Tooth-specific risk indicators for apical periodontitis

Periapical and endodontic status among 65-year-old Oslo-citizens

Aim

This cross-sectional study aimed to investigate the prevalence of apical periodontitis (AP) and root-filled teeth in a 65-year-old population in Oslo, Norway, and to investigate associations of pathosis and endodontic treatment with selected individual risk indicators and technical quality of root fillings.

Material and methods

A random sample of 450 65-year-olds in Oslo answered a questionnaire and underwent a clinical and radiological examination (52% men and 48% women). Periapical radiographs were taken of all root-filled teeth and of teeth with apical radiolucency, and periapical status was evaluated using the Periapical Index. Apex-to-filling distance and homogeneity were assessed for all root fillings. Analyses on individual level and tooth level were performed. The outcome variables were ‘non-root-filled tooth with AP’ (‘untreated AP’), ‘root-filled tooth’, and 'root-filled tooth with AP’. The explanatory variables were gender, education, dental attendance pattern, smoking, remaining teeth (n), tooth group, and root filling quality. Chi-square test and logistic regression analyses were used to assess the associations between outcome variables and explanatory variables. The level of significance was set to p < 0.05.

Results

The mean number of remaining teeth was 26 (SD: 4). AP was present in 45% of the individuals. Sixteen percent of the individuals had untreated AP and 38% had at least one root-filled tooth with AP. Sixty-six percent of the individuals had one or more root-filled teeth. Untreated AP was significantly associated with a decreasing number of remaining teeth and smoking. All the outcome variables were significantly more prevalent in molars compared with premolars and anterior teeth. Thirty-five percent of the root-filled teeth had AP, and AP was more prevalent in teeth with too short apex-to-filling distance (53%) or unsatisfactory homogeneity (46%).

Conclusions

The remaining number of teeth was high, and AP and root-filled teeth were prevalent in the present young-elderly population. A notable amount of untreated AP was observed, especially in smokers. The findings in the present study indicate a substantial need for dental care associated with endodontic conditions in the future elderly.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02406-9.

Coronal Restoration as a Predictor of Periapical Disease in Non-Endodontically Treated Teeth

Objectives

To compare the frequency of apical periodontitis (AP) in non-endodontically treated teeth restored with full coverage crowns, amalgam and resin composite fillings, and to disclose the association of type and quality of coronal restoration with periapical disease.

Material and Methods

The cross-sectional study involved 597 subjects who attended the Dental Clinic of the Clinical Hospital Centre, Rijeka, Croatia for the first time. Data were collected by means of a clinical and radiological survey. The following data were recorded for all permanently restored non-endodontically treated teeth: the type, the quality of coronal restoration according to clinical and radiographic criteria for marginal integrity as well as the recurrent caries presence, periapical status and marginal bone loss. Chi-square tests were used to analyze the difference in periapical status regarding the type and the quality of restoration. The multivariate logistic regression analysis was used to assess the effect of explanatory tooth-specific variables on periapical status.

Results

There was no significant difference in the proportion of AP with regards to the type and material of adequate quality coronal restorations (χ²=5.000, P=0.082). The regression analysis revealed significant positive associations with outcome variable (AP) for crowns (OR=3.39; P<0.001), recurrent caries (OR=4.67; P<0.001) and premolar teeth (OR=1.73; P=0.002).

Conclusion

If the quality of restorations is adequate, there is no difference in the periapical status of non-endodontically treated teeth regarding the type and material of coronal restoration.

YouTube as an information source for instrument separation in root canal treatment

Objectives

The reliability and educational quality of videos on YouTube for patients seeking information regarding instrument separation in root canal treatment were evaluated.

Materials and Methods

YouTube was searched for videos on instrument separation in root canal treatment. Video content was scored based on reliability in terms of 3 categories (etiology, procedure, and prognosis) and based on video flow, quality, and educational usefulness using the Global Quality Score (GQS). Descriptive statistics were obtained and the data were analyzed using analysis of variance and the Kruskal-Wallis test.

Results

The highest mean completeness scores were obtained for videos published by dentists or specialists (1.48 ± 1.06). There was no statistically significant difference among sources of upload in terms of content completeness. The highest mean GQS was found for videos published by dentists or specialists (1.82 ± 0.96), although there was no statistically significant correlation between GQS and the source of upload.

Conclusions

Videos on YouTube have incomplete and low-quality content for patients who are concerned about instrument separation during endodontic treatment, or who experience this complication during endodontic treatment.

Influence of Method of Teaching Endodontics on the Self-Efficacy and Self-Perceived Competence of Undergraduate Dental Students

Objective:

This study assessed whether self-efficacy and the self-perceived competence of undergraduate dental students had been influenced by the method of teaching endodontics.

Methods:

Certain modules of the undergraduate endodontic programme at the Academic Centre for Dentistry Amsterdam (ACTA) including the tutorials, the clinical training and the assessment were revised. The self-efficacy and self-perceived competence close to graduation of an intermediate cohort of 24 students who attended all or some of the former modules or the revised modules were assessed. Additionally, the performance of students in performing root canal treatments was assessed according to predetermined criteria. Data were analysed using Cohen’s Kappa, Cronbach’s Alpha, Mann-Whitney and T-tests.

Results:

Self-efficacy and the self-perceived competence of students who followed the former modules of clinical training and assessment were similar to those of students who followed the revised modules. The revised module with higher number of tutorials increased students’ self-perceived competence, but did not influence their self-efficacy statistically significantly. Not the entire number, but the number of root canal treatments performed under supervision of endodontists was related with an increase in students’ self-efficacy and self-perceived competence. The performance of students in performing root canal tretaments was not statistically significantly related to their self-efficacy and self-perceived competence.

Conclusion:

Among the modules and their components assessed in the present study, only the number of tutorials and the number of root canal treatments performed under supervision of endodontists influenced the self-efficacy and the self-perceived competence of students.

Quality of root fillings performed with two root filling techniques. An in vitro study using micro-CT

Objective.

The aim of this study was to compare the presence of voids in root fillings performed in oval and ribbon-shaped canals with two root filling techniques, lateral compaction technique (LCT) or hybrid technique (HT), a combination of a gutta-percha masterpoint and thermoplastic gutta-percha. Furthermore, the obturation time for the two techniques was evaluated.

Materials and methods.

Sixty-seven roots with oval and ribbon-shaped canals were prepared using Profile Ni-Ti rotary files. After preparation, the roots were randomly allocated to two groups according to root filling technique. All roots were filled with AH plus and gutta-percha. Group 1 was filled using LCT (n = 34) and group 2 was filled using HT (n = 33). The obturation time was measured in 30 cases evenly distributed between the two techniques. Voids in relation to the root canal fillings were assessed using cross-section images from Micro-computed Tomography scans.

Results.

All root canal fillings had voids. Permutation test showed no statistically significant difference between the two root filling techniques in relation to presence of voids (p = 0.092). A statistically significant difference in obturation time between the two techniques was found (p < 0.001).

Conclusion.

The present study found no statistically significant difference in percentage of voids between two root filling techniques. A 40% reduction in obturation time was found for the HT compared to the LCT.