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Kytridou V, Gkikas I, Garcia MN, Cepeda O, Hildebolt CF. A literature review of local and systemic considerations for endodontic treatments in older adults. Gerodontology 2023; 40:410-421. [PMID: 36971290 DOI: 10.1111/ger.12679] [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: 09/02/2022] [Revised: 12/09/2022] [Accepted: 12/28/2022] [Indexed: 11/17/2023]
Abstract
OBJECTIVES The aim of this literature review was to summarise the clinical important findings on the endodontic treatment outcome in older patients (≥60 years old) with pulpal/periapical disease considering local and systemic factors from a body of knowledge that is heterogeneous in methods or disciplines. BACKGROUND Due to the increasing number of older patients in the endodontic practice, and the current trend for tooth preservation, the need for clinicians to have a better understanding of age-related implications that may influence the required endodontic treatment in older adults to retain their natural dentition is indispensable. METHODS PubMed/Medline and Embase was searched by a medical librarian using specific terms based on inclusion/exclusion criteria. The reference list was hand-seached for additional relevant publications between 2005-2020. A combination of these terms was performed uing Boolean operators and MeSH terms. RESULTS Of the 1577 publications identified manually and electronically, 25 were included to be fully reviewed by the examiners. The data was derived from three systematic reviews, one systematic and meta-analysis, three case series, four prospective and 14 retrospective cohorts. Overall, there was heterogeneity in reporting as well as limitations in most studies. CONCLUSIONS The outcome of endodontic treatment (ET) either nonsurgical or surgical or combination of these is not affected by older age. ET can be the treatment of choice in older patients wiht pulpal/periapical disease. There is no evidence that older age per se affects the outcome of any type of endodontic treatment.
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Affiliation(s)
- Vasiliki Kytridou
- Section Head of Endodontics, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Ioannis Gkikas
- Section of Oral and Maxillofacial Surgery, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Miryam Nathalia Garcia
- Applied Dental Medicine Department, Section of Periodontics, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Oscar Cepeda
- Division of Geriatric Medicine, St. Louis VA Medical Center, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Charles F Hildebolt
- Washington University School of Medicine, Saint Louis, Missouri, USA
- Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
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Root Canal Obturation by Electrochemical Precipitation of Calcium Phosphates. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12062956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Achieving adequate disinfection and preventing reinfection is the major goal in endodontic treatment. Variation in canal morphology and open porosity of dentine prevents achieving complete disinfection. Questionable biocompatibility of materials as well as a lack of sealing ability questions the usefulness of current obturation methods. With a novel disinfection approach based on the use of boron-doped diamond (BDD) electrodes having shown promising results it was the goal of this series of experiments to investigate the possibility of BDD-mediated in situ forming of a biocompatible obturation material. A combination of calcium phosphate and maleic acid was used as precursor solution while Ion Chromatography Mass Spectrometry (IC-MS), Raman spectroscopy (RAMAN), X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), dye penetration and micro-computed tomography (µCT) were applied for characterizing the precipitate. It was possible to achieve a BDD-mediated precipitation of brushite in a clinically applicable timeframe. However, tight sealing of the canal system based on brushite could not be achieved.
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Azarpazhooh A, Cardoso E, Sgro A, Elbarbary M, Lighvan NL, Badewy R, Malkhassian G, Jafarzadeh H, Bakhtiar H, Khazaei S, Oren A, Gerbig M, He H, Kishen A, Shah PS. A scoping review of four decades of outcomes in non-surgical root canal treatment, non-surgical retreatment and apexification studies. Part 1: process and general results. J Endod 2021; 48:15-28. [PMID: 34688794 DOI: 10.1016/j.joen.2021.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite initiatives to standardize reports, variance in study design, outcomes assessed, and tools used are persistent in literature. This review scoped existing literature on endodontic outcome studies for future development of core outcome sets. DESIGN Comprehensive literature search of randomized controlled trials, cohort, case-control studies, or case series (≥10 patients), published after 1980, patients aged ≥10 years, and any preoperative pulpal and periapical diagnosis in permanent teeth requiring non-surgical root canal treatment (NS-RCT), retreatment (NS-ReTx), or apexification was performed. Abstracted data were reported through descriptive statistics. RESULTS Of 9,957 studies screened, 354 were included. An increase in the quantity of endodontic outcome publications and levels of evidence in their study design was noted over the past four decades. Although 41% of studies included participants aged 26-50, literature including participants aged >50 has increased since 2000. Apexification and NS-ReTx were mostly provided by specialists and postgraduate students. The most common follow-up period was 2-5 years (35%), and most randomized controlled trials (58%) reported follow-up times <1 year. Multiple visit treatment was most common in apexification studies (85%). Deficiency, inconsistency and ambiguity were observed across many reports. CONCLUSIONS NS-ReTx and NS-RCT/NS-ReTx studies have increased over the past two decades, particularly those focusing on molars and patients >50 years old. Despite the progress in endodontic research, heterogeneity in reporting styles yield considerable limitations, particularly data standardization challenges and inconsistencies in methods and results reporting. This scoping review highlighted the state of available research and supported the development of standardized guidelines for future investigations.
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Affiliation(s)
- Amir Azarpazhooh
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada.
| | - Elaine Cardoso
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - Adam Sgro
- Mount Sinai Hospital, Toronto, ON, Canada
| | | | | | - Rana Badewy
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | | | - Hamid Jafarzadeh
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | | | - Saber Khazaei
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Ariel Oren
- Mount Sinai Hospital, Toronto, ON, Canada
| | - Madeline Gerbig
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Helen He
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Anil Kishen
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - Prakesh S Shah
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
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Abstract
Life expectancy has increased as a result of advancements in health care services; thus, maintaining healthy dentition is an important factor in overall health. Furthermore, the growing desire of elderly patients to maintain their teeth has led to an increased need for the performance of complex dental treatment in elderly patients. Root canal therapy is an essential phase of such treatments. Elderly patients may exhibit one or more systemic conditions that require special care, in addition to other changes that occur within the dentition and oral mucosa as a result of aging. These make root canal treatment in elderly patients a great challenge. The aim of this review was to characterize pathologic and physiologic changes in elderly patients that can interfere with root canal treatment procedures, as well as attitudes of elderly patients toward such treatment, guidelines and clinical considerations for management of root canal treatment in elderly patients.
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Affiliation(s)
- Mothanna K AlRahabi
- Department of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia. E-mail.
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