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Viswanath B, Priyank H, Shivakumar S, Langaliya A, Kumbhar AD, Jakhar A, Cervino G, Minervini G. Periapical healing outcome following non-surgical endodontic intervention among diabetic patients: A systematic review conducted according to PRISMA guidelines and the Cochrane handbook for systematic reviews of interventions. Saudi Dent J 2024; 36:52-59. [PMID: 38375382 PMCID: PMC10874800 DOI: 10.1016/j.sdentj.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 02/21/2024] Open
Abstract
Background Periapical diseases are common dental conditions that require non-surgical endodontic intervention (NEI) for successful treatment. However, the impact of diabetes mellitus (DM) on the periapical healing (PH) outcome in diabetic patients remains somewhat unclear. This review aimed to evaluate the PH outcome following endodontic intervention among DM-afflicted individuals. Methods A comprehensive search was conducted across multiple electronic databases to identify relevant studies. Specifically, a set of selection criteria was applied to select studies that assessed PH outcomes in individuals with DM who underwent different treatment protocols. Data extraction and quality assessment were performed following predetermined protocols. The risk of bias (RoB) 2 assessment tool evaluated the quality of the included studies. Results A total of 11 studies met the inclusion criteria and were included in the investigation. Four studies showed a higher incidence of apical periodontitis in diabetic individuals compared to controls, and five studies reported reduced healing and success rates in this group. Overall, nine studies have shown that DM has a negative impact on periapical outcomes. This suggests that DM is an important factor in the prognosis of endodontic intervention. The assessment tools used were PAI, PR, SC, and FD analysis. RoB-2 assessed the included studies as having a moderate RoB. Conclusion This review provides compelling evidence that DM patients experienced a noticeable negative impact on PH outcomes compared to the control population. These findings highlight the importance of considering the diabetic status of patients when assessing the prognosis of periapical diseases and planning interventions for NEI. Further research is needed to validate these results and explore potential mechanisms underlying the observed associations.
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Affiliation(s)
- Butta Viswanath
- Department of Conservative, Endodontics and Aesthetic Dentistry, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi
| | - Harsh Priyank
- Department of Conservative, Endodontics and Aesthetic Dentistry, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi
| | - Sahana Shivakumar
- Public Health Dentistry, Peoples College of Dental Sciences and Research Centre, Peoples University, Bhopal
| | - Akshayraj Langaliya
- Department of Conservative Dentistry and Endodontics, AMC Dental College and Hospital, Ahmedabad, Gujarat, India
| | - Aravind D Kumbhar
- Department of Dentistry, Chief Dental Surgeon and I/c Superintendent Community Health Center, Kotarvada, Gujarat, India
| | - Ashima Jakhar
- Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai
| | - Gabriele Cervino
- School of Dentistry, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, 1, 98125 Messina, Italy
| | - Giuseppe Minervini
- Saveetha Dental College & Hospitals Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai - 600 077, India
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
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2
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Thomas AR, Mathew M, Nettemu SK, Mayya A. Resective and Regenerative Approach for an Unresolved Periapical Lesion: A Surgical Case Report With 24-Month Follow-Up. Cureus 2023; 15:e49717. [PMID: 38161818 PMCID: PMC10757505 DOI: 10.7759/cureus.49717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
The pulp and the periodontium are inherently interconnected, both anatomically and functionally. Conditions affecting the periodontium and the pulp can create challenges in diagnosis, treatment strategizing, and predicting outcomes. This case report outlines the combination of resection and regeneration techniques utilizing mineral trioxide aggregate (MTA) and bone grafting to address a persistent periapical lesion in a maxillary premolar. The treatment led to the effective alleviation of the patient's symptoms and successful regeneration.
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Affiliation(s)
- Anchu R Thomas
- Endodontics, Manipal University College Malaysia, Melaka, MYS
| | - Melwin Mathew
- Dentistry/Periodontics, Manipal University College Malaysia, Melaka, MYS
| | - Sunil K Nettemu
- Dentistry/Periodontics, Manipal University College Malaysia, Melaka, MYS
| | - Anoop Mayya
- Prosthodontics, Manipal University College Malaysia, Melaka, MYS
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Sathyanarayanan K, Ranjana NI, Bhavana M, R M, Sankar A, Mirnalini S. Asymptomatic Apical Periodontitis Lesions and Their Association With Systemic Inflammatory Burden: A Preliminary Prospective Clinical Study. Cureus 2023; 15:e46357. [PMID: 37920638 PMCID: PMC10619333 DOI: 10.7759/cureus.46357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Abstract
Background: Apical periodontitis (AP) is an inflammatory disorder of the periapical tissues caused by the persistence of a microbial infection within the root canal system of the affected tooth. Clinically, it is symptomatic or asymptomatic depending on several factors such as the type of microorganisms, bacterial load, immunological reaction, and local tissue mediators. Chronic or asymptomatic infections may initiate and modulate intravascular accumulation of inflammatory cells resulting in endothelial dysfunction which subsequently represents a possible systemic inflammatory burden. Aim: The present study aimed to evaluate the relationship between asymptomatic AP and systemic inflammatory burden by assessing the levels of chronic inflammatory cells. Methodology: A total of 25 patients diagnosed with asymptomatic AP who showed a negative response to the pulp sensitivity test with no history of any systemic diseases were included in this preliminary prospective observational study. Blood samples were collected at each phase of the study, and a complete hemogram was carried out. All hematological parameters were recorded before and after root canal therapy and they were analyzed for statistical significance at p <.05 using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States). Results: Evaluation of the mean total leukocyte count (TLC), lymphocyte, and eosinophil cell count showed a significant reduction in the number of cells before and after root canal therapy treatment respectively (p<.05). One-way analysis of variance also revealed statistical significance at p < .05 with a weak positive correlation between the TLC, lymphocyte, and eosinophil count before and after treatment. Conclusion: The present study showed that systemically healthy individuals with asymptomatic AP had increased inflammatory burden in the circulation, and thus, it is essential to identify and quantify the risk associated. It was evident that complete healing of the asymptomatic AP lesions results in an overall reduction of systemic inflammatory cells ultimately reducing the burden and risk of associated systemic inflammatory diseases.
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Affiliation(s)
| | - N I Ranjana
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Mohan Bhavana
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Megavarnan R
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Aravinthan Sankar
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Selvakumar Mirnalini
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
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4
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Sinha A, Jain AK, Rao RD, Sivasailam S, Jain R. Effect of platelet-rich fibrin on periapical healing and resolution of clinical symptoms in patients following periapical surgery: A systematic review and meta-analysis. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2023; 26:366-376. [PMID: 37705554 PMCID: PMC10497090 DOI: 10.4103/jcd.jcd_195_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 09/15/2023]
Abstract
Context Adjuvant use of platelet-rich fibrin (PRF) in many areas of dentistry is well documented. However, its role in periapical surgery remains contested which requires further clarification by a higher level of evidence. Aim The objective of this systematic review was to evaluate the effect of PRF on periapical surgery using meta-analysis. Materials and Methods A comprehensive literature search was conducted in PUBMED, Cochrane Central Register of Controlled Trials, SCIENCE DIRECT, and GOOGLE SCHOLAR for randomized controlled trials (RCT) published until May 2021. Meta-analysis was performed for comparisons of baseline (pretreatment) versus posttreatment values for different measurement parameters (postoperative pain, peri apical healing both qualitatively and quantitatively). The risk of bias in all the included trials was assessed after the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Results Among the 356 eligible articles found in the initial search, 10 RCTs from 2011 through 2021 were included. Qualitative analysis of all the included studies showed that PRF may play a positive role in bone healing, reduction in periapical lesions, and enhancing quality of life using different imaging modalities. The results of the meta-analysis indicated a significant reduction in postoperative pain when PRF was used (standard mean difference [SMD] = 0.515; 95% confidence interval [CI] = 0.061- 0.969;P = 0.026; I 2 = 0%). However, there was no statistically significant association observed while evaluating peri apical bone healing both qualitatively (odds ratio [OR] = 1.427; 95% CI = 0.309-6.584; P = 0.648) and quantitatively measured by Cone beam computed tomography (SMD = -0.264; 95% CI = -0.974-0.447;P = 0.454) between PRF and control group. Conclusions Considering the notable benefits demonstrated by use of PRF, it may be considered as a valuable adjunct in periapical surgery. However, more high-quality trials are necessary to assess the exact role of PRF.
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Affiliation(s)
- Anandita Sinha
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Ashish K Jain
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Rahul D Rao
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Shreya Sivasailam
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Rishab Jain
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Jiang H, Dong Z, Xia X, Li X. Cathepsins in oral diseases: mechanisms and therapeutic implications. Front Immunol 2023; 14:1203071. [PMID: 37334378 PMCID: PMC10272612 DOI: 10.3389/fimmu.2023.1203071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/18/2023] [Indexed: 06/20/2023] Open
Abstract
Cathepsins are a type of lysosomal globulin hydrolase and are crucial for many physiological processes, including the resorption of bone matrix, innate immunity, apoptosis, proliferation, metastasis, autophagy, and angiogenesis. Findings regarding their functions in human physiological processes and disorders have drawn extensive attention. In this review, we will focus on the relationship between cathepsins and oral diseases. We highlight the structural and functional properties of cathepsins related to oral diseases, as well as the regulatory mechanisms in tissue and cells and their therapeutic uses. Elucidating the associated mechanism between cathepsins and oral diseases is thought to be a promising strategy for the treatment of oral diseases and may be a starting point for further studies at the molecular level.
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Affiliation(s)
- Hao Jiang
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Zuoxiang Dong
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Xiaomin Xia
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Xue Li
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
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S A, Azhar S, Manan R, Bansal N, Singh D, Chauhan B. Comparison of the Microleakages of Four Root-End Filling Materials: An In Vitro Study. Cureus 2023; 15:e40461. [PMID: 37456461 PMCID: PMC10349657 DOI: 10.7759/cureus.40461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION When a nonsurgical endodontic treatment is ineffective, surgery is necessary. This entails putting a retrofilling to seal the tooth's apex. Exposing the lesion, performing a curettage, exposing the root apex, resecting it, preparing the root end, and lastly filling the cavity with the proper material are all steps in endodontic surgery. Thus, the aim of this study is to compare the apical microleakage of four root-end filling materials in cavities prepared using ultrasonic retro tip in in vitro conditions. MATERIALS AND METHODS An in vitro study was conducted on 60 extracted single-rooted teeth and was cut at the cementoenamel junction (CEJ). They were biomechanically prepared and obturated. Apical 3 mm root-end resection was done using a diamond disc. Root-end cavities were made using an ultrasonic retro tip. Teeth were separated into four groups and filled with SuperEBA®️ ethoxy-benzoic acid (EBA; Keystone Industries, New Jersey), mineral trioxide aggregate (MTA), Biodentine (Septodont, France), and TotalFill Bioceramic Root Repair Material (BC RRM; FKG Dentaire Sàrl, Switzerland). The samples were kept in methylene blue dye and split longitudinally. The degree of dye penetration was observed under a stereomicroscope and scored. Finally, the results were analyzed. RESULTS TotalFill BC RRM and Biodentine showed the least apical microleakage (p <0.05). Group 1 samples had the highest mean microleakage, followed by Group 2, Group 3, and Group 4 samples. CONCLUSION All of the sample groups showed some evidence of microleakage, but not all of the samples showed leaking. SuperEBA (Group 1) demonstrated the highest microleakage when compared to the other groups.
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Affiliation(s)
- Angitha S
- Conservative Dentistry and Endodontics, Institute of Dental Studies & Technologies, Ghaziabad, IND
| | - Saleem Azhar
- Conservative Dentistry and Endodontics, Institute of Dental Studies & Technologies, Ghaziabad, IND
| | - Rishi Manan
- Conservative Dentistry and Endodontics, Institute of Dental Studies & Technologies, Ghaziabad, IND
| | - Neetu Bansal
- Conservative Dentistry and Endodontics, Institute of Dental Studies & Technologies, Ghaziabad, IND
| | - Digvijay Singh
- Conservative Dentistry and Endodontics, Institute of Dental Studies & Technologies, Ghaziabad, IND
| | - Bharat Chauhan
- Conservative Dentistry and Endodontics, Institute of Dental Studies & Technologies, Ghaziabad, IND
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Arabadzhiev IH, Nix C. Ibuprofen intake after apicoectomy-Quantitative indicator for postoperative pain. J Clin Exp Dent 2023; 15:e441-e445. [PMID: 37388431 PMCID: PMC10306380 DOI: 10.4317/jced.60559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/12/2023] [Indexed: 07/01/2023] Open
Abstract
Background Apicoectomy is one of the procedures that are most frequently performed by specialists in oral surgery. This paper presents an analysis of Ibuprofen consumption after apicoectomy and factors such as patient's age, sex and type of resected tooth. Ibuprofen intake is treated as a quantitative indicator of pain sensation. Material and Methods The presented data cover 89 operations with 98 resected teeth. All those apicoectomies were performed by one and the same specialist in oral surgery and all patients were scheduled for a control examination on the day following the intervention. The reported Ibuprofen intake was recorded and analyzed afterwards. Results The mean number of consumed Ibuprofen 400 mg tablets, necessary to eliminate the pain was 1.71 (SD±1.33). Gender was not established as responsible for statistically significant differences. Poor negative statistical correlation was established between age and number of consumed tablets. Older patients used a smaller amount of analgesics. The intake after resection of mandibular molars was statistically significantly higher versus that of the other teeth groups. Eighteen of the patients did not consume any analgesic tablets, constituting 18.3% of the whole group. Two patients needed 5 tablets which was the greatest reported intake. Conclusions Apicoectomy leads to low Ibuprofen intake. The sex is not a statistically significant factor for Ibuprofen use. Poor negative correlation is observed between age and the amount of administered analgesics. This consumption is increased at resection of mandibular molars compared to that for other teeth groups. Almost one fifth of the patients did not need analgesics during the first postoperative day. Key words:Apicoectomy, postoperative pain, Ibuprofen, oral surgery.
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Affiliation(s)
- Ivan-Hristov Arabadzhiev
- Oral Surgeon, Master in Dental Medicine, Master in Public Healthcare and Healthcare Manegement; Oral Surgeon at Oral Surgery Office Dr. Carsten Nix, Landstuhl, Germany
| | - Carsten Nix
- Oral Surgeon, Doctor of dental medicine, Owner of Oral Surgery Office Dr. Carsten Nix, Landstuhl, Germany
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8
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Oliva Rodríguez R, Rangel Galván GY, González Amaro AM, Gutiérrez Cantú FJ, Muñoz Ruiz AI, García Corté JO, Mariel Cárdena J. Correlation between bacterial type/bacterial quantity and bone loss detected by cone beam computed tomography (CBCT) in primary endodontic infections. INVESTIGACIÓN CLÍNICA 2023. [DOI: 10.54817/ic.v64n1a01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Periapical lesions (PL) of endodontic origin are one of the most common pathological conditions that affect peri-radicular tissues. The main ob-jective of this study was to evaluate the amount and species of microorganisms isolated from necrotic pulps, establish a correlation between these and the size of periapical lesions, and how the amount and species of microorganisms decreased with non-surgical root canal treatment. Twenty-seven patients with a clinical diag-nosis of dental pulp necrosis and chronic periapical lesions were selected; a Cone Beam Computed Tomography (CBCT) and microbial samples of the root canal system were taken previous to a disinfection protocol, a post-instrumentation/disinfection protocol, and a post-medication placement. Samples were processed for colony-forming unit (CFU) counting, Gram staining technique, and bacterial identification by the API-20 Strep/API-20A system. The API system identified 21 species of microorganisms in the pre-instrumentation samples, 11 species in the post-instrumentation samples, and 11 in the post-medication samples. There was a correlation coefficient of 0.598% between the initial size of the lesion and the number of bacteria, with a coefficient of determination up to 35.7%, a correla-tion coefficient of 0.486% and a determination coefficient of 23.6% between the size of the periapical lesion and the number of CFUs. This study contributes to the knowledge of the amount and species of microorganisms isolated and identi-fied from necrotic pulps, establishes a correlation between the amount and spe-cies of microorganisms and the size of the periapical lesions, and shows how the decrease of microorganisms contributes to the healing of PL, corroborating the importance of an adequate disinfection protocol.
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Affiliation(s)
- Ricardo Oliva Rodríguez
- Programa de Postgrado en Endodoncia, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - Georgina Yaretzy Rangel Galván
- Programa de Postgrado en Endodoncia, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - Ana María González Amaro
- Programa de Postgrado en Endodoncia, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - Francisco Javier Gutiérrez Cantú
- Programa de Postgrado en Ciencias Dentales, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - Abraham Israel Muñoz Ruiz
- Programa de Postgrado en Ciencias Dentales, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - José Obed García Corté
- Programa de Postgrado en Ciencias Dentales, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - Jairo Mariel Cárdena
- Programa de Postgrado en Ciencias Dentales, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
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Scardini IL, Sarra G, Braga MM, dos Santos M, Freire LG. The Effect of Number of Visits, Use of Solvent and Gutta-percha Removal Technique on Postoperative Pain following Nonsurgical Endodontic Retreatment; A Systematic Review and Meta-analysis. IRANIAN ENDODONTIC JOURNAL 2023; 18:71-84. [PMID: 37152852 PMCID: PMC10155107 DOI: 10.22037/iej.v18i2.39945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/19/2023] [Accepted: 03/16/2023] [Indexed: 05/09/2023]
Abstract
Introduction The nonsurgical endodontic retreatment (NERT) is the first choice of dental ministration when primary/initial endodontic treatment fails. The present study aimed to investigate the presence of postoperative pain (POP) after NERT in permanent asymptomatic teeth as well as possible factors associated with POP. Materials and Methods A comprehensive search of literature was performed in Pubmed/MEDLINE, Embase, Scopus and Web of Science databases, up to January 2023; including randomized clinical trials and prospective studies. The risk of bias was assessed with RoB 2.0 and ROBINS-I tools. Subgroups analyses were conducted to evaluate the differences in the incidence or level of POP between the number of visits, the use/not use of solvent, the removal technique of gutta-percha, and the period of POP analysis. Mean differences and confidence intervals (CI) of 95% were used as measures of effect, and meta-regression was used along with subgroup analysis. The certainty of evidence was assessed using GRADE, and the probability value of <0.05 was considered significant. Results Twenty-four studies were selected, with thirteen included in the meta-analysis. There was a statistical difference between the incidence of POP after 24 h (95% CI, 0.28 to 0.52) and one week (95% CI, 0.02 to 0.13) from the endodontic retreatment (P<0.01). However, there was no statistical difference between different techniques, number of visits and use of solvent (P>0.05) in the same period. In addition, the certainty of evidence was very low. Conclusions Post-operative pain is a common response to NERT, independent of the retreatment technique(s) applied, number of visits and use of solvent(s); with very low certainty of evidence as well as low risk of bias. Moreover, the current analysis showed a (very) serious risk of inconsistency and imprecision. However, POP was significantly reduced within 1 week of the NERT.
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Affiliation(s)
- Iandara Lima Scardini
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, Sao Paulo, Brazil;
- Corresponding author: Iandara Lima Scardini; Department of Restorative Dentistry, Faculty of Dentistry, University of Sao Paulo, Avenue Professor Lineu Prestes, 2227, Zip Code 05508-000, Sao Paulo, SP, Brazil. E-mail:
| | - Giovanna Sarra
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, Sao Paulo, Brazil;
| | - Mariana Minatel Braga
- Department of Pediatric Dentistry, Faculty of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | - Marcelo dos Santos
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, Sao Paulo, Brazil;
| | - Laila Gonzales Freire
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, Sao Paulo, Brazil;
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10
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Comparison of Endodontic Failures between Nonsurgical Retreatment and Endodontic Surgery: Systematic Review and Meta-Analysis with Trial Sequential Analysis. Medicina (B Aires) 2022; 58:medicina58070894. [PMID: 35888613 PMCID: PMC9324533 DOI: 10.3390/medicina58070894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/13/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: In the presence of a persistent endodontic lesion or endodontic failure, the alternative for the recovery of the dental element is endodontic retreatment or endodontic surgery, which consists in the surgical removal of the root apices with retrograde closure of the endodontium. The objective of this systematic review and meta-analysis was to provide an updated value of the Risk Ratio between the two types of treatment in order to offer to clinicians who propose a non-surgical endodontic retreatment or an endodontic surgery a direct comparison. Materials and Methods: The revision was performed according to PRISMA indications: three databases (PubMed, Scopus and Cochrane register) were consulted through the use of keywords relevant to the revision topic: surgical endodontic retreatment, endodontic retreatment, apicoectomy. This search produced 7568 records which, after eliminating duplicates and applying the inclusion and exclusion criteria, resulted in a total of seven included articles. The meta-analyses were conducted by applying fixed-effects models, given the low percentage of heterogeneity. In addition, trial sequency analysis (TSA) was performed for the analysis of the statistical power of the results and GRADE for the quality of the evidence. Results: The results of the meta-analyses’ data report an aggregate risk ratio (RR) between non-surgical endodontic retreatment and surgical endodontic retreatment of: 1.05 [0.74, 1.47] at one year of follow-up; RR 2.22 [1.45, 3.41] at two years of follow-up; an RR 1.08 [0.73 1.62] for a follow-up period of 3–4 years; and an RR 0.92 [0.53, 1.61] for a follow-up period of 8–10 years. Conclusions: The results of the present meta-analysis show that in the long term, the risk of failure is identical for the two groups, and there is only a slightly higher risk of failure for non-surgical endodontic retreatments, when only two years of follow-up are considered.
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11
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Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: A Narrative Review. Pharmaceuticals (Basel) 2021; 14:ph14101041. [PMID: 34681265 PMCID: PMC8539488 DOI: 10.3390/ph14101041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 02/07/2023] Open
Abstract
Platelet concentrates have been widely used in regenerative medicine, including endodontics. The aim of this manuscript was to assess critically the efficacy of PRF in the treatment of endodontic periapical lesions in adult patients on the basis of the literature. The PICO approach was used to properly develop literature search strategies. The PubMed database was analyzed with the keywords: "((PRP) OR (PRF) OR (PRGF) OR (CGF)) AND (endodontic) AND ((treatment) OR (therapy))". After screening of 155 results, 14 articles were included in this review. Different types of platelet concentrates are able to stimulate the processes of proliferation and differentiation of mesenchymal stem cells. Platelet rich fibrin (PRF) releases growth factors for at least 7 days at the application site. Growth factors and released cytokines stimulate the activity of osteoblasts. Moreover, the release of growth factors accelerates tissue regeneration by increasing the migration of fibroblasts. It was not possible to assess the efficacy of PRF supplementation in the treatment of endodontic periapical lesions in permanent, mature teeth with closed apexes, due to the lack of well-designed scientific research. Further studies are needed to analyze the effect of PRF on the healing processes in the periapical region.
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Archila-Montañez E, Medina-Ocampo PE. [Interpretation of periapical healing in radiological images. A review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2021; 9:e087. [PMID: 38463730 PMCID: PMC10919837 DOI: 10.21142/2523-2754-0904-2021-087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/12/2021] [Indexed: 03/12/2024] Open
Abstract
Interpretation of the state of healing of chronic apical periodontitis or apical curettage with apicoectomy in radiological images is based on the analysis of changes in the appearance of the periapical area and in the bone structure adjacent to the site of inflammation or surgical intervention, which are projected onto normal bone structures. However, distortion of structures or the superposition of anatomical images should be considered when interpreting radiographs. We compared conventional studies of evaluation of the periapical area following treatment, together with 2D images, with the periapical index and the criteria of evaluation in both successful and unsuccessful cases of endodontic surgical treatment. Some studies have reported that the radiographic appearance of the tooth crown and root may facilitate interpretation of the periapical area. In addition, cone-beam computed tomography can show the relationship between injured and repairing tissue using buccal and lingual tables to measure the periphery in transverse reconstruction. Indeed, complex biological events and mechanisms can occur during the healing process of periapical and root tissues. Knowledge of the diversity of tissues is essential to identify the dynamics of the signs of regeneration or the presence of healing due to repair. Hence, the aim of this article was to identify the criteria used to interpret periapical healing in two-dimensional or three-dimensional images and their relationship with diagnosis and treatment according to the literature currently available.
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Affiliation(s)
- Eloísa Archila-Montañez
- Especialista en Endodoncia de la Fundación Universitaria San Martín. Bogotá, Colombia. Especialista en Endodoncia Fundación Universitaria San Martín Bogotá Colombia
| | - Paola Elena Medina-Ocampo
- Universidad Científica del Sur. Lima, Perú. Universidad Científica del Sur Universidad Científica del Sur Lima Peru
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Ling Z, Zheng Z, Zeng Y, Jiang L, Wu Y, Wu B, Yan W. Effect of Heat Softening versus Ultrasonic Removal of Root-End Gutta-Percha on the Quality of Root-End Preparation for Endodontic Microsurgery. SCANNING 2021; 2021:8320234. [PMID: 34405033 PMCID: PMC8355974 DOI: 10.1155/2021/8320234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/15/2021] [Accepted: 07/09/2021] [Indexed: 05/05/2023]
Abstract
This study is aimed at comparing the efficacy of heat softening and ultrasonic removal of root-end gutta-percha during retrograde preparation for root apical microsurgery. Recently extracted single-rooted premolars (n = 40) were prepared with standardized endodontically treated and root-end resection and then randomly divided into four groups that received root-end cavity preparation using four different instruments: a diamond-coated ultrasonic tip (AS3D; SACTEON, Paris, France), AS3D with the modified plugger of cordless heat carrier (MSE; B&L Biotech, Bala Cynwyd, PA, USA), stainless steel ultrasonic tip (Jetip-2; B&L Biotech, Bala Cynwyd, PA, USA), or Jetip-2 with MSE. The time required for root-end preparation was recorded. The root apex samples were examined by scanning electron microscopy to assess root surface microcracks and marginal integrity. The remnants of gutta-percha on the cavity walls were evaluated using a stereomicroscope. Statistical analysis was performed using Student's t-test and Wilcoxon rank-sum test (P < 0.05). Usage of MSE with Jetip-2 significantly reduced preparation time from 99.8 ± 6.8 s to 32.4 ± 1.0 s (P = 0.009), the number of microcracks from 42 to 13 (P = 0.036), and the remnants of gutta-percha from 80% to 20% (P = 0.041). Similar results were observed for AS3D with MSE. The heat softening of MSE was effective in cleaning gutta-percha, thus greatly improving the efficiency of the root-end preparation, thereby producing a root-end cavity with fewer microcracks and better marginal integrity.
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Affiliation(s)
- Zhiting Ling
- Department of Conservative and Endodontic Dentistry, Nanfang Hospital, Southern Medical University, 1838 N Guangzhou Road, Guangzhou 510515, China
| | - Ziting Zheng
- Department of Conservative and Endodontic Dentistry, Nanfang Hospital, Southern Medical University, 1838 N Guangzhou Road, Guangzhou 510515, China
| | - Yuting Zeng
- Department of Conservative and Endodontic Dentistry, Nanfang Hospital, Southern Medical University, 1838 N Guangzhou Road, Guangzhou 510515, China
| | - Lifang Jiang
- Department of Conservative and Endodontic Dentistry, Nanfang Hospital, Southern Medical University, 1838 N Guangzhou Road, Guangzhou 510515, China
| | - Yuan Wu
- Department of Conservative and Endodontic Dentistry, Nanfang Hospital, Southern Medical University, 1838 N Guangzhou Road, Guangzhou 510515, China
| | - Buling Wu
- Department of Conservative and Endodontic Dentistry, Nanfang Hospital, Southern Medical University, 1838 N Guangzhou Road, Guangzhou 510515, China
| | - Wenjuan Yan
- Department of Conservative and Endodontic Dentistry, Nanfang Hospital, Southern Medical University, 1838 N Guangzhou Road, Guangzhou 510515, China
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B.P.F.C.® Bio-Plasma® with Pure Growth Factors (BioPlasma®) Used for the Treatment of a Persistent Great Periapical Lesion of an Endodontically Treated Tooth: A New Therapeutic Option. Case Rep Dent 2020; 2020:4876437. [PMID: 32685218 PMCID: PMC7341431 DOI: 10.1155/2020/4876437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 05/22/2020] [Accepted: 06/13/2020] [Indexed: 11/18/2022] Open
Abstract
The aim of this case report was to evaluate the efficacy of a new platelet-rich plasma preparation and its regenerative capacity of bone periapical tissue for the treatment of a very compromised endodontic treated tooth, with a periapical lesion of 1.5 cm in diameter, using a pure platelet concentrate. This is made without the use of anticoagulant or any type of activator, e.g., bovine thrombin, calcium chloride. For this reason, it has been called "Pure"; it is the B.P.F.C.® Bio-Plasma® with Pure Growth Factors (BioPlasma®) designed and developed by Dr. Raffaello Viganò. The patient has read and signed a written consent form. The study protocol was approved by the Ethics Committee for Human Studies, University of Varese. X-ray at 2 and 6 months and 4 years after endodontic surgery demonstrated the success of the treatment.
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The Efficacy of Rotary, Reciprocating, and Combined Non-Surgical Endodontic Retreatment Techniques in Removing a Carrier-Based Root Canal Filling Material from Straight Root Canal Systems: A Micro-Computed Tomography Analysis. J Clin Med 2020; 9:jcm9061989. [PMID: 32630387 PMCID: PMC7355862 DOI: 10.3390/jcm9061989] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/11/2020] [Accepted: 06/22/2020] [Indexed: 11/23/2022] Open
Abstract
The aim of this study is to analyze and compare the efficacy of three non-surgical endodontic retreatment techniques in removing a carrier-based root canal filling material from straight root canal systems. The study was performed on 99 single-rooted extracted teeth using the ProTaper Gold endodontic rotary system up to the F2 file (Dentsply Maillefer, Baillagues, Switzerland), which were sealed with GuttaCore (Dentsply Maillefer, Ballaigues, Switzerland) and AH plus epoxy resin sealer (Dentsply DeTrey, Konstanz, Germany) and randomly assigned to the following non-surgical retreatment techniques: ProTaper Retreatment endodontic rotary instruments (D1–D3 files, Dentsply Maillefer, Ballaigues, Switzerland; n = 33, PTR), Reciproc Blue endodontic reciprocating instrument (R50, VDW, Munich, Germany; n = 33, RCB50), and a combined root canal retreatment technique between Gates-Glidden drills (sizes #3 and #2, Dentsply Maillefer, Ballaigues, Switzerland) and Hedstrom files (file size 35, 30, and 25, Dentsply Maillefer, Ballaigues, Switzerland; n = 33; H-GG). All of the teeth were submitted twice to a micro-computed tomography (micro-CT) scan, before and after non-surgical endodontic retreatment procedures. The volume of root canal filling material (mm3), volume of remaining root canal filling material (mm3), non-surgical endodontic retreatment working time (min), proportion of remaining root canal filling material (%), and efficacy of root canal filling material removal between the non-surgical endodontic retreatment techniques were analyzed using ANOVA one-way statistical analysis. Statistically significant differences were observed between the proportions of remaining root canal filling material of PTR and H-GG (p = 0.018), between the non-surgical endodontic retreatment working times (min; p < 0.001), and between the efficacies of root canal filling material removal by the non-surgical endodontic retreatment techniques (p = 0.009). However, the non-surgical endodontic retreatment systems allow for similar carrier-based root canal filling material removal.
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