Choice of Treatment Plan Based on Root Canal Therapy versus Extraction and Implant Placement: A Mini Review

Questionnaire-Based Assessment of Patients' Knowledge, Attitude, and Practices Regarding Restorative and Endodontic Treatment at a Multi-disciplinary Tertiary Care Hospital of Jharkhand, India

BACKGROUND

The majority of Indians living in smaller cities and villages don't know much about oral health and how to address it. Thus, this research seeks to assess the endodontic and restorative treatment knowledge, attitudes, behaviors, and perceptions of patients who visit the Dental Institute at the Rajendra Institute of Medical Sciences in Ranchi.

METHODS

This study was conducted on 771 subjects over 2 months at the outpatient department (OPD) of the dental institute, using a prefabricated questionnaire. The participants were divided into three groups based on age. A modified questionnaire consisting of 20 questions obtained from previous studies was provided to the subjects. The first part of the questionnaire was related to demographic details while the second part comprised questions regarding the knowledge of the participants. The third part emphasized on attitude aspect while the last part comprised practice questions.

RESULTS

It was observed that 682 (85%) of the participants had prior information about root canal treatment (RCT) and filling and 555 (72%) thought it to be an alternative to extraction. While 528 (68.5%) participants stated about undergoing RCT, 679 (88%) subjects propagated their recommendation to family and friends. Five hundred thirteen (66%) subjects highlighted anxiety during anesthetic administration.

CONCLUSION

With increasing awareness and information, traditional extraction has given way to the recognition that RCT and filling can salvage a tooth. Patient acceptance of RCT and filling as treatment alternatives may be enhanced by healthcare education and mass activities.

The status of clinical trials regarding root canal sealers

Objectives

This study aimed to present the results and analyses of clinical trials, including updates on the different functions of root canal sealers.

Materials and Methods

In June 2023, we performed a comprehensive search of ClinicalTrials.gov to identify interventional clinical trials pertaining to root canal sealers. In total, 23 clinical trials conducted up to June 2023 were included in this study.

Results

Approximately half of the trials (11 out of 23) were completed, while none were terminated or withdrawn. Each included trial had a minimum of 10 participants, with 11 trials having more than 100 participants. None of the assessed trials provided outcomes, and the majority (17 out of 23) lacked associated publications. In terms of geographic distribution, the USA and Canada did not contribute to any root canal sealer trials.

Conclusions

This study highlights the lack of diversity in trial locations, the absence of reported results, and a scarcity of clinical trials examining the physicochemical properties of different sealers. Most published trials primarily focused on assessing the post-operative pain effect of these sealers, but no significant difference was found regarding post-operative pain control.

German Dentists' Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

Currently, there is no standard treatment protocol for apical periodontitis (AP). Thus, restorable teeth might get extracted and replaced prosthetically. This study evaluated German dentists’ preferred AP treatment decisions and the influencing factors for selecting tooth retention by initial/repeated surgical/non-surgical root-canal treatment (RCT) or extraction with/without prosthetic replacement. Through an online-survey, participants (n = 260) rated different treatment options for four case scenarios with AP in anterior/posterior teeth without/with previous RCT. Statistical analysis included the Friedman test for intra-case comparisons and Chi-squared test for factor-associations (p ≤ 0.05). Tooth retention using initial/repeated RCT was ranked first in all scenarios and rated as (very) appropriate by most participants, while implant-supported crowns (ISC) and apicoectomy had the second ratings. ISC were preferred more on posterior teeth or previous root-canal-treated teeth. Rating levels of treatment options displayed significant differences for all case scenarios. Posterior tooth retention by RCT demonstrated a significant association with work experience. Tooth retention with previous RCT displayed a significant correlation with dentists’ privately insured patients. Most dentists preferred tooth preserving with initial/repeated RCT, while others selected non-evidence-based choices. This reflects a lack of consensus of AP treatment decisions in Germany. Fixed treatment guidelines and further evaluation of treatment–decision-correlated factors are recommended for correct treatment planning.

An In Vitro Model for Candida albicans⁻Streptococcus gordonii Biofilms on Titanium Surfaces

The oral cavity serves as a nutrient-rich haven for over 600 species of microorganisms. Although many are essential to maintaining the oral microbiota, some can cause oral infections such as caries, periodontitis, mucositis, and endodontic infections, and this is further exacerbated with dental implants. Most of these infections are mixed species in nature and associated with a biofilm mode of growth. Here, after optimization of different parameters including cell density, growth media, and incubation conditions, we have developed an in vitro model of C. albicans–S. gordonii mixed-species biofilms on titanium discs that is relevant to infections of peri-implant diseases. Our results indicate a synergistic effect for the development of biofilms when both microorganisms were seeded together, confirming the existence of beneficial, mutualistic cross-kingdom interactions for biofilm formation. The morphological and architectural features of these dual-species biofilms formed on titanium were determined using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). Mixed biofilms formed on titanium discs showed a high level of resistance to combination therapy with antifungal and antibacterial drugs. This model can serve as a platform for further analyses of complex fungal/bacterial biofilms and can also be applied to screening of new drug candidates against mixed-species biofilms.