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Fichera G, Mazzitelli C, Picciariello V, Maravic T, Josic U, Mazzoni A, Breschi L. Structurally compromised teeth. Part I: Clinical considerations and novel classification proposal. J ESTHET RESTOR DENT 2024; 36:7-19. [PMID: 37615505 DOI: 10.1111/jerd.13117] [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: 07/15/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE A comprehensive classification of structurally compromised teeth (SCT) was introduced. CLINICAL CONSIDERATIONS Dental injuries or operative mismanagement undermine the structural integrity of the tooth abutment, reducing its biomechanical strength and rendering restorative procedures challenging. To standardize the overall pre-operative evaluations and determine the biological and mechanical features, a classification of the coronal and cervical tooth defects, as well as an attentive analysis of the most apical location of the residual cervical tooth structure along the whole perimeter and the most coronal location of the bucco/lingual residual structure was presented. Considering the residual cervical structure, five possible clinical scenarios were individuated with respect to the gingival margin, gingival sulcus, supracrestal tissue attachment and bone crest (BC). The latter prevents the isolation procedures rendering the adhesive restorations unfeasible. Instead, the location of the most apical portion of residual cervical structure within subgingival/intrasulcular depth (>1.5 mm above BC) can be considered restorable. CONCLUSIONS This classification is threefold: to enclose all the possible clinically encountered tooth defects, to identify the apical problems of SCT to appropriately manage the perio-restorative interfaces, and to evaluate the tooth resistance capacity of SCT, as to plan and perform the most adequate biomechanical restorative approach. CLINICAL SIGNIFICANCE The present classification is proposed to provide a complete perspective of structurally compromised teeth to standardize the biologic and biomechanical evaluations during planning of restorative procedures.
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Affiliation(s)
| | - Claudia Mazzitelli
- Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Tatjana Maravic
- Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Uros Josic
- Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Annalisa Mazzoni
- Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Urkande NK, Mankar N, Nikhade PP, Chandak M. Beyond Tradition: Non-surgical Endodontics and Vital Pulp Therapy as a Dynamic Combination. Cureus 2023; 15:e44134. [PMID: 37753005 PMCID: PMC10518373 DOI: 10.7759/cureus.44134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
Symptomatic irreversible pulpitis and apical periodontitis in mature permanent teeth present challenges in their management. Traditional treatment approaches, such as root canal therapy or tooth extraction, may compromise tooth structure and oral function. This review article explores the combination of non-surgical endodontic treatment and vital pulp therapy as an alternative approach for these conditions. The purpose is to examine this combined approach's effectiveness, benefits, challenges, and limitations. The objectives include reviewing the literature, evaluating clinical outcomes, discussing potential benefits, and providing recommendations for clinical practice. The combination approach aims to preserve tooth structure, promote healing, and reduce postoperative complications. The article discusses the rationale for combining the two techniques, presents evidence supporting their efficacy, and outlines the techniques and protocols involved. Clinical outcomes, case studies, potential challenges, and comparative analysis with traditional approaches are also explored. Future directions and research recommendations highlight areas for further investigation, innovations, and the development of clinical guidelines. In conclusion, the combination of non-surgical endodontic treatment and vital pulp therapy offers a valuable strategy for managing mature permanent mandibular molars with symptomatic irreversible pulpitis and apical periodontitis. Further research and advancements are needed to refine the treatment protocol and expand the evidence base, and clinicians should stay updated to provide optimal care and improve patient outcomes.
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Affiliation(s)
- Neha K Urkande
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College And Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Nikhil Mankar
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College And Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pradnya P Nikhade
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College And Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Manoj Chandak
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College And Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Deep Margin Elevation: Current Concepts and Clinical Considerations: A Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101482. [PMID: 36295642 PMCID: PMC9610387 DOI: 10.3390/medicina58101482] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/05/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
Dietschi and Spreafico first proposed deep margin elevation (DME) in 1998 to address the multiple clinical problems associated with sub-gingival margins, where sub-gingival margins will be repositioned coronally using composite resin restorations. Given that dentistry is directing towards conservatism, its use is currently trending. Materials and Methods: a search was performed through PubMed, Scopus, and Google Scholar search engines to obtain relevant articles with no time restriction. Results: With biological width taken into consideration, well-defined and polished sub-gingival restorations are compatible with periodontal health. Marginal integrity in the DME technique seems to be affected by the type of adhesive, restoration, and incremental layering of the restoration. Regarding fracture resistance, DME has no significant effects. Conclusion: The DME technique seems to be a minimally invasive alternative to surgical crown lengthening (SCL) and orthodontic extrusion (OE) with respect to biological width. Well-controlled clinical trials are limited in this field; further long-term follow-up studies emphasizing the periodontal outcomes and prevention of complications are needed.
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Watts J, Jayawardena DS, Ahmed R, Cunliffe J, Darcey J. Considerations for restorative dentistry secondary care referrals - part 2: predictability of treatment. Br Dent J 2022; 233:101-108. [DOI: 10.1038/s41415-022-4446-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/17/2022] [Indexed: 11/09/2022]
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Wang C, Jia XT, Zhen M, Hu WJ, Zhang H, Chung KH. Success rate of fractured teeth receiving modified crown lengthening surgery and restorations. BMC Oral Health 2022; 22:99. [PMID: 35354462 PMCID: PMC8969369 DOI: 10.1186/s12903-022-02143-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/23/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Whether to preserve a structurally compromised tooth or remove it is a dilemma often encountered by clinicians. The aim of this study was to assess the long-term success rate of fractured teeth preserved by modified crown lengthening surgery and restorations. METHODS Thirty-nine patients with a total of 45 fractured teeth who had received modified crown lengthening surgery were recruited and examined. Numbers of teeth lost were recorded, and the criteria for successful teeth were defined. Kaplan-Meier estimator was used to determine the success rate. Possible risk factors were compared between successful and unsuccessful groups by a Cox regression analysis to explore the potential predictors of failure with a significant level at α = 0.05. RESULTS The mean ± SD of success time without considering variants was 6.2 ± 0.6 years (95% CI 5.1-7.7). The mean survival rates ± SD at 1.0-, 2.0-, 3.0-, 5.0-, 7.0-, and 9.0-year intervals was 97.8 ± 2.2%, 92.2 ± 4.4%, 72.8 ± 7.9%, 68.2 ± 8.6%, 60.7 ± 10.5%, and 40.4 ± 13.6%, respectively. Failure cases in teeth with poor plaque control and step-shaped fracture margin were significantly more than those with good plaque control and knife-shaped fracture margin (HR = 7.237, p = 0.011; HR = 15.399, p = 0.006; respectively). CONCLUSIONS Fractured teeth treated with modified crown lengthening surgery are anticipated to have a high clinical success rate for 6.2 ± 0.6 years. Plaque control and fracture morphology appeared to be significantly associated with the success of the multidisciplinary treatment approach.
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Affiliation(s)
- Cui Wang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun S Ave, Haidian District, Beijing, 100081, China
| | - Xue-Ting Jia
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun S Ave, Haidian District, Beijing, 100081, China
| | - Min Zhen
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun S Ave, Haidian District, Beijing, 100081, China
| | - Wen-Jie Hu
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun S Ave, Haidian District, Beijing, 100081, China.
| | - Hao Zhang
- Department of Restorative Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Kwok-Hung Chung
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA, USA
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Jameson LM, Al‐Tarawneh SK. Informed Consent from a Historical, Societal, Ethical, Legal, and Practical Perspective. J Prosthodont 2022; 31:464-471. [PMID: 35184338 PMCID: PMC9541224 DOI: 10.1111/jopr.13493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/02/2022] [Indexed: 12/01/2022] Open
Abstract
Informed consent is often perceived as a regulatory obligation without recognizing its educational potential in the dynamic provider/patient relationship. This article discusses the complex interaction of ethics, society, and law through a historical and practical perspective. The purpose is to provide general dentists and specialists with a comprehensive understanding of the complexity and practical dimensions of informed consent.
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Affiliation(s)
- Lee M. Jameson
- Department of Restorative Dentistry, College of Dentistry University of Illinois at Chicago Chicago Illinois
| | - Sandra K. Al‐Tarawneh
- Department of Restorative Dentistry, College of Dentistry University of Illinois at Chicago Chicago Illinois
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Pre-endodontic restoration of structurally compromised teeth: current concepts. Br Dent J 2021; 231:343-349. [PMID: 34561585 PMCID: PMC8463293 DOI: 10.1038/s41415-021-3467-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/21/2021] [Indexed: 11/29/2022]
Abstract
Teeth that require endodontic treatment are often structurally compromised and this considerably complicates endodontic procedures. Therefore, pre-endodontic restoration is a key approach that dentists should consider for such teeth. This article discusses current concepts of pre-endodontic restoration, with a focus on adhesive restorative methods and surgical/orthodontic techniques, and provides a relevant decision-making flowchart. Highlights the importance of pre-endodontic restoration for the predictability of endodontic treatment. Discusses restorability aspects for structurally compromised teeth. Reviews current restorative and surgical/orthodontic techniques for pre-endodontic restoration and provides a decision-making flowchart.
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Babaier RS, Basudan SO. Do dentists practice what they know? A cross-sectional study on the agreement between dentists' knowledge and practice in restoring endodontically treated teeth. BMC Oral Health 2021; 21:110. [PMID: 33691705 PMCID: PMC7945671 DOI: 10.1186/s12903-021-01479-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 03/03/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There are very few studies comparing dentists' knowledge in relation to their clinical approach despite the existence of a possible gap between what they know and what they do. AIM To measure the agreement between knowledge and practice methods related to a selected clinical scenario involving the placement of an indirect post in endodontically treated teeth (ETT) among different types of practitioners. METHODS An electronic questionnaire was emailed to members of the Saudi Dental Society. The questionnaire presented a clinical scenario of restoring a posterior ETT with an indirect post, core unit, and crown, followed by specific questions regarding knowledge and practice related to ten different treatment aspects such as who prepares the post space, technique, isolation, time, gap between gutta-percha, and time to cementation of the crown. Each question was presented twice for each aspect, once asking about their practice method and then what they thought was the correct practice (knowledge). The relationship between the participants' responses and their specialty and the agreement between the responses of knowledge and practice for each participant were analyzed by Pearson's chi-square test and Kappa. RESULTS 203 completed questionnaires were analyzed. Most participants were 30 years old or younger (62.6%), and general dental practitioners (59%). When comparing the knowledge to the practice methods of each participant, nine out of ten aspects were of a "weak" level agreement or below (kappa < 0.59, p < 0.001). Only one aspect demonstrated a "strong" level of agreement (Kappa = 0.804), which was related to the duration of time between obturation and post space preparation in the presence of a periapical lesion. However, this strong agreement in the responses was not aligned with current evidence. There was also a significant difference among the responses of endodontists, restorative dentists and general practitioners in most of the aspects. CONCLUSION Overall, there was a weak agreement between what practitioners know and do in most aspects of a selected clinical scenario involving the placement of an indirect post in posterior ETT. Moreover, the participant's specialty influenced their responses regarding both knowledge and clinical practice.
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Affiliation(s)
- Rua S Babaier
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, 12372, Saudi Arabia. .,Division of Dentistry, Faculty of Biology, Medicine, and Health, School of Medical Sciences, University of Manchester, Manchester, UK.
| | - Sumaya O Basudan
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Ashnagar S, Barootchi S, Ravidá A, Tattan M, Wang HL, Wang CW. Long-term survival of structurally compromised tooth preserved with crown lengthening procedure and restorative treatment: A pilot retrospective analysis. J Clin Periodontol 2019; 46:751-757. [PMID: 31050812 DOI: 10.1111/jcpe.13124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/11/2019] [Accepted: 04/29/2019] [Indexed: 12/27/2022]
Abstract
AIM Since there is limited study to assist in an evidenced-based decision whether to extract or preserve a structurally compromised tooth, the aim of this retrospective study was to investigate the long-term survival rate of tooth preservation after crown lengthening procedure (CLP) and restorative treatments. METHODS Electronic and paper chart of patients received CLP in our graduate clinic from 1990 to 2015 were reviewed. Statistical analysis was done using Cox regression analysis and Kaplan-Meier estimator. RESULTS A total of 766 coded charts were initially collected. Four hundred and fourteen cases were included in the final analysis. The Kaplan-Meier estimate shows a cumulative survival rate of 88.3% in 5 years, 78.4% in 10 years and 68.1% in 15 years. In terms of reasons for failure, restorative problem such as recurrent decays was the main issue (35.2%), followed by fracture (29.6%), endodontic complications (23.9%) and periodontal breakdown (11.3%). CONCLUSIONS Within the limitation of this study, structurally compromised teeth have a reasonable long-term survival rate close to 80% after 10 years in a teaching institute. Patients with high fracture or caries risk may pose a higher chance of failure. Objective information should be presented to the patient to arrive at an evidence-based decision.
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Affiliation(s)
- Sajjad Ashnagar
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Andrea Ravidá
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Mustafa Tattan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Chin-Wei Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
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The Effect of Crown Lengthening on the Outcome of Endodontically Treated Posterior Teeth: 10-year Survival Analysis. J Endod 2019; 45:696-700. [PMID: 31005334 DOI: 10.1016/j.joen.2019.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/28/2019] [Accepted: 02/01/2019] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate the effect of a crown lengthening (CL) procedure and the crown-root ratio after CL on the long-term survival of endodontically treated teeth (ETT). METHODS Permanent posterior teeth with opposing dentition that had received adequate nonsurgical root canal treatment (NSRCT) and a full-coverage crown between January 1, 2006, and January 1, 2016 were included in this retrospective study. The data collected included dates of the NSRCT, time of extraction if extracted, age, sex, location, the crown-root ratio after CL, and the presence of a lesion. All included ETT were divided into 2 groups: RESULTS: 5-year survival rates of ETT in the control and CL groups were 88.6% and 82.2%, respectively (P > .05). The 10-year survival rates of ETT in the control and CL groups were 74.5% and 51%, respectively (P < .05). ETT that received the CL procedure after NSRCT were almost 2.3 times more likely to get extracted compared with ETT that did not need the CL procedure at the 10-year follow-up (hazard ratio = 2.29, P < .05). Also, ETT with an inadequate crown-root ratio (1:1) after CL showed the lowest survival rate (40%) compared with ETT with an adequate crown-root ratio (<1:1). CONCLUSIONS A crown-root ratio of 1:1 after osseous CL may affect the long-term survival of ETT. Despite the promising survival rate of ETT with an adequate crown-root ratio after CL, the long-term survival of NSRCT with an inadequate crown-root ratio (1:1) should be considered in the treatment planning phase. Also, it is worth mentioning that the results of the present study should be evaluated in future prospective studies.
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Unexpected Complication Ten Years after Initial Treatment: Long-Term Report and Fate of a Maxillary Premolar Rehabilitation. Case Rep Dent 2018; 2018:3287965. [PMID: 30305964 PMCID: PMC6164210 DOI: 10.1155/2018/3287965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 08/26/2018] [Indexed: 11/29/2022] Open
Abstract
Full-coverage restorations represent a well-known rehabilitation strategy for compromised posterior teeth; in the last years, new ceramic materials like zirconia have been introduced and widely adopted for the prosthetic management of molar and premolar areas. A long-term follow-up of a maxillary premolar rehabilitation using a veneered zirconia crown is presented; after ten years of uneventful clinical service of the tooth-restoration complex, a serious complication—namely, a vertical root fracture (VRF)—occurred. An extended time lapse (9 years) between the end of restorative procedures and development of symptoms due to VRF has been observed. On the other hand, a complete functional and esthetic integrity of the zirconia crown (without chippings or crack development) is documented along the follow-up period. Due to periodontal breakdown and severity of fracture, the premolar was extracted. The illustrations of our late failure, aetiological factors, and available data on the literature regarding VRF are addressed. Patients and clinicians should be aware of potential occurrences of some long-term, serious complications when dealing with previously treated and/or structurally weakened teeth. The development of a VRF might be unexpected and might occur many years after the end of tooth rehabilitation, despite adoption of contemporary restorative protocols and techniques.
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Stadler AF, Mendez M, Oppermann RV, Gomes SC. Tooth Loss in Patients under Periodontal Maintenance in a Private Practice: A Retrospective Study. Braz Dent J 2018; 28:440-446. [PMID: 29160395 DOI: 10.1590/0103-6440201701476] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 03/29/2017] [Indexed: 12/18/2022] Open
Abstract
The aim of the present study was to evaluate the incidence and causes of tooth loss in periodontal subjects from a private practice in Brazil. Two trained examiners extracted data from the records of subjects who sought periodontal treatment from 1980 to 2013. Only records of patients who completed the non-surgical periodontal treatment and had at least one visit for maintenance were included. Data were analyzed by chi-square test, Student's t-test, Kaplan-Meier survival curve and Cox regression. A total of 3,319 records were reviewed and 737 records included (58.6% women, mean age of 46.6±13.0 years at the beginning of the treatment). Maintenance period ranged from 1 to 33 years (7.4±6 years). During this period, 202 individuals (27.4%) lost 360 teeth, 47.5% of losses within the first five years (n=171). Non-compliers lost more teeth than compliers (p<0.001), respectively 211 and 149 teeth. Regarding reasons of tooth loss, 84 individuals lost 38% of the teeth from periodontal disease progression (n=137). Survival analysis showed that most patients lost only one tooth from periodontal disease, and differences in the survival rates between compliers and non-compliers were observed following the second tooth loss. Approximately one-third of tooth losses was related to periodontal disease progression, and there was stability in time of the proportion of losses from disease progression and other reasons. Therefore, it is possible to conclude that compliant patients in a private practice lose fewer teeth than do non-compliers. Among compliers, periodontal disease progression was not the main cause of tooth loss.
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Affiliation(s)
- Amanda Finger Stadler
- Department of Periodontology, School of Dentistry, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Department of Periodontics, The Dental College of Georgia at Augusta University, Augusta, GA, USA
| | - Marina Mendez
- Department of Periodontology, School of Dentistry, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rui Vicente Oppermann
- Department of Periodontology, School of Dentistry, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Sabrina Carvalho Gomes
- Department of Periodontology, School of Dentistry, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Wong AWY, Zhang S, Li SKY, Zhang C, Chu CH. Clinical studies on core-carrier obturation: a systematic review and meta-analysis. BMC Oral Health 2017; 17:167. [PMID: 29284463 PMCID: PMC5747112 DOI: 10.1186/s12903-017-0459-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 12/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This systematic review aimed to evaluate the clinical performance of core-carrier obturation in endodontic treatment. METHODS Keywords of "(core carrier OR Thermafil) OR (cold lateral condensation OR lateral condensation) OR (warm vertical condensation OR vertical condensation) AND (obturation OR root canal filling) AND clinical study" were searched for all obtainable publications up to year 2017 in the databases of PubMed, ScienceDirect, EMBASE, Scopus and Web of Science. The success rate, short-term postoperative pain, overfilling and adaptation of core-carrier obturation from clinical studies were selected. Reviews, laboratory studies, animal studies and irrelevant reports were excluded. RESULTS 1349 relevant articles were identified with 149 duplicated articles removed and 1173 irrelevant articles were excluded after screening. The titles and abstracts of the 19 identified articles were screened in the systematic review. The full texts of remaining articles were retrieved with data extracted for meta-analysis on the success rate, postoperative pain, overfilling and adaptation of obturation. The pooled success rate of core-carrier obturation was 83% (95% CI: 69%-91%). The pooled incidence of 1-day and 7-day short-term postoperative pain were 35% (95% CI: 15%-62%) and 6% (95% CI: 1-35%). The pooled proportion of teeth with overfilling and adequate adaptation of the obturation material were 31% (95% CI: 18%-50%) and 85% (95% CI: 75%-91%), respectively. CONCLUSIONS The success rate of endodontic treatment using core-carrier obturation was 83%. Short-term postoperative pain was not uncommon (24%). Most teeth (85%) had adequate adaptation using core-carrier obturation material, but a considerable amount of teeth (31%) had overfilling.
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Affiliation(s)
- Amy Wai-Yee Wong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Shinan Zhang
- School of Stomatology, Kunming Medical University, Yunnan, China
| | | | - Chengfei Zhang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China. .,3B53A, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China.
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Pilalas I, Tsalikis L, Tatakis DN. Pre-restorative crown lengthening surgery outcomes: a systematic review. J Clin Periodontol 2016; 43:1094-1108. [DOI: 10.1111/jcpe.12617] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Ioannis Pilalas
- Department of Preventive Dentistry, Periodontology and Implant Biology; School of Dentistry; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Lazaros Tsalikis
- Department of Preventive Dentistry, Periodontology and Implant Biology; School of Dentistry; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Dimitris N. Tatakis
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
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