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Alhailaa AA, Al-Nazhan SA, Aldosimani MA. Prevalence of apical periodontitis and quality of root canal treatment in an adult Kuwaiti sub-population: a cross-sectional study. Restor Dent Endod 2024; 49:e16. [PMID: 38841383 PMCID: PMC11148409 DOI: 10.5395/rde.2024.49.e16] [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: 01/13/2024] [Revised: 01/26/2024] [Accepted: 02/13/2024] [Indexed: 06/07/2024] Open
Abstract
Objectives This cross-sectional study evaluated the prevalence of apical periodontitis (AP) and the technical quality of root canal fillings in an adult Kuwaiti subpopulation using cone-beam computed tomography (CBCT) images. Materials and Methods Two experienced examiners analyzed 250 CBCT images obtained from Kuwaiti patients aged 15-65 years who attended government dental specialist clinics between January 2019 and September 2020. The assessment followed the radiographic scoring criteria proposed by De Moor for periapical status and the technical quality of root canal filling. Chi-square and Fisher's exact tests were used for statistical analysis, with significance level set at p < 0.05. Results Among the 2,762 examined teeth, 191 (6.91%) exhibited radiographic signs of AP, and 176 (6.37%) had undergone root canal filling. AP prevalence in root canal-treated teeth was 32.38%, with a significant difference between males and females. Most of the endodontically treated teeth exhibited adequate root canal filling (71.5%). Conclusions The study demonstrated a comparable prevalence of AP and satisfactory execution of root canal treatment compared to similar studies in different countries.
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Affiliation(s)
- Abdulrahman A. Alhailaa
- Department of Restorative Dentistry, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
- Farwania Dental Department, Ministry of Health, Kuwait City, Kuwait
| | - Saad A Al-Nazhan
- Department of Restorative Dentistry – Endodontics, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Mazen A Aldosimani
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Hussain MA, Singh SK, Naz S, Haque M, Shah HK, Singh A. Predictors of apical periodontitis in root canal treated teeth from an adult Nepalese subpopulation: a cross-sectional study. BMC Oral Health 2024; 24:400. [PMID: 38553672 PMCID: PMC10979567 DOI: 10.1186/s12903-024-04139-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 03/12/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Endodontic literature search revealed that no study has been conducted to evaluate the prevalence of apical periodontitis (AP) in root canal treated teeth from an adult Nepalese population of Madhesh Province. Consequently, little is known about the extent and risk factors associated with it. This study aimed to determine AP prevalence in root canal treated teeth from an adult Nepalese subpopulation and to analyze the related risk factors including age, sex, tooth type, type of coronal restoration and quality of root canal treatment and coronal restoration as predictors of AP. METHODS Digital panoramic radiographs were evaluated. Periapical status of 300 root canal-treated teeth was scored by using the periapical index. The quality of root canal treatment and coronal restorations were categorized as adequate or inadequate through radiographic and clinical evaluation. The data were analyzed using univariate and multivariate logistic regression models. RESULTS Prevalence of AP in the present study was 31.7%. In 45.7% of the treated teeth, quality of root canal treatment was adequate whereas 46% of the cases had adequate coronal restorations. Multivariate logistic regression analysis revealed statistically significant associations and remarkably increased risk for AP in teeth with inadequate root canal treatment (odds ratio [OR] = 7.92; 95% CI: 3.96-15.82; p < 0.001) whereas lower risk for AP was found in females (OR = 0.51; 95% CI: 0.28-0.90; p = 0.021) and in teeth restored with crown (OR = 0.22; 95% CI: 0.09-0.51; p < 0.001) and filling (OR = 0.18; 95% CI: 0.08-0.42; p < 0.001). Quality of coronal restoration, tooth type and age of the patient were not found to be the predictors of AP. CONCLUSIONS Within the limits of this study, a high prevalence of AP and poor overall quality of root canal treatment and coronal restoration was found in the subpopulation studied. Quality of root canal treatment, type of coronal restoration and sex of the patient are significant predictors of possible AP development in root canal treated teeth. Substantial efforts are needed to improve the endodontic treatment standards.
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Affiliation(s)
- Md Asdaq Hussain
- Department of Conservative Dentistry & Endodontics, National Medical College, Birgunj, Nepal.
| | - Shailendra Kumar Singh
- Department of Prosthodontics & Maxillofacial Prosthesis, National Medical College, Birgunj, Nepal
| | - Shazia Naz
- Department of Operative Dentistry, de'Montmorency College of Dentistry, Lahore, Pakistan
| | - Merazul Haque
- Department of Prosthodontics & Maxillofacial Prosthesis, National Medical College, Birgunj, Nepal
| | - Harish Kumar Shah
- Department of Periodontology & Oral Implantology, National Medical College, Birgunj, Nepal
| | - Abanish Singh
- Department of Community Dentistry, National Medical College, Birgunj, Nepal
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Ling D, Chen Y, Chen G, Zhang Y, Wang Y, Wang Y, He F. Outcome of nonsurgical management of large cyst-like periapical lesions using a modified apical negative pressure irrigation system: a case series study. BMC Oral Health 2024; 24:336. [PMID: 38491469 PMCID: PMC10943812 DOI: 10.1186/s12903-024-04110-2] [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: 01/17/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE To assess the effectiveness of a self-constructed modified apical negative pressure irrigation (ANPI) system employing commonly used clinical instruments in nonsurgical root canal therapy (NSRCT) for large cyst-like periapical lesions (LCPLs). METHODS From 2017 to 2022, 35 patients diagnosed with LCPLs (5-15 mm) via preoperative clinical and radiographic evaluations of endodontic origin underwent NSRCT combined with ANPI. These patients were subjected to postoperative clinical and radiographic follow-up at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years, with a CBCT scan specifically conducted at 6-month follow-up. Through the reconstruction of three-dimensional cone beam computed tomography (CBCT) data, an early prognosis was facilitated by monitoring changes in lesion volume. Various treatment predictors-including sex, type of treatment, lesion size, preoperative pain, jaw, type of teeth involved, sealer extrusion, and the number of root canals-were meticulously analyzed. The evaluation of post-treatment outcomes leveraged both clinical observations and radiographic data collected during the follow-up periods. The Kruskal‒Wallis test and one-way ANOVA were also conducted to determine the independent factors influencing treatment outcomes. A significance level of 5% was established. RESULTS Thirty-five teeth from 35 patients with a median age of 28 years (range 24-34) were treated; the median follow-up duration was 19 months (range 12-26). The overall success rate was 91.4%, with a median lesion reduction of 77.0% (range 54.2-96.4%) at 6 months. Patients under 30 years of age exhibited a significantly greater success rate than older patients did (100.0% vs. 80.0%, p = 0.037). Other factors, such as sex, jaw, treatment type, preoperative pain, cyst size, tooth location, sealer extrusion, and the number of roots, did not significantly impact treatment outcomes. CONCLUSIONS Despite limitations related to the observational case-series study design and relatively small sample size, our findings suggest that utilizing the ANPI in the NSRCT for LCPLs may hold promise. The notably higher success rate in patients younger than 30 years is worth noting.
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Affiliation(s)
- Danhua Ling
- Department of General Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
- Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, 166 Qiutao North Road, Shangcheng District, Hangzhou, Zhejiang Province, China
| | - Yun Chen
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Gongpei Chen
- Department of General Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yanzhen Zhang
- Department of General Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yanhong Wang
- Department of Comprehensive Dentistry, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 311221, China
| | - Ying Wang
- Department of General Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Fuming He
- Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, 166 Qiutao North Road, Shangcheng District, Hangzhou, Zhejiang Province, China.
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Jakab A, Volom A, Sáry T, Vincze-Bandi E, Braunitzer G, Alleman D, Garoushi S, Fráter M. Mechanical Performance of Direct Restorative Techniques Utilizing Long Fibers for “Horizontal Splinting” to Reinforce Deep MOD Cavities—An Updated Literature Review. Polymers (Basel) 2022; 14:polym14071438. [PMID: 35406311 PMCID: PMC9002665 DOI: 10.3390/polym14071438] [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: 01/26/2022] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023] Open
Abstract
Excessive cavity preparation and root canal treatment leads to a weakened tooth structure with a lower resistance to fracture. Fiber reinforcement is frequently used to reinforce such teeth, and multiple fiber types and possible applications exist. Various methods for utilizing long fibers to internally splint the remaining cavity walls in the case of large mesio-occluso-distal (MOD) cavities have been proposed; however, no summary of their performance has been written up to now. Our study aims to review the available literature to evaluate and compare the mechanical performance of the different materials and methods utilized for horizontal splinting in large MOD cavities. Three independent authors performed a thorough literature search using PubMed, ScienceDirect, and Google Scholar up until January 2022. The authors selected in vitro studies that used long fibers placed horizontally in posterior teeth with large MOD cavities to reinforce these teeth. From 1683 potentially relevant articles, 11 publications met our inclusion criteria. Seven out of eleven studies showed that horizontal splinting with long fibers improved the fracture resistance of the restored teeth. Three articles showed no significant difference between the fracture resistance of the restored groups. Only one article reported a lower fracture resistance to the horizontally splinted group, compared to conventional direct composite restoration. Within the limitations of this review, evidence suggests that long fiber reinforcement could be used to improve the fracture resistance of heavily restored teeth.
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Affiliation(s)
- András Jakab
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
| | | | - Tekla Sáry
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
| | - Eszter Vincze-Bandi
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
| | | | - David Alleman
- The Alleman Center for Biomimetic Dentistry, South Jordan, UT 84095, USA;
| | - Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku, FI-20520 Turku, Finland;
| | - Márk Fráter
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
- Correspondence:
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Association between patient-, tooth- and treatment-level factors and root canal treatment failure: A retrospective longitudinal and machine learning study. J Dent 2021; 117:103937. [PMID: 34942278 DOI: 10.1016/j.jdent.2021.103937] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/10/2021] [Accepted: 12/17/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES We aimed to assess patient-, tooth- and treatment-level covariates on the failure of root canal treatments (RT) and to predict failure using machine learning (ML). METHODS Teeth receiving RT at one large university hospital from 2016-2020 with a minimum follow-up of ≥6 months were included. Failure compromised absent radiographic healing and/or the presence of clinical symptoms. Covariates were selected on tooth-, treatment- and patient-level. We used logistic regression (logR) to determine associations in the full dataset, and logR as well as more advanced ML (random forests (RF), gradient boosting machine (GBM) and extremely gradient boosting (XGB)) for predictive modeling (area-under-the-receiver operating characteristic-curve (ROCAUC)) and testing on a separate test dataset. RESULTS 458 patients (female/male 47.2/52.8%) with 591 permanent teeth were included (overall success rate 79.5%). In logR, tooth-level covariates showed strong associations with failure: Alveolar bone loss 66-100% (ABL, OR 6.48, 95% CI [2.86; 14.89], p<0.001); Periapical index (PAI) score≥4 (OR 4.59, [2.44; 8.79], p<0.001); ABL 33-66% (OR 2.59 [1.49; 4.49], p<0.001); PAI=3 (OR 2.45, [1.43; 4.34], p<0.01); Treatment type "retreatment" (OR 1.77, [1.01; 2.86], p<0.01). On patient level only smoking (OR 2.05, [1.18; 3.53], p<0.05) was significantly associated with risk of failure. For predictive modelling, the predictive power of all models was limited (ROCAUC: logR 0.63, [0.53, 0.73]; GBM 0.59, [0.50, 0.68]; RF 0.59, [0.50, 0.68]; XGB 0.60, [0.50, 0.70]). CONCLUSIONS Failure of RT was associated mainly with tooth-level covariates. Predicting failure was only limitedly possible, also with more complex ML. CLINICAL SIGNIFICANCE Identifying specific risk factors for failure of RT and predicting the outcome of RT is relevant for treatment planning and informed shared decision-making. The present study found tooth-level factors to be associated with failure. Notably, predicting failure was only limitedly possible.
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Chauhan NS, Saraswat N, Parashar A, Sandu KS, Jhajharia K, Rabadiya N. Comparison of the Effect for Fracture Resistance of Different Coronally Extended Post Length with Two Different Post Materials. J Int Soc Prev Community Dent 2019; 9:144-151. [PMID: 31058064 PMCID: PMC6489518 DOI: 10.4103/jispcd.jispcd_334_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/03/2018] [Indexed: 11/20/2022] Open
Abstract
Aims and Objectives: To compare the effect for fracture resistance of different coronally extended post length with two different post materials. Materials and Methods: One hundred and sixty endodontically treated maxillary central incisors embedded in acrylic resin with decoronated root portion were taken for the study. The postspaces were prepared according to standard protocol. The samples were divided into two groups according to the post material: glass-fiber post and Quartz fiber post. These groups were further subdivided on the basis of coronal extension of 4 and 6 mm for glass fiber and Quartz fiber posts, respectively. The posts were then luted with dual-polymerizing resin cement followed by core buildup. Samples were subjected to increasing compressive oblique load until fracture occurred in a universal testing machine. Data were analyzed with one-way ANOVA and independent Student's t-test. Analysis was done using SPSS version 15 (SPSS Inc., Chicago, IL, USA) Windows software program. Results: Glass fiber post with coronal extension of 4 mm (182.8 N) showed better results than with 6-mm length (124.1 N). Similarly, in quartz fiber posts group, 4-mm postlength (314 N) was better when compared with 6 mm (160 N). The 4-mm coronal extension of quartz fiber post displayed superior fracture resistance. Conclusions: Glass fiber posts showed better fracture resistance than Quartz fiber posts. 4-mm coronal length showed more fracture resistance than 6 mm.
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Affiliation(s)
- Niharika Singh Chauhan
- Department of Prosthodontics, MA Rangoonwala Dental College and Research Center, Pune, Maharashtra, India
| | - Nidhi Saraswat
- Department of Dentistry, Ingham Institute Applied Medical Research, Western Sydney University, South Western Sydney Local Health District, Sydney, Australia
| | - Ankita Parashar
- Index Institute of Dental Science, Indore, Madhya Pradesh, India
| | - Kuldeep Singh Sandu
- Department of Conservative and Endodontics, R R Dental College, Udaipur, Rajasthan, India
| | - Kapil Jhajharia
- Department of Endodontics, Faculty of Dentistry, Melaka Manipal Medical College, Melaka, Malaysia
| | - Nirav Rabadiya
- BDS, MPH, Grand Valley State University, Allendale, Michigan, USA
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The Effect of Intraradicular Multiple Fiber and Cast Posts on the Fracture Resistance of Endodontically Treated Teeth with Wide Root Canals. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1671498. [PMID: 30186851 PMCID: PMC6114070 DOI: 10.1155/2018/1671498] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/02/2018] [Indexed: 12/13/2022]
Abstract
Introduction The endodontically treated teeth (ETT) with thin remaining radicular dentin thickness are predisposed to fracture; hence it requires the diligent selection and the execution of endodontic post treatment. The objective of the study was to evaluate the reinforcing effect of both multiple fiber reinforced composite (FRC) and Ni-Cr cast metal posts at anterior and posterior regions. Material and Methods Forty recently extracted root canal treated canine and single rooted premolar teeth were used for the study. They were randomly divided into four groups (n=10) as: Group 1, single FRC post; Group 2, multiple FRC posts; Group 3, single Ni-Cr metal post, Group 4, multiple Ni-Cr posts. The posts were cemented with self-adhesive resin cement and subsequently restored with full veneer metal crown. The compressive static load at 1300 for canine and 450 for premolar was applied with the cross-head speed of 0.5mm/minute until the fracture. The obtained data was analyzed using the Kruskal–Wallis and Pairwise comparison tests with SPSS. Results The results indicate that multiple FRC post restored canine had the maximum fracture load (1843.80±7.13 N), followed by cast multiple posts (1648.99±26.84 N), single fiber post (1623±40.31 N), and cast metal single post (1493±27.33 N). A similar trend was observed in premolar with higher max fracture load with multiple FRC posts at 1920.86±20.61 N and multiple cast metal posts at 1735.43±6.05 N. Conclusion The restoration of ETT with larger canals by multiple FRC and metal posts provides substantially higher fracture resistance in comparison to wider single post.
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