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Vieira AR, Pacheco-Yanes J, Gazzaneo ID, Neves MAS, Siqueira JF, Gonçalves LS. Factors influencing the outcome of nonsurgical root canal treatment and retreatment: A retrospective study. AUST ENDOD J 2024. [PMID: 38214429 DOI: 10.1111/aej.12828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 12/20/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
This study assessed the influence of diverse variables on the outcome of nonsurgical root canal treatment/retreatment. In general, 304 teeth from 218 patients were treated/retreated and the outcome evaluated by the periapical index (PAI). Teeth with apical periodontitis lesions that have not completely healed were classified as success or failure based on lenient and rigid criteria, respectively. Findings were evaluated using a logistic regression analysis. The overall success rates were 74% and 82% using the PAI-rigid and lenient success criteria, respectively. Specifically for treatment, the success rates were 73% (rigid) and 82% (lenient), while for retreatment they were 78% (rigid) and 83% (lenient). The treatment outcome was negatively affected by overextension, presence of preoperative lesion, lesion size >10 mm, and higher number of treatment visits (with no intracanal medication). Regarding retreatment, the chance of success was greater for teeth with adequate coronal restorations.
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Affiliation(s)
- Adalberto R Vieira
- Postgraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Juan Pacheco-Yanes
- Postgraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Isbelia D Gazzaneo
- Postgraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Mônica A S Neves
- Postgraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - José F Siqueira
- Postgraduate Program in Dentistry, Grande Rio University, Rio de Janeiro, Brazil
| | - Lucio S Gonçalves
- Postgraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
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Pacheco-Yanes J, Reynolds E, Li J, Mariño E. Microbiome-targeted interventions for the control of oral-gut dysbiosis and chronic systemic inflammation. Trends Mol Med 2023; 29:912-925. [PMID: 37730461 DOI: 10.1016/j.molmed.2023.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023]
Abstract
Recent research has confirmed the strong connection between imbalances in the oral and gut microbiome (oral-gut dysbiosis), periodontitis, and inflammatory conditions such as diabetes, Alzheimer's disease, and cardiovascular diseases. Microbiome modulation is crucial for preventing and treating several autoimmune and inflammatory diseases, including periodontitis. However, the causal relationships between the microbiome and its derived metabolites that mediate periodontitis and chronic inflammation constitute a notable knowledge gap. Here we review the mechanisms involved in the microbiome-host crosstalk, and describe novel precision medicine for the control of systemic inflammation. As microbiome-targeted therapies begin to enter clinical trials, the success of these approaches relies upon understanding these reciprocal microbiome-host interactions, and it may provide new therapeutic avenues to reduce the risk of periodontitis-associated diseases.
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Affiliation(s)
- Juan Pacheco-Yanes
- Department of Biochemistry and Molecular Biology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Eric Reynolds
- Oral Health Collaborative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Victoria, Australia
| | - Jian Li
- Department of Microbiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Eliana Mariño
- Department of Biochemistry and Molecular Biology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia; ImmunoBiota Therapeutics Pty Ltd, Melbourne, Australia.
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Pacheco-Yanes J, Gazzaneo I, Campello AF, Marceliano-Alves MF, Estrela C, Bueno MR, Lopes RT, Rôças IN, Alves FRF, Siqueira JF. Planned Apical Preparation Using Cone-Beam Computed Tomographic Measures: A Micro-Computed Tomographic Proof of Concept in Human Cadavers. J Endod 2021; 48:280-286. [PMID: 34871632 DOI: 10.1016/j.joen.2021.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/12/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION This study assessed the amount of unprepared surface areas at the apical 4-mm segment of the root canal after a planned preparation based on cone-beam computed tomography (CBCT) measurements. METHODS Eighteen posterior mandible segments were obtained from cadavers and scanned using CBCT and micro-computed tomographic (micro-CT) imaging. CBCT images were used to measure the largest initial canal diameter from 29 root canals of premolars at 1, 2, 3, and 4 mm short of the apical foramen. Each measurement was used to select a master apical instrument with size/taper that was 1 diameter larger to prepare the apical 4 mm of each particular root canal. A post-preparation micro-CT scan was obtained, and the unprepared canal areas were calculated. RESULTS A very high amount of surface areas over the apical 4 mm of the root canal was included in the final preparation (mean >90%). The unprepared areas ranged from as low as 3.7% to a maximum of 14.6% (mean and median, 9.2% and 9.1%, respectively). CONCLUSIONS The proposed planned apical root canal preparation resulted in optimized root canal shaping with a substantial amount of prepared surface areas. The protocol used also resulted in a conservative canal enlargement using final instruments that were 1 size larger than the initial largest canal diameter.
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Affiliation(s)
- Juan Pacheco-Yanes
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Isbelia Gazzaneo
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Andrea F Campello
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Marília F Marceliano-Alves
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Carlos Estrela
- School of Dentistry, Department of Endodontics, Federal University of Goiás, Goiânia, Brazil
| | | | - Ricardo T Lopes
- Department of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isabela N Rôças
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávio R F Alves
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil.
| | - José F Siqueira
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
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Gazzaneo I, Amoroso-Silva P, Pacheco-Yanes J, Alves FRF, Marceliano-Alves M, Olivares P, Meto A, Mdala I, Siqueira JF, Rôças IN. Disinfecting and Shaping Type I C-shaped Root Canals: A Correlative Micro-computed Tomographic and Molecular Microbiology Study. J Endod 2020; 47:621-630. [PMID: 33220400 DOI: 10.1016/j.joen.2020.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION This ex vivo study compared the disinfection and shaping abilities of 2 preparation protocols in C-shaped canals. METHODS Mandibular second molars with type I C-shaped canals were pair matched based on micro-computed tomographic (micro-CT) analysis and distributed into 2 groups. The canals were contaminated with a mixed bacterial culture and prepared using 2 protocols, both with 2.5% sodium hypochlorite irrigation: XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) supplemented with XP-endo Finisher (FKG Dentaire) (XP-E) and BioRaCe (FKG Dentaire) supplemented with a Hedström file (Dentsply/Sirona, Tulsa, OK) (BR-Hed). Micro-CT scans and intracanal bacteriologic samples were taken before (scan #1 and sample 1) and after preparation (scan #2 and sample 2) and after the supplementary step (scan #3 and sample 3). Canal shaping was evaluated by micro-CT imaging, and disinfection was assessed by quantitative polymerase chain reaction. RESULTS Micro-CT data from the XP-E (n = 21) and BR-Hed (n = 23) protocols revealed no significant differences between groups regarding shaping parameters (canal volume, surface area, structure model index, and prepared walls) after preparation and after the supplementary step (P > .05). All these parameters significantly increased after each preparation step (P < .05), except for structure model index changes after the XP-endo Finisher (P > .05). Bacteriologic data from the XP-E (n = 21) and BR-Hed (n = 22) groups showed that 14 (66.7%) and 10 (45.5%) S2 samples still had detectable bacteria, respectively. The corresponding figures for supplementary steps with the XP-endo Finisher and Hedström file were 11 (52.4%) and 10 (45.5%), respectively. Bacterial counts in sample 1 significantly decreased in samples 2 and 3 in both groups (P < .01). Intragroup comparison between sample 2 and sample 3 showed a 66% reduction in counts after using the Hedström file and 18% after using the XP-endo Finisher (P > .05 for both groups). The quantitative bacterial reduction was not different between groups (P > .05). CONCLUSIONS The XP-endo Shaper and BioRaCe systems have similar disinfecting and shaping abilities in C-shaped canals. Supplementary steps with the Hedström file and the XP-endo Finisher were similarly effective in improving shaping, but this was not sufficient to enhance disinfection. About half of the cases, in both groups, still harbored detectable amounts of bacteria.
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Affiliation(s)
- Isbelia Gazzaneo
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pablo Amoroso-Silva
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Restorative Dentistry, Londrina State University, Paraná, Brazil
| | - Juan Pacheco-Yanes
- Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil.
| | - Marilia Marceliano-Alves
- Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Patricia Olivares
- Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Aida Meto
- Laboratory of Microbiology and Virology, University of Modena and Reggio Emilia, Modena, Italy
| | - Ibrahimu Mdala
- Department of General Practice, University of Oslo, Oslo, Norway
| | - José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Isabela N Rôças
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
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Salas H, Vieira GCS, Palomino I, Valero J, Pacheco-Yanes J, Campello AF, Pérez AR. Outcome of endodontic treatment with chlorhexidine gluconate as main irrigant: A case series. AUST ENDOD J 2020; 46:307-314. [PMID: 32154646 DOI: 10.1111/aej.12401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2020] [Indexed: 11/27/2022]
Abstract
This study evaluated the overall endodontic therapy success using 0.12% or 2% chlorhexidine gluconate as main irrigant. Seventy-two teeth diagnosed as vital, necrotic or previously treated teeth with apical periodontitis that were consecutively treated by orthograde therapy. All cases were followed clinically and radiographically for at least 1-year period. Success was established in teeth without signs or adverse clinical symptoms and complete or incomplete radiographic healing. Failure was determined in teeth with any sign or adverse clinical symptoms and a new, unchanged or enlarged radiographic periapical lesion. The data were analysed using chi-square and Fischer's exact tests. The overall success rate for teeth undergoing vital pulp was 84.6%, 76.2% as for the necrotic teeth and 84% for the retreatment cases. No significant differences were observed between groups (P > 0.05). Cases treated with CHX as main irrigant showed a high overall endodontic therapy success rate.
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Affiliation(s)
- Hair Salas
- School of Dentistry of the Catholic University of Santa Maria, Arequipa, Perú
| | - Gaya C S Vieira
- Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - Ivo Palomino
- School of Dentistry of the Catholic University of Santa Maria, Arequipa, Perú
| | - Javier Valero
- School of Dentistry of the Catholic University of Santa Maria, Arequipa, Perú
| | - Juan Pacheco-Yanes
- Post-graduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Andrea F Campello
- Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - Alejandro R Pérez
- Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Brazil
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Costa FFNP, Pacheco-Yanes J, Siqueira JF, Oliveira ACS, Gazzaneo I, Amorim CA, Santos PHB, Alves FRF. Association between missed canals and apical periodontitis. Int Endod J 2018; 52:400-406. [DOI: 10.1111/iej.13022] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 09/30/2018] [Indexed: 12/28/2022]
Affiliation(s)
- F. F. N. P. Costa
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | - J. Pacheco-Yanes
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | - J. F. Siqueira
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | - A. C. S. Oliveira
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | - I. Gazzaneo
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | - C. A. Amorim
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | | | - F. R. F. Alves
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
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