1
|
Beauquis J, Setbon HM, Dassargues C, Carsin P, Aryanpour S, Van Nieuwenhuysen JP, Leprince JG. Short-Term Pain Evolution and Treatment Success of Pulpotomy as Irreversible Pulpitis Permanent Treatment: A Non-Randomized Clinical Study. J Clin Med 2022; 11:jcm11030787. [PMID: 35160239 PMCID: PMC8836521 DOI: 10.3390/jcm11030787] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 02/05/2023] Open
Abstract
The objective of this work was to evaluate (1) the short-term evolution of pain and (2) the treatment success of full pulpotomy as permanent treatment of irreversible pulpitis in mature molars. The study consisted of a non-randomized comparison between a test group (n = 44)—full pulpotomy performed by non-specialist junior practitioners, and a control group (n = 40)—root canal treatments performed by specialized endodontists. Short-term pain score (Heft–Parker scale) was recorded pre-operatively, then at 24 h and 7 days post-operatively. Three outcomes were considered for treatment success: radiographic, clinical and global success. For short-term evolution of pain, a non-parametric Wilcoxon test was performed (significance level = 0.05). For treatment success, a Pearson Chi square or Fisher test were performed (significance level = 0.017–Bonferroni correction). There was no significant difference between test and control groups neither regarding short term evolution of pain at each time point, nor regarding clinical (80% and 90%, respectively) or global success (77% and 67%, respectively). However, a significant difference in radiographic success was observed (94% and 69%, respectively). The present work adds to the existing literature to support that pulpotomy as permanent treatment could be considered as an acceptable and conservative treatment option, potentially applied by a larger population of dentists.
Collapse
Affiliation(s)
- Julien Beauquis
- Adult and Child Dentistry, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium; (C.D.); (P.C.); (S.A.); (J.-P.V.N.)
- DRIM Research Group & Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium;
- Correspondence: (J.B.); (J.G.L.)
| | - Hugo M. Setbon
- DRIM Research Group & Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium;
- Private Practice, Av. Louise 391, 1050 Brussels, Belgium
| | - Charles Dassargues
- Adult and Child Dentistry, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium; (C.D.); (P.C.); (S.A.); (J.-P.V.N.)
- DRIM Research Group & Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium;
- Private Practice, Rue Edmond Laffineur 9, 1300 Wavre, Belgium
| | - Pierre Carsin
- Adult and Child Dentistry, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium; (C.D.); (P.C.); (S.A.); (J.-P.V.N.)
- DRIM Research Group & Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium;
- Private Practice, All. de la Minerva 2, 1150 Brussels, Belgium
| | - Sam Aryanpour
- Adult and Child Dentistry, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium; (C.D.); (P.C.); (S.A.); (J.-P.V.N.)
- DRIM Research Group & Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium;
- Private Practice, Rte du Lion 10, 1420 Braine-l’Alleud, Belgium
| | - Jean-Pierre Van Nieuwenhuysen
- Adult and Child Dentistry, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium; (C.D.); (P.C.); (S.A.); (J.-P.V.N.)
- DRIM Research Group & Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium;
| | - Julian G. Leprince
- Adult and Child Dentistry, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium; (C.D.); (P.C.); (S.A.); (J.-P.V.N.)
- DRIM Research Group & Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium;
- Correspondence: (J.B.); (J.G.L.)
| |
Collapse
|
2
|
Aryanpour S, D'Hoore W, Van Nieuwenhuysen JP. [Test your decision making skills. When should endodontic treatment be redone?]. Rev Belge Med Dent (1984) 2003; 54:233-41. [PMID: 12723165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Research has shown wide variations in dentists' clinical attitude towards root canal treated teeth. Simulated cases are used as tools in the investigation of practitioners' clinical behavior and decision making. We therefore used simulated cases (clinical histories and radiographs) of 14 endodontically treated teeth to: (1) determine the predominant proposed treatment strategy for each case, (2) evaluate the consensus, if any, among practitioners, (3) identify pathology and dentist factors influencing the treatment choice.
Collapse
Affiliation(s)
- S Aryanpour
- Service de Pathologie et Thérapeutique Dentaires, Ecole de Médecine dentaire et de Stomatologie, Université Catholique de Louvain, Ecole de Médecine dentaire et de Stomatologie, Avenue Hippocrate, No. 15, 1200 Bruxelles
| | | | | |
Collapse
|
3
|
Abstract
AIM To describe a rare case of gemination involving a mandibular first premolar. SUMMARY The complex morphology of geminated teeth renders their endodontic and periodontal management difficult. Root canal and periodontal treatments were performed on a geminated mandibular first premolar with three canals. Clinical examination showed two separated crowns with united roots. Radiographically, two distinct pulp chambers with two joined and a third independent canal were seen. Conventional root canal treatment resulted in complete healing of the apical lesion. However, the occurrence of a vertical fracture led to the extraction of the mesial segment. At the follow-up visit, the distal segment was clinically healthy and continued to satisfy functional demands.
Collapse
Affiliation(s)
- S Aryanpour
- Department of Dental Medicine and Stomatology, Université Catholique de Louvain, Brussels, Belgium
| | | | | |
Collapse
|
4
|
Aryanpour S, D'Hoore W, Van Nieuwenhuysen JP. [Test your decision-making. When to do endodontic retreatment? Some therapeutic alternatives]. Rev Belge Med Dent (1984) 2001; 55:302-12. [PMID: 11505756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The aim of the present article was to propose examples of treatment alternatives for the management of 14 clinical cases. All these cases involved endodontically treated teeth and have been managed by the same practitioner. In this paper, the authors tried to show the variety of treatment alternatives as well as the complexity of the decision-making process and, not to consider that proposed alternatives were the most adequate.
Collapse
Affiliation(s)
- S Aryanpour
- Service de Pathologie et Thérapeutique Dentaires, Ecole de Médecine Dentaire et de Stomatologie, Université Catholique de Louvain, Avenue Hippocrate, no. 15, 1200 Bruxelles
| | | | | |
Collapse
|
5
|
Aryanpour S, D'Hoore W, Van Nieuwenhuysen JP. [Test your decision-making. When to do endodontic retreatment? Results of a study]. Rev Belge Med Dent (1984) 2001; 55:289-301. [PMID: 11505755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The goals of this survey were to determine the most frequent therapeutic option and to evaluate the consensus among a sample of Belgian practitioners managing the same simulated cases of root treated teeth. On average, conservative options (nonsurgical retreatment 35.27% and no retreatment 29.61%) are the most selected alternatives. Surgical options and extraction respectively constitute 21.18% and 13% of the treatment propositions. As expected, the presence of radiographic and/or clinical signs resulted in a more aggressive attitude, but the presence of symptoms does not seem to be a valid reason for reintervention. The results of the study demonstrate considerable interindividual variations in clinical management of root treated teeth, regardless of personal factors, such as gender, years of experience and graduation institution. Even if a consensus appears within a group of professionals, it is not necessarily applied by a majority of practitioners; this contributes certainly to the explanation of the geographical or institutional variations noted in the medical practices.
Collapse
Affiliation(s)
- S Aryanpour
- Service de Pathologie et Thérapeutique Dentaires, Ecole de Médecine Dentaire et de Stomatologie, Universite Catholique de Lovain, Avenue Hippocrate No 15 1200 Bruxelles
| | | | | |
Collapse
|
6
|
Abstract
AIM The objectives of the present study were to: (i) evaluate the consensus, if any, amongst dental schools, students and their instructors managing the same clinical cases, all of which involved endodontically treated teeth; and (ii) determine the predominant proposed treatment option. METHODOLOGY Final year students, endodontic staff members and instructors of 10 European dental schools were surveyed as decision makers. Fourteen different radiographic cases of root canal treated teeth accompanied by a short clinical history were presented to them in a uniform format. For each case the decision makers were requested to: (i) choose only one out of nine treatment alternatives proposed, from 'no treatment' to 'extraction' via 'retreatment' and 'surgery' (ii) assess on two 5-point scales: the difficulty of making a decision, and the technical complexity of the retreatment procedure. RESULTS The results indicate wide inter- and also intra-school disagreements in the clinical management of root canal treated teeth. Analysis of variance showed that the main source of variation was the 'school effect', explaining 1.8% (NS) to 18.6% (P < 0.0001) of the treatment variations. No other factor explained as much variance. Decision difficulty was moderately correlated to technical complexity (Pearsons' r ranging from 0.19 to 0.35, P < 0.0001). CONCLUSIONS No clear consensus occurred amongst and within dental schools concerning the clinical management of the 14 cases. The lack of consensus amongst schools seems to be due mainly to chance or uncertainty, but can be partly explained by the 'school effect'.
Collapse
Affiliation(s)
- S Aryanpour
- Department of Operative Dentistry, School of Dental Medicine and Stomatology, Université Catholique de Louvain, Belgium
| | | | | |
Collapse
|