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Xiqian L, Ying Z, Mian M. The effect of apical patency on postoperative pain following endodontic therapy: A systematic review and meta-analysis. Eur J Oral Sci 2024; 132:e12986. [PMID: 38632110 DOI: 10.1111/eos.12986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/26/2024] [Indexed: 04/19/2024]
Abstract
This systematic review and meta-analysis aimed to determine whether apical patency increases postoperative pain after endodontic therapy. This study explored the degree and incidence of postoperative pain during root canal therapy, as well as the number of required analgesic doses. We searched PubMed, Scopus, Embase, Web of Science, Cochrane Library, and gray literature from the date of database inception until May 2023. RevMan 5.4 software was used for data analysis. Twelve studies were considered eligible for meta-analysis. The mean pain scores on days 1 (mean difference [MD] = -1.69) and 2 (MD = -0.85) differed significantly between the apical patency and non-patency groups. The odds for pain after 24 h were significantly lower (OR 0.59) in the apical patency group than in the non-patency group. Furthermore, the mean number of required analgesic doses was not significantly different between the two groups. In conclusion, apical patency significantly alleviated postoperative pain (low-quality evidence) and reduced the incidence of pain (moderate evidence). However, high-quality randomized controlled trials are required to validate these findings.
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Affiliation(s)
- Liu Xiqian
- Department of Stomatology, Changzhi Medical College Affiliated Heping Hospital, Changzhi City, Shanxi Province, China
| | - Zhai Ying
- Department of Stomatology, Yangquan Coal Industry Group General Hospital, Yangquan City, Shanxi Province, China
| | - Mao Mian
- Department of Pharmacy, Sichuan Cancer Hospital and Institute, Chengdu, China
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Eliyas S, Shah K, Dhamecha N, Jayaram T, Yusuf A, Jasani V, Kaur N. GIRFT and Measuring Outcomes in MCNs: endodontics in 646 teeth treated in Tier 2 (Primary Care) and Tier 3 (Secondary Care) settings in England. Prim Dent J 2024; 13:36-52. [PMID: 38888078 DOI: 10.1177/20501684241230799] [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: 06/20/2024]
Abstract
AIM This paper aims to assess the complexity, quality and outcome of endodontic treatment provided in Managed Clinical Networks (MCNs) in England to understand if we are "getting it right first time" (GIRFT). METHODS In a convenient sample of endodontic treatments provided between May 2011 and April 2017, the complexity of teeth treated, the quality of treatment procedure, the radiographic appearance of root fillings, as well as clinical and radiographic healing were retrospectively assessed using records taken as part of treatment. Trained, calibrated examiners independently scored radiographs using previously published scoring systems. RESULTS 646 teeth were followed up for 24.7 months (standard deviation [SD] 17.08). The average age of those patients treated was 46.7 years (SD 15.38) with 48.3% being male. Of teeth treated, 70.4% were of complexity level 3. 88.2% of teeth were asymptomatic, and 80% demonstrated complete radiographic healing. Procedural errors inhibited achieving correct working length and taper, with more voids within root canal fillings. When patency filing was reported as being carried out, complete radiographic healing was more likely. CONCLUSIONS It is possible to collate outcome data in the NHS system, especially if there is provision for ongoing follow up and time allocated for collection of data. Endodontic treatment provided within primary and secondary care settings are of high quality, with outcomes being better with single operators carrying out high volumes of endodontic treatment.
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Affiliation(s)
- Shiyana Eliyas
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Kewal Shah
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Nalin Dhamecha
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Tapasya Jayaram
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Aaron Yusuf
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Vishal Jasani
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
| | - Nirvair Kaur
- Shiyana Eliyas BDS, MFDS, MRD, FDS (Rest Dent), PhD Consultant in Restorative Dentistry, St George's University Hospitals NHS Foundation Trust, London, UK
- Kewal Shah BDS, MFDS, MEndo. Endodontic Specialist and Clinical Teacher in Endodontics, King's College London, London, UK
- Nalin Dhamecha BDS Speciality Doctor in Endodontics, St George's University Hospitals NHS Foundation Trust, London, UK
- Tapasya Jayaram BDS Dentist with Enhanced Skills in Endodontics, Green Dental Care, London, UK
- Aaron Yusuf BDS Dentist with Enhanced Skills in Endodontics, Ridgway Dental, London, UK
- Vishal Jasani BDS Dentist with Enhanced Skills in Endodontics, Malden Dental Care, London, UK
- Nirvair Kaur BDS Specialist in Endodontics, Bupa Dental Marylebone, London, UK
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Rech LC, Montagner F, Luisi SB, Melo TAFD. How is working length determination taught? A survey to assess what is recommended in undergraduate Schools of Dentistry in Brazil. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:516-522. [PMID: 34816557 DOI: 10.1111/eje.12728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/28/2021] [Accepted: 11/17/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION To analyse what are the methods for working length (WLD) determination taught for undergraduate students in Brazilian Dental Schools and the perception of professors about the use of electronic WL determination in the clinical practice. METHODS An online questionnaire with eighteen closed questions was sent to 209 Schools of Dentistry in Brazil using the Google Forms Platform. The questionnaire was structured to analyse the perception of professors in the department of endodontics about the method of working length determination taught in undergraduate courses in Dentistry. The data collected in the questionnaires were transferred to an Excel® spreadsheet and analysed using absolute and relative frequencies. The non-parametric Mann-Whitney test was used to compare groups. RESULTS Of the 209 schools contacted, 41 (19.61%) returned answers to the questionnaire. According to professors, electronic working length (WL) determination had a shorter length of time to perform it (p < .001), WL measurement accuracy (p < .001) and ease of performance (p < .001). Professors felt safer when maintaining patency when using electronic WL determination (p = .0020). CONCLUSIONS Both radiographic and electronic methods of WL determination are taught in Brazilian Schools of Dentistry. The electronic method was used more frequently, especially in undergraduate clinical courses.
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Affiliation(s)
- Luara Cristina Rech
- Departamento de Odontologia Conservadora, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Francisco Montagner
- Departamento de Odontologia Conservadora, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Simone Bonato Luisi
- Departamento de Odontologia Conservadora, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tiago André Fontoura de Melo
- Departamento de Odontologia Conservadora, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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