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Razdan A, Schropp L, Væth M, Kirkevang LL. Longitudinal study of endodontic and periapical status of an adult Danish population examined in 2009, 2014, and 2019: a repeated cohort study. Acta Odontol Scand 2024; 83:20-29. [PMID: 37874536 DOI: 10.1080/00016357.2023.2268699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/04/2023] [Accepted: 10/04/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE To describe endodontic changes in an adult Danish population (C2;2009-2014-2019) and compare them with a similar cohort (C1;1997-2003-2008). MATERIAL AND METHODS A randomly selected cohort (C2) with three full-mouth radiographic examinations. The frequencies of teeth, apical periodontitis (AP), root filled teeth, and lost teeth in C2 were compared to a similar cohort (C1) using regression analyses; effect of age, cohort, and period was assessed. RESULTS C1 had 330 and C2, 170 participants (mean age, C1: 42.9; C2: 47.3 years, p < .001). The proportion of individuals with no AP was similar in C1 and C2 (p = .46). C2 had a higher proportion of individuals with no root filled teeth (p < .001) and no tooth loss (p = .02) than C1. The proportion of AP and root filled teeth increased with age in both cohorts. C2 had fewer root filled teeth and lost teeth, fewest lost teeth in the youngest age groups. CONCLUSIONS In C2, the prevalence of teeth with AP and root fillings increased with age, and few teeth were lost. Change in proportion of AP was similar in two cohorts; fewer root filled teeth and lost teeth in C2. The proportion of lost teeth in C2 showed cohort effect for older age groups.
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Affiliation(s)
- Ankur Razdan
- Section for Oral Radiology and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
| | - Lars Schropp
- Section for Oral Radiology and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Michael Væth
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lise-Lotte Kirkevang
- Section for Oral Radiology and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Al-Manei KK, Alzaidi S, Almalki G, Al-Manei K, Almotairy N. Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations: a systematic review and meta-analysis. BMC Oral Health 2023; 23:195. [PMID: 37009911 PMCID: PMC10069144 DOI: 10.1186/s12903-023-02826-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/21/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Restoring vital teeth with indirect restorations may threaten dental pulp integrity. However, the incidence of and influential factors on pulp necrosis and periapical pathosis in such teeth are still unknown. Therefore, this systematic review and meta-analysis aimed to investigate the incidence of and influential factors on pulp necrosis and periapical pathosis of vital teeth following indirect restorations. METHODS The search was conducted in five databases, using MEDLINE via PubMed, Web of Science, EMBASE, CINAHL, and Cochrane Library. Eligible clinical trials and cohort studies were included. The risk of bias was assessed using Joanna Briggs Institute's critical appraisal tool and Newcastle-Ottawa Scale. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were calculated using a random effects model. Subgroup meta-analyses were also performed to determine the potential influencing factors for pulp necrosis and periapical pathosis. The certainty of the evidence was assessed using the GRADE tool. RESULTS A total of 5,814 studies were identified, of which 37 were included in the meta-analysis. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were determined to be 5.02% and 3.63%, respectively. All studies were assessed as having a moderate-low risk of bias. The incidence of pulp necrosis following indirect restorations increased when the pulp status was objectively assessed (thermal/electrical testing). The presence of pre-operative caries or restorations, treatment of anterior teeth, temporization for more than two weeks, and cementation with eugenol-free temporary cement, all increased this incidence. Final impression with polyether and permanent cementation with glass ionomer cement both increased the incidence of pulp necrosis. Longer follow-up periods (> 10 years) and treatment provided by undergraduate students or general practitioners were also factors that increased this incidence. On the other hand, the incidence of periapical pathosis increased when teeth were restored with fixed partial dentures, the bone level was < 35%, and the follow-up was > 10 years. The certainty of the evidence overall was assessed as low. CONCLUSIONS Although the incidences of pulp necrosis and periapical pathosis following indirect restorations remain low, many factors affect these incidences that should thus be considered when planning indirect restorations on vital teeth. DATABASE REGISTRATION PROSPERO (CRD42020218378).
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Affiliation(s)
- Kholod Khalil Al-Manei
- Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh, 11545, Saudi Arabia
| | - Shuruq Alzaidi
- College of Dentistry, King Saud University, Riyadh, 11545, Saudi Arabia
| | - Ghadah Almalki
- College of Dentistry, King Saud University, Riyadh, 11545, Saudi Arabia
| | - Khaled Al-Manei
- Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh, 11545, Saudi Arabia.
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institute, Alfred Nobels Allé 8, 141 04, Huddinge, Stockholm County, Sweden.
| | - Nabeel Almotairy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraidah, 52571, Saudi Arabia
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Razdan A, Jungnickel L, Schropp L, Vaeth M, Kirkevang LL. Trends of endodontic and periapical status in adult Danish populations from 1997 to 2009: A repeated cross-sectional study. Int Endod J 2021; 55:164-176. [PMID: 34716998 DOI: 10.1111/iej.13658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/27/2021] [Indexed: 12/17/2022]
Abstract
AIM To compare the endodontic and periapical status of two similar adult Danish populations examined in 1997-1998 and 2007-2009, respectively. METHODOLOGY Two populations from Aarhus County, Denmark (age range: 20-64 years) were randomly selected using the Danish Civil Registration System. Full-mouth intraoral radiographs (14 periapical, 2 bitewing) of 616 individuals in 1997-1998 (C1: 16 018 teeth) and 398 individuals in 2007-2009 (C2: 10 668 teeth) were taken to ascertain the number of teeth, presence of root fillings (RFs) and apical periodontitis (AP) using the periapical index (PAI). T-tests with unequal variances were used to assess differences between C1 and C2 with respect to age and the number of teeth. Multivariable and multinomial logistic regression analyses were used to assess the effect of cohort, age and tooth type on the prevalence and relative frequency of RFs and AP. RESULTS Mean age and mean number of teeth were higher in C2 than C1 (age; C1: 42.3 years, C2: 44.6 years; p = .003), (teeth; C1: 26.0, C2: 26.8; p < .001). The prevalence of root filled teeth was lower in C2 than C1 (C1: 51.8%, C2: 45.0%; p = .03); however, the prevalence of AP was similar (C1: 42.0%, C2: 45.0%). The relative frequency of root filled teeth was lower in C2 than C1 (C1: 4.8%, C2: 3.6%; p = .004), although the individuals were older in C2. The relative frequency of AP was similar in the two cohorts (C1: 3.3%, C2: 3.6%; p = .42). The relative frequency of AP in non-root filled teeth doubled from 0.9% in C1 to 1.8% in C2. C2 had higher PAI scores than C1 for root filled and non-root filled teeth, despite age correction (p ≤ .0007). CONCLUSIONS Two similar general Danish populations examined, respectively, in 1997-1998 and 2007-2009, were associated with a decreasing trend in the prevalence and relative frequency of RFs over the decade. There was no difference in relative frequency of AP in root filled teeth, but an increase in relative frequency of AP in non-root filled teeth. Further population-based studies including analysis of non-root filled teeth using the full-scale PAI and quality assessment of restorations are recommended.
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Affiliation(s)
- Ankur Razdan
- Section for Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Luise Jungnickel
- Section for Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Lars Schropp
- Section for Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Michael Vaeth
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lise-Lotte Kirkevang
- Section for Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Tibúrcio-Machado CS, Michelon C, Zanatta FB, Gomes MS, Marin JA, Bier CA. The global prevalence of apical periodontitis: a systematic review and meta-analysis. Int Endod J 2021; 54:712-735. [PMID: 33378579 DOI: 10.1111/iej.13467] [Citation(s) in RCA: 155] [Impact Index Per Article: 51.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 12/24/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Apical periodontitis (AP) frequently presents as a chronic asymptomatic disease. To arrive at a true diagnosis, in addition to the clinical examination, it is mandatory to undertake radiographic examinations such as periapical or panoramic radiographs, or cone-beam computed tomography (CBCT). Thus, the worldwide burden of AP is probably underestimated or unknown. Previous systematic reviews attempted to estimate the prevalence of AP, but none have investigated which factors may influence its prevalence worldwide. OBJECTIVES To assess: (i) the prevalence of AP in the population worldwide, as well as the frequency of AP in all teeth, nontreated teeth and root filled teeth; (ii) which factors can modify the prevalence of AP. METHODS A search was conducted in the PubMed-MEDLINE, EMBASE, Cochrane-CENTRAL, LILACS, Google scholar and OpenGrey databases, followed by hand searches, until September 2019. Cross-sectional, case-control and cohort studies reporting the prevalence of AP in humans, using panoramic or periapical radiograph or CBCT as image methods were included. No language restriction was applied. An adaptation of the Newcastle-Ottawa Scale was used to evaluate the quality of the studies. A meta-analysis was performed to determine the pooled prevalence of AP at the individual level. Secondary outcomes were the frequency of AP in all teeth, nontreated teeth and rootfilled teeth. Subgroup analyses using random-effect models were carried out to analyse the influence of explanatory covariables on the outcome. RESULTS The search strategy identified 6670 articles, and 114 studies were included in the meta-analysis, providing data from 34 668 individuals and 639 357 teeth. The prevalence of AP was 52% at the individual level (95% CI 42%-56%, I2 = 97.8%) and 5% at the tooth level (95% CI 4%-6%; I2 = 99.5%). The frequency of AP in root-filled teeth and nontreated teeth was 39% (95% CI 36%-43%; I2 = 98.5%) and 3% (95% CI 2%-3%; I2 = 99.3%), respectively. The prevalence of AP was greater in samples from dental care services (DCS; 57%; 95% CI 52%-62%; I2 = 97.8%) and hospitals (51%; 95% CI 40%-63%; I2 = 95.9%) than in those from the general population (GP; 40%; 95% CI 33%-46%; I2 = 96.5%); it was also greater in people with a systemic condition (63%; 95% CI 56%-69%, I2 = 89.7%) compared to healthy individuals (48%; 95% CI 43%-53%; I2 = 98.3%). DISCUSSION The subgroup analyses identified explanatory factors related to the variability in the prevalence of AP. However, the high clinical heterogeneity and high risk of bias across the primary studies indicate that the findings must be interpreted with caution. CONCLUSIONS Half of the adult population worldwide have at least one tooth with apical periodontitis. The prevalence of AP is greater in samples from the dental care services, but it is also high amongst community representative samples from the general population. The present findings should bring the attention of health policymakers, medical and dental communities to the hidden burden of endodontic disease in the population worldwide.
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Affiliation(s)
- C S Tibúrcio-Machado
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - C Michelon
- Medical and Dental Center of the Brazilian Army, Santa Maria, Brazil
| | - F B Zanatta
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.,Department of Stomatology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - M S Gomes
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Medical and Dental Center of the Military Police, Porto Alegre, Brazil
| | - J A Marin
- Universidade Franciscana (UFN), Santa Maria, Brazil
| | - C A Bier
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.,Department of Stomatology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
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Skallsjö K, Johansson JE, Jonasson P, Hasséus B. Apical periodontitis as potential source of infection in patients with lymphoma treated with chemotherapy. Clin Oral Investig 2019; 24:133-140. [DOI: 10.1007/s00784-019-02909-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 04/09/2019] [Indexed: 12/22/2022]
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Abstract
Life expectancy has increased as a result of advancements in health care services; thus, maintaining healthy dentition is an important factor in overall health. Furthermore, the growing desire of elderly patients to maintain their teeth has led to an increased need for the performance of complex dental treatment in elderly patients. Root canal therapy is an essential phase of such treatments. Elderly patients may exhibit one or more systemic conditions that require special care, in addition to other changes that occur within the dentition and oral mucosa as a result of aging. These make root canal treatment in elderly patients a great challenge. The aim of this review was to characterize pathologic and physiologic changes in elderly patients that can interfere with root canal treatment procedures, as well as attitudes of elderly patients toward such treatment, guidelines and clinical considerations for management of root canal treatment in elderly patients.
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Affiliation(s)
- Mothanna K AlRahabi
- Department of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia. E-mail.
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Bains R, Bains VK. Lesions of endodontic origin: An emerging risk factor for coronary heart diseases. Indian Heart J 2018; 70 Suppl 3:S431-S434. [PMID: 30595303 PMCID: PMC6309294 DOI: 10.1016/j.ihj.2018.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 07/06/2018] [Accepted: 07/06/2018] [Indexed: 01/18/2023] Open
Abstract
A high inflammatory state, such as atherosclerosis, is a major underlying cause of coronary heart diseases (CHDs). Inflammatory mediators are known to lead to endothelial dysfunction and play a key role in initiation, progression, and rupture of atherothrombotic plaque. Chronic inflammatory dental infections such as periodontitis and lesions of endodontic origin or chronic apical periodontitis (CAP) may provide an environment conducive for such events. Atherosclerosis has shown to share a common spectrum of inflammatory markers with apical periodontitis. The possible correlation between CHD and CAP is emerging at microbiological, clinical, inflammatory, and molecular levels. This less recognized fact should be discussed more among the dental and medical fraternity so that more awareness and positive approach toward oral health can be created among patients and health-care providers.
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Affiliation(s)
- Rhythm Bains
- Department of Conservative Dentistry & Endodontics, King George's Medical University, Lucknow, India.
| | - Vivek K Bains
- Department of Periodontology, Saraswati Dental College, Lucknow, India
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Al-Nazhan SA, Alsaeed SA, Al-Attas HA, Dohaithem AJ, Al-Serhan MS, Al-Maflehi NS. Prevalence of apical periodontitis and quality of root canal treatment in an adult Saudi population. Saudi Med J 2017; 38:413-421. [PMID: 28397949 PMCID: PMC5447195 DOI: 10.15537/smj.2017.4.16409] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To determine the health status of periradicular tissue and the quality of root canal fillings in an adult Saudi population attending dental clinics for the first time. Methods: This cross sectional study was conducted in the dental clinics at King Saud University, Riyadh and other dental centers (Jeddah, Najran, and Albaha City), Kingdom of Saudi Arabia between year 2010 and 2012. Good-quality panoramic radiographs of 926 Saudi subjects (540 males and 386 females)were analyzed based on the gender, age, health status, smoking habits, periapical status of the endodontically treated teeth, technical quality of the root canal fillings, and the presence or absence of coronal restoration. Data were calibrated and statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 17. Results: Of the 25,028 teeth examined, 1,556 teeth (6.2%) had apical periodontitis (AP). Male subjects aged over 55 years and females between 36 and 45 years had higher AP. A total of 36 diabetic and 87 smokers subjects had AP. The AP was more common in male diabetics than female (p=0.383), and in female smokers more than male (p=0.44). Only 42.2% of male and 57.7% of female teeth had adequate root canal treatment. Conclusions: Apical periodontitis was significantly related to diabetes, smoking, and inadequate endodontic treatment.
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Affiliation(s)
- Saad A Al-Nazhan
- Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Timmerman A, Calache H, Parashos P. A cross sectional and longitudinal study of endodontic and periapical status in an Australian population. Aust Dent J 2017; 62:345-354. [DOI: 10.1111/adj.12512] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 12/20/2022]
Affiliation(s)
- A Timmerman
- The Melbourne Dental School; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
| | - H Calache
- The Melbourne Dental School; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
- Deakin Health Economics; Faculty of Health; Deakin University; Geelong Victoria Australia
- School of Dentistry and Oral Health; La Trobe University; Bendigo Victoria Australia
| | - P Parashos
- The Melbourne Dental School; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
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Malmberg L, Björkner AE, Bergenholtz G. Establishment and maintenance of asepsis in endodontics - a review of the literature. Acta Odontol Scand 2016; 74:431-5. [PMID: 27310020 DOI: 10.1080/00016357.2016.1195508] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Successful endodontic treatment depends on effective measures to eliminate and prevent infection of root canals. Initially treatment should start with isolation and disinfection of the operating field. This review makes an inventory of the available knowledge regarding its establishment and maintenance. MATERIALS AND METHODS A literature search was conducted in the PubMed database in order to identify clinical trials examining disinfection or unintentional contamination of the endodontic operative field. A list of 115 articles was obtained and screened. Five relevant articles were identified. These articles were read in full text. The reference lists from these articles were checked manually for additional studies and three studies were obtained. A total of eight articles met the inclusion criteria. RESULTS There was a great variety in terms of aim, method, and material of the included studies. None could prove a totally reliable aseptic operative field and not one chemical, or combination of chemicals, were found in more than one study. CONCLUSIONS No study documented complete asepsis following initial disinfection, and no study could document predictable maintenance of an established bacteria-free surface. Critical appraisal and standardization of the disinfection and aseptic procedures in endodontics are needed.
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Hebling E, Coutinho LA, Ferraz CCR, Cunha FL, Queluz DDP. Periapical status and prevalence of endodontic treatment in institutionalized elderly. Braz Dent J 2016; 25:123-8. [PMID: 25140716 DOI: 10.1590/0103-6440201302348] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 03/17/2014] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine the prevalence and frequency of apical periodontitis and root fillings in 450 institutionalized Brazilian elderly. The teeth with apical periodontitis were assessed using the Periapical Index (PAI) score. A total of 942 teeth were evaluated in 98 subjects (57 females and 41 males) with mean age of 74 years. The observed frequency of total edentulous subjects was high (76%) in this population. A total of 126 teeth showed root fillings, of these only 46 (36.5%) were scored as having adequate quality. Apical periodontitis was found in 114 teeth (12.1%) in 42 (42.9%) subjects. 80 (70.2%) inadequate root-filled teeth showed apical periodontitis. There was a significant correlation between the presence of periapical pathology and inadequate root-filled teeth. Inadequate root-filled teeth were associated with an increased prevalence of apical periodontitis in these subjects. This fact may result in increased endodontic retreatment needs for this population.
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Affiliation(s)
- Eduardo Hebling
- Department of Community Dentistry, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, SP, Brazil
| | - Lorena Alves Coutinho
- Department of Community Dentistry, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, SP, Brazil
| | - Caio Cézar Randi Ferraz
- Department of Restorative Dentistry, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, SP, Brazil
| | - Fernanda Lopes Cunha
- Department of Community Dentistry, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, SP, Brazil
| | - Dagmar de Paula Queluz
- Department of Community Dentistry, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, SP, Brazil
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Alsomadi L, Al Habahbeh R. Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain. J Contemp Dent Pract 2015; 16:939-943. [PMID: 27018027 DOI: 10.5005/jp-journals-10024-1785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. MATERIALS AND METHODS After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. RESULTS Peak postoperative pain occurred at 16 hours post-treatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402). CONCLUSION Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. CLINICAL SIGNIFICANCE Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients.
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Affiliation(s)
- Leena Alsomadi
- Associate Professor Department of Conservative Dentistry, University of Jordan PO Box 830453, Amman, Jordan, Phone: 009626797728100 e-mail:
| | - Riyad Al Habahbeh
- Department Conservative Dentistry, Royal Medical Services Amman, Jordan
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Cotti E, Mercuro G. Apical periodontitis and cardiovascular diseases: previous findings and ongoing research. Int Endod J 2015; 48:926-32. [DOI: 10.1111/iej.12506] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 07/05/2015] [Indexed: 11/28/2022]
Affiliation(s)
- E. Cotti
- Department of Conservative Dentistry and Endodontics; University of Cagliari; Sardinia Italy
| | - G. Mercuro
- Department of Medical Sciences; University of Cagliari; Sardinia Italy
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Rutz da Silva F, Padilha EZ, Cândido VS, Cavassim R, Pereira AC, Hebling E. Relationship between quality of root canal obturation and periapical lesion in elderly patients: a systematic review. Gerodontology 2014; 33:290-8. [DOI: 10.1111/ger.12146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2014] [Indexed: 01/08/2023]
Affiliation(s)
- Fabrício Rutz da Silva
- Department of Community Dentistry; Piracicaba Dental School; University of Campinas; Piracicaba Brazil
| | - Edna Zakrzevski Padilha
- Department of Community Dentistry; Piracicaba Dental School; University of Campinas; Piracicaba Brazil
| | - Valéria Silva Cândido
- Department of Community Dentistry; Piracicaba Dental School; University of Campinas; Piracicaba Brazil
| | | | - Antonio Carlos Pereira
- Department of Community Dentistry; Piracicaba Dental School; University of Campinas; Piracicaba Brazil
| | - Eduardo Hebling
- Department of Community Dentistry; Piracicaba Dental School; University of Campinas; Piracicaba Brazil
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Hamedy R, Shakiba B, Pak JG, Barbizam JV, Ogawa RS, White SN. Prevalence of root canal treatment and periapical radiolucency in elders: a systematic review. Gerodontology 2014; 33:116-27. [DOI: 10.1111/ger.12137] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2014] [Indexed: 12/17/2022]
Affiliation(s)
- Reza Hamedy
- School of Dentistry; UCLA; Los Angeles CA USA
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Kirkevang LL, Vaeth M, Wenzel A. Ten-year follow-up of root filled teeth: a radiographic study of a Danish population. Int Endod J 2014; 47:980-8. [DOI: 10.1111/iej.12245] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 01/03/2014] [Indexed: 12/11/2022]
Affiliation(s)
- L.-L. Kirkevang
- Section of Endodontics; Institute of Clinical Dentistry; Faculty of Dentistry; Oslo University; Oslo Norway
- Department of Dentistry, Health; Aarhus University; Aarhus Denmark
| | - M. Vaeth
- Section of Biostatistics; Department of Public Health; Health, Aarhus University; Aarhus Denmark
| | - A. Wenzel
- Section of Oral Radiology; Department of Dentistry, Health; Aarhus University; Aarhus Denmark
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Huumonen S, Vehkalahti MM, Nordblad A. Radiographic assessments on prevalence and technical quality of endodontically-treated teeth in the Finnish population, aged 30 years and older. Acta Odontol Scand 2012; 70:234-40. [PMID: 22364221 DOI: 10.3109/00016357.2011.637510] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To assess the prevalence and technical quality of endodontic treatment (ET) in Finland by panoramic radiography. MATERIALS AND METHODS As part of the Finnish nationwide Health 2000 Survey, panoramic radiographs of 5244 dentate subjects, aged 30-95 years, were analyzed. The criterion for a technically adequate ET was a distance from the root filling to the root apex of ≤3 mm. RESULTS Sixty-one per cent of subjects had one or more teeth with ET. ET was more prevalent in older subjects and among women. Of all teeth (n = 120 250), 7% had had ET, the percentages being greatest for molars and premolars. Technical quality was adequate in 47% of all ET, in 71% of anterior teeth, in 51% of premolars and in 25% of molars. CONCLUSIONS Prevalence and technical quality of endodontic treatment in Finland are comparable to that reported elsewhere, but are still calling for improvement in endodontic treatment, especially regarding molars.
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Kirkevang LL, Vaeth M, Wenzel A. Ten-year follow-up observations of periapical and endodontic status in a Danish population. Int Endod J 2012; 45:829-39. [DOI: 10.1111/j.1365-2591.2012.02040.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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KIRKEVANG LISELOTTE. Root canal treatment and apical periodontitis: What can be learned from observational studies? ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1601-1546.2011.00258.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cotti E, Dessì C, Piras A, Mercuro G. Can a chronic dental infection be considered a cause of cardiovascular disease? A review of the literature. Int J Cardiol 2010; 148:4-10. [PMID: 20851474 DOI: 10.1016/j.ijcard.2010.08.011] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 07/24/2010] [Accepted: 08/07/2010] [Indexed: 12/19/2022]
Abstract
Cardiovascular diseases (CVD) have a complex etiology determined by risk factors, which are in turn associated to a strong genetic component and to environmental factors. In the biological background for the development of CVD, low-grade chronic inflammation plays a role as a pathogenetic determinant of atherosclerosis. Dental infections have been associated with CVD. Periodontal disease is a chronic infection of the supporting tissues of the tooth that can lead to teeth loss. In recent years, a number of reports have demonstrated the possible relationship between periodontal disease and CVD. Apical periodontitis, on the other hand, is the late consequence of an endodontic infection, which is caused by the persistence of coronal caries and involves the root canal system of the tooth. Most of the time, it is a chronic infection. Some studies have found a correlation between a "composite status" of oral health (eg. caries, tooth loss, periodontal disease) and CVD, but only a few of them have addressed the association between apical periodontitis and CVD. This "state of the art" paper represents the first stage of an incoming study on the relationship between chronic endodontic infection and CVD.
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Affiliation(s)
- Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy
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Frisk F, Hugoson A, Hakeberg M. Technical quality of root fillings and periapical status in root filled teeth in Jönköping, Sweden. Int Endod J 2009; 41:958-68. [PMID: 19133085 DOI: 10.1111/j.1365-2591.2008.01457.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM To study changes in technical quality of root fillings and periapical status in root filled teeth in random samples of 20 to 70 year-olds between 1973 and 2003. METHODOLOGY Data from dentate subjects aged 20-70 years from examinations conducted in 1973 (n = 498), 1983 (n = 530), 1993 (n = 547) and 2003 (n = 491) were used for the analysis. Length of root fillings were measured on radiographs to the nearest 0.1 mm. Adequate seal was defined as a root filling without lateral and/or apical voids. Periapical status was assessed according to the periapical index. All observations were made by one calibrated observer registered from full mouth radiographic examinations. Teeth with root fillings ending within the canal without lateral or apical voids were considered adequate. The association between root filling quality and periapical status was analysed by means of the Chi-squared test and a multilevel logistic regression analysis. RESULTS Adequately root filled teeth had a significantly lower frequency of apical periodontitis than inadequately root filled teeth (11.8% vs. 22.8%). The frequency of technically adequate root fillings increased statistically significant from 1973 (23.7%) to 2003 (36.4%) without a concomitant improvement of the periapical status in root filled teeth over time (24.5% vs. 24.6%). CONCLUSIONS This study reports on an improving technical quality of root fillings over time, without a concomitant improvement of the periapical status in root filled teeth. A larger proportion of treated molars over time may be of importance for the result.
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Affiliation(s)
- F Frisk
- Department of Endodontology, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
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Touré B, Kane AW, Sarr M, Ngom CTH, Boucher Y. Prevalence and technical quality of root fillings in Dakar, Senegal. Int Endod J 2007; 41:41-9. [PMID: 18005046 DOI: 10.1111/j.1365-2591.2007.01305.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To examine the prevalence and technical quality of root fillings and the periapical status of root-filled teeth in a subpopulation of Dakar, Senegal. METHODOLOGY Full-mouth periapical radiographs were obtained from 208 consecutive adults presenting as new patients to the Dental Service of the University. The occurrence and technical quality of root fillings were assessed for each root according to the apical extent of the root fillings and its density. The periapical status was evaluated using the Periapical Index Scoring System with a PAI > 2 indicating periapical disease. The presence of coronal restorations and posts was also noted. Statistical analysis was performed with the chi-square test with a significance level set at P < 0.05%. RESULTS Of the 6234 teeth examined, 2.6% were root filled. A PAI > 2 was associated with 56.1% of the filled roots. Only 17.7% of the root fillings were technically acceptable and 26.2% of these were associated with a PAI > 2. In roots with unacceptable root fillings, 62.5% had a PAI > 2. Unacceptable root fillings were associated with a higher prevalence of periapical disease (P < 0.001). A post was seen in 18.9% of the filled roots with 66.2% associated with a PAI > 2. A permanent coronal restoration was present in 78.5% of the filled roots, of which 50.7% had a PAI > 2 vs 75.7% for no permanent restoration. At least one periapical lesion was seen in 59.6% of the subjects. CONCLUSION The results indicate a low prevalence of teeth with radiographic periapical disease, a low prevalence of root-filled teeth and a high prevalence of unacceptable root fillings.
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Affiliation(s)
- B Touré
- Endodontics and Restorative Dentistry Section, Department of Dentistry, Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop, Dakar, Senegal
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Abstract
OBJECTIVE The aim of this study was to reveal possible socio-economic risk indicators for apical periodontitis. MATERIAL AND METHODS In 1992-93 a representative sample of women in Göteborg, Sweden, aged 38-84 years, participated in a medical and dental survey (n=981) which included dental and medical examinations and dental radiographic examination (OP). The dependent variable was apical periodontitis (AP=0, AP>0). The independent variables were age, number of teeth, number of restored teeth, number of root-filled teeth, number of teeth with carious lesions, satisfactory masticatory function, and dental esthetics as crude measures of self-reported dental health, dental anxiety, time elapsed since last visit to a dental office, regular dental visiting habits, smoking, alcohol habits, and marital status. A subjective evaluation of economy, health and life situation (acceptable or poor) was accounted for as socio-economic variables. The oldest age group, women born 1908, and edentulous individuals were omitted, leaving 844 subjects for analysis. Statistical analysis included multivariate logistic regression, chi-squared test, and independent t-test for comparison of group characteristics (AP=0 vs AP>0). RESULTS For socio-economic variables there was a significant association between acceptable health and apical periodontitis (OR=1.72 (CI=1.09-2.70)). For oral-related variables, root-filled teeth (OR=1.17 (CI=1.10-1.23)) and teeth with carious lesions (OR=1.48 (CI=1.19-1.85)) were predictive of apical periodontitis. CONCLUSIONS In the present study, socio-economic variables and dental visiting habits did not appear to have obvious implications for periapical health, whereas root-filled teeth and carious lesions were associated with apical periodontitis.
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Affiliation(s)
- Fredrik Frisk
- Department of Endodontology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
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Kirkevang LL, Vaeth M, Hörsted-Bindslev P, Wenzel A. Longitudinal study of periapical and endodontic status in a Danish population. Int Endod J 2006; 39:100-7. [PMID: 16454789 DOI: 10.1111/j.1365-2591.2006.01051.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To describe and discuss changes in periapical and endodontic status in a general Danish population. METHODOLOGY In 1997, 616 randomly selected individuals had a full-mouth radiographic survey taken. In 2003, 77% of the participants attended for a new full-mouth radiographic examination. Information on endodontic treatment and periapical status was obtained. The periapical index (PAI) was used to assess apical periodontitis (AP). RESULTS More participants had root filling(s) and AP in 2003 than in 1997. More teeth had AP and/or root fillings in 2003. Fewer of the root-filled teeth (RFT) had AP in 2003. Less than 3% of the teeth without root fillings (NRFT) that in 1997 had no AP, developed AP and/or received a root filling. Of the NRFT which in 1997 had AP, more than 35% still had AP and no root filling in 2003. Approximately, 30% of the NRFT with AP in 1997 received a root filling. Of the teeth that received a root filling, 40% had healed, whereas 60% had not. Approximately, 25% of the NRFT that in 1997 had AP had been extracted. In 1997 there were 618 RFT, 314 of the RFT had no AP in 1997. Almost 20% of the RFT that in 1997 were periapically sound, developed AP. Of the 304 RFT with AP in 1997, approximately 30% had healed, in 60% AP persisted, and 10% were extracted. CONCLUSIONS The present study indicates that caution must be exercised when statements on the outcome of root canal treatment are made based on the cross-sectional studies.
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Affiliation(s)
- L-L Kirkevang
- Department of Oral Radiology, School of Dentistry, Royal Dental College, University of Aarhus, Vennelyst Boulevard, DK-8000 Aarhus C, Denmark.
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