1
|
Dawson VS, Fransson H, Isberg PE, Wigsten E. Further Interventions after Root Canal Treatment Are Most Common in Molars and Teeth Restored with Direct Restorations: A 10-11-Year Follow-Up of the Adult Swedish Population. J Endod 2024; 50:766-773. [PMID: 38492798 DOI: 10.1016/j.joen.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION The aims were to investigate 1) the frequency of nonsurgical retreatment, root-end surgery, extraction, and further restorative treatment during a follow-up of 10-11 years after root filling and compare the frequencies according to tooth group and type of coronal restoration and 2) the timing of nonsurgical retreatment, root-end surgery, and extraction. METHODS Data were collected from the Swedish Social Insurance Agency's register. A search for treatment codes identified teeth root filled in 2009 and the type of coronal restoration (direct, indirect, and unspecified) registered within 6 months of root filling. The root-filled teeth were followed 10-11 years, and further interventions were recorded. Descriptive statistics and chi-square tests were used for statistical analysis. RESULTS In 2009, root fillings were registered for 215,611 individuals/teeth. Nonsurgical retreatment, root-end surgery, and extraction were undertaken in 3.5%, 1.4%, and 20% teeth, respectively. The frequency of further interventions varied with respect to tooth group and type of coronal restoration, but only slightly for endodontic retreatments. Further interventions, except for root-end surgery, were registered more often for molars and directly restored teeth (P < .001). The majority of endodontic retreatments were undertaken within 4 years, while extractions were evenly distributed over 10-11 years. CONCLUSIONS The frequency numbers of nonsurgical retreatment and root-end surgery were low, despite 1 in 5 root-filled teeth registered as extracted. Further interventions were most common in molars and directly restored teeth. Endodontic retreatments were performed more often during the first 4 years.
Collapse
Affiliation(s)
- Victoria S Dawson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - Helena Fransson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Per-Erik Isberg
- Department of Statistics, Lund University School of Economics and Management, Lund University, Lund, Sweden
| | - Emma Wigsten
- Department of Endodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
2
|
Liu C, Liu X, Wang X, Liu Y, Bai Y, Bai S, Zhao Y. Endodontic Microsurgery With an Autonomous Robotic System: A Clinical Report. J Endod 2024; 50:859-864. [PMID: 38369101 DOI: 10.1016/j.joen.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Endodontic microsurgery (EMS) requires minimally invasive osteotomy and accurate root-end resection, which can be challenging in many instances. Evidence suggests that autonomous robotic systems can significantly enhance the precision of dental implantation. The aim of this case report is to introduce a novel EMS technique that employs robot-guided osteotomy and root resection procedures. METHODS A 59-year-old man was diagnosed with previously treated, symptomatic apical periodontitis in the mandibular left first molar. Patient data were used to integrate a digital model into preoperative planning software to design the surgical plan. The robotic system utilizes spatial alignment techniques for registration, guiding the robotic arm to autonomously perform a 3-mm osteotomy and root-end resection, based on the surgical plan. After completing the resection, the clinician confirmed the absence of cracks or root fractures and subsequently performed root-end preparation and filling under a microscope. RESULTS To the best of our knowledge, this case marks the first use of autonomous robotic assistance in EMS. CONCLUSIONS Utilizing an autonomous robotic system could enable precise apicoectomy in patients with intact cortical plates, thus facilitating successful EMS procedures. This has the potential to minimize errors caused by operator inexperience and mitigate the risks associated with excessive bone removal.
Collapse
Affiliation(s)
- Chen Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Xin Liu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Stomatology, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Xin Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Yuchen Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Yu Bai
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Stomatology, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Shizhu Bai
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China.
| | - Yimin Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China.
| |
Collapse
|
3
|
Isufi A, Hsu TY, Chogle S. Robot-Assisted and Haptic-Guided Endodontic Surgery: A Case Report. J Endod 2024; 50:533-539.e1. [PMID: 38280513 DOI: 10.1016/j.joen.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/10/2023] [Accepted: 01/15/2024] [Indexed: 01/29/2024]
Abstract
There has been a significant increase in robot-assisted dental procedures in the past decade, particularly in the area of robot-assisted implant placement. The objective of this case report was to assess the initial use of the Yomi Robot's assistance and haptic guidance during endodontic microsurgery. The robot was used during the osteotomy and root-end resection of the first and second upper left premolars. The report aims to inform clinicians of the initial implementation of this cutting-edge technology in endodontics and its potential to enhance endodontic microsurgery. The Yomi Robot was used in performing osteotomy and root-end resection during apical surgery in a patient presenting with symptomatic upper left first and second premolars. The treatment procedure was decided after clinical examination, chart data, and radiographic examinations, which showed periapical lesions on both premolars, taking into consideration the failed endodontic retreatment on the first premolar, the post and ceramic coronal restorations on both teeth, and the desire of the patient to save them. The Yomi Robot system provides auditory, visual, and physical guidance to clinicians during surgery while using a cone-beam computed tomography scan for precision planning with greater accuracy and minimized potential for human error. Further studies are needed to prepare a protocol for robotic-guided procedures in endodontics.
Collapse
Affiliation(s)
- Almira Isufi
- Department of Endodontics, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts.
| | - Tun-Yi Hsu
- Department of Endodontics, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts
| | - Sami Chogle
- Department of Endodontics, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts
| |
Collapse
|
4
|
Mon A, Kim ME, Kum KY, Kwon HB. 3D finite element analysis of stress distribution on the shape of resected root-end or with/without bone graft of a maxillary premolar during endodontic microsurgery. J Dent Sci 2024; 19:837-845. [PMID: 38618133 PMCID: PMC11010716 DOI: 10.1016/j.jds.2023.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/29/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Apical root resection pattern affects the stress distribution behavior in the apical region of the resected tooth. The purpose of the study was to compare the biomechanical responses of resected teeth between endodontic microsurgery (horizontal resection) and targeted endodontic microsurgery (round resection). Materials and methods Five different models were developed. The basic model without resection (NR) was regarded as the control model, and the others involved: horizontal resection without bone grafting (HN), horizontal resection with bone grafting (HG), round resection without bone grafting (RN), and round resection with bone grafting (RG) models. A static load of 100 N was applied to the buccal and palatal cusps of all the teeth in a 30° oblique direction. The maximum von-Mises stress and tooth displacement values were analyzed and compared. Results Both the HN and RN models exhibited lower stress distribution values on bone compared with the NR (control) model. Regarding maximum stress distribution at the root apex, the stress value of the RN model was slightly higher compared to the HN model, whereas the RG model displayed a slightly lower stress value in comparison with the HG model. For maximum tooth displacement value, there were no significant differences between the HN and RN models, as well as the HG and RG models. Conclusion The round resection pattern had comparable stress distribution behaviors at the root apex and tooth displacement values with the horizontal resection pattern. Targeted endodontic microsurgery might provide better biomechanical response of the resected tooth after root-end resection.
Collapse
Affiliation(s)
- Aein Mon
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Mi-El Kim
- Dental Research Institute and Department of Oral Anatomy, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Kee-Yeon Kum
- Dental Research Institute and Department of Conservative Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Ho-Beom Kwon
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
5
|
Harinkhere C, Patni PM, Jain P, Raghuwanshi S, Pandey SH, Bilaiya S. Comparison of the sealing ability amongst orthograde apical plugs of mineral trioxide aggregate plus, mineral trioxide aggregate repair HP, and Biodentine after root resection: a bacterial leakage study. Odontology 2024; 112:364-371. [PMID: 37632561 DOI: 10.1007/s10266-023-00847-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 08/15/2023] [Indexed: 08/28/2023]
Abstract
This study aimed to analyse the effect of root-end resection on the sealing ability of orthograde apical plugs of three root-end filling materials (MTA Repair HP, Biodentine, MTA Plus) using the bacterial leakage method and compare it with the retrograde root-end filling technique. Eighty-four extracted mandibular premolar teeth with single root and single straight canals were selected and randomly divided into two main experimental groups (n = 36) depending on the apical plug placement technique and a control: Group I: orthograde technique, followed by root-end resection; Group II: retrograde root-end filling technique; one control Group III (n = 12): obturation with gutta-percha, followed by root-end resection. Experimental groups were further subdivided into three subgroups A, B, and C (n = 12) depending on the three different root-end filling materials used. An apical plug of 3 mm thickness was obtained in both the experimental groups. The apical sealing ability was evaluated with the dual-chamber bacterial leakage method. Statistical analysis was performed using the Kaplan-Meier survival analysis test. By the end of 30 days, the occurrence of turbidity indicating bacterial leakage was 75% in MTA Repair HP, 83.3% in Biodentine, and 91.7% in MTA Plus samples. This trend of turbidity was similar in both orthograde and retrograde technique. The control group showed turbidity in all the samples (100%). More MTA Repair HP samples (25%) survived the 30 days observation period with no bacterial leakage compared to Biodentine (16.7%) and MTA Plus (8.3%). The sealing ability of already set root-end filling materials placed through the orthograde technique did not deteriorate after root-end resection. Also among three root-end filling materials, MTA Repair HP presented the lowest bacterial microleakage followed by Biodentine and MTA Plus, respectively.
Collapse
Affiliation(s)
- Chhaya Harinkhere
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India.
| | - Pallav Mahesh Patni
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Pradeep Jain
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Swadhin Raghuwanshi
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Sanket Hans Pandey
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Sakshi Bilaiya
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| |
Collapse
|
6
|
Yang X, Chen X, Zhang Y, Huang L, Chen D, Zeng Q, Qiu X. Clinical outcomes of endodontic microsurgery in complicated cases with large or through-and-through lesions: a retrospective longitudinal study. Clin Oral Investig 2024; 28:172. [PMID: 38400913 DOI: 10.1007/s00784-024-05557-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES To investigate the clinical outcomes of endodontic microsurgery in complicated cases presenting with large or through-and-through lesions. MATERIALS AND METHODS We retrospectively collected and analyzed preoperative, intraoperative, and follow-up data from 143 complicated cases that underwent endodontic microsurgery. Clinical outcomes were assessed in terms of tooth survival and surgery success. Cox regression analysis was used to evaluate the survival rate and identify associated risk factors. Additionally, the success rate was compared across different postoperative periods, and potential factors contributing to surgical failure were identified through binary logistic regression. RESULTS The overall survival and success rates were 93.0% and 91.7%, respectively. The Cox regression model identified four risk factors affecting tooth survival, including apicoectomy of four teeth (HR = 35.488; P = 0.0002), an open apex observed on preoperative radiographs (HR = 6.300; P = 0.025), the performance of guided tissue regeneration technique (HR = 8.846; P = 0.028), and a palatal surgical approach (HR = 8.685; P = 0.030). The success rate demonstrated an initial increase in the early postoperative period (from 0.5 to 2 years; P = 5.8124e-30), followed by stabilization (from 2 to 9 years; P = 0.298). Surgery success rate significantly declined when apicoectomy involved four teeth (OR = 109.412; P = 0.002). CONCLUSIONS Endodontic microsurgery demonstrates satisfactory outcomes in complicated cases, maintaining a stable success rate after two years. However, tooth survival and surgery success are significantly compromised when apicoectomy involves four teeth. Factors such as guided tissue regeneration, an open apex, and the palatal surgical approach are associated with an increased risk of tooth extraction. CLINICAL RELEVANCE Despite achieving acceptable outcomes in complicated cases, endodontic microsurgery is adversely affected by the apicoectomy of four teeth.
Collapse
Affiliation(s)
- Xiaoxia Yang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Xuan Chen
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Yinchun Zhang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Lei Huang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Dongjie Chen
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Qinfang Zeng
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Xiaoling Qiu
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China.
| |
Collapse
|
7
|
Kaur J, Sroa RB, Kaur A, Kaur M, Kumar B, Kaur G. Surgical Management of Radicular Cyst with the Application of a Natural Platelet Concentrate and Ostoden: A Case Report. J Pharm Bioallied Sci 2024; 16:S987-S989. [PMID: 38595372 PMCID: PMC11001145 DOI: 10.4103/jpbs.jpbs_979_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 04/11/2024] Open
Abstract
The most frequent cystic lesions that affect the jaw are radicular cysts. The current case report describes the surgical management of a radicular cyst in the periapical region of maxillary central and lateral incisors, and highlights the efficacy of natural platelet concentrate [platelet-rich fibrin (PRF)] along with Ostoden bone graft material used for postoperative healing. A 46-year-old male patient presented to the department with swelling in the palatal aspect of the maxillary anterior region. On radiographic examination, a radiolucent periapical lesion was evident in relation to the left maxillary central and lateral incisor. In the maxillary anterior region, root canal therapy was performed, followed by periapical surgery, and PRF with Ostoden bone graft was placed in the surgical site to initiate the healing at a faster rate. The patient was recalled at follow-ups after 7 days, 3, 6, and 9 months. No symptoms such as pain, inflammation, or discomfort were observed during the review period.
Collapse
Affiliation(s)
- Jaspreet Kaur
- Department of Pediatric Dentistry, Government Dental College, Patiala, Punjab, India
| | - Renu Bala Sroa
- Department of Conservative Dentistry and Endodontics, Punjab Government Dental College and Hospital, Amritsar, Punjab, India
| | - Avreet Kaur
- Department of Orthodontics and Dentofacial Orthopaedics, Luxmi Bai Institute of Dental Science and Hospital, Patiala, Punjab, India
| | - Mandeep Kaur
- Department of Conservative Dentistry and Endodontics, Punjab Government Dental College and Hospital, Amritsar, Punjab, India
| | - Baljeet Kumar
- Department of Conservative Dentistry and Endodontics, Punjab Government Dental College and Hospital, Amritsar, Punjab, India
| | - Gaganpreet Kaur
- Department of Pediatric Dentistry, Government Dental College, Patiala, Punjab, India
| |
Collapse
|
8
|
Shaik I, Veluru K, Sai Pranathi Gundimeda N, Jeevan Kakumanu N, Gowraram S, Pasupuleti S, Dikkala NSS. Outcomes of Regenerative Endodontic Treatment Performed Using Different Magnification Devices: A Systematic Review. J Pharm Bioallied Sci 2024; 16:S87-S89. [PMID: 38595596 PMCID: PMC11001110 DOI: 10.4103/jpbs.jpbs_555_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/20/2023] [Accepted: 09/01/2023] [Indexed: 04/11/2024] Open
Abstract
Aim In this systematic review, we assessed whether the effects of the usage of various devices help with magnification in endodontics and whether they resulted in any significant changes in the clinical result of treatment. Materials and Methods An exhaustive search was performed across MEDLINE and Cochrane Registers for various clinical studies, which were focused on comparing regenerative endodontic treatment based on the usage of magnification devices. Various terms were used to search these clinical trials such as microscope, regenerative endodontic surgery, apicoectomy, endoscope, and loupes. Results After scrutinizing the studies, around three clinical trials based on magnification in endodontic surgeries were included in the present review. It was observed that no statistically noteworthy betterment of treatment outcome was seen in patients treated with either of the magnification devices such as loupes and microscope. Conclusion It was evident that these magnification devices can alter the effectiveness of regenerative endodontic treatment in a very minimal way. However, we believe that more randomized clinical studies should be conducted in this area.
Collapse
Affiliation(s)
- Izaz Shaik
- Lakewood Family Dental, Bloomington, Illinios, USA
| | - Keerthini Veluru
- Government Dental College and Hospital, Hyderabad, Telangana, India, Masters in Health Informatics at University of North Texas, Texas, United States
| | | | | | - Sanjupriya Gowraram
- Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chattisgarh, India
| | - Sowmya Pasupuleti
- SIBAR Institute of Dental Sciences, Takelapadu, Guntur, Andhra Pradesh, India
| | | |
Collapse
|
9
|
Liao F, Wang H, Zhao J, Zhang B, Zhong H. Effectiveness evaluation of autotransplanted teeth after performing extraoral endodontic surgery instead of conventional root canal therapy. BMC Oral Health 2023; 23:1005. [PMID: 38097962 PMCID: PMC10722803 DOI: 10.1186/s12903-023-03733-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/02/2023] [Indexed: 12/17/2023] Open
Abstract
PURPOSE The aim of this study was to examine the viability and efficacy of utilizing extraoral apicoectomy and retrograde filling in combination to seal the root canal system of mature molars without the need for root canal therapy (RCT) during the autotransplantation of teeth (ATT). MATERIALS AND METHODS This study screened 27 patients who received ATT at the Department of Oral Surgery in the Hospital of Stomatology from 2019 to 2021. Extraoral apicoectomy and retrograde filling were performed, while RCT was temporarily not performed. The study analysed the periodontal status and masticatory function of transplanted teeth one to three years postoperation and used cone-beam computed tomography (CBCT) and periapical radiograph (PA) to evaluate the integrity of the periodontal space and intra/periapical inflammation. The potential predictors of survival/success were analysed statistically. We also conducted questionnaires and chewing efficiency tests. RESULTS In this study, 27 TTs from 27 patients were found to be fully functional in terms of chewing ability. The overall survival rate was 100% (27/27), and the success rate was 70.4% (19/27). A total of 90.9% (20/22) of patients reported being satisfied or very satisfied with their TTs. Additionally, the chewing efficiency of the transplantation side was on average 82.0% of that of the healthy side, with a significant difference between the two sides (P < 0.05). None of the potential predictors were found to significantly affect the success or survival of the transplanted tooth (TT). CONCLUSION The combination of extraoral apicoectomy and retrograde filling in TT showed promising outcomes, but further clinical cases and longer follow-up times are still required to validate the treatment plan.
Collapse
Affiliation(s)
- Fenglin Liao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hui Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jihong Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Biao Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Endodontics,School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Haoyan Zhong
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| |
Collapse
|
10
|
Thanatipanont N, Louwakul P. Comparison of Marginal Adaptation, Surface Hardness and Bond Strength of Resected and Retrofilled Calcium Silicate-based Cements Used in Endodontic Surgery: An In Vitro Study. J Contemp Dent Pract 2023; 24:638-644. [PMID: 38152935 DOI: 10.5005/jp-journals-10024-3562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIMS This study compared the effects of orthograde and retrograde methods on marginal adaptation, surface hardness, and push-out bond strength (POBS) of three calcium silicate-based used in endodontic surgery. MATERIALS AND METHODS Ninety single-rooted human mandibular premolars were randomly assigned into six groups (n = 15/group): groups I and II, ProRoot mineral trioxide aggregate (MTA) with orthograde and retrograde methods; groups III and IV, Biodentine (BD) with orthograde and retrograde methods; groups V and VI, iRoot BP Plus (BP-RPM) with orthograde and retrograde methods. After obturation, the apical 3 mm of each root was sectioned into two 1-mm-thick root slices and evaluated for marginal adaptation using a scanning electron microscope, surface hardness using Vickers hardness tester and POBS using a universal testing machine. RESULTS Orthograde placement had a higher maximum gap width than retrograde placement (p < 0.05), but there was no significant difference among the tested materials (p > 0.05). Biodentine exhibited lower surface hardness than ProRoot MTA and iRoot BP Plus (p < 0.05), but there was no significant difference between ProRoot MTA and iRoot BP Plus (p > 0.05). Orthograde placement had higher POBS compared with retrograde placement (p < 0.05). Biodentine had higher POBS than iRoot BP Plus (p < 0.05), but no significant difference from ProRoot MTA (p > 0.05). The failure mode was mainly mixed for all the tested materials regardless of material type or placement technique. CONCLUSION The retrograde method had better marginal adaptation; however, the orthograde method provided better dislodgement resistance. Biodentine had lower surface hardness than MTA and iRoot BP Plus with both techniques, whereas iRoot BP Plus demonstrated lower dislodging resistance than BD. CLINICAL SIGNIFICANCE The current findings suggest that orthograde technique, a simpler periapical surgery, with ProRoot MTA provides potentially better surface hardness and POBS than BD and iRoot BP Plus in single-canal teeth.
Collapse
Affiliation(s)
- Napassorn Thanatipanont
- Department of Restorative Dentistry and Periodontology, Division of Endodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand, https://orcid.org/0009-0008-3013-7362
| | - Phumisak Louwakul
- Department of Restorative Dentistry and Periodontology, Division of Endodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand, Phone: +66-53-944457, e-mail: , https://orcid.org/0000-0003-1776-6697
| |
Collapse
|
11
|
Modaresi J, Khademi A, Hemati H, Mokhtari F. Histological evaluation of ProRoot mineral trioxide aggregate and Cold ceramic as root-end filling materials in animal models. Dent Res J (Isfahan) 2023; 20:58. [PMID: 37388307 PMCID: PMC10300271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/20/2021] [Accepted: 06/25/2022] [Indexed: 07/01/2023] Open
Abstract
Background This study aimed to evaluate the reaction of the periapical tissue to Cold ceramic and mineral trioxide aggregate (MTA) following periapical endodontic surgery. Materials and Methods In this experimental study, a total of 12 mandibular first, second, and third premolars of two male dogs were selected. All procedures were performed under general anesthesia. The access cavities were prepared, and the length of canals was determined. Root canal treatment was performed. A week later, periradicular surgery was performed. After osteotomy, 3 mm of the root end was cut. Then, a 3-mm cavity was created by an ultrasonic. The teeth were randomly divided into two groups (n = 12). The root-end cavities were filled with MTA in the first group and with Cold ceramic in the second group. After 4 months, the animals were scarified. Histological evaluation of the periapical tissues was performed. Data were analyzed using SPSS 22 and Chi-square test and P = 0.05. Results The findings showed 87.5% and 58.3% cementum formation in MTA and Cold ceramic groups, respectively, indicating a significant difference (P < 0.001). In addition, the results showed 91.7% and 83.3% bone formation in MTA and Cold ceramic groups, respectively, but the difference was not statistically significant (P = 0.6). Furthermore, the findings revealed 87.5% and 58.3% periodontal ligament (PDL) formation in MTA and Cold ceramic groups, respectively (P = 0.05). Conclusion Cold ceramic was able to induce the regeneration of cementum, bone, and PDL; hence, it can be considered as a biocompatible root-end filling material in endodontic surgery.
Collapse
Affiliation(s)
- Jalil Modaresi
- Department of Endodontics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abbasali Khademi
- Department of Endodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Hemati
- Department of Endodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Mokhtari
- Department of Endodontics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
12
|
Garg M, Srivastava V, Chauhan R, Pramanik S, Khanna R. Application of platelet-rich fibrin and freeze-dried bone allograft following apicoectomy: A comparative assessment of radiographic healing. Indian J Dent Res 2023; 34:40-44. [PMID: 37417055 DOI: 10.4103/ijdr.ijdr_810_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
Background Apicoectomy conceptualizes surgically maintaining a tooth with an endodontic lesion that cannot be resolved by conventional endodontic (re-) treatment. To achieve this, continuous improvement in surgical techniques, materials and instruments is being done to enhance the outcome of periapical endodontic surgeries. The purpose of this study was to compare, radiographically, the healing kinetics of platelet-rich fibrin (PRF) and mineralized freeze-dried bone allograft (FDBA) in patients undergoing apicoectomy. Materials and Methods Nineteen patients (aged 18-40 years) were included in the study and randomly assigned to groups A or B, where they received PRF or FDBA, respectively. Following apicoectomy, PRF gel and FDBA graft were prepared and placed in the osseous defect followed by placement of PRF membrane for graft stabilization and flap closure. Radiographic follow-up was done at the 1st, 3rd, 6th and 12th months for evaluation of healing using Molven's criteria. Statistical analysis was done with Pearson's and McNemar's Chi-square tests. Results A highly significant difference (P = 0.002) in radiographic healing was observed at 6 months. Complete healing was observed in 50% of cases in Group A whereas in Group B, none of the cases presented with complete radiographic healing. However, at the end of 12 months, complete radiographic healing was observed in both groups. Conclusion Our data suggest that PRF accelerates bone healing as compared to FDBA and is both time and cost-efficient.
Collapse
Affiliation(s)
- Madhur Garg
- Department of Conservative Dentistry and Endodontics, Vardaan Dental Clinic, Jabalpur, Madhya Pradesh, India
| | - Vipul Srivastava
- Department of Conservative Dentistry and Endodontics, 32 Pearls Multi-Speciality Dental Clinic, Lucknow, Uttar Pradesh, India
| | - Raju Chauhan
- Department of Conservative Dentistry and Endodontics, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Saurabh Pramanik
- Department of Department of Pediatric and Preventive Dentistry, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
| | - Rinee Khanna
- Department of Pediatric and Preventive Dentistry, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
| |
Collapse
|
13
|
Lu YJ, Chiu LH, Tsai LY, Fang CY. Dynamic navigation optimizes endodontic microsurgery in an anatomically challenging area. J Dent Sci 2022; 17:580-582. [PMID: 35028089 PMCID: PMC8739741 DOI: 10.1016/j.jds.2021.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/08/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
- Yi-Jung Lu
- Division of Endodontics, Department of Dentistry, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Liang-Han Chiu
- Division of Endodontics, Department of Dentistry, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Liang-Yi Tsai
- Division of Endodontics, Department of Dentistry, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chih-Yuan Fang
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.,School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
14
|
Feli M, Taheri A, Raeesi P, Mashhadi Abbas F, Alam M. Conservative Management of Periapical Cementoblastoma: A Case Report. Iran Endod J 2022; 17:151-155. [PMID: 36704082 PMCID: PMC9869013 DOI: 10.22037/iej.v17i3.37470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/02/2022] [Accepted: 07/20/2022] [Indexed: 01/28/2023]
Abstract
As a rare ectomesenchymal neoplasm, benign cementoblastoma comprises less than 6% of all odontogenic tumors. The typical treatment plan involves surgical excision and extraction of the affected tooth. Limited evidence, however, suggests the conservative management of this condition as the best treatment. This article discusses the case of a 32-year-old man who had benign cementoblastoma and underwent conservative treatment. The diagnosis was established based on clinical and radiological features analyses. Root canal therapy was performed on the tooth, followed by enucleation, curettage, apicoectomy, and guided bone regeneration (GBR) 30 days later. After a year of follow-up, there was no recurrence, and the tooth was in healthy conditions. These findings demonstrated that the tooth affected by cementoblastoma can be saved. It was treated conservatively to preserve the patient's oral health and masticatory function.
Collapse
Affiliation(s)
- Mojgan Feli
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | - Anita Taheri
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | - Pooya Raeesi
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | - Fatemeh Mashhadi Abbas
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | - Mostafa Alam
- Department of Oral and Maxillofacial surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding author: Mostafa Alam, Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-912 6409330, E-mail:
| |
Collapse
|
15
|
Sumangali A, Tiwari RVC, Kollipara J, Mirza MB, Brar RS, Dhewale AM. Various Assisted Bone Regeneration in Apicectomy Defects Systematic Review and Meta Analysis. J Pharm Bioallied Sci 2021; 13:S927-S932. [PMID: 35017900 PMCID: PMC8686878 DOI: 10.4103/jpbs.jpbs_375_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/15/2021] [Accepted: 05/21/2021] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION In the endodontic surgery, the common applications are the procedures that apply regenerative methods. There are various methods that help in the regeneration after the endodontic root end cutting or apicectomy. The outcome of the apicectomy depends on the procedure and the material. Hence in the present study, we intend to conduct the systemic review and meta-analysis of the various assisted bone regeneration in apicectomy defects. MATERIALS AND METHODS The study was conducted by the online search of the data that included the studies for the regenerative procedure in the endodontic surgery in patients with various periapical pathologies. The data search engines were Scopus, Web of Science, Google Scholar, and PubMed. The risk of the bias was calculated. The study participants were divided into case and control groups. Case group had undergone the regenerative surgery for the persistent periapical lesions, while the control group had not undergone the regenerative surgery for the persistent periapical l. The clinical and the radiograph outcomes were compared between the control and the case groups. Meta-analysis was done and the subgroups were evaluated. RESULTS From a total of 1561 articles, only 11 were finalized for the study to conduct the meta-analysis. The bias was noted for majority of the studies most of which were clinical trials. It was observed that the regenerative methods used in the endodontic surgery have significantly improved the outcome. The application of the expanded polytetrafluoroethylene only has no significant effect; however, application of the autologous platelet concentrates or collagen membranes only had good outcomes. The combination of the materials showed a significant outcome than when applied alone. CONCLUSIONS From this meta-analysis, it is evident that regenerative procedures are beneficial in the endodontic apicectomy procedures. The materials used in these procedures will augment the outcome. A better prognosis is expected if the combination of the materials is used.
Collapse
Affiliation(s)
- Ananad Sumangali
- Department of Endodontics, Sebha Dental College, University of Sebha, Sebha, Libya, North Africa,Address for correspondence: Dr. Ananad Sumangali, Endodontist, Associate Professor, Sebha Dental College, University of Sebha, Sebha, Libya. E-mail:
| | - Rahul V. C. Tiwari
- Department of OMFS, Narsinbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
| | | | - Mubashir Baig Mirza
- Department of Conservative Dental Science, College of Dentistry, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Rajwinder Singh Brar
- Department of Orthodontics, Rayat Bahra Dental College, SAS Nagar, Punjab, India
| | - Akshay M. Dhewale
- Department of Conservative Dentistry and Endodontics, VYWS Dental College and Hospital, Amravati, Maharashtra, India
| |
Collapse
|
16
|
Nagy E, Braunitzer G, Gryschka DG, Barrak I, Antal MA. Accuracy of digitally planned, guided apicoectomy with a conventional trephine and a custom-made endodontic trephine: An in vitro comparative study. J Stomatol Oral Maxillofac Surg 2021; 123:388-394. [PMID: 34601166 DOI: 10.1016/j.jormas.2021.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/27/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Static guided trephine apicoectomy has been developed as a less invasive and more accurate alternative to conventional freehand apicoectomy with drills. Overpenetration is a frequent issue with this procedure, which deteriorates accuracy and raises safety concerns. A safety improvement to address this problem is presented. MATERIALS AND METHODS Guided apicoectomies were performed in porcine mandibles with either a conventional bone trephine or a custom-made endo-trephine with built-in depth control. The deviation of the apical endpoint of the trephine from the digital surgical plan was analyzed. Overpenetration frequency was recorded. RESULTS Procedures performed with the custom trephine were significantly more accurate both along the x-axis and globally, but no significant difference was found for the y and z axes. Overpenetration frequency was 70% in the conventional trephine group versus 38% in the stop trephine group. CONCLUSION The results indicate that the lack of physical depth control can interfere with the accuracy (and safety) of these procedures to a significant extent, as visual cues (such as the depth markings on a conventional trephine) are insufficient to prevent overpenetration. Our results show that custom-made trephines with a built-in stop offer an optimal solution for this problem.
Collapse
Affiliation(s)
- Eszter Nagy
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | | | - Dániel Gerhard Gryschka
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Ibrahim Barrak
- Faculty of Medicine, Department of Oral and Maxillofacial Surgery, University of Szeged, Szeged, Hungary
| | - Mark Adam Antal
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary; Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE.
| |
Collapse
|
17
|
Alroomy R. Apical fenestration in endodontically treated teeth: A report of two cases. Niger J Clin Pract 2021; 24:1092-1095. [PMID: 34290189 DOI: 10.4103/njcp.njcp_473_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Root canal therapy in teeth with root fenestrations can present with pain on apical palpation or persistent pain. The signs and symptoms of root fenestration in the absence of mucosal fenestration may be misleading, which may be misdiagnosed as non-odontogenic pain. Although CBCT is superior to periapical radiographs for the diagnosis of root fenestration, it failed to detect the intact cortical plate in the middle third in our cases. Therefore, the type was different in CBCT from its actual size surgically. Repeated non-surgical root canal treatment would not alleviate pain in the presence of root fenestration and may lead to apical root fracture. Root-resection relieves pain, unless the fenestration is accompanied by fracture. The aim of these two case reports was to describe the diagnosis and treatment of endodontically treated teeth with a persistent pain. Also, the difference of root fenestration type between CBCT and its actual size was described.
Collapse
Affiliation(s)
- R Alroomy
- Department of Restorative Dental Sciences, College of Dentistry, Majmaah University, AlMajmaah, Saudi Arabia
| |
Collapse
|
18
|
Taschieri S, Gambarini G, Makeeva I, Tarasenko S, Corbella S. Persistence of postoperative pain due to extrusion of endodontic obturator plastic carrier: A report of two cases treated with a periradicular microsurgical approach. Dent Res J (Isfahan) 2021; 18:34. [PMID: 34322210 DOI: pmid/34322210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/26/2020] [Accepted: 03/05/2020] [Indexed: 12/03/2022] Open
Abstract
The aim of the present study was to describe two clinical cases showing postoperative pain associated with the use of plastic carrier obturation system and apical bone fenestration. The patients were treated by surgical access and apicoectomy through a modern technique (using magnification and microsurgical approach), thus removing the direct contact between obturation material and submucosal connective tissue. The surgical interventions were carried on without the occurrence of any complication. Postsurgical adverse sequelae were negligible. After few weeks from the surgery, all symptoms disappeared. Radiographic healing was observed after 48 months. The presence of apical bone fenestration could be the cause of persistent pain after root canal treatment. The contact between plastic carrier and submucosal connective tissue could be the direct cause of spontaneous pain even in absence of periapical infection. Since the clinical diagnosis could be difficult, the use of tridimensional radiology could be justified. Surgical approach, by the removal of the contact between the carrier and connective tissues, can be considered a viable option to treat these particular affections.
Collapse
Affiliation(s)
- Silvio Taschieri
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Italy.,Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Gianluca Gambarini
- Department of Dental and Maxillofacial Sciences, Università Sapienza di Roma, Rome, Italy
| | - Irina Makeeva
- Department of Therapeutic Dentistry, Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Svetlana Tarasenko
- Oral Surgery, Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Stefano Corbella
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Italy.,Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Oral Surgery, Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| |
Collapse
|
19
|
Jamal S, Gul M, Khan FR, Ghafoor R. Effect of full sulcular versus papilla-sparing flap on periodontal parameters in periradicular surgeries: A systematic review and meta-analysis. J Indian Soc Periodontol 2021; 25:186-192. [PMID: 34158683 PMCID: PMC8177167 DOI: 10.4103/jisp.jisp_290_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 11/29/2020] [Accepted: 12/19/2020] [Indexed: 11/15/2022] Open
Abstract
Background: Access to apical root canal system is gained after flap elevation using various incision techniques. Soft-tissue healing after periradicular surgery may include gingival recession, papilla recession, changes in probing depth, and clinical attachment loss. Objective: The objective of this study was to compare the effect of full sulcular flap design versus papilla-sparing flap design on the periodontal parameters in periradicular surgeries. Materials and Methods: It was a systematic review and meta-analysis. Electronic and manual searches were conducted in multiple databases including PubMed, Dental and Oral Sciences, Cochrane, and CINAHL Plus until May 2019. Initial search yielded 2575 studies with 5 articles meeting the inclusion criteria. The primary outcomes assessed were gingival recession and change in the papilla height. The secondary outcomes evaluated were probing depth, clinical attachment loss, postoperative pain, bleeding, and discomfort. Random-effects model was employed for computation of effect size, and forest plots were made. Results: Out of the five articles that satisfied the inclusion criteria, three were randomized control trials and two were nonrandom trials. No significant differences were found in the gingival recession (P = 0.79), papilla height (P = 0.55), gingival bleeding, and plaque indices. Statistically significant differences in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004) were observed for the two flap designs in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004). Conclusions: The present systematic review and meta-analysis showed that probing depth and attachment loss are affected by the choice of flap design. On the other hand, gingival recession and papilla height are not influenced by the type of incision. However, finding of the present review may change if more studies on this topic will be included in the future. Therefore, more clinical trials with long-term follow-ups are needed.
Collapse
Affiliation(s)
- Shizrah Jamal
- Department of Surgery, Section of Dentistry, JHS Building, Aga Khan University Hospital, Karachi, Pakistan
| | - Meisha Gul
- Department of Paediatric/Operative Dentistry, Bahria University Medical and Dental College, Karachi, Pakistan
| | - Farhan Raza Khan
- Department of Surgery, Section of Dentistry, JHS Building, Aga Khan University Hospital, Karachi, Pakistan
| | - Robia Ghafoor
- Department of Surgery, Section of Dentistry, JHS Building, Aga Khan University Hospital, Karachi, Pakistan
| |
Collapse
|
20
|
Karwa SS, Shiggaon LB, Waghmare AS, Dhavan MA. A regenerative approach using xenograft and PRF membrane in the management of muscosal fenestration in posterior maxilla - A rare case report. J Indian Soc Periodontol 2021; 25:171-175. [PMID: 33888952 PMCID: PMC8041070 DOI: 10.4103/jisp.jisp_224_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/29/2019] [Accepted: 12/29/2019] [Indexed: 11/16/2022] Open
Abstract
Mucosal fenestration is a rare entity wherein apex of the tooth is exposed in the oral cavity due to breakdown of the overlying bone and mucosa. This leads to accumulation of plaque and if left untreated can hamper the further prognosis of the tooth. Although there are few evidences regarding mucosal fenestrations in posterior region of maxilla, treatment of the same have been challenging for the clinicians. This case report describes the management of mucosal fenestrations in the posterior maxilla by regenerative periodontal flap surgical approach using xenograft (Osseograft) and platelet-rich fibrin membrane.
Collapse
Affiliation(s)
| | | | | | - Mayur Ashok Dhavan
- Department of Periodontics, ACPM Dental College, Dhule, Maharashtra, India
| |
Collapse
|
21
|
Kopacz M, Neal JJ, Suffridge C, Webb TD, Mathys J, Brooks D, Ringler G. A Clinical Evaluation of Cone-beam Computed Tomography: Implications for Endodontic Microsurgery. J Endod 2021; 47:895-901. [PMID: 33798543 DOI: 10.1016/j.joen.2021.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/05/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Cone-beam computed tomographic (CBCT) imaging is a valuable diagnostic tool for endodontics. Some studies report that CBCT images have limitations in representing the true clinical presentation. This prospective, in vivo study compared limited field of view (LFOV) CBCT measurements with clinical measurements made during endodontic surgery. METHODS Eighty-seven subjects requiring endodontic surgery and LFOV CBCT acquisition of the surgical site were enrolled. Data collection involved clinicians answering standardized questions during the radiographic and surgical assessment. Intraoperatively, data were collected and photographically documented. Postoperatively, CBCT scans were evaluated by 3 calibrated, board-certified specialists: 2 endodontists and 1 oral and maxillofacial radiologist. The 2 subsets of data were compared through statistical analysis to quantify their relationship. RESULTS The subjects included 65 maxillary and 29 mandibular teeth from 87 subjects: 25 women and 62 men with an average age of 42 years old. The CBCT evaluators correctly identified the presence or absence of buccal plate fenestrations with 91.0% accuracy (95% confidence interval, 83.1-96.0) with 89.4% sensitivity and 92.9% specificity. The area of fenestrations measured clinically (mean = 19.6 ± 33.4 mm2) was generally larger than the area measured by CBCT imaging (mean across CBCT evaluators = 12.2 ± 19.1 mm2). Fenestration size in the maxillary arch was more likely to be underestimated than in the mandibular arch (P < .0001). Vertical bone height was also underestimated when measured on CBCT imaging. CONCLUSIONS Based on the findings of this study, LFOV CBCT imaging accurately identifies the presence or absence of buccal plate fenestrations, yet, when a fenestration is present, underestimates its area.
Collapse
Affiliation(s)
- Molly Kopacz
- Department of Endodontics, Naval Postgraduate Dental School, Navy Medicine Professional Development Center, Bethesda, Maryland; Department of Uniformed Services, University of the Health Sciences, Bethesda, Maryland
| | - John J Neal
- Department of Endodontics, Naval Postgraduate Dental School, Navy Medicine Professional Development Center, Bethesda, Maryland; Department of Uniformed Services, University of the Health Sciences, Bethesda, Maryland.
| | - Calvin Suffridge
- Department of Endodontics, Naval Postgraduate Dental School, Navy Medicine Professional Development Center, Bethesda, Maryland; Department of Uniformed Services, University of the Health Sciences, Bethesda, Maryland
| | - Terry D Webb
- Department of Endodontics, Naval Postgraduate Dental School, Navy Medicine Professional Development Center, Bethesda, Maryland; Department of Uniformed Services, University of the Health Sciences, Bethesda, Maryland
| | - Jason Mathys
- Department of Endodontics, Naval Postgraduate Dental School, Navy Medicine Professional Development Center, Bethesda, Maryland; Department of Uniformed Services, University of the Health Sciences, Bethesda, Maryland
| | - Daniel Brooks
- Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Gregory Ringler
- Department of Uniformed Services, University of the Health Sciences, Bethesda, Maryland; Oral and Maxillofacial Radiology, Naval Postgraduate Dental School, Navy Medicine Professional Development Center, Bethesda, Maryland
| |
Collapse
|
22
|
Multiple Microsurgery Intervention with Apicoectomy Guidance in Single Session: A Case Report. Iran Endod J 2021; 16:193-7. [PMID: 36704394 DOI: 10.22037/iej.v16i3.30842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/24/2021] [Accepted: 06/10/2021] [Indexed: 01/28/2023]
Abstract
The aim of this manuscript is to describe and discuss the advantages and obstacles of using a guided implant system adapted for endodontic microsurgery in the execution of a case with indication of multiple endodontic microsurgery intervention in a single appointment. Cone-beam computed tomography (CBCT) scans were aligned and processed with the planning software, complementing the Straumann® guided instruments. The drill handles of the system employed directed milling cutters and guided drills based on the sleeve-in-sleeve concept used in the osteotomy and apical resection of teeth #13, #14, #23 and #24. The root-ends were retro-prepared and sealed with putty bioceramic sealer. The patient was completely asymptomatic at the 12 months follow up visit and CBCT revealed complete tissue healing of the involved teeth. The protocol demonstrated to be reliable and reproducible. Its applicability can be extended to other anatomical complex scenarios. The reproducibility of the technique would encourage the maintenance of teeth in patients with indication to multiple endodontic surgery and permitted the conclusion of this case with precision and comfort to both patient and operator.
Collapse
|
23
|
Raabe C, Bornstein MM, Ducommun J, Sendi P, von Arx T, Janner SFM. A retrospective analysis of autotransplanted teeth including an evaluation of a novel surgical technique. Clin Oral Investig 2020; 25:3513-3525. [PMID: 33263141 PMCID: PMC8137630 DOI: 10.1007/s00784-020-03673-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/29/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To assess survival rates and frequency of complications for immature and mature autotransplanted teeth after at least 1 year in function. MATERIALS AND METHODS All consecutive patients who had undergone tooth autotransplantation between 2000 and 2018 were invited to a clinical and radiographic follow-up examination. First, survival rates were calculated on the basis of a phone inquiry. A clinical follow-up examination allowed for the calculation of the success rate, i.e., absence of any potentially adverse clinical and radiographic findings of the autotransplanted teeth. Moreover, the effect of demographic, dental, and surgical variables on survival/success was analyzed statistically. RESULTS Thirty-eight teeth in 35 patients were transplanted during the study period. Three teeth in 3 patients were excluded due to missing records. All other patients were successfully contacted and interviewed by phone. Out of these 35 transplants, 32 were still in function, and 3 had been extracted, yielding a 91.4% survival probability after a median follow-up of 3.4 years. Of the 32 teeth qualifying for the success analysis, 20 (62.5%) showed absence of potentially adverse findings, while 3 (9.4%) required root canal treatment (RCT). Out of the 9 mature, root-end resected transplants, 4 exhibited ongoing pulp canal obliteration, all with a single root canal. Postoperative and potentially adverse findings or failures were found more frequently in the group of mature transplants (55.6%) than immature transplants (30.4%) and for molars (72.7%) than premolars (17.6%) or canines (25%). None of the potential predictors had a statistically significant effect on survival or success. CONCLUSION Autotransplanted teeth yielded a satisfying midterm survival rate regardless of their stage of development. An additional, extraoral root-end resection of mature transplants may lead to rates of revascularization and postoperative pulp canal obliteration higher than the data reported on unmodified mature transplants. CLINICAL RELEVANCE Extraoral root-end resection of mature teeth shows promising outcomes for transplants especially with a single root canal and uncomplicated root morphology.
Collapse
Affiliation(s)
- Clemens Raabe
- Department of Oral Surgery & Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel, University of Basel, Mattenstrasse 40, CH-4058, Basel, Switzerland
| | - Julien Ducommun
- Department of Oral Surgery & Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Pedram Sendi
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel, University of Basel, Mattenstrasse 40, CH-4058, Basel, Switzerland
| | - Thomas von Arx
- Department of Oral Surgery & Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Simone F M Janner
- Department of Oral Surgery & Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
| |
Collapse
|
24
|
Lieblich SE. Current Concepts of Periapical Surgery: 2020 Update. Oral Maxillofac Surg Clin North Am 2020; 32:571-582. [PMID: 32912776 DOI: 10.1016/j.coms.2020.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although conventional endodontic procedures are very successful, failure of the initial treatment can occur. Consideration for surgical treatment versus endodontic retreatment needs to be part of the decision along with thoughts of extraction with implant replacement. Apical surgery can preserve many teeth that remain symptomatic after conventional endodontic treatment especially because endodontic failure can occur after 1 year, usually after a definitive restoration is placed. This article reviews current indications for periapical surgery and discusses factors that can predict successful outcomes.
Collapse
Affiliation(s)
- Stuart E Lieblich
- Oral and Maxillofacial Surgery, University of Connecticut Health Center; Private Practice, Avon Oral, Facial and Dental Implant Surgery, 34 Dale Road, Suite 105, Avon, CT 06001, USA.
| |
Collapse
|
25
|
Hatzke MW, Daigle FC, Augsburger RA, Kesterke MJ, Jalali P. Retrograde Instrumentation of Surgically Resected Roots Using Controlled Memory Files: A Human Cadaver Study. J Endod 2020; 46:1317-1322. [PMID: 32553877 PMCID: PMC7295473 DOI: 10.1016/j.joen.2020.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/26/2020] [Accepted: 05/31/2020] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The purpose of this study is to evaluate the amount of residual obturation material of retroinstrumented surgically resected roots using controlled memory files and to evaluate the incidence of adverse treatment outcomes. METHODS Thirty maxillary anterior teeth in human cadavers were selected, and nonsurgical root canal treatment was performed on these teeth. A standardized 4-mm osteotomy and a 3-mm root resection with as close to 0° bevel as possible were made on each tooth. A microsurgical diamond tip was used to create a 1- to 2-mm starting point for each retropreparation. A 25/06 and 30/06 VTaper 2H were bent at about 90° angle to mimic the clinical and anatomic restrictions and used to create a retropreparation to a depth of 14 mm. Micro-computed tomography scans were taken and analyzed for volume and percentage of residual obturation material at 5 and 10 mm. In addition, the incidences of instrument separation and crack and ledge formation in the teeth were recorded. RESULTS The median volume of residual obturation at 5 and 10 mm was 0.18 mm3 (interquartile range, 0.36 mm3) and 1.97 mm3 (interquartile range, 1.99 mm3), respectively. The overall incidence of file separation during retropreparation was 13.33% (4/30). Among the cases analyzed with micro-computed tomography, none showed crack or ledge formation. CONCLUSIONS Retroinstrumentation of surgically resected roots using controlled memory files cleans the canal effectively with relatively low adverse treatment outcomes. Although this novel technique is limited in application, it is a safe and effective way to achieve a deep, clean retropreparation.
Collapse
Affiliation(s)
- Matthew W Hatzke
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Francesca C Daigle
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas
| | | | - Matthew J Kesterke
- Department of Biomedical Sciences, Texas A&M College of Dentistry, Dallas, Texas
| | - Poorya Jalali
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas.
| |
Collapse
|
26
|
Nepal M, Shubham S, Tripathi R, Khadka J, Kunwar D, Gautam V, Gautam N. Spectrophotometric analysis evaluating apical microleakage in retrograde filling using GIC, MTA and biodentine: an in-vitro study. BMC Oral Health 2020; 20:37. [PMID: 32013975 PMCID: PMC6998061 DOI: 10.1186/s12903-020-1025-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 01/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study compares the apical microleakage of three different root-end filling materials in which the retrograde cavity is prepared by two different burs. METHODS Eighty extracted single rooted maxillary and mandibular premolars were taken. Root canal treatment was completed. Apical 3 mm of all the teeth were resected with diamond disk. The tooth were divided into four groups with two subgroups for each group containing 10 tooth (N = 10) as: Group IA (Negative Control and IB (Positive Control); Group IIA and IIB: Prepared with round carbide bur and round diamond bur respectively, filled with GIC; Group IIIA and IIIB: Prepared with round carbide bur and round diamond bur respectively, filled with MTA; Group IVA and IVB: Prepared with round carbide bur and round diamond bur, filled with Biodentine. After applying two coats of nail varnish leaving apical 3 mm (except for negative control group) all teeth were immersed in 2% methylene blue for 3 days and again in 65% nitric acid for next 3 days for extraction of dye. The obtained solution was then transferred to eppendorf tube and centrifuged in microcentrifuges at 14,000 revolution per minutes (RPM) for 5 min. Optical density or absorbance of the supernatant solution was measured with UV spectrophotometer at 550 nm. RESULTS The absorbance of the supernatant solution after dye extraction is decreasing in the order of positive control> GIC > MTA > Biodentine> negative control group. The significant difference was observed between GIC and MTA (p = 0.0001) and GIC and Biodentine (p = 0.0001) with two different burs but statistically non-significant difference was observed between MTA and Biodentine with Carbide bur (p = 0.127) and Diamond bur (p = 0.496) respectively. CONCLUSIONS Within the limitations of the present study, it can be concluded that Biodentine and MTA showed less microleakage as compared to GIC. There is no significant difference between mean microleakage of MTA and Biodentine. However, the mean OD of the Biodentine was least of all evaluated materials. Preparation of the root-end using round carbide bur as well as round diamond burs showed comparable microleakage for all three filling materials.
Collapse
Affiliation(s)
- Manisha Nepal
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal.
| | - Snigdha Shubham
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Rupam Tripathi
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Jwolan Khadka
- Department of Conservative Dentistry and Endodontics, KIST Medical College, Lalitpur, Nepal
| | - Deepa Kunwar
- Department of Conservative Dentistry and Endodontics, Gandaki Medical College, Pokhara, Nepal
| | - Vanita Gautam
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Narayan Gautam
- Department of Biochemistry, Universal College of Medical Sciences, Bhairahawa, Nepal
| |
Collapse
|
27
|
Sutter E, Valdec S, Bichsel D, Wiedemeier D, Rücker M, Stadlinger B. Success rate 1 year after apical surgery: a retrospective analysis. Oral Maxillofac Surg 2020; 24:45-9. [PMID: 31758280 DOI: 10.1007/s10006-019-00815-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/04/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of the current study was the retrospective analysis of the outcomes of teeth treated with apical surgery after a 1-year follow-up period. Furthermore, potential factors associated with the success rate were investigated. METHODS All patients were treated at the Clinic of Cranio-Maxillofacial and Oral Surgery at the University of Zurich between 2010 and 2017. To be eligible for inclusion, all patients were required to have undergone apical surgery with a retrograde root-end filling, and a 1-year follow-up examination at the University of Zurich. Treatment success at the 1-year follow-up time-point was defined as an absence of clinical complaints and radiographically determined healing. Parameters that were analysed included tooth localisation, periapical index of the preoperative lesion, administration of antibiotics, smoker status, histopathology of the apical lesion, radiographically determined sufficiency of root canal treatment pain and clinical signs of inflammation at the initial examination. RESULTS A total of 81 teeth fulfilled all the inclusion criteria. At the 1-year follow-up, 91.4% of the teeth exhibited successful clinical and radiographic healing. The type of tooth was significantly associated with the success of the surgery (p = 0.006), but radiological severity of periapical inflammation, lesion histopathology, administration of antibiotics, smoker status, the quality of the root canal treatment, and preoperative pain and clinical signs of inflammation were not. CONCLUSION The results of the present study suggest that apical surgery with retrograde root-end filling is a reliable therapy for the preservation of teeth. Furthermore, there are limited factors that affect the treatment outcome.
Collapse
|
28
|
Kim JE, Shim JS, Shin Y. A new minimally invasive guided endodontic microsurgery by cone beam computed tomography and 3-dimensional printing technology. Restor Dent Endod 2019; 44:e29. [PMID: 31485425 PMCID: PMC6713074 DOI: 10.5395/rde.2019.44.e29] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 07/18/2019] [Accepted: 07/18/2019] [Indexed: 12/02/2022] Open
Abstract
Endodontic microsurgery is defined as the treatment performed on the root apices of an infected tooth, which was unresolved with conventional root canal therapy. Recently, the advanced technology in 3-dimensional model reconstruction based on computed tomography such as cone beam computed tomography has opened a new avenue in application of personalized, accurate diagnosis and has been increasingly used in the field of dentistry. Nevertheless, direct intra-oral localization of root apex based on the 3-dimensional information is extremely difficult and significant amount of bone removal is inevitable when freehand surgical procedure was employed. Moreover, gingival flap and alveolar bone fenestration are usually required, which leads to prolonged time of surgery, thereby increasing the chance of trauma as well as the risk of infection. The purpose of this case report is to present endodontic microsurgery using the guide template that can accurately target the position of apex for the treatment of an anterior tooth with calcified canal which was untreatable with conventional root canal therapy and unable to track the position of the apex due to the absence of fistula.
Collapse
Affiliation(s)
- Jong-Eun Kim
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - June-Sung Shim
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Yooseok Shin
- Department of Conservative Dentistry, Oral Science Research Center and Microscope Center, College of Dentistry, Yonsei University, Seoul, Korea
| |
Collapse
|
29
|
Fan Y, Glickman GN, Umorin M, Nair MK, Jalali P. A Novel Prefabricated Grid for Guided Endodontic Microsurgery. J Endod 2019; 45:606-610. [PMID: 30876703 DOI: 10.1016/j.joen.2019.01.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/07/2019] [Accepted: 01/17/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to introduce a novel method using cone-beam computed tomographic (CBCT) imaging and prefabricated grids to guide apical access during endodontic microsurgery and to compare its accuracy with that of the nonguided method. METHODS Forty-two roots from human cadaver jaws were selected. Twenty-one were randomly assigned to the experimental group (grid based) and their contralateral counterparts to the control group (nonguided). Preoperative CBCT images were used to design a drill path that intended to reach the palatal/lingual aspect of the roots without attempting to complete the osteotomy or to resect the entire root end. In the experimental group, prefabricated metal grids used during imaging and surgery acted as a reference in the design and drilling. Postoperative CBCT volumes were superimposed on the preoperative volumes, and the distances between the actual drill paths and the target points were measured. A dichotomized outcome of success versus failure was also recorded and compared. Statistical analysis was performed using the paired t test and Fisher exact test. RESULTS The mean deviation of the drill paths from the target points was 0.66 mm ± 0.54 mm (mean ± standard deviation) for grid-based drilling and 1.92 mm ± 1.05 mm (mean ± standard deviation) for nonguided drilling (P < .001). Grid-based drilling was on average 1.27 mm (95% confidence interval, 0.81-1.72 mm) closer to the target point than nonguided drilling. The probability of successful drilling was also significantly higher with grids than without grids (P = .02). CONCLUSIONS The proposed method of guided osteotomy and root-end resection using prefabricated grids was more accurate than the nonguided method.
Collapse
Affiliation(s)
- Yuehong Fan
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Gerald N Glickman
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Mikhail Umorin
- Department of Biomedical Sciences, Texas A&M College of Dentistry, Dallas, Texas
| | - Madhu K Nair
- Department of Diagnostic Sciences, Texas A&M College of Dentistry, Dallas, Texas
| | - Poorya Jalali
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas.
| |
Collapse
|
30
|
Kattimani VS, Lingamaneni KP. Natural bioceramics: our experience with changing perspectives in the reconstruction of maxillofacial skeleton. J Korean Assoc Oral Maxillofac Surg 2019; 45:34-42. [PMID: 30847295 PMCID: PMC6400697 DOI: 10.5125/jkaoms.2019.45.1.34] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/27/2018] [Accepted: 05/06/2018] [Indexed: 12/20/2022] Open
Abstract
Objectives Various bone graft substitute materials are used to enhance bone regeneration in the maxillofacial skeleton. In the recent past, synthetic graft materials have been produced using various synthetic and natural calcium precursors. Very recently, eggshell-derived hydroxyapatite (EHA) has been evaluated as a synthetic bone graft substitute. To assess bone regeneration using EHA in cystic and/or apicectomy defects of the jaws through clinical and radiographic evaluations. Materials and Methods A total of 20 patients were enrolled in the study protocol (CTRI/2014/12/005340) and were followed up at 4, 8, 12, and 24 weeks to assess the amount of osseous fill through digital radiographs/cone-beam computed tomography along with clinical parameters and complications. Wilcoxon matched pairs test, means, percentages and standard deviations were used for the statistical analysis. Results The sizes of the lesions in the study ranged from 1 to 4 cm and involved one to four teeth. The study showed significant changes in the formation of bone, the merging of material and the surgical site margins from the first week to the first month in all patients (age range, 15-50 years) irrespective of the size of the lesions and the number of teeth involved. Bone formation was statistically significant from the fourth to the eighth week, and the trabecular pattern was observed by the end of 12 weeks with uneventful wound healing. Conclusion EHA showed enhancement of bone regeneration, and healing was complete by the end of 12 weeks with a trabecular pattern in all patients irrespective of the size of the lesion involved. The study showed enhancement of bone regeneration in the early bone formative stage within 12 weeks after grafting. EHA is cost effective and production is environment friendly with no disease transfer risks. Thus, natural bioceramics will play an important role in the reduction of costs involved in grafting and reconstruction.
Collapse
|
31
|
Beck-Broichsitter BE, Schmid H, Busch HP, Wiltfang J, Becker ST. Long-term survival of teeth in the posterior region after apical surgery. J Craniomaxillofac Surg 2018; 46:1934-8. [PMID: 30249486 DOI: 10.1016/j.jcms.2018.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/08/2018] [Accepted: 08/08/2018] [Indexed: 11/24/2022] Open
Abstract
Oftentimes the discussion of long-term success rates and treatment modalities becomes a central issue in consultations with patients. The aim of this study was to retrospectively evaluate survival rates of teeth after apicoectomy in an established private practice for Oral and Maxillofacial Surgery in Kiel, Germany. All teeth treated with apicoectomy between 2001 and 2006 were included. Treatment success was previously defined as preservation of the tooth. Putative influence factors on success as kind and quality of endodontic treatment, additional intraoperative endodontic filling, inflammatory status, tooth mobility, and pre- and postoperative X-rays were further evaluated. A total of 149 teeth could be included. The mean observation period was 6.3 (SD: 4.4) years. In all, 48.3% of these teeth could be retained after a 10-year period. Teeth that received an additional retrograde root canal filling during surgery resulted in a significantly higher success rate (p = 0.0237) compared to those with orthograde root canal fillings or without additional endodontic treatment. The quality of endodontic treatment had no impact (p = 0.125). Our results suggest that apical surgery is a reliable procedure to treat and ensure the survival of symptomatic teeth in the posterior region for several years. A significant improvement was further determined for a retrograde filling.
Collapse
|
32
|
Torul D, Kurt S, Kamberoglu K. Apical surgery failures: Extraction or re-surgery? Report of five cases. J Dent Res Dent Clin Dent Prospects 2018; 12:116-119. [PMID: 30087762 PMCID: PMC6076882 DOI: 10.15171/joddd.2018.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 05/19/2018] [Indexed: 11/24/2022] Open
Abstract
Apical surgery (AS) is considered as the last attempt to save teeth which cannot be treated with conventional endodontic approach. The main goal of apical surgery is to create a barrier between the root-canal system and the peri-radicular tissues by means of a tight root-end filling after resection. However, failures in this treatment is usually result with tooth loss. In such cases surgical re-treatment would take into consideration as viable alternative. In this case series, successful ARs that performed in ten teeth of five patients who applied for extraction after an unsuccessful apical surgery, were presented. It is pointed that if appropriate surgical and endodontic intervention is performed and adequate apical obturation is provided with retrograde filling, teeth can be treat without extraction.
Collapse
Affiliation(s)
- Damla Torul
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
| | - Sevda Kurt
- Department of Periodontology, Recep Tayyip Erdoğan University, Rize, Turkey
| | | |
Collapse
|
33
|
Akbulut MB, Arpaci PU, Eldeniz AU. Effects of four novel root-end filling materials on the viability of periodontal ligament fibroblasts. Restor Dent Endod 2018; 43:e24. [PMID: 30135845 PMCID: PMC6103538 DOI: 10.5395/rde.2018.43.e24] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 03/24/2018] [Indexed: 11/22/2022] Open
Abstract
Objectives The aim of this in vitro study was to evaluate the biocompatibility of newly proposed root-end filling materials, Biodentine, Micro-Mega mineral trioxide aggregate (MM-MTA), polymethylmethacrylate (PMMA) bone cement, and Smart Dentin Replacement (SDR), in comparison with contemporary root-end filling materials, intermediate restorative material (IRM), Dyract compomer, ProRoot MTA (PMTA), and Vitrebond, using human periodontal ligament (hPDL) fibroblasts. Materials and Methods Ten discs from each material were fabricated in sterile Teflon molds and 24-hour eluates were obtained from each root-end filling material in cell culture media after 1- or 3-day setting. hPDL fibroblasts were plated at a density of 5 × 103/well, and were incubated for 24 hours with 1:1, 1:2, 1:4, and 1:8 dilutions of eluates. Cell viability was evaluated by XTT assay. Data was statistically analysed. Apoptotic/necrotic activity of PDL cells exposed to material eluates was established by flow cytometry. Results The Vitrebond and IRM were significantly more cytotoxic than the other root-end filling materials (p < 0.05). Those cells exposed to the Biodentine and Dyract compomer eluates showed the highest survival rates (p < 0.05), while the PMTA, MM-MTA, SDR, and PMMA groups exhibited similar cell viabilities. Three-day samples were more cytotoxic than 1-day samples (p < 0.05). Eluates from the cements at 1:1 dilution were significantly more cytotoxic (p < 0.05). Vitrebond induced cell necrosis as indicated by flow cytometry. Conclusions This in vitro study demonstrated that Biodentine and Compomer were more biocompatible than the other root-end filling materials. Vitrebond eluate caused necrotic cell death.
Collapse
Affiliation(s)
- Makbule Bilge Akbulut
- Department of Endodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Pembegul Uyar Arpaci
- Department of Biotechnology, Faculty of Science, Selcuk University, Konya, Turkey
| | - Ayce Unverdi Eldeniz
- Department of Endodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
| |
Collapse
|
34
|
Kohli MR, Berenji H, Setzer FC, Lee SM, Karabucak B. Outcome of Endodontic Surgery: A Meta-analysis of the Literature-Part 3: Comparison of Endodontic Microsurgical Techniques with 2 Different Root-end Filling Materials. J Endod 2018; 44:923-31. [PMID: 29681480 DOI: 10.1016/j.joen.2018.02.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/17/2018] [Accepted: 02/19/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The aim of the present study was to investigate the influence of root-end preparation and filling material on endodontic surgery outcome. A systematic review and meta-analysis was conducted to determine the outcome of resin-based endodontic surgery (RES, the use of high-magnification preparation of a shallow and concave root-end cavity and bonded resin-based root-end filling material) versus endodontic microsurgery (EMS, the use of high-magnification ultrasonic root-end preparation and root-end filling with SuperEBA [Keystone Industries, Gibbstown, NJ], IRM [Dentsply Sirona, York, PA], mineral trioxide aggregate [MTA], or other calcium silicate cements). METHODS An exhaustive literature search was conducted to identify prognostic studies on the outcome of root-end surgery. Human studies conducted from 1966 to the end of December 2016 in 5 different languages (ie, English, French, German, Italian, and Spanish) were searched in 4 electronic databases (ie, Medline, Embase, PubMed, and Cochrane Library). Relevant review articles on the subject were scrutinized for cross-references. In addition, 5 dental and medical journals (Journal of Endodontics; International Endodontic Journal; Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics; Journal of Oral and Maxillofacial Surgery; and International Journal of Oral and Maxillofacial Surgery) were hand checked dating back to 1975. All abstracts were screened by 3 independent reviewers (H.B., M.K., and F.S.). Strict inclusion-exclusion criteria were defined to identify relevant articles. Raw data were extracted from the full-text review of these selected articles independently by each of the 3 reviewers. In case of disagreement, an agreement was reached by discussion, and qualifying articles were assigned to group RES. For EMS, the same search strategy was performed for the time frame October 2009 to December 2016, whereas up to October 2009 the data were obtained from a previous systematic review with identical criteria and search strategy. Weighted pooled success rates and a relative risk assessment between RES and EMS were calculated. To make a comparison between groups, a random effects model was used. RESULTS Sixty-eight articles were eligible for full-text review. Of these, per strict inclusion exclusion criteria, 14 studies qualified, 3 for RES (n = 862) and 11 for EMS (n = 915). Weighted pooled success rates for RES were 82.20% (95% confidence interval [CI], 0.7965-0.8476) and 94.42% for EMS (95% CI, 0.9295-0.9590). This difference was statistically significant (P < .0005). CONCLUSIONS The probability for success for EMS proved to be significantly greater than the probability for success for RES, providing best available evidence on the influence of cavity preparation with ultrasonic tips and/or SuperEBA (Keystone Industries, Gibbstown, NJ), IRM (Dentsply Sirona, York, PA), MTA, or silicate cements as root-end filling material instead of a shallow cavity preparation and placement of a resin-based material. Additional large-scale randomized clinical trials are needed to assess other predictors of outcome.
Collapse
|
35
|
Abstract
This case report presents the successful surgical treatment of a symptomatic open apex upper central incisor with a failed overfilled mineral trioxide aggregate (MTA) apical plug. Unintentional overextension of the MTA had occurred two years before the initial visit. An apical lesion adjacent to the excess MTA was radiographically detectable. Endodontic surgery was performed using calcium-enriched mixture (CEM) cement as a root-end filling material. Curettage of the apical lesion showed a mass of unset MTA particles; histopathological examination revealed fragments of MTA and granulation tissues. Up to 18-month follow-up, the tooth was clinically asymptomatic and fully functional. Periapical radiograph and CBCT images showed a normal periodontal ligament around the root. In conclusion, favorable outcomes in this case study suggested that root-end filling with CEM cement might be an appropriate approach; in addition, however many factors probably related to the initial failure of the case, the extrusion of MTA into the periapical area should be avoided.
Collapse
Affiliation(s)
- Saeed Asgary
- Iranian Center For Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Fayazi
- The University of Texas Health Science Center at San Antonio, Texas, USA
| |
Collapse
|
36
|
Dawson VS, Isberg PE, Kvist T, Fransson H; EndoReCo. Further Treatments of Root-filled Teeth in the Swedish Adult Population: A Comparison of Teeth Restored with Direct and Indirect Coronal Restorations. J Endod 2017; 43:1428-32. [PMID: 28673492 DOI: 10.1016/j.joen.2017.03.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 02/20/2017] [Accepted: 03/16/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the frequencies of nonsurgical retreatment, root-end surgery, extraction, and further restoration of root-filled teeth in Sweden in 2009 during a follow-up period of 5 years and to compare the outcomes in teeth restored with direct or indirect restorations. METHODS Data from the Swedish Social Insurance Agency were analyzed, and the frequencies of nonsurgical retreatment, root-end surgery, extractions, and further restoration were calculated for all teeth registered as root filled during 2009. Chi-square tests were applied to detect any significant differences in the frequency of further treatment in teeth registered as restored with either a direct or an indirect restoration within 6 months of root filling. RESULTS Of the 248,299 teeth reported root filled in Sweden in 2009, nonsurgical retreatment was registered in 2.2%, root-end surgery in 1.0%, and extractions in 9.2% during the follow-up period. Of the teeth restored with a direct restoration within 6 months after the root filling, 30.3% were registered as having undergone at least 1 further direct restoration; the corresponding percentage of teeth with indirect restorations was 6.4%. A statistically significant difference in the frequency of nonsurgical retreatment, extraction, and further restoration was found; teeth restored with an indirect restoration within 6 months of root filling had fewer of these treatments than those restored by direct restoration. CONCLUSIONS Low frequencies of nonsurgical retreatment and root-end surgery were reported 5 years after root filling, whereas extraction was more common. Fewer additional treatment procedures were registered for teeth with indirect restorations than for those with direct restorations.
Collapse
|
37
|
Schloss T, Sonntag D, Kohli MR, Setzer FC. A Comparison of 2- and 3-dimensional Healing Assessment after Endodontic Surgery Using Cone-beam Computed Tomographic Volumes or Periapical Radiographs. J Endod 2017; 43:1072-9. [PMID: 28527841 DOI: 10.1016/j.joen.2017.02.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/06/2017] [Accepted: 02/12/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The aim of this study was to compare the assessment of healing after endodontic microsurgery using 2-dimensional (2D) periapical films versus 3-dimensional (3D) cone-beam computed tomographic (CBCT) imaging. METHODS The healing of 51 teeth from 44 patients was evaluated using Molven's criteria (2D) and modified PENN 3D criteria. The absolute area (2D) and volume (3D) changes of apical lesions preoperatively and at follow-up were calculated by segmentation using OsiriX software (Pixmeo, Bernex, Switzerland) and ITK-Snap (free software). RESULTS There was a significant difference between the mean preoperative lesion volumes of 95.34 mm3 (n = 51, standard deviation [SD] ±196.28 mm3) versus 6.48 mm3 (n = 51, SD ±17.70 mm3) at follow-up (P < .05). The mean volume reduction was 83.7%. Preoperatively, mean lesion areas on periapical films were 13.55 mm2 (n = 51, SD ±18.80 mm2) and 1.83 mm2 (n = 51, SD ±.68 mm2) at follow-up (P < .05). According to Molven's criteria, 40 teeth were classified as complete healing, 7 as incomplete healing, and 4 as uncertain healing. Based on the modified PENN 3D criteria, 33 teeth were classified as complete healing, 14 as limited healing, 1 as uncertain healing, and 3 as unsatisfactory healing. The variation in the distribution of the 2D and 3D healing classifications was significantly different (P < .05). Periapical healing statuses incomplete healing or uncertain healing according to Molven's criteria could be clearly classified using 3D criteria. CONCLUSIONS CBCT analysis allowed a more precise evaluation of periapical lesions and healing of endodontic microsurgery than periapical films. Significant differences existed between the 2 methods. Over the observation period, the mean periapical lesion sizes significantly decreased in volume. Given the correct indications, the use of CBCT imaging may be a valuable tool for the evaluation of healing of endodontic surgery.
Collapse
|
38
|
Kumar Singh A, Saxena A. Treatment of Periradicular Bone Defect by Periosteal Pedicle Graft as a Barrier Membrane and Demineralized Freeze-Dried Bone Allograft. J Clin Diagn Res 2017; 11:ZD12-ZD14. [PMID: 28274066 DOI: 10.7860/jcdr/2017/22498.9161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 10/10/2016] [Indexed: 11/24/2022]
Abstract
The purpose of this case report is to describe the usefulness of Periosteal Pedicle Graft (PPG) as a barrier membrane and Demineralized Freeze-Dried Bone Allograft (DFDBA) for bone regeneration in periradicular bone defect. A patient with intraoral discharging sinus due to carious exposed pulp involvement was treated by PPG and DFDBA. Clinical and radiological evaluations were done immediately prior to surgery, three months, six months and one year after surgery. Patient was treated using split-thickness flap, PPG, apicoectomy, defect fill with DFDBA and lateral displacement along with suturing of the PPG prior to suturing the flap, in order to close the communication between the oral and the periapical surroundings through sinus tract opening. After one year, successful healing of periradicular bone defect was achieved. Thus, PPG as a barrier membrane and DFDBA have been shown to have the potential to stimulate bone formation when used in periradicular bone defect.
Collapse
Affiliation(s)
- Awadhesh Kumar Singh
- Professor, Department of Periodontology, Chandra Dental College and Hospital , Barabanki, Uttar Pradesh, India
| | - Anurag Saxena
- Junior Resident, Department of Periodontology, Chandra Dental College and Hospital , Barabanki, Uttar Pradesh, India
| |
Collapse
|
39
|
Abstract
Since the invention of laser, various applications for lasers in endodontics have been proposed, such as disinfection of the root canal system, canal shaping, pulp diagnosis, and apico-ectomy. One of the major applications of laser in endodontics is apicoectomy. The aim of this article is to review the benefits and drawbacks of laser applications in apicoectomy, including effect on apical seal, effect on dentin permeability, effect on postsurgery pain, effect on crack formation, effect on root-end morphology, effect on treatment outcome, and connective tissue response to laser-treated dentin.
Collapse
Affiliation(s)
- Zahed Mohammadi
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.,Iranian National Elite Foundation, Tehran, Islamic Republic of Iran
| | - Hamid Jafarzadeh
- Department of Endodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran, Phone: +985138829501, e-mail: /
| | | | - Jun-Ichiro Kinoshita
- Department of Conservative Dentistry, Showa University Dental Hospital, Tokyo, Japan
| | | |
Collapse
|
40
|
Costa BC, de Oliveira GJPL, Chaves MDGAM, da Costa RR, Gabrielli MFR, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Surgical treatment of cementoblastoma associated with apicoectomy and endodontic therapy: Case report. World J Clin Cases 2016; 4:290-295. [PMID: 27672646 PMCID: PMC5018628 DOI: 10.12998/wjcc.v4.i9.290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 05/31/2016] [Accepted: 07/13/2016] [Indexed: 02/05/2023] Open
Abstract
This case report describes the surgical removal of cementoblastoma associated with apicoectomy and endodontic therapy. The patient, an 18-year-old man, presented pain in the region of the mandibular body on the right side. On clinical exam, bone expansion was observed in the region at the bottom of the vestibular sulcus, pain on palpation, slight extrusion of tooth 46 with presence of pulp vitality. Radiographic exams demonstrated the presence of a radiopaque area and discrete radiolucent halo associated with the root of tooth 46, suggesting the diagnosis of cementoblastoma. Endodontic treatment of tooth 46 was performed and exeresis of the lesion by apicoectomy. Twelve months after the first surgery, recurrence of the lesion was observed, and a new apicoectomy was necessary, this time up to the middle third of the root. Clinical radiographic control 12 mo after the second surgical intervention demonstrated absence of signs and symptoms, radiographic repair, with tooth 46 shown to be fully functional.
Collapse
|
41
|
Kim D, Ha JH, Jin MU, Kim YK, Kim SK. Proximity of the mandibular molar root apex from the buccal bone surface: a cone-beam computed tomographic study. Restor Dent Endod 2016; 41:182-8. [PMID: 27508159 PMCID: PMC4977348 DOI: 10.5395/rde.2016.41.3.182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 05/17/2016] [Indexed: 11/24/2022] Open
Abstract
Objectives The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery. Materials and Methods Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT. Results The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01). Conclusions For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration.
Collapse
Affiliation(s)
- Dokyung Kim
- Department of Conservative Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Jung-Hong Ha
- Department of Conservative Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Myoung-Uk Jin
- Department of Conservative Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Young-Kyung Kim
- Department of Conservative Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Sung Kyo Kim
- Department of Conservative Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
| |
Collapse
|
42
|
Hirsch V, Kohli MR, Kim S. Apicoectomy of maxillary anterior teeth through a piezoelectric bony-window osteotomy: two case reports introducing a new technique to preserve cortical bone. Restor Dent Endod 2016; 41:310-315. [PMID: 27847753 PMCID: PMC5107433 DOI: 10.5395/rde.2016.41.4.310] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/27/2016] [Indexed: 12/20/2022] Open
Abstract
Two case reports describing a new technique of creating a repositionable piezoelectric bony window osteotomy during apicoectomy in order to preserve bone and act as an autologous graft for the surgical site are described. Endodontic microsurgery of anterior teeth with an intact cortical plate and large periapical lesion generally involves removal of a significant amount of healthy bone in order to enucleate the diseased tissue and manage root ends. In the reported cases, apicoectomy was performed on the lateral incisors of two patients. A piezoelectric device was used to create and elevate a bony window at the surgical site, instead of drilling and destroying bone while making an osteotomy with conventional burs. Routine microsurgical procedures - lesion enucleation, root-end resection, and filling - were carried out through this window preparation. The bony window was repositioned to the original site and the soft tissue sutured. The cases were re-evaluated clinically and radiographically after a period of 12 - 24 months. At follow-up, radiographic healing was observed. No additional grafting material was needed despite the extent of the lesions. The indication for this procedure is when teeth present with an intact or near-intact buccal cortical plate and a large apical lesion to preserve the bone and use it as an autologous graft.
Collapse
Affiliation(s)
- Viola Hirsch
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA.; Private Practice, Munich, Germany
| | - Meetu R Kohli
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| | - Syngcuk Kim
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| |
Collapse
|
43
|
Taschieri S, Del Fabbro M, Francetti L, Perondi I, Corbella S. Does the Papilla Preservation Flap Technique Induce Soft Tissue Modifications over Time in Endodontic Surgery Procedures? J Endod 2016; 42:1191-5. [PMID: 27291502 DOI: 10.1016/j.joen.2016.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/06/2016] [Accepted: 05/10/2016] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The aim of the present controlled clinical trial was to compare 2 incision techniques, papilla base incision (PBI) and sulcular incision (IS), evaluating changes in papilla and recession height over a 12-month period. METHODS A total of 24 subjects requiring endodontic surgery on a single tooth were enrolled. PBI was used in 1 group and IS in the other group. The primary outcomes were changes in gingival recession of the tooth affected by periapical lesions and the mesial and distal teeth and the mesial and distal papilla height using the treated tooth as the reference. Outcome variables were assessed at baseline and 12 months after the surgical intervention. Statistical analysis was performed by a blinded operator through appropriate tests, with significance set at a P value equal to .05. RESULTS In the PBI group, the papilla height at the 12-month follow-up in the mesial and distal aspect decreased 0.10 ± 0.32 mm and 0.10 ± 0.32 mm, respectively, and 0.23 ± 0.68 mm and 0.25 ± 0.40 mm, respectively, in the IS group without any significant differences. There were no differences found for recession change values between groups. CONCLUSIONS The PBI and IS approaches in endodontic surgery showed similar results in terms of papilla height preservation and recession changes.
Collapse
Affiliation(s)
- Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Isabella Perondi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
| |
Collapse
|
44
|
Jamshidi D, Moazami F, Sobhnamayan F, Taheri A. Clinical and Histopathologic Investigation of Periapical Actinomycosis with Cutaneous Lesion: a Case Report. J Dent (Shiraz) 2015; 16:286-90. [PMID: 26535411 PMCID: PMC4623829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Management of an extra-radicular infection is a challenging procedure that requires surgical intervention. This report describes a patient with discharging cutaneous lesion that required apical surgery. A 40-year-old woman was referred to the Department of Endodontics, Shiraz Dental School with chief complaint of a cutaneous sinus tract. She had been treated by a dermatologist and an otolaryngologist. The patient had also received orthograde root canal treatment of tooth #16. Yet, the lesion was still discharging and the patient was scheduled for surgery. Histopathologic analysis of the lesion showed actinomycosis infection. A 36-month follow-up revealed clinical and radiographic healing.
Collapse
Affiliation(s)
- Davood Jamshidi
- Dept. of Endodontics, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Fariborz Moazami
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fereshteh Sobhnamayan
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ali Taheri
- Dept. of Pathology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.
| |
Collapse
|
45
|
Mittal S, Kumar T, Mittal S, Sharma J. An innovative approach for rubber dam isolation of root end tip: A case report. J Conserv Dent 2015; 18:269-70. [PMID: 26069419 PMCID: PMC4450539 DOI: 10.4103/0972-0707.157271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 01/19/2015] [Accepted: 02/24/2015] [Indexed: 12/01/2022] Open
Abstract
The success of an apicoectomy with a retrofilling is dependent upon obtaining an acceptable apical seal. The placement of the variously approved retrograde materials requires adequate access, visibility, lighting, and a sterile dry environment. There are instances, however, in which it is difficult to use the rubber dam. One such instance is during retrograde filling. This case report highlights an innovative technique for rubber dam isolation of root end retrograde filling.
Collapse
Affiliation(s)
- Sunandan Mittal
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Tarun Kumar
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Shifali Mittal
- Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Jyotika Sharma
- Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| |
Collapse
|
46
|
Vidhale G, Jain D, Jain S, Godhane AV, Pawar GR. Management of Radicular Cyst Using Platelet-Rich Fibrin & Iliac Bone Graft - A Case Report. J Clin Diagn Res 2015; 9:ZD34-6. [PMID: 26266233 DOI: 10.7860/jcdr/2015/13368.6136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/11/2015] [Indexed: 02/02/2023]
Abstract
Radicular cyst is one of the most commonly occurring cyst in the oral cavity it is usually preceded by trauma or an infectious condition which is followed by enlargement. In recent times there are several treatment procedures that are being applied in order to improve the postoperative condition and to accelerate the process of healing and regeneration in the affected site. A 22-year-old patient reported to our OPD with the chief complaint of swelling on the left side of the face since 2-3 months, on investigating it was diagnosed as Radicular cyst which was initially treated by endodontic treatment of the involved tooth followed by enucleation of the cyst further an apicoectomy was done. Finally a PRF and iliac crest graft was placed for aesthetic rehabilitation with 21.
Collapse
Affiliation(s)
- Gaurav Vidhale
- Assistant Professor, Department of Oral Pathology and Microbiology, V.Y.W.S Dental College , Amravati, India
| | - Deepali Jain
- Senior Resident, Department of Dentistry, Chirayu Medical College and Hospital , Bhopal-Indore Road, Bhopal, India
| | - Sourabh Jain
- Assistant Professor, Department of Surgery, Chirayu Medical College and Hospital , Bhopal-Indore Road, Bhopal, India
| | - Alkesh Vijayrao Godhane
- Assistant Professor, Department of Pedodontics, Maitree Dental College and Research Centre , Durg, India
| | - Ganesh R Pawar
- Assistant Professor, Department of Periodontology, Vidharbh Youth Welfare Society Dental college & Hospital , Amravati, India
| |
Collapse
|
47
|
Abstract
The aim was to evaluate treatment outcomes after apicoectomy and apexification in adjacent non-vital maxillary central incisors with large periapical radiolucencies, in a 10-year-old boy. The patient had complained of tenderness in the upper central incisors on mastication and gave a history of trauma to those teeth three years ago. On examination, there were found to be non-vital. Apexification (using Metapex) and apicoectomy (obturation with gutta percha) were performed on 11 and 21, respectively. Radiographical observations were made six months, one year and two years, post-operatively. Apical repair was found to be more favorable after apicoectomy than apexification, for a non-vital maxillary central incisor with an open apex and large periapical radiolucency.
Collapse
Affiliation(s)
- Paul Chalakkal
- Lecturer, Department of Pedodontics & Preventive Dentistry, Goa Dental College & Hospital , Bambolim, Goa, India
| | - Francis Akkara
- Professor, Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital , Bambolim, Goa, India
| | - Ida De Noronha De Ataide
- Professor and Head, Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital , Bambolim, Goa, India
| | - Rajdeep Pavaskar
- Lecturer, Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital , Bambolim, Goa, India
| |
Collapse
|
48
|
Tawil PZ, Saraiya VM, Galicia JC, Duggan DJ. Periapical microsurgery: the effect of root dentinal defects on short- and long-term outcome. J Endod 2015; 41:22-7. [PMID: 25282374 PMCID: PMC4306457 DOI: 10.1016/j.joen.2014.08.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 08/09/2014] [Accepted: 08/18/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The purpose of this prospective clinical study was to evaluate the clinical outcome of endodontic microsurgery on roots exhibiting the presence or absence of dentinal defects at 1-year and 3-year follow-up period. METHODS One hundred fifty-five teeth were treated with periapical microsurgery using a modern microsurgical protocol in a private practice setting. The root apices were resected and inspected for dentinal defects with a surgical operating microscope and a 0.8-mm head diameter light-emitting diode microscope diagnostic probe light. After inspection, root-end preparations were performed using ultrasonic tips, and root-end fillings were placed. Follow-up visits occurred at 1 year and 3 years postoperatively. The primary outcome measure used was the change in the radiographic apical bone density, and the secondary outcome measure used was the absence of clinical symptoms. RESULTS Of the 155 treated teeth, a total of 134 teeth were assessed at the 1-year follow-up and 127 teeth at the 3-year evaluation. In the "intact" group, 94.8% healed at 1 year, and 97.3% healed at 3 years. In the "dentinal defect" group, 29.8% healed at 1 year, and 31.5% healed at 3 years. The baseline root condition of either "dentinal defect" or "intact" showed a statistical difference in the healing outcome at both 1 and 3 years. CONCLUSIONS This prospective periapical microsurgery study showed a significant superior clinical outcome for intact roots when compared with roots with dentinal defects at both 1 year and at 3 years postoperatively.
Collapse
Affiliation(s)
- Peter Z Tawil
- Department of Endodontics, UNC School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Veeral M Saraiya
- Department of Endodontics, UNC School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Johnah C Galicia
- Department of Endodontics, University of the Pacific, Stockton, California
| | - Derek J Duggan
- Department of Endodontics, UNC School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
49
|
Abstract
INTRODUCTION Periapical surgery needs asepsis, a bloodless field for ensuring success of the treatment. Efficacy of Povidone Iodine (PVI) in the elimination of pathogen causing periapical lesions is well established. PVI is also widely used as a disinfectant, sclerosing agent, styptic as well as an anti-odematous agent. MATERIALS AND METHODS This prospective pilot study done on 20 males between 20-40 years age group with periapical lesions in single rooted maxillary anterior tooth of 1-2 cm in diameter. The bleeding time, clotting time, bleeding time at the apex, drugs used and visual analogue scale of oedema on postoperative days were obtained. Descriptive statistics, paired t test and independent t-test were used. RESULTS AND CONCLUSION Results show a statistically significant reduction in the time required to achieve a bloodless field and a marked decrease in oedema in the first and second postoperative days resulting in lesser consumption of NSAIDs. In conclusion, the effect of PVI in periapical surgery seems to reduce the bleeding time at apex, total dose of NSAIDs used, oedema on first two postoperative days with high statistical significance. Hence the routine use of saline in periapical surgeries may be effectively substituted with PVI. The finding of this pilot study has to be evaluated using wider samples for effective clinical translations.
Collapse
Affiliation(s)
- K Senthil Kumar
- Department of Conservative Dentistry, Chettinad Dental College and Research Institute, Kelambakkam, Chennai, India
| | | | | | | |
Collapse
|
50
|
Moradi S, Disfani R, Ghazvini K, Lomee M. Sealing Ability of Orthograde MTA and CEM Cement in Apically Resected Roots Using Bacterial Leakage Method. Iran Endod J 2013; 8:109-13. [PMID: 23922571 PMCID: PMC3734512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 04/13/2013] [Accepted: 04/30/2013] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The aim of this in vitro study was to determine the sealing ability of orthograde ProRoot mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM) cement as root-end filling materials. MATERIALS AND METHODS Fifty four extracted single-rooted human teeth were used. The samples were randomly divided into 3 experimental groups. In group A and B, 4 mm of WMTA and CEM cement were placed in an orthograde manner and 3 mm of apices were resected after 24 hours. In group C the apical 3 mm of each root was resected and the root-end prepared with ultrasonic tips to a depth of 3 mm and subsequently, then filled with MTA. The apical sealing ability was performed with bacterial leakage method. Statistical analysis was carried out with Chi-square test. RESULTS There were no significant differences in the extent of bacterial leakage between the three experimental groups (P>0.05). CONCLUSION Based on the limitations of this in vitro study, we concluded that MTA and CEM cement can be placed in an orthograde manner when there is a potential need for root-end surgery.
Collapse
Affiliation(s)
- Saeed Moradi
- Department of Endodontics, Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Corresponding author: Saeed Moradi, Department of Endodontics, Mashhad University of Medical Sciences, Mashhad, Iran. Tel: +98-915 3139275, Fax: +98-511 8829500,
| | - Reza Disfani
- Department of Endodontics, Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kiarash Ghazvini
- Department of Microbiology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Lomee
- Department of Endodontics, Dental School, Mazandaran University of Medical Sciences, Mazandaran, Iran
| |
Collapse
|