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Smith RB, Bryce GE, Ng Y, Gulabivala K, Dermont MA. Eight-year retrospective study investigating tooth survival after primary non-surgical root canal treatment in a UK military cohort. BMJ Mil Health 2024; 170:107-111. [PMID: 35788109 DOI: 10.1136/bmjmilitary-2021-002042] [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: 03/28/2022] [Accepted: 05/19/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Root canal treatment (RCT) plays an important role in preserving the dentition by deferring other invasive treatments. Data on tooth survival and predictive factors for tooth loss after RCT in the military cohort are lacking. This investigation aimed to determine the proportion of teeth surviving in an 8-year period after RCT and identify potential predictive factors for tooth loss in a UK military cohort. METHODOLOGY A retrospective review of an integrated electronic health record for military patients who had received RCT was performed in a random sample of 205 patients (n=219 root-filled teeth) who had received RCT between 1 January 2011 and 1 January 2012. Tooth survival was defined as tooth presence, regardless of signs or symptoms, and measured from the point of root filling until either the end of the designated study period or time of extraction. Survival was evaluated using Kaplan-Meier estimates and association with tooth loss using the χ2 test. Potentially significant predictive factors were investigated using univariate Cox regression. RESULTS Tooth survival following RCT was 98% after 24 months; 88% after 48 months; 83% after 72 months; and 78% after 96 months. Four predictive factors were found to affect tooth loss as follows: preoperative pain (HR=3.2; p<0.001), teeth with less than two proximal contacts (HR=3.0; p=0.01), teeth with cores involving more than two surfaces (HR=2.0; p=0.03) and postoperative unscheduled dental attendances (UDA) (HR=2.7; p=0.01). CONCLUSIONS Within the limitations of this study, the presence of preoperative pain; teeth with less than two proximal contacts or with cores involving more than two tooth surfaces; and occurrence of postoperative UDA were found to significantly increase the hazard of tooth loss.
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Affiliation(s)
| | - G E Bryce
- DCRD, Aldershot Garrison, Aldershot, UK
| | - Y Ng
- Endodontology, University College London, London, UK
- Restorative Dentistry and Endodontology, UCL Eastman Dental Institute, London, UK
| | - K Gulabivala
- Restorative Dentistry and Endodontology, UCL Eastman Dental Institute, London, UK
| | - M A Dermont
- Defence Public Health Unit, Defence Medical Services, Lichfield, UK
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Mannocci F, Bitter K, Sauro S, Ferrari P, Austin R, Bhuva B. Present status and future directions: The restoration of root filled teeth. Int Endod J 2022; 55 Suppl 4:1059-1084. [PMID: 35808836 PMCID: PMC9796050 DOI: 10.1111/iej.13796] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
This narrative review will focus on a number of contemporary considerations relating to the restoration of root filled teeth and future directions for research. Clinicians are now more than ever, aware of the interdependence of the endodontic and restorative aspects of managing root filled teeth, and how these aspects of treatment are fundamental to obtaining the best long-term survival. To obtain the optimal outcomes for patients, clinicians carrying out endodontic treatment should have a vested interest in the restorative phase of the treatment process, as well as an appreciation for the structural and biomechanical effects of endodontic-restorative procedures on restoration and tooth longevity. Furthermore, the currently available research, largely lacks appreciation of occlusal factors in the longevity of root filled teeth, despite surrogate outcomes demonstrating the considerable influence this variable has. Controversies regarding the clinical relevance of minimally invasive endodontic and restorative concepts are largely unanswered with respect to clinical data, and it is therefore, all too easy to dismiss these ideas due to the lack of scientific evidence. However, conceptually, minimally invasive endodontic-restorative philosophies appear to be valid, and therefore, in the pursuit of improved clinical outcomes, it is important that the efficacies of these treatment protocols are determined. Alongside an increased awareness of the preservation of tooth structure, developments in adhesive bonding, ceramic materials and the inevitable integration of digital dentistry, there is also a need to evaluate the efficacy of new treatment philosophies and techniques with well-designed prospective clinical studies.
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Affiliation(s)
- Francesco Mannocci
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Kerstin Bitter
- Department of Operative and Preventive DentistryCharité ‐ University Medicine BerlinBerlinGermany
| | - Salvatore Sauro
- Departamento de Odontología, Facultad de Ciencias de la SaludUniversidad CEU‐Cardenal Herrera ValenciaAlfara del PatriarcaSpain
| | - Paolo Ferrari
- Department of Operative DentistryUniversity of ParmaParmaItaly
| | - Rupert Austin
- Department of ProsthodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Bhavin Bhuva
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
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Bhuva B, Giovarruscio M, Rahim N, Bitter K, Mannocci F. The restoration of root filled teeth: a review of the clinical literature. Int Endod J 2021; 54:509-535. [PMID: 33128279 DOI: 10.1111/iej.13438] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023]
Abstract
Clinicians often face dilemmas regarding the most appropriate way to restore a tooth following root canal treatment. Whilst there is established consensus on the importance of the ferrule effect on the predictable restoration of root filled teeth, other factors, such as residual tooth volume, tooth location, number of proximal contacts, timing of the definitive restoration and the presence of cracks, have been reported to influence restoration and tooth survival. The continued evolution of dental materials and techniques, combined with a trend towards more conservative endodontic-restorative procedures, prompts re-evaluation of the scientific literature. The aim of this literature review was to provide an updated overview of the existing clinical literature relating to the restoration of root filled teeth. An electronic literature search of the PubMed, Ovid (via EMBASE) and MEDLINE (via EMBASE) databases up to July 2020 was performed to identify articles that related the survival of root filled teeth and/or restoration type. The following and other terms were searched: restoration, crown, onlay, root canal, root filled, post, clinical, survival, success. Wherever possible, only clinical studies were selected for the literature review. Full texts of the identified articles were independently screened by two reviewers according to pre-defined criteria. This review identifies the main clinical factors influencing the survival of teeth and restorations following root canal treatment in vivo and discusses the data related to specific restoration type on clinical survival.
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Affiliation(s)
- B Bhuva
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - M Giovarruscio
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - N Rahim
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - K Bitter
- Department of Operative and Preventive Dentistry, Charité - University Medicine, Berlin, Germany
| | - F Mannocci
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Karunanayake G, Ng YL, Knowles JC, Delgado AHS, Young AM, Gulabivala K, Nazhat SN. The effect of NaOCl and heat treatment on static and dynamic mechanical properties and chemical changes of dentine. J Mech Behav Biomed Mater 2019; 97:330-338. [PMID: 31153114 DOI: 10.1016/j.jmbbm.2019.05.042] [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: 01/23/2019] [Revised: 05/23/2019] [Accepted: 05/27/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the effect of heat on flexural strength (FS), maximum strain (MS), storage modulus (SM), tan delta (TD) and chemical changes through micro-Raman spectroscopy of dentine exposed to 2.5% NaOCl or saline. METHOD ology: Dentine bars were randomly allocated to 8 test groups. Half (groups 2,4,6,8) were treated with NaOCl for 20 min; the rest (groups 1,3,5,7) remained in saline. FS/MS were measured in groups 1-4 (n = 15) (3/4 were also heated to 200 °C & re-hydrated in saline). Micro-Raman spectroscopy was performed on bars from groups 1-4. SM/TD were measured in 5-8: in 5/6 (n = 10), repeated after heating (200 °C), then following re-hydration; in 7/8 (n = 3) after heating to 25-185 °C. RESULTS Increase in MS on heat and FS/MS on heat + NaOCl was not significant (P > 0.05). SM increased (P = 0.06) after heat treatment but reduced to initial state after rehydration (P = 0.03). TD did not change (P = 0.4) after heat (200 °C) treatment but rehydration increased it compared with pre-treatment state (P = 0.001). For dentine bars pre-treated with NaOCl, SM did not change (P = 0.6) after heat (200 °C) treatment or rehydration but TD significantly increased (P = 0.02) upon re-hydration compared with pre- (P=0.007), or post- (P = 0.03) heat-treatment states. SM and TD varied between 25-185 °C with no consistent trend amongst the NaOCl pre-treated bars. Micro-Raman only detected chemical changes following NaOCl treatment in the mineral phase. CONCLUSIONS Exposure of dentine bars to heat and NaOCl produced only moderate changes to quasi-static but marked changes to viscoelastic properties, which may be explained by chemical alterations.
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Affiliation(s)
- G Karunanayake
- Unit of Endodontology, Division of Restorative Dental Science, UCL Eastman Dental Institute, University College London, London, UK
| | - Y-L Ng
- Unit of Endodontology, Division of Restorative Dental Science, UCL Eastman Dental Institute, University College London, London, UK.
| | - J C Knowles
- Biomaterials & Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK; Institute of Tissue Regeneration Engineering (ITREN) and Department of NanobiomedicalScience and BK21 Plus NBM, Global Research Center for Regenerative Medicine, DankookUniversity, 518-10, Anseo-dong, Dongnam-gu, Cheonan, Chungcheongnam-do, South Korea; The Discoveries Centre for Regenerative and Precision Medicine, UCL Campus, GowerStreet, London, WC1E 6BT, UK
| | - A H S Delgado
- Biomaterials & Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK
| | - A M Young
- Biomaterials & Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK
| | - K Gulabivala
- Unit of Endodontology, Division of Restorative Dental Science, UCL Eastman Dental Institute, University College London, London, UK
| | - S N Nazhat
- Department of Mining and Materials Engineering, McGill University, Montreal, Qc, H3A 0C5, Canada
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Gulabivala K, Ng YL. Value of root-filled teeth in maintaining a functional dentition for life. Br Dent J 2019; 226:769-784. [DOI: 10.1038/s41415-019-0313-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Danley BT, Hamilton BN, Tantbirojn D, Goldstein RE, Versluis A. Cuspal Flexure and Stress in Restored Teeth Caused by Amalgam Expansion. Oper Dent 2018; 43:E300-E307. [DOI: 10.2341/17-329-l] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective:
Cracks in amalgam-filled teeth may be related to amalgam expansion. This study measured cuspal flexure and used finite element analysis to assess associated stress levels in amalgam-filled teeth.
Methods and Materials:
External surfaces of 18 extracted molars were scanned in three dimensions. Nine molars were restored with mesio-occluso-distal amalgam fillings; the other teeth were left intact as controls. All teeth were stored in saline and scanned after two, four, and eight weeks. Cuspal flexure and restoration expansion were determined by calculating the difference between scanned surfaces. Stresses in a flexed tooth were calculated using finite element analysis.
Results:
Cusps of amalgam-filled teeth flexed outward approximately 3 μm, and restoration surfaces expanded 4 to 8 μm during storage. Cuspal flexure was significantly higher in the amalgam group (multivariate tests, p<0.05), but storage time had no significant effect (repeated measures, p>0.05). Expansion caused stress concentrations at the cavity line angles. These stress concentrations increased stresses due to mastication 44% to 178%.
Conclusions:
Amalgam expansion pushed cavity walls outward, which created stress concentrations at the cavity line angles. Expansion stresses can raise stresses in amalgam-filled teeth and contribute to incidentally observed cracks.
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Affiliation(s)
- BT Danley
- Brent T Danley, BS, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - BN Hamilton
- Bruce N Hamilton, MS, DDS, Department of Restorative Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - D Tantbirojn
- Daranee Tantbirojn, DDS, MS, PhD, Department of Restorative Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - RE Goldstein
- Ronald E Goldstein, DDS, private practice, Atlanta, and clinical professor of Oral Rehabilitation, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - A Versluis
- Antheunis Versluis, PhD, College of Dentistry, Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
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Abstract
Root-filled teeth are weakened by loss of strategic tooth structure through restorative procedures and caries, rather than by the endodontic procedures. Therefore, prompt restoration is required to minimise coronal leakage and the risk of tooth fracture. However, restorability should be confirmed before root canal treatment begins, by removing caries and existing restoration to evaluate the residual tooth structure. Based on the remaining tooth structure, the restoration is planned to maximise the longevity of root-filled teeth as a functional unit. This review considers risk factors for survival of root-filled teeth and principles of restoration, rather than detailed techniques, including direct and indirect restorations.
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Affiliation(s)
- Nessrin A Taha
- Department of Conservative Dentistry, Jordan University of Science and Technology, Jordan
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8
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Zarow M, Ramírez-Sebastià A, Paolone G, de Ribot Porta J, Mora J, Espona J, Durán-Sindreu F, Roig M. A new classification system for the restoration of root filled teeth. Int Endod J 2017; 51:318-334. [DOI: 10.1111/iej.12847] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 08/23/2017] [Indexed: 12/28/2022]
Affiliation(s)
| | - A. Ramírez-Sebastià
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - G. Paolone
- Dental School; Universitá Vita e Salute San Raffaele; Milan Italy
| | - J. de Ribot Porta
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - J. Mora
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - J. Espona
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - F. Durán-Sindreu
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - M. Roig
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
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Plotino G, Grande NM, Isufi A, Ioppolo P, Pedullà E, Bedini R, Gambarini G, Testarelli L. Fracture Strength of Endodontically Treated Teeth with Different Access Cavity Designs. J Endod 2017; 43:995-1000. [DOI: 10.1016/j.joen.2017.01.022] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 11/27/2022]
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Eliyas S, Jalili J, Martin N. Restoration of the root canal treated tooth. Br Dent J 2016; 218:53-62. [PMID: 25613259 DOI: 10.1038/sj.bdj.2015.27] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2014] [Indexed: 11/09/2022]
Abstract
When considering endodontically treated teeth, the quality of the restoration is important from the outset. It sheds light into possible causes of pulp necrosis or failure of endodontic treatment and influences the outcome of future endodontic treatment. A tooth undergoing endodontic treatment requires an effective coronal seal during and following completion of endodontic treatment. This paper discusses, using the available literature, the maintenance of optimal coronal seal and coronal integrity during and after root canal treatment.
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Affiliation(s)
- S Eliyas
- Glenfield Hospital, University Hospitals of Leicester NHS Trust, Groby Road, Leicester, LE3 9QP
| | - J Jalili
- Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Wellesley Road, Sheffield, S10 2SZ
| | - N Martin
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, University of Sheffield
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Isufi A, Plotino G, Grande NM, Ioppolo P, Testarelli L, Bedini R, Al-Sudani D, Gambarini G. Fracture resistance of endodontically treated teeth restored with a bulkfill flowable material and a resin composite. ANNALI DI STOMATOLOGIA 2016; 7:4-10. [PMID: 27486505 PMCID: PMC4955920 DOI: 10.11138/ads/2016.7.1.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To determine and compare the fracture resistance of endodontically treated teeth restored with a bulk fill flowable material (SDR) and a traditional resin composite. METHODS Thirty maxillary and 30 mandibular first molars were selected based on similar dimensions. After cleaning, shaping and filling of the root canals and adhesive procedures, specimens were assigned to 3 subgroups for each tooth type (n=10): Group A: control group, including intact teeth; Group B: access cavities were restored with a traditional resin composite (EsthetX; Dentsply-Italy, Rome, Italy); Group C: access cavities were restored with a bulk fill flowable composite (SDR; Dentsply-Italy), except 1.5 mm layer of the occlusal surface that was restored with the same resin composite as Group B. The specimens were subjected to compressive force in a material static-testing machine until fracture occurred, the maximum fracture load of the specimens was measured (N) and the type of fracture was recorded as favorable or unfavorable. Data were statistically analyzed with one-way analysis of variance (ANOVA) and Bonferroni tests (P<0.05). RESULTS No statistically significant differences were found among groups (P<0.05). Fracture resistance of endodontically treated teeth restored with a traditional resin composite and with a bulk fill flowable composite (SDR) was similar in both maxillary and mandibular molars and showed no significant decrease in fracture resistance compared to intact specimens. CONCLUSIONS No significant difference was observed in the mechanical fracture resistance of endodontically treated molars restored with traditional resin composite restorations compared to bulk fill flowable composite restorations.
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Affiliation(s)
- Almira Isufi
- Endodontics Unit, Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Italy
| | - Gianluca Plotino
- Endodontics Unit, Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Italy
| | | | - Pietro Ioppolo
- Istituto Superiore di Sanità, Technology and Health Department, Rome, Italy
| | - Luca Testarelli
- Endodontics Unit, Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Italy
| | - Rossella Bedini
- Istituto Superiore di Sanità, Technology and Health Department, Rome, Italy
| | - Dina Al-Sudani
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Gianluca Gambarini
- Endodontics Unit, Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Italy
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Krishan R, Paqué F, Ossareh A, Kishen A, Dao T, Friedman S. Impacts of Conservative Endodontic Cavity on Root Canal Instrumentation Efficacy and Resistance to Fracture Assessed in Incisors, Premolars, and Molars. J Endod 2014; 40:1160-6. [DOI: 10.1016/j.joen.2013.12.012] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 12/02/2013] [Accepted: 12/13/2013] [Indexed: 11/30/2022]
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13
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Rajasingham R, Ng YL, Knowles JC, Gulabivala K. The effect of sodium hypochlorite and ethylenediaminetetraacetic acid irrigation, individually and in alternation, on tooth surface strain. Int Endod J 2010; 43:31-40. [DOI: 10.1111/j.1365-2591.2009.01625.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hinckfuss S, Wilson PR. Effect of Core Material and Restoration Design on Strength of Endodontically Treated Bovine Teeth: A Laboratory Study. J Prosthodont 2008; 17:456-61. [DOI: 10.1111/j.1532-849x.2008.00324.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Laustsen MH, Munksgaard EC, Reit C, Bjørndal L. A temporary filling material may cause cusp deflection, infractions and fractures in endodontically treated teeth. Int Endod J 2005; 38:653-7. [PMID: 16104979 DOI: 10.1111/j.1365-2591.2005.01003.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To test the hypothesis that Coltosol F might cause infractions and cusp fracture in root-filled teeth because of material expansion. METHODOLOGY Thirty-two extracted human molar teeth were root filled and prepared with mesial-occlusal-distal (MOD) cavities with or without undercuts. The specimens were filled proximally with glass-ionomer cement and then occlusally with either Coltosol F or zinc oxide eugenol (ZOE). The tooth specimens were kept in water at 37 degrees C for a period of 20 days, and every second day the intercusp distance (ICD) of each specimen was measured in a travelling microscope, and the number of infraction lines as well as fractures were noted. RESULTS The number of infraction lines increased in teeth filled with Coltosol F. Between day 8 and 16, seven of 16 teeth filled with Coltosol F showed fracture and exhibited a mean increase in ICD of 316 +/- 156 microm. Teeth filled with ZOE did not show an increase in number of infraction lines or in ICD, and none showed fracture. CONCLUSIONS The hygroscopic expansion of Coltosol F in a cavity may lead to cusp deflection, infraction development and fracture. Masticatory forces will in vivo aggravate this unfavourable condition. The material is not recommended for temporary filling in root-filled teeth except for a few days.
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Affiliation(s)
- M H Laustsen
- Department of Cariology and Endodontics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
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16
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Tait CME, Ricketts DNJ, Higgins AJ. Restoration of the root-filled tooth: pre-operative assessment. Br Dent J 2005; 198:395-404. [PMID: 15870790 DOI: 10.1038/sj.bdj.4812187] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This is the first in a series of four papers related to the management of root canal treated teeth. When teeth compromised by extensive restorations become non-vital, suggestions have been given as to how root canal treatment can be carried out with the greatest chance of success. Once root canal treated, either by a previous dentist or by the current dentist, a review of the assessment process that should be carried out prior to placing costly indirect definitive restorations is given. It will be clear that post-retained restorations are mainly reserved for anterior or single-rooted teeth, posterior teeth rarely requiring a post for core retention. The second paper in this series describes the basic tooth preparation that should be carried out prior to placing a post. Depending on the type of post system used, further modifications to tooth preparation may be required and the cementation techniques may also have to be modified. The third paper therefore discusses the various post types, when and how they should be used for optimum results. The final paper addresses reinforcement and restoration of compromised root canals, such as those with immature, open apices, or those that have been over-prepared for previous post-retained restorations.
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Affiliation(s)
- C M E Tait
- Dundee Dental Hospital and School, Park Place, Dundee, DD1 4HR
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17
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Caplan DJ, Cai J, Yin G, White BA. Root Canal Filled Versus Non-Root Canal Filled Teeth: A Retrospective Comparison of Survival Times. J Public Health Dent 2005; 65:90-6. [PMID: 15929546 DOI: 10.1111/j.1752-7325.2005.tb02792.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This matched cohort study used data from a large dental HMO in the Pacific Northwest to evaluate the degree to which pulpal involvement and subsequent endodontic therapy affects tooth survival. Root canal filled (RCF) teeth were used as an indicator of pulpal involvement. Our hypothesis was that RCF teeth would be extracted sooner than non-RCF teeth matched within subjects, controlling for tooth-level variables of interest. METHODS The HMO's treatment databases and a subsequent chart audit were used to identify 202 eligible subjects, each of whom had one tooth endodontically treated in 1987-88 and a similar contralateral tooth that was non-RCF at that time. Both teeth were followed from the endodontic access date through the extraction date, the endodontic access date (for initially non-RCF teeth), or 12/31/94, whichever was earliest. Time-to-event analyses were carried out, with Kaplan-Meier curves generated and multivariable marginal proportional hazards regression models fitted to describe the effect of RCF status on tooth survival. All statistical analyses accounted for the complex sampling strategy used in generating the dataset. RESULTS Teeth were followed for up to eight (median = 6.7) years. RCF teeth had substantially worse survival than their non-RCF counterparts (p < 0.001), with a greater effect of RCF status evident among molars than non-molars. Adjusted hazard ratios (95% confidence intervals) for loss of RCF versus non-RCF molars and non-molars were 7.4 (3.2-15.1) and 1.8 (0.7-4.6), respectively. CONCLUSION Though endodontic therapy can prolong tooth survival, pulpal involvement still may hasten tooth loss, underscoring the importance of caries prevention and prompt restorative care.
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Affiliation(s)
- Daniel J Caplan
- Department of Dental Ecology, School of Dentistry, University of North Carolina, CB #7450, Chapel Hill, NC 27599-7450, USA.
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Gulabivala K, Patel B, Evans G, Ng YL. Effects of mechanical and chemical procedures on root canal surfaces. ACTA ACUST UNITED AC 2005. [DOI: 10.1111/j.1601-1546.2005.00133.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Sim TP, Knowles JC, Ng YL, Shelton J, Gulabivala K. Effect of sodium hypochlorite on mechanical properties of dentine and tooth surface strain. Int Endod J 2001; 34:120-32. [PMID: 11307260 DOI: 10.1046/j.1365-2591.2001.00357.x] [Citation(s) in RCA: 215] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM The aim of this study was to test the null hypothesis that sodium hypochlorite irrigation of root canals does not alter the properties of dentine and contribute to the weakening of root-treated teeth. METHODOLOGY The effect of two concentrations (0.5%, 5.25%) of sodium hypochlorite (NaOCl) and saline on (i) the elastic modulus and flexural strength of machined dentine bars, and (ii) changes in strain of 'whole' extracted human teeth were evaluated. One hundred standardized plano-parallel dentine bars (> 11.7 x 0.8 x 0.8 mm) were randomly divided into the three groups, immersed for 2 h in the respective solutions and then subjected to a three-point bend test. Changes in strain of each of 10 teeth on cyclical nondestructive occlusal loading were measured using electrical resistance strain gauges bonded to the cervical aspects. Each tooth had its crown and enamel reduced and root canal prepared. These were irrigated sequentially in a series of four separate, 30-minute regimes; initial-saline, 0.5% NaOCl, 5.25% NaOCl and final-saline. The changes in strains after each irrigation regime were compared. RESULTS There was a significant decrease in elastic modulus of the dentine bars immersed in 5.25% NaOCl compared with the saline group (P < 0.01). There was also a significant decrease in flexural strength of the dentine bars in the 5.25% NaOCl group compared to both the saline and 0.5% NaOCl groups (P < 0.01). The strain data from the nondestructive tooth loading tests revealed significant increases in tensile strain between the initial-saline and the final-saline stages (P < 0.01). Significant increases in compressive strains were also found between initial-saline and 5.25% NaOCl; and between 0.5% NaOCl and 5.25% NaOCl stages (P < 0.01). CONCLUSIONS The null hypothesis was rejected, 5.25% NaOCl reduced the elastic modulus and flexural strength of dentine. Irrigation of root canals of single, mature rooted premolars with 5.25% NaOCl affected their properties sufficiently to alter their strain characteristics when no enamel was present.
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Affiliation(s)
- T P Sim
- Departments of Conservative Dentistry, Eastman Dental Institute for Oral Health Care Sciences, University College London
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Brown D, McCabe JF, Clarke RL, Nicholson J, Curtis R, Sherriff M, Hatton PV, Strang R, Ireland AJ, Watts DC. Dental materials: 1993 literature review. J Dent 1995; 23:67-93. [PMID: 7738270 DOI: 10.1016/0300-5712(95)98973-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- D Brown
- United Medical and Dental Schools, Guy's Hospital, London
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