A Comparative study for the management of Peri-radicular Pathosis by Conventional Root Canal Therapy and Non Instrumental Endodontic Therapy

Non-surgical endodontics is one of the realities in modern endodontics globally which is a highly sophisticated specialized technical clinical procedure to conserve the teeth. Lesion Sterilized Tissue Repair (LSTR) is an alternative of conventional non-surgical endodontics (C-RCT) considered being a valuable adjunct to the treatment of infected root canal. This cross sectional prospective study was carried out in the department of Conservative Dentistry & Endodontics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2002 to January 2003. This study involved 100 cases of symptomatic endodontically involved teeth with peri radicular pathosis treated by non-surgical method (C-RCT) & (LSTR therapy) in multi-visit technique and immediate and long-term clinical and radiological follow-up done for 24 months. The result revealed complete disappearance of sinus tract 46(92%) in C-RCT and 35(70%) in LSTR therapy group and success in C-RCT was 88% and in LSTR therapy as 86% after 24 months follow-up by clinical and radiological evaluation. So, it can be concluded that non-surgical approach in the management of periradicular pathosis by C-RCT and LSTR therapy was found safe, effective and practical method of treatment of an endodontically involved tooth.

Endodontic management of symptomatic pulpal pathosis by single -visit root canal therapy

Single-visit root canal therapy is one of the reality in modern endodontics globally, both for vital and non-vital teeth, despite many research efforts and much controversy, specially when post-operative pain is concerned. There are increased post-operative complications as pain, swelling, discomfort in managing teeth having symptomatic pulpal pathosis. To clinically verify the possibility to treat symptomatic vital and non-vital teeth in one visit technique, 126 patiens were selected and advised to undergone single visit endodontic treatment at the Department of Conservative Dentistry and Endodontics, Bangabandhu Sheikh Mujib Medical University, Dhaka. Endodontically involved symptomatic vital and symptomatic non-vital teeth were enrolled in two groups and advised to undergone single visit endodontic treatment. Both groups were assessed at 24 hours, 48 hours, 72 hours and long term post operative evaluation up to 10 months. The main outcome measure was post operative pain. The result of our study indicates that single visit root canal treatment is a safe, effective and practical method of treatment of an endodontically involved tooth both in vital and non vital cases when applied in appropriate situation. Significantly fewer patients of symptomatic vital cases reported pain in immediate follow up i.e. 24 hours, 48 hours and 72 hours in comparison to non vital cases (12.69% vs. 22.2%, 4.16% vs. 11.11%, 1.58% vs. 7.93%). At 10 months of long term follow up the recall rate was 74.35% and 90(71%) of patients were comfortable after receiving treatment. Post operative pain incidence in single visit was equivalent to that of multi visit endodontics, provided one had an accurate diagnosis, proper case selection and skilled technique.