic navigation using real-time monitoring could reduce the attendant risk of iatrogenic errors in complex treatment cases.
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Affiliation(s)
| | | | - Elma Vega-Lizama
- Universidad Autónoma de Yucatán, Faculty of Dentistry, Mérida, Yucatán, México
| | | | | | - Kenneth S Serota
- University of Toronto, Faculty of Dentistry, Toronto, ON, Canada
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15
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Duke A, Gilvetti C, Shelley M. Investigating the appropriateness of surgical endodontic referrals to a West Sussex regional referral unit. Br Dent J 2021:10.1038/s41415-020-2354-4. [PMID: 33627849 DOI: 10.1038/s41415-020-2354-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/23/2020] [Indexed: 11/09/2022]
Abstract
Aim To audit the appropriateness, after triage, of surgical endodontic referrals to Queen Victoria Hospital, a regional referral unit in West Sussex. To discuss the current referral pathway with the aim of improving general dental practitioner (GDP) understanding of indications for surgical endodontics via the referral process.Methodology A three-year retrospective review of all surgical endodontic referrals made to Queen Victoria Hospital, East Grinstead was completed. This was inclusive of all referrals made via the National Health Service (NHS) Vantage Rego e-referral system and GDP referral letters. The quality of referrals was analysed as indicated or contraindicated in accordance with the Royal College of Surgeons guidelines for surgical endodontics and periradicular surgery.Results Out of the 34 referrals included in data analysis, 50% contained one or more contraindication for surgical intervention. The most commonly recorded contraindications to treatment were poor-quality root canal treatment, periodontal disease compromising the long-term success of treatment and a poor coronal seal deeming the tooth unrestorable post-surgical intervention.Conclusions A more efficient surgical endodontic referral system will aid resource allocation within the NHS. These results are a first step to aiding necessary modification of the primary care referral pathway to achieve a more effective service for patients, with improved acceptance rate of referrals and better surgical outcomes.
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Affiliation(s)
- Alice Duke
- Glasgow Dental Hospital and School, Department of Restorative Dentistry, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK.
| | - Ciro Gilvetti
- Oral and Maxillofacial Surgery, East Grinstead, RH19 3DZ, UK
| | - Mike Shelley
- Oral and Maxillofacial Surgery, East Grinstead, RH19 3DZ, UK
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16
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Quintero-Álvarez M, Bolaños-Alzate LM, Villa-Machado PA, Restrepo-Restrepo FA, Tobón-Arroyave SI. In vivo detection of vertical root fractures in endodontically treated teeth: Accuracy of cone-beam computed tomography and assessment of potential predictor variables. J Clin Exp Dent 2021; 13:e119-e131. [PMID: 33574996 PMCID: PMC7864364 DOI: 10.4317/jced.57471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/23/2020] [Indexed: 01/17/2023] Open
Abstract
Background This study aimed: (a) to determine the diagnostic performance of cone-beam computed tomography (CBCT) for detection of vertical root fractures (VRFs); (b) to evaluate the predictive value of diagnostic criteria regarding the definition of VRFs; and (c) to examine the robustness of the association of patient-, tooth-, and treatment-related variables with VRFs.
Material and Methods 130 root-filled teeth with signs/symptoms of VRFs underwent clinical and CBCT assessments. Definite diagnosis of VRF was confirmed by endodontic microsurgical (EMS) exploration. Determination of diagnostic performance of CBCT was based on standard algorithms derived from two-way contingency table analysis. Predictive value of diagnostic criteria and the association between predictor variables with VRFs were analyzed using logistic regression models.
Results VRFs were detected during EMS in 50% of the teeth. Based on the finding of fracture lines on CBCT scans, sensitivity, specificity, and accuracy were 86.2%, 13.8%, and 50%, respectively. Teeth having more than three diagnostic criteria present had significant higher odds for VRF diagnosis. After logistic regression analysis, parafunctional habits, one-canal roots, excessive root canal enlargement, and absence of intra-radicular posts remained as robust predictor variables of VRFs.
Conclusions Although the sensitivity of CBCT for VRFs detection is high, the risk of false-positive results related to its low specificity makes that all suspected cases must be confirmed by surgical exploration. VRFs cannot be reliably diagnosed by isolated clinical signs/symptoms; instead those teeth possessing more than three diagnostic criteria might be considered practically pathognomonic. The parafunctional habits, one-canal roots, excessive root canal enlargement, and the absence of intra-radicular posts may act strongly/independently for the occurrence of VRFs in endodontically treated teeth. Key words:Cone-beam computed tomography, diagnostic accuracy, diagnostic surgery, predictor variables, root canal treatment, vertical root fracture.
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Affiliation(s)
- Marcela Quintero-Álvarez
- Senior Resident, Graduate Endodontic Program, Faculty of Dentistry, University of Antioquia. Medellín, Colombia
| | | | - Paula-Andrea Villa-Machado
- Associate Professor. Graduate Endodontic Program, Faculty of Dentistry, University of Antioquia. Medellín, Colombia
| | | | - Sergio-Iván Tobón-Arroyave
- Titular Professor. Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia. Medellín, Colombia
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Jeevanandan G, Govindaraju L, Subramanian EMG, Priyadarshini P. Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial. Int J Clin Pediatr Dent 2021; 14:88-96. [PMID: 34326591 PMCID: PMC8311770 DOI: 10.5005/jp-journals-10005-1895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background One of the cardinal points to be considered during endodontic procedures in children is the measure of postoperative pain. Aim and objective To evaluate the quality of obturation and its effect on postoperative pain with three file systems in primary mandibular molars during 1 week follow-up. Materials and methods The study was conducted as a double-blinded randomized controlled trial. The participants between 6 years and 9 years old requiring a pulpectomy were recruited for the trial. Forty-five primary mandibular molars were randomly allocated into 15 teeth each in Hand K-files; Kedo-SH and Kedo-SG Blue groups. Wong Baker's FACES Pain Rating Scale was used for assessing the postoperative pain in the children for 1 week. Pearson's Chi-square test, Kruskal-Wallis test, and Mann-Whitney U test were used for analyzing the data statistically. Results Optimal fillings were observed more in the Kedo-SG Blue group (80.0%) compared to the other two groups (p < 0.017). On intergroup analysis, the Kedo-SG Blue group reported less postoperative pain compared to Kedo-SH group on day 1 while on day 7 no postoperative pain was experienced in either of the groups. Less postoperative pain was reported by the children in whom the canals were optimally filled compared to overfilling and underfilling. Conclusion Kedo-SG Blue resulted in less postoperative pain when compared to Kedo-SH and hand K-files, whereas optimally filled children experienced less postoperative pain compared to overfilling and underfilling. Clinical significance A felicitous pediatric dental practice includes appropriate assessment and management of postoperative pain in children. Hence, the present study is important in highlighting the affiliation of postoperative pain with quality of obturation following an endodontic intervention in children. How to cite this article Jeevanandan G, Govindaraju L, Subramanian EMG, et al. Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial. Int J Clin Pediatr Dent 2021;14(1):88-96.
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Affiliation(s)
- Ganesh Jeevanandan
- Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Lavanya Govindaraju
- Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Erulappan Muthu Ganapathi Subramanian
- Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Pragyna Priyadarshini
- Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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Yoo YJ, Kim DW, Perinpanayagam H, Baek SH, Zhu Q, Safavi K, Kum KY. Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years. J Clin Med 2020; 9:jcm9072210. [PMID: 32668578 PMCID: PMC7409012 DOI: 10.3390/jcm9072210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/03/2020] [Accepted: 07/10/2020] [Indexed: 01/23/2023] Open
Abstract
The aim of this study was to analyze the long-term outcomes of endodontic microsurgeries in a cohort and identify their association with prognostic factors. A cohort of endodontic microsurgeries followed up periodically with complete clinical and radiographic records for at least 5 years were reviewed retrospectively. Their survival and healing status and profile characteristics were analyzed by Pearson chi-square test and logistic regression (α = 0.05) to identify prognostic factors that influenced outcomes. Of 652 cases in the cohort, 225 (34.5%) were included. The mean follow-up period was 90.4 months (range, 60–168 months). The long-term success rate was 80.5%, and the 5-year survival rate was 83.5%. Logistic regression showed higher success in anteriors compared to molars (OR = 5.405, (95% CI, 1.663–17.571; p = 0.005)) and in teeth with crown restorations (OR = 10.232, (95% CI, 3.374–31.024; p < 0.001)). Conversely, lower success was found in teeth with periodontal disease (OR = 0.170, (95% CI, 0.032–0.900; p = 0.037)) and maxillary sinus involvement (OR = 0.187, (95% CI, 0.035–0.994; p = 0.049)). Endodontic microsurgery has a highly favorable long-term outcome. Tooth position, crown restoration, periodontal disease, and maxillary sinus involvement were identified as main prognostic factors.
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Affiliation(s)
- Yeon-Jee Yoo
- Department of Comprehensive Treatment Center, Seoul National University Dental Hospital, Seoul 03080, Korea;
| | - Dong-Won Kim
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul 03080, Korea; (D.-W.K.); (S.-H.B.)
| | - Hiran Perinpanayagam
- Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada;
| | - Seung-Ho Baek
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul 03080, Korea; (D.-W.K.); (S.-H.B.)
| | - Qiang Zhu
- Division of Endodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA; (Q.Z.); (K.S.)
| | - Kamran Safavi
- Division of Endodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA; (Q.Z.); (K.S.)
| | - Kee-Yeon Kum
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul 03080, Korea; (D.-W.K.); (S.-H.B.)
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital for Persons with Special Needs, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-2072-2656
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Nepal M, Shubham S, Tripathi R, Khadka J, Kunwar D, Gautam V, Gautam N. Spectrophotometric analysis evaluating apical microleakage in retrograde filling using GIC, MTA and biodentine: an in-vitro study. BMC Oral Health 2020; 20:37. [PMID: 32013975 PMCID: PMC6998061 DOI: 10.1186/s12903-020-1025-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 01/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study compares the apical microleakage of three different root-end filling materials in which the retrograde cavity is prepared by two different burs. METHODS Eighty extracted single rooted maxillary and mandibular premolars were taken. Root canal treatment was completed. Apical 3 mm of all the teeth were resected with diamond disk. The tooth were divided into four groups with two subgroups for each group containing 10 tooth (N = 10) as: Group IA (Negative Control and IB (Positive Control); Group IIA and IIB: Prepared with round carbide bur and round diamond bur respectively, filled with GIC; Group IIIA and IIIB: Prepared with round carbide bur and round diamond bur respectively, filled with MTA; Group IVA and IVB: Prepared with round carbide bur and round diamond bur, filled with Biodentine. After applying two coats of nail varnish leaving apical 3 mm (except for negative control group) all teeth were immersed in 2% methylene blue for 3 days and again in 65% nitric acid for next 3 days for extraction of dye. The obtained solution was then transferred to eppendorf tube and centrifuged in microcentrifuges at 14,000 revolution per minutes (RPM) for 5 min. Optical density or absorbance of the supernatant solution was measured with UV spectrophotometer at 550 nm. RESULTS The absorbance of the supernatant solution after dye extraction is decreasing in the order of positive control> GIC > MTA > Biodentine> negative control group. The significant difference was observed between GIC and MTA (p = 0.0001) and GIC and Biodentine (p = 0.0001) with two different burs but statistically non-significant difference was observed between MTA and Biodentine with Carbide bur (p = 0.127) and Diamond bur (p = 0.496) respectively. CONCLUSIONS Within the limitations of the present study, it can be concluded that Biodentine and MTA showed less microleakage as compared to GIC. There is no significant difference between mean microleakage of MTA and Biodentine. However, the mean OD of the Biodentine was least of all evaluated materials. Preparation of the root-end using round carbide bur as well as round diamond burs showed comparable microleakage for all three filling materials.
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Affiliation(s)
- Manisha Nepal
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal.
| | - Snigdha Shubham
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Rupam Tripathi
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Jwolan Khadka
- Department of Conservative Dentistry and Endodontics, KIST Medical College, Lalitpur, Nepal
| | - Deepa Kunwar
- Department of Conservative Dentistry and Endodontics, Gandaki Medical College, Pokhara, Nepal
| | - Vanita Gautam
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Narayan Gautam
- Department of Biochemistry, Universal College of Medical Sciences, Bhairahawa, Nepal
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Antal M, Nagy E, Braunitzer G, Fráter M, Piffkó J. Accuracy and clinical safety of guided root end resection with a trephine: a case series. Head Face Med 2019; 15:30. [PMID: 31861995 PMCID: PMC6925511 DOI: 10.1186/s13005-019-0214-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 11/26/2019] [Indexed: 11/29/2022] Open
Abstract
Background Root-end resection is an endodontic surgical intervention that requires high precision so that all ramifications and lateral canals so as infected tissues are eliminated. An exploratory study was conducted to justify the clinical safety and accuracy of guided root-end resection with a trephine. Methods Fourteen root-end resections were performed in 11 patients. With the aid of computer tomography and rapid prototyping a stereolithographically fabricated, tooth-supported surgical template was used to guide trephinations. Surgery was performed using the printed surgical stent and a trephine was used not only for the osteotomy but for the root end resection as well. Results The root end was successfully and completely resected by the trephine in all cases. No intraoperative complications were observed in any of the cases, and the patients were free of symptoms indicating recurrence or complications at the 6-month follow-up. The median angular deviation of the trephination was 3.95° (95% CI: 2.1–5.9), comparable to the angular deviation of guided implant surgery. The mean apex removal error (ARE) was 0.19 mm (95% CI: 0.03–0.07). The mean osteotomy depth error (ODE) was 0.37 mm (95% CI: 0.15–1.35). Overpenetration was a characteristic finding, which indicates the necessity of a stop-trephine. Conclusions Within the limitations of this study, we conclude that our results support the use of guided trephination for root-end resection.
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Affiliation(s)
- Márk Antal
- Department of Operative and Esthetic Dentistry, University of Szeged, Faculty of Dentistry, Szeged, Hungary.
| | - Eszter Nagy
- Department of Operative and Esthetic Dentistry, University of Szeged, Faculty of Dentistry, Szeged, Hungary
| | | | - Márk Fráter
- Department of Operative and Esthetic Dentistry, University of Szeged, Faculty of Dentistry, Szeged, Hungary
| | - József Piffkó
- Department of Oral and Maxillofacial Surgery, University of Szeged, Faculty of Medicine, Szeged, Hungary
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Monaghan L, Jadun S, Darcey J. Endodontic microsurgery. Part one: diagnosis, patient selection and prognoses. Br Dent J 2019; 226:940-948. [PMID: 31253911 DOI: 10.1038/s41415-019-0415-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Historically, surgical endodontics has been viewed as a treatment of last resort, mainly due to poor outcomes as a result of limitations in materials and techniques. Contemporary techniques, modern materials and better visualisation have all led to an improvement in success rates, making endodontic microsurgery a valuable treatment option to certain patients. Such advances, however, are no substitute for skill in endodontic diagnosis and treatment planning, which can often prove challenging. A variety of tools are available to test for fractures and assess both periodontal and pulpal health. More advanced techniques such as cone beam computed tomography are often invaluable in pre-surgical assessment and diagnosis. Once an accurate diagnosis has been established, a favourable prognosis is explicitly linked to careful patient selection. Orthograde treatment, or retreatment, remains the gold standard for the majority of endodontic problems. However, there are a number of indications for surgery where orthograde treatment is either impossible, or less likely to be successful. It is paramount for any clinician undertaking endodontic surgery to have a detailed understanding of the local and systemic factors associated with successful treatment. Whilst there are few absolute medical contraindications, there are a number of conditions which may influence patient management and make treatment more challenging.
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Affiliation(s)
- Liam Monaghan
- University Dental Hospital of Manchester, Orthodontic Department, Higher Cambridge Street, Manchester, UK
| | - Sarah Jadun
- University Dental Hospital of Manchester, Oral Surgery, Higher Cambridge Street, Manchester, UK
| | - James Darcey
- University Dental Hospital of Manchester, Restorative Department, Higher Cambridge Street, Manchester, UK.
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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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Şimşek-Kaya G, Saruhan N, Yapıcı-Yavuz G, Ertaş Ü. A decision analysis for periapical surgery: Retrospective Study. J Clin Exp Dent 2018; 10:e914-e920. [PMID: 30386525 PMCID: PMC6203926 DOI: 10.4317/jced.53334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 07/05/2018] [Indexed: 12/17/2022] Open
Abstract
Background Periapical surgery is now a reliable therapeutic procedure for the treatment of teeth with periapical lesions, particularly when orthograde retreatment is problematic. However, little information is available regarding treatment planning of cases referred for periapical surgery. Therefore, this study was conducted to analyze and evaluate the factors that affect the decision-making process for periapical surgery. Material and Methods This study retrospectively assessed clinical and radiographic data from patients undergoing periapical surgery. The factors involved in deciding to perform periapical surgery were classified into technical, biological, and combined factors. Results Out of 821 patients, 544 (66.3%) underwent endodontic treatment/retreatment, 204 (24.8%) were treated with coronal restorations and 60 (7.3%) were treated with post. Periapical surgery was indicated for biological reasons in 35% of patients and for technical reasons in 17.9%. The common biological factor was persistent clinical symptoms (19.7%). The most common technical cause was failure of previous endodontic treatment (66.3%). Nearly half of all periapical lesions (45%) were <5 mm in size. Periapical surgery was justified in only 434 (52.9%) subjects. Conclusions We suggest that it is very important for patients to be informed and encouraged about endodontic retreatment in order to reduce unnecessary surgical procedures. Key words:Periapical surgery, case selection, treatment planning.
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Affiliation(s)
- Göksel Şimşek-Kaya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Nesrin Saruhan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Osmangazi University, Eskişehir, Turkey
| | - Günay Yapıcı-Yavuz
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adıyaman University, Adıyaman, Turkey
| | - Ümit Ertaş
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
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Influence of Hemostatic Agents in the Prognosis of Periapical Surgery: A Randomized Study of Epinephrine versus Aluminum Chloride. J Endod 2018; 44:1205-1209. [PMID: 30053934 DOI: 10.1016/j.joen.2018.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 03/15/2018] [Accepted: 03/19/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Several variables have been associated with a better prognosis of periapical surgery. The aim of this study was to evaluate the influence of 2 hemostatic agents on the prognosis of periapical surgery at 12 months. METHODS A prospective study was designed with 2 randomized parallel groups established depending on the hemostatic agent used: epinephrine or aluminum chloride. The analysis of the hemorrhage control was recorded as 0 (no hemorrhage control), 1 (slight but apparent intermittent bleeding persisted after application of the material), or 2 (complete hemorrhage control). At 12 months, periapical lesion healing was determined clinically and radiologically as success, improvement, or failure. RESULTS Ninety-five patients (67 women and 28 men) with periapical lesions involving a single tooth were enrolled in this study; in 45 teeth, epinephrine was used and in 50 teeth aluminum chloride. In the epinephrine group, 28 teeth were classified as successes, 10 as improvements, and 7 as failures. In the aluminum chloride group, 34 teeth were classified as successes, 11 as improvements, and 5 as failures. No statistically significant difference was found. CONCLUSIONS The present study found no association between the use of epinephrine or aluminum chloride as hemostatic agents on the prognosis of periapical surgery. The efficacy of hemostatic agents at the time of surgery showed no relationship with the healing outcome.
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25
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Surgical endodontics: are the guidelines being followed? A pilot survey. Br Dent J 2018; 224:157-162. [PMID: 29371691 DOI: 10.1038/sj.bdj.2018.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2017] [Indexed: 11/09/2022]
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26
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Zhou W, Zheng Q, Tan X, Song D, Zhang L, Huang D. Comparison of Mineral Trioxide Aggregate and iRoot BP Plus Root Repair Material as Root-end Filling Materials in Endodontic Microsurgery: A Prospective Randomized Controlled Study. J Endod 2017; 43:1-6. [DOI: 10.1016/j.joen.2016.10.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/07/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
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Abstract
A better understanding of endodontic disease and the causes of treatment failure has refined the role of surgery in endodontics. The advent of newer materials, advances in surgical armamentarium and techniques have also led to an improved endodontic surgical outcome. The aim of this article is to provide a contemporary and up-to-date overview of endodontic surgery. It will focus primarily on the procedures most commonly performed in endodontic surgery.
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Affiliation(s)
- B S Chong
- Professor/Honorary Consultant in Restorative Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London
| | - J S Rhodes
- Specialist in Endodontics, Poole, Dorset
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Alsomadi L, Al Habahbeh R. Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain. J Contemp Dent Pract 2015; 16:939-943. [PMID: 27018027 DOI: 10.5005/jp-journals-10024-1785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. MATERIALS AND METHODS After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. RESULTS Peak postoperative pain occurred at 16 hours post-treatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402). CONCLUSION Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. CLINICAL SIGNIFICANCE Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients.
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Affiliation(s)
- Leena Alsomadi
- Associate Professor Department of Conservative Dentistry, University of Jordan PO Box 830453, Amman, Jordan, Phone: 009626797728100 e-mail:
| | - Riyad Al Habahbeh
- Department Conservative Dentistry, Royal Medical Services Amman, Jordan
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Çalışkan MK, Tekin U, Kaval ME, Solmaz MC. The outcome of apical microsurgery using MTA as the root-end filling material: 2- to 6-year follow-up study. Int Endod J 2015; 49:245-54. [PMID: 25819748 DOI: 10.1111/iej.12451] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 03/23/2015] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the influence of various predictors on the healing outcome 2-6 years after apical microsurgery (AMS) using MTA as the root-end filling material. METHODOLOGY A total of 90 anterior teeth with asymptomatic persistent periradicular periodontitis of strictly endodontic origin that failed after either nonsurgical or surgical treatment were included. Surgery was completed under local anaesthesia using a standardized clinical protocol. Clinical and radiographic measures as well as the follow-up period were used to determine the healing outcome. For statistical analysis of the predictors, the outcome was dichotomized into healed cases and nonhealed cases. Odds ratios were calculated, and Pearson chi-square or Fisher's exact tests were used to analyse the data. RESULTS Clinical and radiographic assessment of AMS revealed that 80% were healed, 14.4% were nonhealed, whilst 5.6% were judged to be uncertain. None of the various predictors investigated had a significant influence on the outcome of AMS. CONCLUSIONS The results of this clinical study demonstrated that 80% of cases that received apical microsurgery healed when using MTA as the root-end filling material.
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Affiliation(s)
- M K Çalışkan
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - U Tekin
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Izmir, Turkey
| | - M E Kaval
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - M C Solmaz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Izmir, Turkey
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Outcome of nonsurgical retreatment and endodontic microsurgery: a meta-analysis. Clin Oral Investig 2015; 19:569-82. [DOI: 10.1007/s00784-015-1398-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 01/02/2015] [Indexed: 01/23/2023]
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31
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Segari WAO, El Khalek Radwan DA, Abd El Hamid MA. The effect of adding hyaluronic acid to calcium phosphate on periapical tissue healing following periradicular surgery in dogs. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.tdj.2014.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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33
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Tomson RME, Polycarpou N, Tomson PL. Contemporary obturation of the root canal system. Br Dent J 2014; 216:315-22. [DOI: 10.1038/sj.bdj.2014.205] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2014] [Indexed: 11/09/2022]
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34
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Song M, Kim SG, Lee SJ, Kim B, Kim E. Prognostic Factors of Clinical Outcomes in Endodontic Microsurgery: A Prospective Study. J Endod 2013; 39:1491-7. [DOI: 10.1016/j.joen.2013.08.026] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 08/27/2013] [Indexed: 11/25/2022]
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35
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Villa‐Machado PA, Botero‐Ramírez X, Tobón‐Arroyave SI. Retrospective follow‐up assessment of prognostic variables associated with the outcome of periradicular surgery. Int Endod J 2013; 46:1063-76. [DOI: 10.1111/iej.12100] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 02/18/2013] [Indexed: 11/30/2022]
Affiliation(s)
- P. A. Villa‐Machado
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - X. Botero‐Ramírez
- 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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36
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Tsesis I, Rosen E, Taschieri S, Telishevsky Strauss Y, Ceresoli V, Del Fabbro M. Outcomes of Surgical Endodontic Treatment Performed by a Modern Technique: An Updated Meta-analysis of the Literature. J Endod 2013; 39:332-9. [PMID: 23402503 DOI: 10.1016/j.joen.2012.11.044] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 11/21/2012] [Accepted: 11/26/2012] [Indexed: 10/27/2022]
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37
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Ahmed HMA, Al Rayes MHI, Saini D. Management and prognosis of teeth with trauma induced crown fractures and large periapical cyst like lesions following apical surgery with and without retrograde filling. J Conserv Dent 2012; 15:77-9. [PMID: 22368341 PMCID: PMC3284020 DOI: 10.4103/0972-0707.92612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 04/29/2011] [Accepted: 05/07/2011] [Indexed: 11/29/2022] Open
Abstract
Crown fractures are common detrimental consequences of dental traumatic injuries. Early management of such cases is mandatory in order to prevent subsequent pathological changes that could further complicate the treatment. Pulp necrosis, chronic and cystic apical periodontitis can be the fate if these teeth are left untreated. Despite these serious complications, root canal treatment followed by apical surgery is considered a valid treatment option when such cases become complicated with large periapical lesions. However, whether a retrograde filling is essential to be placed or not is still a matter of debate. This case report discusses the orthograde endodontic management, the surgical approach and the clinical outcomes of longstanding crown fractured teeth with large cyst-like periapical lesions with and without retrograde filling.
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Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, School of Dental Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia, Malaysia
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38
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Lee W, Shon WJ, Baek SH, Kum KY, Kim HC. Outcomes of intentionally replanted molars according to preoperative locations of periapical lesions and the teeth. J Dent Sci 2012. [DOI: 10.1016/j.jds.2012.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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39
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von Arx T, Jensen SS, Hänni S, Friedman S. Five-Year Longitudinal Assessment of the Prognosis of Apical Microsurgery. J Endod 2012; 38:570-9. [DOI: 10.1016/j.joen.2012.02.002] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 02/06/2012] [Indexed: 11/27/2022]
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40
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Setzer FC, Kohli MR, Shah SB, Karabucak B, Kim S. Outcome of endodontic surgery: a meta-analysis of the literature--Part 2: Comparison of endodontic microsurgical techniques with and without the use of higher magnification. J Endod 2011; 38:1-10. [PMID: 22152611 DOI: 10.1016/j.joen.2011.09.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 09/26/2011] [Accepted: 09/30/2011] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The aim of this study was to investigate the outcome of root-end surgery. It identifies the effect of the surgical operating microscope or the endoscope on the prognosis of endodontic surgery. The specific outcomes of contemporary root-end surgery techniques with microinstruments but only loupes or no visualization aids (contemporary root-end surgery [CRS]) were compared with endodontic microsurgery using the same instruments and materials but with high-power magnification as provided by the surgical operating microscope or the endoscope (endodontic microsurgery [EMS]). The probabilities of success for a comparison of the 2 techniques were determined by means of a meta-analysis and systematic review of the literature. The influence of the tooth type on the outcome was investigated. METHODS A comprehensive literature search for longitudinal studies on the outcome of root-end surgery was conducted. Three electronic databases (ie, Medline, Embase, and PubMed) were searched to identify human studies from 1966 up to October 2009 in 5 different languages (ie, English, French, German, Italian, and Spanish). Review articles and relevant articles were searched for cross-references. In addition, 5 dental and medical journals (ie, Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics, Journal of Oral and Maxillofacial Surgery, and International Journal of Oral and Maxillofacial Surgery) dating back to 1975 were hand searched. Following predefined inclusion and exclusion criteria, all articles were screened by 3 independent reviewers (S.B.S., M.R.K., and F.C.S.). Relevant articles were obtained in full-text form, and raw data were extracted independently by each reviewer. After agreement among the reviewers, articles that qualified were assigned to group CRS. Articles belonging to group EMS had already been obtained for part 1 of this meta-analysis. Weighted pooled success rates and a relative risk assessment between CRS and EMS overall as well as for molars, premolars, and anteriors were calculated. A random-effects model was used for a comparison between the groups. RESULTS One hundred one articles were identified and obtained for final analysis. In total, 14 studies qualified according to the inclusion and exclusion criteria, 2 being represented in both groups (7 for CRS [n = 610] and 9 for EMS [n = 699]). Weighted pooled success rates calculated from extracted raw data showed an 88% positive outcome for CRS (95% confidence interval, 0.8455-0.9164) and 94% for EMS (95% confidence interval, 0.8889-0.9816). This difference was statistically significant (P < .0005). Relative risk ratio analysis showed that the probability of success for EMS was 1.07 times the probability of success for CRS. Seven studies provided information on the individual tooth type (4 for CRS [n = 457] and 3 for EMS [n = 222]). The difference in probability of success between the groups was statistically significant for molars (n = 193, P = .011). No significant difference was found for the premolar or anterior group (premolar [n = 169], P = .404; anterior [n = 277], P = .715). CONCLUSIONS The probability for success for EMS proved to be significantly greater than the probability for success for CRS, providing best available evidence on the influence of high-power magnification rendered by the dental operating microscope or the endoscope. Large-scale randomized clinical trials for statistically valid conclusions for current endodontic questions are needed to make informed decisions for clinical practice.
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Affiliation(s)
- Frank C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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41
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Tolasaria S, Das UK. Surgical and nonsurgical management of bilateral periapical lesions in the maxillary anterior region. J Surg Tech Case Rep 2011; 3:44-8. [PMID: 22022655 PMCID: PMC3192519 DOI: 10.4103/2006-8808.78473] [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] [Indexed: 11/27/2022] Open
Abstract
Conventional nonsurgical endodontic treatment has a high degree of clinical success, but in certain cases surgical intervention becomes necessary. This is the case report of a patient presenting with bilaterally separate periapical lesions in the maxillary anterior region. One lesion was managed by periapical surgery using a novel and safe method of separating the soft tissue mass of the periapical lesion which was in proximity to vital and vulnerable anatomical tissues, and the other was managed by long-term intracanal medicament, emphasizing the need of application of treatment in the best interest of the patient.
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Affiliation(s)
- Sweta Tolasaria
- Department of Conservative Dentistry and Endodontics, Guru Nanak Institute of Dental Science and Research, Kolkata, India
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42
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Song M, Jung IY, Lee SJ, Lee CY, Kim E. Prognostic Factors for Clinical Outcomes in Endodontic Microsurgery: A Retrospective Study. J Endod 2011; 37:927-33. [DOI: 10.1016/j.joen.2011.04.005] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 04/05/2011] [Accepted: 04/10/2011] [Indexed: 11/17/2022]
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Elemam RF, Pretty I. Comparison of the success rate of endodontic treatment and implant treatment. ISRN DENTISTRY 2011; 2011:640509. [PMID: 21991484 PMCID: PMC3168915 DOI: 10.5402/2011/640509] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Accepted: 04/18/2011] [Indexed: 01/10/2023]
Abstract
Dentists and patients are facing a perplexity between saving a compromised tooth through endodontic treatment and restoration or by extraction and replacement with an implant. The purpose of this paper was to compare the success rates of these two treatments. Success was measured as the longevity of the tooth or implant. Studies which met strict inclusion criteria to ensure best evidence were included. Searches were performed in Ovid Medline, Pubmed, Scopus database, and the Cochrane Library. Evidence-based groups were formed following the assessment of inclusion/exclusion criteria. The overall success rates for primary endodontic, nonsurgical retreatment, and surgical treatment were (86.02%), (78.2%), and (63.4%), respectively, implants was 90.9%. In conclusion, choice between implant and endodontic therapy cannot be exclusively based on outcome as both treatments differ in the biological process, diagnostic modalities, failure patterns, and patients preferences. More research is required with improved study designs before long-term success rates can be compared.
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Symptoms Before Periapical Surgery Related to Histologic Diagnosis and Postoperative Healing at 12 Months for 178 Periapical Lesions. J Oral Maxillofac Surg 2011; 69:e31-7. [DOI: 10.1016/j.joms.2010.07.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Revised: 06/21/2010] [Accepted: 07/03/2010] [Indexed: 11/17/2022]
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45
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Song M, Shin SJ, Kim E. Outcomes of Endodontic Micro-resurgery: A Prospective Clinical Study. J Endod 2011; 37:316-20. [PMID: 21329814 DOI: 10.1016/j.joen.2010.11.029] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Revised: 11/22/2010] [Accepted: 11/23/2010] [Indexed: 10/18/2022]
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Affiliation(s)
- Minju Song
- Department of Conservative Dentistry, Microscope Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Euiseong Kim
- Department of Conservative Dentistry, Microscope Center, Yonsei University College of Dentistry, Seoul, Korea
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47
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Barnes JJ, Patel S, Mannocci F. Why do general dental practitioners refer to a specific specialist endodontist in practice? Int Endod J 2010; 44:21-32. [DOI: 10.1111/j.1365-2591.2010.01791.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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48
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Tsesis I, Faivishevsky V, Kfir A, Rosen E. Outcome of Surgical Endodontic Treatment Performed by a Modern Technique: A Meta-analysis of Literature. J Endod 2009; 35:1505-11. [DOI: 10.1016/j.joen.2009.07.025] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2009] [Revised: 07/22/2009] [Accepted: 07/27/2009] [Indexed: 02/08/2023]
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49
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Outcomes of Nonsurgical Retreatment and Endodontic Surgery: A Systematic Review. J Endod 2009; 35:930-7. [DOI: 10.1016/j.joen.2009.04.023] [Citation(s) in RCA: 237] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 04/14/2009] [Accepted: 04/25/2009] [Indexed: 11/20/2022]
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50
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Radiographic Morphometric Study of 37 Periapical Lesions in 30 Patients: Validation of Success Criteria. J Oral Maxillofac Surg 2009; 67:846-9. [DOI: 10.1016/j.joms.2008.08.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Revised: 07/15/2008] [Accepted: 08/27/2008] [Indexed: 11/22/2022]
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