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Viet DH, Son LH, Tuyen DN, Tuan TM, Thang NP, Ngoc VTN. Comparing the accuracy of two machine learning models in detection and classification of periapical lesions using periapical radiographs. Oral Radiol 2024:10.1007/s11282-024-00759-1. [PMID: 38862834 DOI: 10.1007/s11282-024-00759-1] [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: 09/17/2023] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND Previous deep learning-based studies were mainly conducted on detecting periapical lesions; limited information in classification, such as the periapical index (PAI) scoring system, is available. The study aimed to apply two deep learning models, Faster R-CNN and YOLOv4, in detecting and classifying periapical lesions using the PAI score from periapical radiographs (PR) in three different regions of the dental arch: anterior teeth, premolars, and molars. METHODS Out of 2658 PR selected for the study, 2122 PR were used for training, 268 PR were used for validation and 268 PR were used for testing. The diagnosis made by experienced dentists was used as the reference diagnosis. RESULTS The Faster R-CNN and YOLOv4 models obtained great sensitivity, specificity, accuracy, and precision for detecting periapical lesions. No clear difference in the performance of both models among these three regions was found. The true prediction of Faster R-CNN was 89%, 83.01% and 91.84% for PAI 3, PAI 4 and PAI 5 lesions, respectively. The corresponding values of YOLOv4 were 68.06%, 50.94%, and 65.31%. CONCLUSIONS Our study demonstrated the potential of YOLOv4 and Faster R-CNN models for detecting and classifying periapical lesions based on the PAI scoring system using periapical radiographs.
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Affiliation(s)
- Do Hoang Viet
- School of Dentistry, Hanoi Medical University, Hanoi, 100000, Vietnam
| | - Le Hoang Son
- School of Information and Communication Technology, Hanoi University of Science and Technology, Hanoi, 100000, Vietnam
| | - Do Ngoc Tuyen
- School of Information and Communication Technology, Hanoi University of Science and Technology, Hanoi, 100000, Vietnam
| | - Tran Manh Tuan
- Faculty of Computer Science and Engineering, Thuyloi University, Hanoi, 100000, Vietnam
| | - Nguyen Phu Thang
- School of Dentistry, Hanoi Medical University, Hanoi, 100000, Vietnam
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Do HV, Vo TNN, Nguyen PT, Luong THL, Cu NG, Le HS. A Dataset of apical periodontitis lesions in panoramic radiographs for deep-learning-based classification and detection. Data Brief 2024; 54:110486. [PMID: 38770039 PMCID: PMC11103410 DOI: 10.1016/j.dib.2024.110486] [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: 02/29/2024] [Revised: 04/15/2024] [Accepted: 04/24/2024] [Indexed: 05/22/2024] Open
Abstract
Deep learning has been studied in recent years to identify periapical lesions- a significant indicator of periapical periodontitis in radiographs. An accurate dataset is essential for constructing an efficient learning model for detecting periapical lesions. In order to achieve this goal, we gathered and created a database of panoramic radiographs containing periapical lesions from the High-quality Dental Treatment Centre, School of Dentistry, Hanoi Medical University, between January 2016 and March 2021. Out of 16,519 radiographs, three experienced dentists identified 3,926 images of periapical lesions and annotated those lesions based on the Periapical Lesions Classification. By applying well-known data processing techniques (e.g. scaling, mirroring, and flipping), the amount of data is increased to 17,004 images through generating additional images for machine learning. The dataset has three folders: one for the original photos, one for the post-augmentation images, and the rest for the annotation of periapical lesions. The information could assist researchers in developing a predictive machine model for detecting periapical lesions in radiographs.
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Affiliation(s)
- Hoang Viet Do
- Dentistry School, Hanoi Medical University, Hanoi 010000, Vietnam
| | | | - Phu Thang Nguyen
- Dentistry School, Hanoi Medical University, Hanoi 010000, Vietnam
| | - Thi Hong Lan Luong
- Faculty of Information Technology, Hanoi University of Industry, Hanoi 010000, Vietnam
| | - Nguyen Giap Cu
- Science and Technology Research and Development Centre, Thuongmai University, Hanoi 010000, Vietnam
| | - Hoang Son Le
- VNU Information Technology Institute, Vietnam National University, Hanoi 010000, Vietnam
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Sampath Kumar S, Bano S, P J. Placebo hypoalgesic and nocebo hyperalgesic effects in post-extraction patients-A cross sectional study. Br J Pain 2023; 17:366-374. [PMID: 37538946 PMCID: PMC10395389 DOI: 10.1177/20494637231161915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
Background and objectives Pain is an unpleasant sensory and emotional experience that affects people's physical, mental, and social health. Patients at times present with postoperative pain with no clinical signs after the surgical dental procedures and adequate pharmacological management. This can be due to the amplified emotional component of the individual in their postoperative period. Hence, this study aimed to estimate the association between placebo, nocebo effects, and postoperative pain associated with tooth extraction procedures. Methods A cross-sectional study was conducted among 301 patients attending the Department of Oral and Maxillofacial Surgery for tooth extraction. Preoperatively, the expected postoperative pain score was recorded using the "Numerical Rating Scale" (NRS), Anxiety and Depression were assessed using the "Hospital Anxiety and Depression Scale" (HADS), and Patients' expectancy regarding the treatment outcome was assessed using the "Credibility Expectancy Questionnaire" (CEQ). Observed postoperative pain scores at the 6th hour, 24th hour, and peak pain score of the day were recorded using the NRS. Results There were statistically significant associations (p < 0.05) found between expected and observed postoperative pain, preoperative anxiety and observed postoperative pain, preoperative depression and observed postoperative pain, placebo, nocebo effects, and observed postoperative pain. Interpretation and conclusion Our study showed a strong association between these variables suggesting that post-extraction pain is a multifaceted condition wherein pain expectation, preoperative anxiety, depression, and expectancy regarding the treatment outcome should be scrutinized before the extraction procedure.
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Affiliation(s)
| | - Sidra Bano
- Department of Oral Medicine and Radiology, Sri Ramakrishna Dental College and Hospital, Coimbatore, India
| | - Jagan P
- Department of Public Health Dentistry, Sri Ramakrishna Dental College and Hospital, Coimbatore, India
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Muacevic A, Adler JR, Baeisa DS, Alghamdi FT. Prevalence of Periapical Radiolucency and Conventional Root Canal Treatment in Adults: A Systematic Review of Cross-Sectional Studies. Cureus 2023; 15:e33302. [PMID: 36741594 PMCID: PMC9893866 DOI: 10.7759/cureus.33302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 01/04/2023] Open
Abstract
Cross-sectional studies assess a population's health state and the prevalence of diseases or treatments. Few systematic reviews regarding the prevalence of periapical radiolucency (PARL) and nonsurgical root canal treatment (NSRCT) were conducted in the last decade. The goal of this study was to collect and review all updated and available cross-sectional studies that focus on the prevalence of both PARL and NSRCT in adult populations. It involves a systematic literature review of cross-sectional studies on the prevalence of PARL and NSRCT published from 1987 to 2022 in PubMed, Google Scholar, Web of Science, and Scopus with specific keywords used in the search process. A total of 52 articles were included in this systematic review. The majority of the included articles were from different populations. The overall prevalence of teeth with PARL was 43,522 (6.40%), while the prevalence of NSRCT teeth was 52,149 (7.67%). On the other hand, the overall prevalence of PARL in teeth that have received endodontic treatment and teeth that have not received endodontic treatment were 22,110 (3.25%) and 21,412 (3.15%), respectively. A meta-analysis was not performed due to underreporting of publication bias and the high degree of heterogeneity between studies. The overall risk of bias assessment revealed a low risk of bias in 25 (48%) of the included studies. The prevalence of NSRCT was higher at 7.67%, followed by PARL at approximately 6.40%. However, future studies are recommended to investigate the prevalence of both PARL and NSRCT in different patient populations.
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León‐López M, Cabanillas‐Balsera D, Martín‐González J, Montero‐Miralles P, Saúco‐Márquez JJ, Segura‐Egea JJ. Prevalence of root canal treatment worldwide: A systematic review and meta-analysis. Int Endod J 2022; 55:1105-1127. [PMID: 36016509 PMCID: PMC9826350 DOI: 10.1111/iej.13822] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The prevalence of root filled teeth (RFT) worldwide will inform about the amount of clinical activity of dentists dedicated to treat endodontic disease. OBJECTIVES To carry out a systematic review with meta-analysis answering the following question: What is the prevalence of RFT around the world? The percentage of people with at least one RFT was also investigated. METHODS A systematic review including population-based studies using the following databases: PubMed, EMBASE and Scielo. Studies related to prevalence of RFT were included. The outcome of interest of the study was the prevalence of RFT. The meta-analyses were calculated with the Open Meta Analyst software to determine the global prevalence of RFT. Subgroups analyses were performed comparing geographical distribution, radiographic method and year of the study (classified in 20th or 21th century). The prevalence of people with at least one RFT was also analysed. RESULTS Seventy-four population-based studies fulfilled the inclusion criteria. Twenty-eight, forty-four and two studies reported high, moderate and low risk of bias, respectively. No obvious publication bias was observed. Prevalence of RFT was estimated with 1 201 255 teeth and 32 162 patients. The calculated worldwide prevalence of RFT was 8.2% (95% CI = 7.3%-9.1%; p < .001). The global prevalence of people with at least one RFT was 55.7% (95% CI = 49.6%-61.8%; p < .001). In 20th century, the prevalence of RFT was 10.2% (95% CI = 7.9%-12.5%; p < .001), whereas in the 21st century the overall calculated prevalence of RFT was 7.5% (95% CI = 6.5%-8.6%; p < .001). Brazilian people (12%) and the European population (9.3%) showed the highest prevalence of RFT. In Europe, 59.6% (95% CI = 52.4%-66.8%) of people has at least one RFT. CONCLUSIONS This review showed that root canal treatment is a very common therapy throughout the world. More than half of the studied population have at least one RFT. A limitation of the present study is that most of the studies did not consider random sampling for population selection. REGISTRATION PROSPERO Systematic review registration number: (CRD42022329053).
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Affiliation(s)
- María León‐López
- Endodontic Section, Department of Stomatology, School of DentistryUniversity of SevillaSevillaSpain
| | | | - Jenifer Martín‐González
- Endodontic Section, Department of Stomatology, School of DentistryUniversity of SevillaSevillaSpain
| | - Paloma Montero‐Miralles
- Endodontic Section, Department of Stomatology, School of DentistryUniversity of SevillaSevillaSpain
| | - Juan J. Saúco‐Márquez
- Endodontic Section, Department of Stomatology, School of DentistryUniversity of SevillaSevillaSpain
| | - Juan J. Segura‐Egea
- Endodontic Section, Department of Stomatology, School of DentistryUniversity of SevillaSevillaSpain
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Prevalence of Lateral Radiolucency, Apical Root Resorption and Periapical Lesions in Portuguese Patients: A CBCT Cross-Sectional Study with a Worldwide Overview. Eur Endod J 2021; 6:56-71. [PMID: 33762535 PMCID: PMC8056814 DOI: 10.14744/eej.2021.29981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective: Apical periodontitis develops when bacteria, or their by products, migrate from the infected root canal system space to the surrounding apical tissues. The objective of the present multi-center cross-sectional study was to analyze the prevalence of lateral radiolucency, apical root resorption and periapical lesions in 7 districts of Portugal using cone-beam computed tomographic (CBCT) assessment. Methods: A total of 1,249 CBCT scans, from 11 dental clinics, were screened. Data regarding 22,899 teeth was included. For each tooth the recorded data was the presence of lateral radiolucency, apical root resorption, periapical lesions, previous root canal treatment, missed root canals, length of root canal filling (short, good or overfilling) and type of coronal restoration (intact tooth, non-restored, filling or crown). Differences between districts were tested using chi-squared. A P<0.05 was considered significant. Results: The proportion of lateral radiolucency ranged between 0.0% (Aveiro, Braga and Coimbra) and 0.9% (Lisbon), while the prevalence of apical root resorption ranged from 0.0% (Braga and Coimbra) to 3.0% in Setubal. The nationwide proportion of lateral radiolucency was 0.4%, while for apical root resorption was 1.1%. The prevalence of periapical lesions varied from 4.1% (Braga) and 13.0% (Lisbon) with a nationwide proportion of 10.0%. Significant differences were noted between districts (P<0.05). Conclusion: The prevalence of lateral radiolucency and apical root resorption were low in all districts. Root canal filled teeth were associated with higher periapical lesions proportions than non-treated teeth. Independently of the assessed district, the periapical status may be influenced by both quality of the endodontic treatment and coronal restoration.
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Peršić Bukmir R, Paljević E, Pezelj-Ribarić S, Brekalo Pršo I. Coronal Restoration as a Predictor of Periapical Disease in Non-Endodontically Treated Teeth. Acta Stomatol Croat 2021; 55:56-68. [PMID: 33867538 PMCID: PMC8033623 DOI: 10.15644/asc55/1/7] [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: 11/18/2022] Open
Abstract
Objectives To compare the frequency of apical periodontitis (AP) in non-endodontically treated teeth restored with full coverage crowns, amalgam and resin composite fillings, and to disclose the association of type and quality of coronal restoration with periapical disease. Material and Methods The cross-sectional study involved 597 subjects who attended the Dental Clinic of the Clinical Hospital Centre, Rijeka, Croatia for the first time. Data were collected by means of a clinical and radiological survey. The following data were recorded for all permanently restored non-endodontically treated teeth: the type, the quality of coronal restoration according to clinical and radiographic criteria for marginal integrity as well as the recurrent caries presence, periapical status and marginal bone loss. Chi-square tests were used to analyze the difference in periapical status regarding the type and the quality of restoration. The multivariate logistic regression analysis was used to assess the effect of explanatory tooth-specific variables on periapical status. Results There was no significant difference in the proportion of AP with regards to the type and material of adequate quality coronal restorations (χ2=5.000, P=0.082). The regression analysis revealed significant positive associations with outcome variable (AP) for crowns (OR=3.39; P<0.001), recurrent caries (OR=4.67; P<0.001) and premolar teeth (OR=1.73; P=0.002). Conclusion If the quality of restorations is adequate, there is no difference in the periapical status of non-endodontically treated teeth regarding the type and material of coronal restoration.
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Affiliation(s)
- Romana Peršić Bukmir
- Department of Endodontics and Restorative Dentistry, Rijeka Clinical Hospital Centre, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Ema Paljević
- Department of Endodontics and Restorative Dentistry, Rijeka Clinical Hospital Centre, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Sonja Pezelj-Ribarić
- Department of Oral Medicine and Periodontology, Rijeka Clinical Hospital Centre, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Ivana Brekalo Pršo
- Department of Endodontics and Restorative Dentistry, Rijeka Clinical Hospital Centre, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
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Tibúrcio-Machado CS, Michelon C, Zanatta FB, Gomes MS, Marin JA, Bier CA. The global prevalence of apical periodontitis: a systematic review and meta-analysis. Int Endod J 2021; 54:712-735. [PMID: 33378579 DOI: 10.1111/iej.13467] [Citation(s) in RCA: 174] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 12/24/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Apical periodontitis (AP) frequently presents as a chronic asymptomatic disease. To arrive at a true diagnosis, in addition to the clinical examination, it is mandatory to undertake radiographic examinations such as periapical or panoramic radiographs, or cone-beam computed tomography (CBCT). Thus, the worldwide burden of AP is probably underestimated or unknown. Previous systematic reviews attempted to estimate the prevalence of AP, but none have investigated which factors may influence its prevalence worldwide. OBJECTIVES To assess: (i) the prevalence of AP in the population worldwide, as well as the frequency of AP in all teeth, nontreated teeth and root filled teeth; (ii) which factors can modify the prevalence of AP. METHODS A search was conducted in the PubMed-MEDLINE, EMBASE, Cochrane-CENTRAL, LILACS, Google scholar and OpenGrey databases, followed by hand searches, until September 2019. Cross-sectional, case-control and cohort studies reporting the prevalence of AP in humans, using panoramic or periapical radiograph or CBCT as image methods were included. No language restriction was applied. An adaptation of the Newcastle-Ottawa Scale was used to evaluate the quality of the studies. A meta-analysis was performed to determine the pooled prevalence of AP at the individual level. Secondary outcomes were the frequency of AP in all teeth, nontreated teeth and rootfilled teeth. Subgroup analyses using random-effect models were carried out to analyse the influence of explanatory covariables on the outcome. RESULTS The search strategy identified 6670 articles, and 114 studies were included in the meta-analysis, providing data from 34 668 individuals and 639 357 teeth. The prevalence of AP was 52% at the individual level (95% CI 42%-56%, I2 = 97.8%) and 5% at the tooth level (95% CI 4%-6%; I2 = 99.5%). The frequency of AP in root-filled teeth and nontreated teeth was 39% (95% CI 36%-43%; I2 = 98.5%) and 3% (95% CI 2%-3%; I2 = 99.3%), respectively. The prevalence of AP was greater in samples from dental care services (DCS; 57%; 95% CI 52%-62%; I2 = 97.8%) and hospitals (51%; 95% CI 40%-63%; I2 = 95.9%) than in those from the general population (GP; 40%; 95% CI 33%-46%; I2 = 96.5%); it was also greater in people with a systemic condition (63%; 95% CI 56%-69%, I2 = 89.7%) compared to healthy individuals (48%; 95% CI 43%-53%; I2 = 98.3%). DISCUSSION The subgroup analyses identified explanatory factors related to the variability in the prevalence of AP. However, the high clinical heterogeneity and high risk of bias across the primary studies indicate that the findings must be interpreted with caution. CONCLUSIONS Half of the adult population worldwide have at least one tooth with apical periodontitis. The prevalence of AP is greater in samples from the dental care services, but it is also high amongst community representative samples from the general population. The present findings should bring the attention of health policymakers, medical and dental communities to the hidden burden of endodontic disease in the population worldwide.
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Affiliation(s)
- C S Tibúrcio-Machado
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - C Michelon
- Medical and Dental Center of the Brazilian Army, Santa Maria, Brazil
| | - F B Zanatta
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.,Department of Stomatology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - M S Gomes
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Medical and Dental Center of the Military Police, Porto Alegre, Brazil
| | - J A Marin
- Universidade Franciscana (UFN), Santa Maria, Brazil
| | - C A Bier
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.,Department of Stomatology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
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Alharmoodi R, Al-Salehi S. Assessment of the quality of endodontic re-treatment and changes in periapical status on a postgraduate endodontic clinic. J Dent 2019; 92:103261. [PMID: 31821854 DOI: 10.1016/j.jdent.2019.103261] [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: 11/02/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess endodontic retreatment outcomes based on quality of obturation and healing. MATERIALS AND METHODS A total number of 223 radiographs of patients who had received endodontic retreatment during the period (2008-2015) at a postgraduate teaching clinic were selected. Unreadable radiographs were all excluded. From the original sample of 223 in total 24 radiographs were discarded. The final sample thus consisted of 199 root canal fillings. All radiographs were individually evaluated for the density of the root filling as well as the distance between the end of the root canal filling and radiographic apex based on a six-point scoring system. Subsequently, patients were reviewed and follow up periapical radiographs were exposed. The outcome of healing was assessed using the Periapical Index (PAI) scoring system. The data were analysed using Chi Square test (p < 0.05). RESULTS The study revealed that 78.9 % of the endodontic retreatments were both homogeneity and length acceptable. The corresponding figure was only 13.1 % before endodontic retreatment. Conversely, homogeneity and length unacceptable before endodontic retreatment was 47.2 % reducing to a mere 2.5 % after retreatment. The results were statistically significant (P < 0.001). There was over 80 % improvement in periapical healing following endodontic retreatment and this was also statistically significant (P < 0.001). CONCLUSION There was a significant improvement in outcome after endodontic retreatment on the postgraduate endodontic clinic. The success rate of endodontic retreatment was over 70 % which is in line with the endodontic literature. Radiographic follow up confirmed some 81 % improvement in healing rate following endodontic retreatment. CLINICAL SIGNIFICANCE Endodontic re-treatment cases are normally categorised as high complexity and as such referral to specialist settings should be considered to help improve treatment outcomes.
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Affiliation(s)
- Reem Alharmoodi
- Endodontic Department, Dubai Health Authority, Dubai, United Arab Emirates
| | - Samira Al-Salehi
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Building 34, Dubai Healthcare City, PO Box 505097, Dubai, United Arab Emirates..
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Babić B, Barun J, Jukić Krmek S, Kotarac Knežević A, Salarić I, Ivanišević Malčić A. Clinical and Radiographic Assessment of Cases Referred to Endodontic Surgery. Acta Stomatol Croat 2019; 53:132-140. [PMID: 31341321 PMCID: PMC6604560 DOI: 10.15644/asc53/2/5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective The objective of the study was to assess the quality of root canal fillings of cases referred to endodontic surgery using preoperative radiographs and correlate it with endodontic surgery treatment decision. The objective was also to analyse clinical symptoms and size of periapical lesions on radiographs and correlate them with treatment decisions including non-surgical retreatment, endodontic surgery and extraction. Materials and Methods A questionnaire was composed to record the data. Eighty-six patients with 109 teeth, who were referred to endodontic surgery, participated in the research. The quality of root canal filling was assessed according to its homogeneity and filling length on digital radiographs. The data were analyzed using χ2-test and t-test. Results Of the teeth referred to endodontic surgery, 97.2% were treated by a general practice dentist, endodontic retreatment was attempted in 20.6%, and root canal filling was homogeneous and within 1 mm from the apex in 21.6%. Endodontic surgery, retreatment, extraction and no treatment were selected in 90.1%, 5.4%, 1.8% and 2.7% of the cases, respectively. Conclusions Low percentage of adequate root canal fillings and high percentage of endodontic surgery decisions suggest that there is a need to increase awareness of non-surgical retreatment options.
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Affiliation(s)
- Barbara Babić
- 6th year dental students, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Janja Barun
- 6th year dental students, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Ana Kotarac Knežević
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Ivan Salarić
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Ana Ivanišević Malčić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
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Connert T, Truckenmüller M, ElAyouti A, Eggmann F, Krastl G, Löst C, Weiger R. Changes in periapical status, quality of root fillings and estimated endodontic treatment need in a similar urban German population 20 years later. Clin Oral Investig 2018; 23:1373-1382. [PMID: 30022270 DOI: 10.1007/s00784-018-2566-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/10/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The study aimed at assessing, as primary objective, the periapical status and quality of root fillings, and, as secondary objective, the endodontic treatment need of a German urban population in a cross-sectional study 20 years after the first one. MATERIALS AND METHODS Clinical and radiographic data of 353 patients were evaluated. Descriptive and regression analyses were performed and the endodontic treatment need was calculated. Results were compared with data from the year 1993. RESULTS A total of 9269 teeth were examined (26.2 teeth per patient; 1993, 24.4), of which 337 teeth were root filled (3.6%; 1993, 2.7%). Prevalence of apical periodontitis in root-filled teeth was 34% (1993, 61%). Quality of root fillings was adequate in 117 cases (35%; 1993, 14%). Minimum endodontic treatment need was estimated with 1.6% (1993, 2.3%), including teeth with clinical symptoms. Considering symptomless teeth with apical periodontitis and poor quality of root filling, the treatment need was 2.9% (1993, 3.7%). Regression analysis identified quality of root filling as a significant factor for periapical health (p = 0.01, odds ratio 3.4×, 95% CI 1.9-6.3×), likewise the type of instrumentation. Teeth treated with rotary files had a significantly better outcome (p = 0.02, odds ratio 2.0×, 95% CI 1.1-3.7×). CONCLUSIONS Quality of root fillings and the periapical status have improved over the last 20 years in Germany. However, there is still a need for an increase in quality of root canal treatment.
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Affiliation(s)
- Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Hebelstrasse 3, 4056, Basel, Switzerland.
| | | | - A ElAyouti
- Department of Operative Dentistry, Periodontology, Endodontology and Pediatric Dentistry, School of Dental Medicine, Eberhard-Karls University, Tübingen, Germany
| | - F Eggmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Hebelstrasse 3, 4056, Basel, Switzerland
| | - G Krastl
- Department of Operative Dentistry and Periodontology, University of Würzburg, Würzburg, Germany
| | - C Löst
- Department of Operative Dentistry, Periodontology, Endodontology and Pediatric Dentistry, School of Dental Medicine, Eberhard-Karls University, Tübingen, Germany
| | - R Weiger
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Hebelstrasse 3, 4056, Basel, Switzerland
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Apical periodontitis in southern Estonian population: prevalence and associations with quality of root canal fillings and coronal restorations. BMC Oral Health 2017; 17:147. [PMID: 29233146 PMCID: PMC5727925 DOI: 10.1186/s12903-017-0429-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 11/19/2017] [Indexed: 12/18/2022] Open
Abstract
Background Apical periodontitis (AP) is an inflammatory disease around the apex of a tooth root. Reported prevalence of AP ranges from 27% to 83% while the data about most post-Soviet countries are still missing. Knowing the prevalence of AP within a certain population helps to plan the treatment need and evaluate the success of endodontic interventions. We aimed to collect data about prevalence and determining factors of AP for the first time in Estonia. Methods The cross-sectional study included 6552 patients (age 35.5±19.2 years). Radiographic examination was applied to investigate the prevalence of AP and quality of endodontic treatment. Results AP was diagnosed in 54.7% of subjects. Endodontically treated teeth were present in 58.2% of subjects. Periapical finding was present in 44.6% of endodontically treated and in 30.8% of untreated teeth. Out of 181,495 teeth, 52.7% were intact. AP was diagnosed in 6.3% of teeth, 6.9% of teeth were endodontically treated. Risk factors for AP included caries (OR = 2.30), male gender (OR = 1.44), too short (OR = 1.76) or too long root canal filling (OR = 2.51), root canal filling of low density (OR = 1.61) while not orthodontic appliance. Lower AP risk was associated with restoration of the tooth – filling (OR = 0.45), crown (OR = 0.34) and bridge (OR = 0.33). Conclusions AP is highly prevalent in Southern Estonian population. Most cases are associated with root canal-treated teeth. The overall quality of root canal fillings tends to be low, consistent with the mediocre outcome of treatment. Considerable efforts are required to improve the standards of endodontic treatment. Electronic supplementary material The online version of this article (10.1186/s12903-017-0429-7) contains supplementary material, which is available to authorized users.
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Periapical Status and Quality of Root Canal Fillings in a Moroccan Subpopulation. Int J Dent 2017; 2017:1068982. [PMID: 28713425 PMCID: PMC5497643 DOI: 10.1155/2017/1068982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 05/25/2017] [Indexed: 11/18/2022] Open
Abstract
AIM The aim of the study was to assess the prevalence of apical periodontitis (AP) and quality of root canal fillings in an adult Moroccan subpopulation. METHODS In the study 508 patients were included, attending the Conservative Dentistry Clinic at the Faculty of Dentistry of Casablanca. 508 panoramic and 709 periapical radiographs were observed. The periapical status of all teeth (with the exception of third molars) was examined according to Ørstavik's periapical index. The statistical analysis was performed with the software Epi Info Version 6.04dfr, April 2001. RESULTS A total of 12719 teeth were examined. 45.3% of patients had apical periodontitis. 4.2% of teeth were treated endodontically and 70.4% of these treatments were inadequate. 91,5% with inadequate endodontic treatment presented apical periodontitis, while only 8,2% with adequate endodontic treatment had apical periodontitis. The lower molars and the upper premolars were the most affected teeth. The presence of apical periodontitis was correlated significantly with insufficient root canal fillings (p < 0.05). CONCLUSIONS The present study found a high prevalence of apical periodontitis in this Moroccan population. Inadequate root canal fillings were associated with an increased prevalence of apical periodontitis.
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Timmerman A, Calache H, Parashos P. A cross sectional and longitudinal study of endodontic and periapical status in an Australian population. Aust Dent J 2017; 62:345-354. [DOI: 10.1111/adj.12512] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 12/20/2022]
Affiliation(s)
- A Timmerman
- The Melbourne Dental School; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
| | - H Calache
- The Melbourne Dental School; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
- Deakin Health Economics; Faculty of Health; Deakin University; Geelong Victoria Australia
- School of Dentistry and Oral Health; La Trobe University; Bendigo Victoria Australia
| | - P Parashos
- The Melbourne Dental School; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
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Radiologic assessment of quality of root canal fillings and periapical status in an Austrian subpopulation - An observational study. PLoS One 2017; 12:e0176724. [PMID: 28464019 PMCID: PMC5413016 DOI: 10.1371/journal.pone.0176724] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 04/14/2017] [Indexed: 12/19/2022] Open
Abstract
Background/Objective Progress in endodontic techniques and methodological advances have altered root canal therapy over the last decades. These techniques and methods need periodical documentation. This observational study determined the current prevalence of endodontic treatments, and investigated the relationship of various factors with the periapical status in a Lower Austrian subpopulation. Methodology One thousand orthopantomograms of first-time university adult patients radiographed at an outpatient clinic were evaluated. For each tooth, the presence of periradicular pathosis and/or endodontic treatment was recorded, as was the quality of (post-)endodontic treatment (homogeneity and length of root canal fillings; preparation failures; posts/screws; apicoectomies; coronal restorations). Two evaluators, blinded to each other, scored all teeth. In cases of disagreement, they joined for a consensus score. Results In all, 22,586 teeth were counted. Of these, 2,907 teeth (12.9%) had periapical pathosis, while 2,504 teeth had undergone root canal treatment. Of the endodontically treated teeth, 52% showed no radiographic signs of apical periodontitis, while 44.9% had overt apical lesions, and 3,1% revealed widened periodontal ligament space. The majority of the root canal fillings was inhomogeneous (70.4%); 75.4% were rated too short, and 3.8% too long. The presence of apical pathosis was significantly correlated (odds ratio (OR) 2.556 [confidence interval (CI) 2.076–3.146]; P<0.0001) with poor root canal fillings (length and homogeneity). Posts or screws positively affected periapical status (OR 1.853 [CI 1.219–2.819]; P = 0.004), but endodontically treated posterior teeth were infrequently restored (posts, 7.5%; screws, 2.7%). Best results were found for teeth with both appropriate endodontic treatment and adequate coronal restoration. Conclusion A high prevalence of periradicular radiolucencies was observed with root canal filled teeth, along with high numbers of unmet treatment needs. Periapical health was associated with adequate root canal obturation and high-grade postendodontic restorations, and quality regarding these latter aspects is considered mandatory to promote periapical health.
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Pedro FM, Marques A, Pereira TM, Bandeca MC, Lima S, Kuga MC, Tonetto MR, Semenoff-Segundo A, Borges AH. Status of Endodontic Treatment and the Correlations to the Quality of Root Canal Filling and Coronal Restoration. J Contemp Dent Pract 2016; 17:830-836. [PMID: 27794154 DOI: 10.5005/jp-journals-10024-1939] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION This cross-sectional study evaluated the prevalence and quality of root canal treatment in 1,977 digital radiological files. MATERIALS AND METHODS Data were statistically analyzed using descriptive analysis, and the chi-square test was performed with a 5% significance level. RESULTS The mean age of the study population was 34.9 years. The endodontic treatment frequency was 6.14%, significantly higher in premolars. Adequate endodontic treatment was observed in 39.7% of analyzed cases. Molars were significantly more frequent with regard to inadequate filling quality. In 47.6% of cases, the filling's apical limit was classified as adequate, and there was a higher incidence of molars that were inadequate. Restorations were classified as adequate in 79.0% of cases, and molars were responsible for the highest frequency of inadequate restorations. The frequency of teeth with endodontic treatment that showed no periapical changes was 47.7%. There was no significant difference in the presence of periapical change according to gender. An increased presence of periapical change was observed with increasing age. The periapical lesions were observed in 45% of cases and related to inadequate filling quality. The apical limit was considered inadequate and related to periapical changes in 42% of cases. Periapical changes were present in 52% of cases, regardless of the quality of the filling and apical limit. Such changes were present in 42% of cases with adequate coronal restoration. CONCLUSION It can be concluded that apical periodontitis (AP) is associated with the quality of endodontic treatment. The coronal restoration affects significantly the success rate of endodontic treatment. CLINICAL SIGNIFICANCE The quality of the root filling and coronal restoration is closely related to periapical health.
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Affiliation(s)
- Fabio M Pedro
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil
| | - Atc Marques
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil
| | - Thiago M Pereira
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil
| | - Matheus C Bandeca
- Department of Post-Graduate Program in Dentistry, CEUMA University, São Luis, Brazil
| | - Snl Lima
- Department of Post-Graduate Program in Dentistry, CEUMA University, São Luis, Brazil
| | - Milton C Kuga
- Department of Restorative Dentistry, School of Dentistry Universidade Estadual Paulista, Araçatuba, Brazil
| | - Mateus R Tonetto
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil
| | - Alex Semenoff-Segundo
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil
| | - Alvaro H Borges
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil, Phone: +556533631271, e-mail:
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Tassoker M, Akgunlu F. Radiographic evaluation of periapical status and frequency of endodontic treatment in a turkish population: a retrospective study. J Istanb Univ Fac Dent 2016; 50:10-16. [PMID: 28955560 PMCID: PMC5573526 DOI: 10.17096/jiufd.89048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/15/2016] [Indexed: 12/27/2022] Open
Abstract
PURPOSE The aim of this study was to determine the frequencies of apical periodontitis and endodontic treatment in a Turkish population using a retrospective analysis of orthopantomograms. MATERIALS AND METHODS The sample consisted of orthopantomographs of 250 subjects who had been referred to our clinic for an initial visit between the years of 2013 and 2014. The periapical status of all teeth (with the exception of third molars) was examined using periapical index scoring system (PAI). Data were analyzed statistically using the Chi-squared test at the significance level of p<0.05. RESULTS The study sample comprised 6196 teeth belonging to 250 patients. Out of 6196 examined teeth, the frequencies of apical periodontitis and endodontic treatment was 1.8% and 3.7%, respectively. Gender had no effect on the presence of apical periodontitis or the frequency of endodontic treatment. The frequency of apical periodontitis and endodontic treatment increased with age, but it did not show statistical significance among different age groups. CONCLUSION This study provides epidemiological data about apical periodontitis and endodontic treatment in a Turkish population.
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Affiliation(s)
- Melek Tassoker
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University,
Turkey
| | - Faruk Akgunlu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Selcuk University,
Turkey
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Influence of tobacco smoking on dental periapical condition in a sample of Croatian adults. Wien Klin Wochenschr 2015; 128:260-5. [DOI: 10.1007/s00508-015-0910-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 11/19/2015] [Indexed: 11/25/2022]
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Rutz da Silva F, Padilha EZ, Cândido VS, Cavassim R, Pereira AC, Hebling E. Relationship between quality of root canal obturation and periapical lesion in elderly patients: a systematic review. Gerodontology 2014; 33:290-8. [DOI: 10.1111/ger.12146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2014] [Indexed: 01/08/2023]
Affiliation(s)
- Fabrício Rutz da Silva
- Department of Community Dentistry; Piracicaba Dental School; University of Campinas; Piracicaba Brazil
| | - Edna Zakrzevski Padilha
- Department of Community Dentistry; Piracicaba Dental School; University of Campinas; Piracicaba Brazil
| | - Valéria Silva Cândido
- Department of Community Dentistry; Piracicaba Dental School; University of Campinas; Piracicaba Brazil
| | | | - Antonio Carlos Pereira
- Department of Community Dentistry; Piracicaba Dental School; University of Campinas; Piracicaba Brazil
| | - Eduardo Hebling
- Department of Community Dentistry; Piracicaba Dental School; University of Campinas; Piracicaba Brazil
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Jokić D, Macan D, Perić B, Tadić M, Biočić J, Đanić P, Brajdić D. Ambulatory oral surgery: 1-year experience with 11680 patients from Zagreb district, Croatia. Croat Med J 2013; 54:49-54. [PMID: 23444246 PMCID: PMC3583394 DOI: 10.3325/cmj.2013.54.49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
AIM To examine the types and frequencies of oral surgery diagnoses and ambulatory oral surgical treatments during one year period at the Department of Oral Surgery, University Hospital Dubrava in Zagreb, Croatia. METHODS Sociodemographic and clinical data on 11680 ambulatory patients, treated between January 1 and of December 31, 2011 were retrieved from the hospital database using a specific protocol. The obtained data were subsequently analyzed in order to assess the frequency of diagnoses and differences in sex and age. RESULTS The most common ambulatory procedure was tooth extraction (37.67%) and the most common procedure in ambulatory operating room was alveolectomy (57.25%). The test of proportions showed that significantly more extractions (P<0.001) and intraoral incisions (P<0.001) were performed among male patients, whereas significantly more alveolectomies and apicoectomies were performed among female patients (P<0.001). A greater prevalence of periodontal disease was found in patients residing in Zagreb than in patients residing in rural areas. CONCLUSION The data from this study may be useful for planning of ambulatory oral surgery services, budgeting, and sustaining quality improvement, enhancing oral surgical curricula, training and education of primary health care doctors and oral surgery specialists, and promoting patients' awareness of the importance of oral health.
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Affiliation(s)
- Dražen Jokić
- Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Komar D. Dental medical education in Croatia. Croat Med J 2011; 52:663-4. [PMID: 22180263 PMCID: PMC3243321 DOI: 10.3325/cmj.2011.52.663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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