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Atique S, Ali K, Haroon S, Ahmed A, Javed MQ, Zafar MS, Abulhamael AM. Effectiveness of H-files and Pro-Taper universal systems in removing Gutta-percha during endodontic retreatment: A comparative study. J Taibah Univ Med Sci 2024; 19:537-544. [PMID: 38711796 PMCID: PMC11070706 DOI: 10.1016/j.jtumed.2024.04.002] [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: 01/09/2024] [Revised: 03/13/2024] [Accepted: 04/12/2024] [Indexed: 05/08/2024] Open
Abstract
Objective This research was aimed at assessing the effectiveness of manual H-files versus a combination of a Pro-Taper universal rotary canal preparation system and retreatment system in removing gutta-percha (GP) during endodontic retreatment, by using a digital radiography technique. Methods This ex vivo study used a non-probability consecutive sampling technique. The study sample comprised 60 extracted anterior permanent teeth, each with one root with a straight root canal (RC). After preparation, RCs were obturated with GP and sealer. Subsequently, teeth were stored for 2 weeks in a humid environment at 37 °C. Thirty teeth each were randomly assigned to the control (group I), and experimental (group II) groups. GP removal was performed with H-files {group I) or a combination of a Pro-Taper universal rotary canal preparation system and retreatment system (group 2). Digital radiographs were acquired with Carestream digital radiovisiography software (Kodak; version-VER.6.10.8.3-A), and the presence of residual GP was analyzed. AutoCAD (2006) software was used to demarcate the RC and residual root filling. The residual GP in both groups was compared with independent sample t-tests. Results The remaining root filling did not significantly differ when GP was removed with conventional Hedstrom files versus a combination of Pro-Taper Universal preparation and retreatment file systems. The residual GP was confined to the apical third of the canals in both groups. Conclusions Pro-Taper Universal preparation and retreatment file systems have similar effectiveness to manual H-files in GP removal in straight canals.
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Affiliation(s)
- Sundus Atique
- Department of Preclinical Oral Health Sciences, College of Dental Medicine, Qatar University, Doha, Qatar
| | - Kamran Ali
- Department of Preclinical Oral Health Sciences, College of Dental Medicine, Qatar University, Doha, Qatar
| | - Saad Haroon
- Department of Endodontics, Specialist Endodontist, Primary Health Care Corporation, Qatar
| | - Alia Ahmed
- Department of Operative Dentistry, College of Dentistry, Riphah International University, Islamabad, Pakistan
| | - Muhammad Q. Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, Qassim, KSA
| | - Muhammad S. Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Almadinah Almunawwarah, KSA
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, 346, United Arab Emirates
- School of Dentistry, University of Jordan, Amman, Jordan
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
| | - Ayman M. Abulhamael
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, KSA
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Zargar N, Khosravi K, Zadsirjan S, Safi Y, Vatankhah M, Akbarzadeh Baghban A, Aghajani Varzaneh F. The association of endodontic prognostic factors with the presence of periapical lesion, its volume, and bone characteristics in endodontically treated molars: a cross-sectional study. BMC Oral Health 2024; 24:28. [PMID: 38183066 PMCID: PMC10771002 DOI: 10.1186/s12903-023-03818-x] [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: 11/16/2023] [Accepted: 12/21/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND This study intended to evaluate the association between several endodontic prognostic factors with the presence of periapical lesions (PLs), their volume, and bone characteristics including cortical bone destruction (CBD) and buccal plate bone height (BPBH) in root-filled molar teeth using cone-beam computed tomography. METHODS A collection of 143 scans of endodontically treated maxillary/mandibular first or second molars recorded over 8 years, were obtained from a specialized radiology center. Data on prognostic factors including tooth number, gender, jaw type, the status and number of missed canals, obturation length, restoration type, presence of a separated instrument, presence of a post or screw in the canals, and presence of perforation were collected. The assessed outcomes included PL presence, PL volume, CBD, and BPBH. The association between prognostic factors and outcomes was evaluated using multiple logistic regression models with adjusted covariates and multifactorial ANOVA at a significance level of 0.05. RESULTS A total of 282 molars from 82 women and 50 men with a mean age of 40.6 ± 12.27 were included. Among those, 139 teeth presented PL with a mean volume of 18.68 mm3. CBD was prevalent in 137 teeth and the mean BPBH appeared to be 9.45 mm. The presence of a missed canal (OR = 10.022, P < .05), underfilled canal (OR = 3.725, P < .05), overfilled canal (OR = 15.859, P = .018), and perforation (OR = 15.261, P = .013) was significantly associated with PLs. None of the prognostic factors could considerably contribute to the CBD (P > .05). The presence of a missed canal was positively associated with the PL volume (P < .05). Similarly, missed canals (P < .05), perforation (P < .05), and separated instruments (P = .004) were associated with a significantly reduced BPBH. CONCLUSIONS Overfillings, perforations, missed canals, and underfillings were identified as remarkable predictors of PL, arranged in descending order of their respective impact. The only factor capable of significantly increasing the PL volume was the missed canal. In brief, obturation length errors, perforations, missed canals, and separated instruments were robustly correlated with endodontic failure, which highlights the importance of mitigating the potential for errors by following the fundamentals of endodontics.
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Affiliation(s)
- Nazanin Zargar
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Khosravi
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeede Zadsirjan
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Vatankhah
- School of Dentistry, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Dos Santos VC, Kublitski PMDO, da Silva BM, Gabardo MCL, Tomazinho FSF. Periapical Lesions Associated with Demographic Variables, Dental Conditions, Systemic Diseases, and Habits. J Contemp Dent Pract 2023; 24:864-870. [PMID: 38238274 DOI: 10.5005/jp-journals-10024-3596] [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] [Indexed: 01/23/2024]
Abstract
AIM AND BACKGROUND The aim of this study was to analyze the prevalence of periapical lesions and possible associations with demographic, dental conditions, systemic diseases, and habit variables in patients from a private Brazilian university. MATERIALS AND METHODS Data from 452 patients of both sexes, aged 18-78 years, from a Brazilian university were evaluated. Panoramic radiographs were analyzed, and the presence of periapical lesions was recorded. In these cases, the dental condition was assessed for the presence or absence of endodontic treatment. Medical records provide information related to general health (diabetes, cardiovascular diseases, altered cholesterol, autoimmune diseases, gallstones, or kidney stones) and habits (smoking or alcoholism). The data were descriptively analyzed, and then logistic regression and the Wald test were performed in Stata/SE v.14.1. RESULTS A rate of 58.4% of participants were women, and the mean age was 36.4 (±14.6) years. Periapical lesions prevailed in 193 (42.7%) patients, and 281 (72.4%) teeth were not previously endodontically treated. Mandibular first molars (19%) and men (48.9%) were the most affected. The adjusted model showed that the age group of 26-45 years was 5 times more likely [odds ratio (OR) = 5.01; 95% confidence interval (CI): 2.85-8.82] to have lesions than those aged ≤25 years. Participants aged above 46 years were 19.1 times more prone (OR = 19.1; 95% CI: 10.2-36.0) to morbidity than younger ones (≤25 years). CONCLUSION The studied sample showed that periapical lesions were more prevalent in males, in mandibular molars, and without prior endodontic treatment. There was no observed association between periapical lesions and comorbidities or habits; however, a significant correlation occurred with advancing age. CLINICAL SIGNIFICANCE Comorbidities and habits were not associated with the presence of periapical lesions. However, aging has been identified as a significant risk factor for the development of periapical lesions. This finding is clinically relevant as it highlights the importance of monitoring and maintaining oral health in patients with advanced age. How to cite this article: dos Santos VC, de Oliveira Kublitski PM, Marques da Silva B, et al. Periapical Lesions Associated with Demographic Variables, Dental Conditions, Systemic Diseases, and Habits. J Contemp Dent Pract 2023;24(11):864-870.
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Affiliation(s)
- Valéria Custódio Dos Santos
- School of Health Sciences, Universidade Positivo, Curitiba, Paraná, Brazil, Orcid: https://orcid.org/0000-0001-5911-5695
| | | | - Bruno Marques da Silva
- School of Health Sciences, Universidade Positivo, Curitiba, Paraná, Brazil, Orcid: https://orcid.org/0000-0002-6227-4125
| | - Marilisa Carneiro Leão Gabardo
- School of Health Sciences, Universidade Positivo, Curitiba, Paraná, Brazil, Orcid: https://orcid.org/0000-0001-6832-8158
| | - Flávia Sens Fagundes Tomazinho
- School of Health Sciences, Universidade Positivo, Curitiba, Paraná, Brazil, Phone: +55 41 988339146, e-mail: , Orcid: https://orcid.org/0000-0001-5553-6943
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Prado HS, Petean IBF, Franco NJS, Camargo RV, Carvalho KKTD, Mazzi-Chaves JF, Lopes-Olhê FC, Silva-Sousa YTC, Souza-Gabriel AE, Sousa-Neto MD. Impact of access cavities on root canal preparation, restorative protocol quality, and fracture resistance of teeth. Braz Oral Res 2023; 37:e096. [PMID: 38055514 DOI: 10.1590/1807-3107bor-2023.vol37.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/15/2023] [Indexed: 12/08/2023] Open
Abstract
The survival of endodontically treated teeth depends on the remaining tooth structure. The aim of this study was to evaluate the impact of different access cavities on root canal preparation, restorative protocol, and fracture resistance of endodontically treated teeth. Fifty-six mandibular molars were divided into control (n=8) and experimental (n=16) groups according to access cavity: Traditional, Conservative, and Truss; and redistributed (n=8) according to instrumentation protocols: Reciproc Blue and R-motion. After, teeth were scanned in micro-CT and then filled and redistributed according to composite resin restoration (n=8): Filtek One BulkFill and Filtek Z350. A new micro-CT scan was performed to analyze the restorative material. Then, samples were submitted to fracture resistance testing and the failure pattern was determined. Data were analyzed using paired T-test, ANOVA, Tukey, and chi-square tests (α=0.05). In Truss, R-Motion promoted less transportation in different thirds of root canals. Higher percentages of voids (5.05%) and filling material (11.7%) were observed in Truss. Fracture resistance values were higher for the control group, followed by Truss, Conservative, and Traditional. The predominant failure pattern was type-II. In Truss, reciprocating instruments with smaller taper showed less canal transportation. Also, Truss provided higher values of fracture resistance, although it presented a higher percentage of voids and remaining filling material. Thus, in Truss, reciprocating files with smaller taper showed less canal transportation, and these cavities provided higher values of fracture resistance, although it presented a higher percentage of voids and remaining filling material.
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Affiliation(s)
- Heitor Silva Prado
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Igor Bassi Ferreira Petean
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Natália Junqueira Saud Franco
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Rafael Verardino Camargo
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | | | - Jardel Francisco Mazzi-Chaves
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | | | - Aline Evangelista Souza-Gabriel
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
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Streck JNZ, Arcaro S, Ceretta RA, Bortoluzzi EA, Garcia LDFR, de Almeida J, Kopper PMP, Bernardi AV. Tip and taper compatibility of accessory gutta-percha points with rotary and reciprocating instruments. Restor Dent Endod 2023; 48:e22. [PMID: 37675449 PMCID: PMC10477427 DOI: 10.5395/rde.2023.48.e22] [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: 12/13/2022] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 09/08/2023] Open
Abstract
Objectives This study was conducted to evaluate and compare the tip and taper compatibility of accessory gutta-percha points (AGPs) with various rotary and reciprocating instruments. Materials and Methods Using a profile analyzer, tip and taper measurements were taken of 10 AGPs of each of the 14 models available from Odous de Deus and the 4 models available from Dentsply-Maillefer. Diameter measurements were taken at 1-mm intervals, from 3 mm from the tip (D3) to 16 mm. Results Based on the mean values obtained, 3-dimensional (3D) models of the AGPs were drawn in Autodesk Fusion 360 and superimposed on 3D models of each instrument selected (Mtwo, Reciproc, RaCe, K3, and ProDesign Logic) to determine the compatibility between the instrument and the AGP. Data corresponding to the tips and tapers of the various AGPs, as well as the tip and taper differences between the AGPs and the instruments, were analyzed using descriptive statistics. The tapers of the AGPs were subject to the American National Standards Institute/American Dental Association No. 57 standard. The Odous de Deus extra-long medium and extra-long extra-medium AGPs were shown to be compatible with Mtwo, K3, and ProDesign Logic instruments with taper 0.06 and tip sizes 25 and 30, while the Dentsply fine and fine medium cones were compatible with Mtwo, RaCe, and K3 instruments with conicity of 0.04 and tip sizes 35 and 40. Conclusions Both the Odous de Deus and Dentsply commercial brands included 2 AGP models with tip (D3) and taper compatibility with Mtwo, RaCe, K3, and/or Prodesign Logic instruments.
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Affiliation(s)
- Júlia Niero Zanatta Streck
- Department of Endodontics, School of Dentistry, University of Extreme Southern Santa Catarina, Criciúma, SC, Brazil
| | - Sabrina Arcaro
- Department of Endodontics, School of Dentistry, University of Extreme Southern Santa Catarina, Criciúma, SC, Brazil
| | - Renan Antônio Ceretta
- Department of Endodontics, School of Dentistry, University of Extreme Southern Santa Catarina, Criciúma, SC, Brazil
| | - Eduardo Antunes Bortoluzzi
- Department of Diagnosis & Oral Health, Division of Endodontics, School of Dentistry, University of Louisville, Louisville, KY, USA
| | | | - Josiane de Almeida
- Department of Endodontics, School of Dentistry, University of Southern Santa Catarina, Florianópolis, SC, Brazil
| | - Patrícia Maria Poli Kopper
- Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Anarela Vassen Bernardi
- Department of Endodontics, School of Dentistry, University of Extreme Southern Santa Catarina, Criciúma, SC, Brazil
- Biomaterials Group, Graduate Program in Materials Science and Engineering, University of Extreme Southern Santa Catarina, Criciúma, SC, Brazil
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de Castro GAP, Petean IBF, de Paula-Silva FWG, Kuchler EC, Antunes LDS, Segato RAB, da Silva LAB, Silva-Sousa AC, Sousa-Neto MD. Genetic polymorphism in the tumour necrosis factor alpha gene (G-308A) is associated with persistent apical periodontitis in Brazilians. Int Endod J 2023; 56:17-26. [PMID: 36183324 DOI: 10.1111/iej.13841] [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: 05/03/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 12/13/2022]
Abstract
AIM To investigate if there was an association between genetic polymorphisms in tumour necrosis factor (TNF)-⍺ and its receptors TNFRSF1A and TNFRSF1B with persistent apical periodontitis (PAP) in Brazilian subjects. METHODOLOGY Patients who had pulpal necrosis and apical periodontitis at the time of treatment, with at least 1-year of follow-up after non-surgical root canal treatment were recalled. Three hundred and seventy eight subjects were included, 150 subjects with signs/symptoms of PAP and 228 subjects with root canal-treated teeth exhibiting healthy perirradicular tissues (healed). Genomic DNA was extracted from saliva and used for TNF-⍺ (rs1800629), TNFRSF1A (rs1800693) and TNFRSF1B (rs1061622) genotyping by real-time PCR. Genotypes and alleles frequencies were evaluated by c2 or Fisher's exact tests and odds ratios were implemented (α = 5%). RESULTS The genetic polymorphism in TNF-α (rs1800629) was associated as a protective factor for the development of PAP (p < .05), once subjects who presented at least one allele A (AA+AG X GG), had a higher chance to lesion repair (p < .05). The polymorphisms rs1800693 and rs1061622 in TNF receptors (TNFRSF1A and TNFRSF1B, respectively) were not associated with the development of PAP (p > .05). CONCLUSIONS The observed results demonstrate that polymorphism in TNF-α but not in its receptors is associated with PAP.
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Affiliation(s)
| | - Igor Bassi Ferreira Petean
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Erika Calvano Kuchler
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.,Department of Orthodontics, University of Regensburg, Regensburg, Germany
| | - Leonardo Dos Santos Antunes
- Research Unit, Fluminense Federal University, Rio de Janeiro, Brazil.,Specific Formation Department, School of Dentistry of Nova Friburgo, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Raquel Assed Bezerra Segato
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Lea Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Alice Corrêa Silva-Sousa
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Ferreira ML, Buligon MP, Sfreddo CS, Liedke GS, Morgental RD. Factors related to apical periodontitis in a southern Brazilian population: a multilevel analysis. Braz Oral Res 2022; 36:e112. [PMID: 35946740 DOI: 10.1590/1807-3107bor-2022.vol36.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 09/11/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this cross-sectional study was to evaluate the effects of individual-level and tooth-level factors on apical periodontitis (AP) in an urban population in southern Brazil. A random sample of digital panoramic radiographs (n = 545) from a dental school database was evaluated. The diagnosis of AP was determined by using a dichotomous scale (yes/no). AP was assessed according to gender, age, presence and quality of endodontic treatment (ET), presence of an intracanal post, coronal condition, and dental group. Data were analyzed descriptively and through multilevel Poisson regression analysis, considering teeth characteristics (level 1) nested in individuals (level 2). In this sample of 545 participants, the prevalence of AP was 49.5% (n =2 70) and ET was 43.5% (n = 237). Considering 13,595 teeth, AP was identified in 596 (4.4%) and ET in 617 (4.5%). Of the teeth with ET, 153 (24.8%) presented AP. Among individual-level factors, the disease was not significantly associated with gender or age. For tooth-level factors, AP was significantly associated with ET quality: teeth with short fillings (< 3 mm) and teeth with over-fillings had 2.77 (CI: 1.95-3.94, p < 0.001) and 1.08 (CI: 0.39-2.98, p < 0.001) higher prevalence of AP, respectively. There was no association between AP and age, gender, dental group, coronal condition, or the presence of an intracanal post. AP was highly prevalent in this population, and multilevel analysis indicated a significant association with ET quality.
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Affiliation(s)
- Monika Lamas Ferreira
- Universidade Federal de Pelotas - UFPel, Graduate Program in Dentistry , Pelotas , RS , Brazil
| | - Mônica Pagliarini Buligon
- Universidade Federal de Santa Maria - UFSM, Graduate Program in Dental Sciences , Santa Maria , RS , Brazil
| | - Camila Silveira Sfreddo
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Department of Semiology and Clinics , Pelotas , RS , Brazil
| | - Gabriela Salatino Liedke
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Stomatology , Santa Maria , RS , Brazil
| | - Renata Dornelles Morgental
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Stomatology , Santa Maria , RS , Brazil
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Petean IBF, Silva-Sousa AC, Cronenbold TJ, Mazzi-Chaves JF, Silva LABD, Segato RAB, Castro GAPD, Kuchler EC, Paula-Silva FWG, Damião Sousa-Neto M. Genetic, Cellular and Molecular Aspects involved in Apical Periodontitis. Braz Dent J 2022; 33:1-11. [PMID: 36043561 PMCID: PMC9645190 DOI: 10.1590/0103-6440202205113] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/03/2022] [Indexed: 11/26/2022] Open
Abstract
The development, establishment and repair of apical periodontitis (AP) is
dependent of several factors, which include host susceptibility, microbial
infection, immune response, quality of root canal treatment and organism's
ability to repair. The understanding of genetic contributions to the risk of
developing AP and presenting persistent AP has been extensively explored in
modern Endodontics. Thus, this article aims to provide a review of the
literature regarding the biochemical mediators involved in immune response
signaling, osteoclastogenesis and bone neoformation, as the genetic components
involved in the development and repair of AP. A narrative review of the
literature was performed through a PUBMED/MEDLINE search and a hand search of
the major AP textbooks. The knowledge regarding the cells, receptors and
molecules involved in the host's immune-inflammatory response during the
progression of AP added to the knowledge of bone biology allows the
identification of factors inherent to the host that can interfere both in the
progression and in the repair of these lesions. The main outcomes of studies
evaluated in the review that investigated the correlation between genetic
polymorphisms and AP in the last five years, demonstrate that genetic factors of
the individual are involved in the success of root canal treatment. The
discussion of this review gives subsides that may help to glimpse the
development of new therapies based on the identification of therapeutic targets
and the development of materials and techniques aimed at acting at the molecular
level for clinical, radiographic and histological success of root canal
treatment.
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Affiliation(s)
- Igor Bassi Ferreira Petean
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | - Alice Corrêa Silva-Sousa
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | | | | | - Lea Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Raquel Assed Bezerra Segato
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Erika Calvano Kuchler
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Orthodontics, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | | | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
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Yan YQ, Wang HL, Liu Y, Zheng TJ, Tang YP, Liu R. Three-dimensional inlay-guided endodontics applied in variant root canals: A case report and review of literature. World J Clin Cases 2021; 9:11425-11436. [PMID: 35071574 PMCID: PMC8717512 DOI: 10.12998/wjcc.v9.i36.11425] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 09/06/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Root canal retreatment is common after root canal therapy in clinical situations. Especially, completing the retreatment of variant root canals can be challenging. This is particularly true for the molars located at the end of the dental arch. However, advancements in digital dental diagnosis and treatment techniques can solve these problems. Here, we describe a case of a maxillary second molar with a variant distobuccal root canal treated via a novel “inlay-guided endodontics” technique based on improved computer-generated programs.
CASE SUMMARY A 63-year-old man complained of a defect in the maxillary left second molar. The tooth, diagnosed with post-treatment endodontic disease, was initially treated by conventional methods, which were ineffective. Our “inlay-guided endodontics” technique was subsequently adopted, with the establishment of a precise integrated three-dimensional (3D) plate model of cone-beam computed tomography data and a digital impression of the dentition. An optimal root canal approach was generated for the “virtual file” in the 3D model. The plate data were imported into a 3D printer and printed. With the help of the guide plate, the file was accurately placed into the cervical third of the distal root canal. The root canal and prosthodontic treatments successfully proceeded subsequently.
CONCLUSION Our newly developed inlay guide plates may facilitate individualized and minimally invasive root canal treatment.
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Affiliation(s)
- Yin-Qiu Yan
- Department of Stomatology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing 400042, China
- College of Stomatology, Chongqing Medical University, Chongqing 400016, China
| | - Hui-Li Wang
- Department of Nursing, Xi’an International University, Xi’an 710077, Shaanxi Province, China
| | - Yu Liu
- Chuang Neng Technology Co., Ltd., Chongqing 400042, China
| | - Tai-Jing Zheng
- Department of Stomatology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing 400042, China
| | - Ya-Ping Tang
- Department of Stomatology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing 400042, China
| | - Rui Liu
- Department of Stomatology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing 400042, China
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Bhandi S, Mashyakhy M, Abumelha AS, Alkahtany MF, Jamal M, Chohan H, Raj AT, Testarelli L, Reda R, Patil S. Complete Obturation-Cold Lateral Condensation vs. Thermoplastic Techniques: A Systematic Review of Micro-CT Studies. MATERIALS (BASEL, SWITZERLAND) 2021; 14:4013. [PMID: 34300930 PMCID: PMC8304925 DOI: 10.3390/ma14144013] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 01/31/2023]
Abstract
To prevent re-infection and provide a hermetic seal of the root canal system, an endodontist must aim to produce a void-free obturation. This review aimed to compare the completeness of root canal obturation between the two most prevalent methods-cold lateral condensation and warm gutta-percha techniques-using micro-CT (PROSPERO reg no. 249815). MATERIALS AND METHODS A search of Scopus, Embase, PubMed (Medline via PubMed), and Web of Science databases was done without any time restriction according to the PRISMA protocol. Articles that compared both techniques and were published in English were included. Data was extracted and the risk of bias was assessed using an adapted tool based on previous studies. RESULTS A total of 141 studies were identified by the search. Following the screening and selection of articles, 9 studies were included for review. Data was extracted manually and tabulated. Most studies had a moderate risk of bias. None determined operator skill in both methods before comparison. The data extracted from the included studies suggests that both techniques produce voids in the obturation. The thermoplasticized gutta-percha techniques may result in fewer voids compared to cold lateral condensation. CONCLUSION Considering the limitations of the included studies, it was concluded that neither technique could completely obturate the root canal. Thermoplasticized gutta-percha techniques showed better outcomes despite a possible learning bias in favor of cold lateral condensation. Establishing operator skills before comparison may help reduce this bias.
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Affiliation(s)
- Shilpa Bhandi
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia; (S.B.); (M.M.); (H.C.)
| | - Mohammed Mashyakhy
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia; (S.B.); (M.M.); (H.C.)
| | - Abdulaziz S. Abumelha
- Department of Restorative Dental Science, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Mazen F. Alkahtany
- Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Saud University, Riyadh 11362, Saudi Arabia;
| | - Mohamed Jamal
- Department of Endodontics, Hamdan Bin Mohamed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health Care City, Dubai 505055, United Arab Emirates;
| | - Hitesh Chohan
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia; (S.B.); (M.M.); (H.C.)
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Luca Testarelli
- Department of Oral and Maxillo Facial Sciences, University of Rome La Sapienza, 00161 Rome, Italy; (L.T.); (R.R.)
| | - Rodolfo Reda
- Department of Oral and Maxillo Facial Sciences, University of Rome La Sapienza, 00161 Rome, Italy; (L.T.); (R.R.)
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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11
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Alim-Uysal BA, Dincer AN, Yurtgezen B, Guneser MB. Does the Endodontic Education Level Affect Decision-Making for Endodontically Treated Teeth With Apical Periodontitis? A Web-Based Survey. Int Dent J 2021; 71:477-483. [PMID: 33612264 PMCID: PMC9275181 DOI: 10.1016/j.identj.2021.01.003] [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: 11/30/2022] Open
Abstract
Objectives The management of endodontically treated teeth with apical periodontitis is debated among clinicians. The aim of this study was to evaluate treatment choices for endodontically treated teeth with different sizes of periapical lesions among endodontists, endodontics postgraduate students, general dental practitioners, and undergraduate students who had fulfilled their theoretical and clinical training in endodontics. Materials and Methods Periapical lesion images (no periapical lesion and 1-mm, 3-mm, and 5-mm periapical lesions) were formed on 4 different radiographs with a software program, and the survey included 16 radiographs that were emailed to 1881 participants. Treatment options included extraction, surgical or nonsurgical retreatment, and wait and see. The χ2 test was used to compare the responses of the participants. Results The survey was returned by 1039 participants (55.23%). There were statistically significant differences among the responses of all participants for all cases (P < .05), except a case with a broken file and no lesion (P = .918). All participants decided to extract at an increased size from a 1-mm periapical lesion to a 5-mm periapical lesion. At all lesion sizes, general dental practitioners planned retreatment less when compared with other groups. Conclusions This survey study showed that there was a positive correlation between endodontic education level and retreatment decision-making. Dentists who confront seemingly hopeless endodontically treated teeth such as an instrument fracture, a missing canal, or a large periapical lesion should consult with an endodontist before making the decision to extract the tooth.
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Affiliation(s)
- Betul Aycan Alim-Uysal
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey.
| | - Asiye Nur Dincer
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Mehmet Burak Guneser
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey
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Sadaf D. Survival Rates of Endodontically Treated Teeth After Placement of Definitive Coronal Restoration: 8-Year Retrospective Study. Ther Clin Risk Manag 2020; 16:125-131. [PMID: 32110030 PMCID: PMC7041432 DOI: 10.2147/tcrm.s223233] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 01/27/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Preservation of endodontically treated teeth (ETT) depends upon several patient-related and operator-related factors. The objectives of this study were to assess the effects of different types of coronal restoration and delayed placement on ETT survival. Methods Data on dates of root canal treatment (RCT), restoration type, and extraction time of tooth, when applicable, were analyzed for all patients who underwent RCT from 2010 to 2018 at our institution. Inclusion Criteria Root canal-treated teeth with complete preoperative and postoperative radiographs; ETT that were restorable and received final permanent coronal restorations; no periodontal disease or crack detected during RCT; and ETT with acceptable RCT quality. Exclusion Criteria Patients who did not attend for follow-up, those had incomplete information available about the coronal restoration, and those with periodontally compromised teeth were excluded. ETT that involved any procedural error were also excluded. The teeth were categorized according to whether they underwent definitive coronal restoration 0–14 days, 15–59 days, or 60+ days after RCT. The statistical analysis was performed using SPSS version 25 (IBM Corp., Armonk, NY). The rate of survival of ETT of 8 years was estimated, and the differences between groups were determined after applying Kaplan–Meier statistics and log-rank tests. A multivariate Cox regression test and Wilcoxon (Gehan) statistics were computed to analyze the influence of different variables. A P-value <0.05 was considered as statistically significant. Results The type of restoration, opposing dentition, presence of a post, and dentistry training (year 4 or 5 students) showed significant effects on the survival of ETT (P ≤ 0.000). ETT which received crowns was 2.05 times more likely to need extraction than those in which a composite buildup was performed (hazard ratio [HR] 2.05; confidence interval [CI] 1.84–2.29; P ≤ 0.000). All composite buildups were performed within 14 days of completion of RCT. There was a significant correlation between the time of placement of the final coronal restoration and ETT survival (P ≤ 0.000). Extraction of ETT was 25% more likely (HR 0.25; CI 0.231–0.277) when the final coronal restoration was placed 15–59 days after completion of RCT and 73% more likely (HR 0.73; CI 0.655–0.814) when placed after 60 days than when placed at 0–14 days. Conclusion Timely placement of the final coronal restoration is found to be the most critical factor affecting the long-term survival of teeth after RCT.
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Affiliation(s)
- Durre Sadaf
- Conservative Dentistry Department, College of Dentistry, Qassim University, Qassim, Saudi Arabia.,Graduate Reading, Centre of Evidence-Based Medicine, University of Oxford, Oxford, UK
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Evaluation of the presence of microorganisms from root canal of teeth submitted to retreatment due to prosthetic reasons and without evidence of apical periodontitis. Clin Oral Investig 2020; 24:3243-3254. [DOI: 10.1007/s00784-020-03200-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 01/07/2020] [Indexed: 12/25/2022]
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Duarte ML, Pepino JC, Sancas MC, Moreira JPDL, Neves ADA, Pintor AVB, Primo LG. Reliability of Two Methods of Evaluation of the Apical Limit of Obturation of Root Canals of Primary Teeth: A Pilot Study. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Ramos ATPR, Belizário LG, Jordão-Basso KCF, Shinohara AL, Kuga MC. Effects of photodynamic therapy on the adhesive interface using two fiber posts cementation systems. Photodiagnosis Photodyn Ther 2018; 24:136-141. [DOI: 10.1016/j.pdpdt.2018.08.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/13/2018] [Accepted: 08/27/2018] [Indexed: 12/28/2022]
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