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Alfaisal Y, Idris G, Peters OA, Zafar S, Nagendrababu V, Peters CI. Vital pulp therapy-Factors influencing decision-making for permanent mature teeth with irreversible pulpitis: A systematic review. Int Endod J 2024; 57:505-519. [PMID: 38326290 DOI: 10.1111/iej.14036] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND There is an increased tendency towards adopting minimally invasive interventions in dentistry, supported by advancement in materials and techniques. However, the decision-making process in choosing conservative or invasive treatments is influenced by several factors, particularly in permanent teeth with irreversible pulpitis. OBJECTIVES The objective of the study was to systematically review the literature regarding factors that influence decision-making for vital pulp therapy (VPT) as definitive treatment option in permanent mature teeth diagnosed with irreversible pulpitis. METHODS Two independent reviewers searched five electronic databases (PubMed, Embase, Web of Science, Scopus and Cochrane Library). Grey literature was searched through Google Scholar and contact with experts. Defined search keys were applied, and all peer-reviewed literature published with no language nor publication date limits were included. The All studies investigating the factors influencing treatment decision-making in mature permanent teeth with irreversible pulpitis were included. The quality of included studies was assessed by two independent reviewers using the Joanna Briggs Institute quality assessment tool. RESULTS Six articles were included in the review. All included studies used questionnaires to characterize clinician preferences and attitudes in choosing treatment options for mature permanent teeth with irreversible pulpitis. The available evidence suggests that dentist-related factors have a significant influence on the chosen treatment in teeth with irreversible pulpitis, with speciality training and years of experience influencing the choice of VPT over other treatment options. COVID-19 reportedly swayed the dentists' decision to favour VPT. Only one article studied the influence of patient-related factors, such as age and presence of spontaneous pain on decision-making. Of note, a history of cardiovascular disease moved dentists towards prescribing VPT. DISCUSSION Collectively, the included studies demonstrated an overriding influence of dentist-related factors on choosing among treatment options for painful teeth diagnosed with irreversible pulpitis. Patient-related factors were acknowledged but there are also potential factors such as socio-economic constraints that were not included in the component studies. CONCLUSION In teeth with irreversible pulpitis clinicians educational background influence the decision towards a specific treatment option. Further data, preferably derived from clinical records, is necessary in future investigations to explore the effect of other important factors related to both dentists and patients. REGISTRATION PROSPERO database (CRD42022339653).
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Affiliation(s)
- Yasmen Alfaisal
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Ghassan Idris
- Metro North Hospital and Health Services, Queensland Health, Brisbane, Queensland, Australia
| | - Ove A Peters
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Sobia Zafar
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Christine I Peters
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
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Keratiotis G, Spineli L, De Bruyne MAA, De Moor RJG, Meire MA. A 22-year follow-up cross-sectional study on periapical health in relation to the quality of root canal treatment in a Belgian population. Int Endod J 2024; 57:533-548. [PMID: 38314902 DOI: 10.1111/iej.14032] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/12/2023] [Accepted: 01/15/2024] [Indexed: 02/07/2024]
Abstract
AIM To investigate the prevalence of apical periodontitis (AP) and the technical standard of root canal treatment in a Belgian population, assess the association of different variables with periapical status, and compare the results to a similar study conducted 22 years previously. METHODOLOGY In this cross-sectional study, 614 panoramic radiographs of first-time adult attendees at the Dental School of the University Hospital of Ghent were examined. Recorded patient-level parameters included gender, age, number of teeth, number of root filled teeth, presence of any AP lesion, and number of implants. The following tooth-level data were collected: tooth presence, coronal status, quality of coronal restoration, post presence, type of root-filling material, length and density of root filling, root-end filling material, presence of AP, and adjacent implant. Multivariable multilevel binary logistic regression was used to explore the association between patient and tooth characteristics and AP prevalence. Risk differences and confidence intervals were calculated to compare the present with the previous study. RESULTS The prevalence of AP at patient and tooth level was 46.9% and 5.6%, respectively. Fifty-one per cent of the 614 patients had at least one root filled tooth, and 5.9% of the 14 655 teeth studied were root filled. AP was found in 45% of root filled teeth. Fifty-four per cent of the root-filled teeth were rated as inadequate. Multivariable multilevel logistic regression revealed that more teeth, more implants, fewer root-filled teeth, adequate density, adequate coronal restoration, and no caries reduced the likelihood of AP. There were no statistically significant differences between the two studies regarding the prevalence of root-filled teeth or AP and the technical quality of root canal treatment. CONCLUSIONS The prevalence of AP and the technical quality of root canal treatment in Belgium have not substantially changed over the last 22 years, despite the technological advancements and continuing education in the field.
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Affiliation(s)
- Georgios Keratiotis
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Loukia Spineli
- Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany
| | - Mieke A A De Bruyne
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Roeland J G De Moor
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Maarten A Meire
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
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Nagendrababu V, Pigg M, Duncan HF, Abbott PV, Fouad AF, Kruse C, Patel S, Rechenberg DK, Setzer FC, Rossi-Fedele G, Dummer PMH. PRIDASE 2024 guidelines for reporting diagnostic accuracy studies in endodontics: A consensus-based development. Int Endod J 2024. [PMID: 38669132 DOI: 10.1111/iej.14075] [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: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Studies investigating the accuracy of diagnostic tests should provide data on how effectively they identify or exclude disease in order to inform clinicians responsible for managing patients. This consensus-based project was undertaken to develop reporting guidelines for authors submitting manuscripts, which describe studies that have evaluated the accuracy of diagnostic tests in endodontics. These guidelines are known as the Preferred Reporting Items for Diagnostic Accuracy Studies in Endodontics (PRIDASE) 2024 guidelines. A nine-member steering committee created an initial checklist by integrating and modifying items from the Standards for Reporting of Diagnostic Accuracy (STARD) 2015 checklist and the Clinical and Laboratory Images in Publications (CLIP) principles, as well as adding a number of new items specific to the specialty of endodontics. Thereafter, the steering committee formed the PRIDASE Delphi Group (PDG) and the PRIDASE Online Meeting Group (POMG) in order to collect expert feedback on the preliminary draft checklist. Members of the Delphi group engaged in an online Delphi process to reach consensus on the clarity and suitability of the items in the checklist. The online meeting group then held an in-depth discussion on the online Delphi-generated items via the Zoom platform on 20 October 2023. According to the feedback obtained, the steering committee revised the PRIDASE checklist, which was then piloted by several authors when preparing manuscripts describing diagnostic accuracy studies in endodontics. Feedback from this process resulted in the final version of the PRIDASE 2024 checklist, which has 11 sections and 66 items. Authors are encouraged to use the PRIDASE 2024 guidelines when developing manuscripts on diagnostic accuracy in endodontics in order to improve the quality of reporting in this area. Editors of relevant journals will be invited to include these guidelines in their instructions to authors.
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Affiliation(s)
- Venkateshbabu Nagendrababu
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Maria Pigg
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Henry F Duncan
- Division of Restorative Dentistry, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Paul V Abbott
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Ashraf F Fouad
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Casper Kruse
- Section of Oral Radiology and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Center for Oral Health in Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Shanon Patel
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences at Kings' College London, London, UK
| | - Dan K Rechenberg
- Department of Conservative and Preventive Dentistry, University of Zürich, Zürich, Switzerland
| | - Frank C Setzer
- University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Giampiero Rossi-Fedele
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Stiklaru I, Lalum E, Hamoud S, Paz M, Levin A, Ben Itzhak J, Yavnai N, Gorenbein P, Solomonov M. The ability of different compositions of calcium silicate and epoxy sealers to withstand gutta percha removal via in vitro pull-out testing. BDJ Open 2024; 10:31. [PMID: 38589349 PMCID: PMC11001859 DOI: 10.1038/s41405-024-00212-9] [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: 12/19/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVE examination of the influence of chemical composition changes on the ability of sealers to withstand a pull-out test. MATERIALS AND METHODS Fifty distal or palatal canals of extracted teeth were prepared by Dc Taper files. The teeth were divided into five groups: AH Plus, BJM RCS, Total Fill BC,AH Plus Bioceramic and a group with Gutta Percha with no sealer added. Ten days after obturation, each cone was subjected to the "pull-out test" with the Shimadzo Universal Testing Machine until it was torn or removed from the canal. A force to Stroke graph was generated and the maximum vertex of this graph was recorded. The number of times the cone was torn or removed was recorded. RESULTS The amount of force needed to remove or rupture the cone was significantly higher in all sealer groups compared to the AH Plus Bioceramic group. The force needed for the AH Plus group was double that needed for the AH Plus Bioceramic group 4 (1.87 ± 0.53 N vs 0.93 ± 0.48 N, respectively, P < 0.001). All of the cones (n = 10) in the AH Plus Bio Ceramic Sealer group were removed in their entirety (P = 0.01 compared to each of the other groups). CONCLUSIONS The addition of macromolecules to epoxy sealer does not change the material's ability to withstand the pull-out test. Decreasing the amount of tri- and di-calcium silicate compounds combined with increasing amounts of zirconium oxide in a Bioceramic sealer significantly decreased the material's ability to withstand the pull-out test.
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Affiliation(s)
- Idan Stiklaru
- Department of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer, Shiba Road 2, Ramat- gan, Israel.
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel.
| | - Ella Lalum
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
| | - Sobhi Hamoud
- Department of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer, Shiba Road 2, Ramat- gan, Israel
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
| | - Maayan Paz
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
| | - Avi Levin
- Department of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer, Shiba Road 2, Ramat- gan, Israel
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer, Shiba Road 2, Ramat- gan, Israel
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
| | - Nirit Yavnai
- Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University, Hadassah Ein Kerem Campus, 12271, Jerusalem, Israel
| | - Pavel Gorenbein
- Medical Supplies, Pharmacy, and Biomedical Engineering Branch, Israel Defense Forces (IDF), Medical Corps, Tel Aviv, Israel
| | - Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer, Shiba Road 2, Ramat- gan, Israel
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
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Al-Ani AM, Ali AH, Koller G. Assessment of Bacterial Load and Post-Endodontic Pain after One-Visit Root Canal Treatment Using Two Types of Endodontic Access Openings: A Randomized Controlled Clinical Trial. Dent J (Basel) 2024; 12:88. [PMID: 38668000 PMCID: PMC11049031 DOI: 10.3390/dj12040088] [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: 02/27/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
The need for controlling bacteria and pain during root canal therapy is undeniable. This clinical trial aimed to assess whether there is a difference in colony-forming unit (CFU) reduction after instrumentation and post-endodontic pain after root canal treatment (RCT) using a traditional endodontic cavity (TEC) versus a conservative endodontic cavity (CEC). This clinical study was conducted on 89 patients designated for a single-visit RCT. Patients were allocated randomly (TEC n = 45 and CEC n = 44). The access opening was gained accordingly in each group by a single operator. A pre-instrumentation sample of root canal dentin was collected using an endodontic file; the second sample was collected similarly, right after shaping and cleaning the root canal. The CFU was calculated based on the samples collected. The pain level was recorded preoperatively and at 1, 7, and 21 days postoperatively utilizing a visual analog scale (VAS). There were no statistically significant differences in the CFU reduction between the TEC and CEC groups (p > 0.05). Additionally, there were no statistically significant differences found in postoperative pain levels between the TEC and CEC at 1, 7, and 21 days (p > 0.05). Despite the limitations of this study, both the CEC and TEC demonstrate a decrease in bacteria within the root canals and alleviate postoperative pain with no difference between them.
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Affiliation(s)
- Ahmed M. Al-Ani
- Aesthetic and Restorative Dentistry Department, College of Dentistry, University of Baghdad, Baghdad 10071, Iraq;
| | - Ahmed H. Ali
- Aesthetic and Restorative Dentistry Department, College of Dentistry, University of Baghdad, Baghdad 10071, Iraq;
| | - Garrit Koller
- Conservative and MI Dentistry (Including Endodontics), King’s College London Dental Institute at Guy’s Hospital, King’s Health Partners, London SE1 9RT, UK;
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London WC2R 2LS, UK
- London Centre for Nanotechnology, London WC1H 0AH, UK
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Kökan EC, Atik Y, Özüpek Ş, Podnos E, Erişen R. Finite element study of the fatigue behaviour of nickel-titanium endodontic files utilised with pecking motion technique. AUST ENDOD J 2024; 50:97-109. [PMID: 37994546 DOI: 10.1111/aej.12813] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/18/2023] [Accepted: 10/30/2023] [Indexed: 11/24/2023]
Abstract
The purpose of the study is to evaluate the influence of the pecking motion (reciprocal axial motion) surgical technique on the durability behaviour of the Nickel-Titanium endodontic files using Finite Element Analysis (FEA). A commonly used endodontic file, ProTaper Universal F2, is selected for the study. Root canal treatment procedure is simulated on a test-bench (simulated root canal) proposed by G. Gambarini for cyclic fatigue loading of endodontic files with and without the pecking motion via FEA. The hysteresis energy density is used as evaluation criteria for low cycle fatigue life estimation of Shape Memory Alloy files. In an additional study, the root canal treatment procedure is also simulated for an FEA model of a molar tooth with significant root canal curvature to understand the influence of the realistic curvature of a root canal on the fatigue behaviour of endodontic files. For the simulated root canal, analysis accurately predicts the endodontic file's failure location, and fatigue life estimation based on the hysteresis energy density is shown to increase significantly with the introduction of the pecking motion, an observation confirmed by reported experimental results. Molar tooth simulations reveal greater file fatigue resistance than in simulated root canals, confirming the pecking motion's efficacy in enhancing file durability, even in real root canal conditions. Simulations indicate that the pecking motion technique increases the fatigue life of endodontic files for simulated as well as real root canals and the hysteresis energy is confirmed as an acceptable parameter to quantify fatigue life of Nickel-Titanium endodontic files.
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Affiliation(s)
- Eyüp Can Kökan
- Department of Mechanical Engineering, Boğaziçi University, İstanbul, Turkey
| | - Yasin Atik
- Department of Mechanical Engineering, Boğaziçi University, İstanbul, Turkey
| | - Şebnem Özüpek
- Department of Mechanical Engineering, Boğaziçi University, İstanbul, Turkey
| | - Evgeny Podnos
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, Texas, USA
| | - Raif Erişen
- Department of Clinical Sciences, Nişantaşı University, İstanbul, Turkey
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Li T, Meng X, Zhou S, Li S, Luo Q, Zhang T. Complete idiopathic resorption of distobuccal root of a maxillary first molar: A case report. Clin Case Rep 2024; 12:e8786. [PMID: 38645604 PMCID: PMC11031742 DOI: 10.1002/ccr3.8786] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/30/2024] [Accepted: 04/01/2024] [Indexed: 04/23/2024] Open
Abstract
Key Clinical Message This case report provides a rare case of idiopathic root resorption in maxillary first molar and suggests the importance of CBCT in the diagnosis and treatment outcome of complex endodontic diseases. Endodontic surgery is an effective method for treating teeth with persistent apical periodontitis. Abstract Idiopathic root resorption is an unexplained root resorption when the patient experiences root resorption without any local or systemic factors. Early diagnosis and appropriate treatment are crucial for long-term outcomes.
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Affiliation(s)
- Tianqi Li
- Medical School of Chinese PLABeijingChina
- Department of Stomatology, The First Medical CentreChinese PLA General HospitalBeijingChina
- Department of StomatologyFujian People's Armed Police Corps HospitalFuzhouChina
| | - Xiangbo Meng
- Medical School of Chinese PLABeijingChina
- Department of Stomatology, The First Medical CentreChinese PLA General HospitalBeijingChina
| | - Sunxin Zhou
- Medical School of Chinese PLABeijingChina
- Department of Stomatology, The First Medical CentreChinese PLA General HospitalBeijingChina
| | - Shuaichen Li
- Medical School of Chinese PLABeijingChina
- Department of Stomatology, The First Medical CentreChinese PLA General HospitalBeijingChina
| | - Qiang Luo
- Department of Stomatology, The First Medical CentreChinese PLA General HospitalBeijingChina
| | - Tong Zhang
- Department of Stomatology, The First Medical CentreChinese PLA General HospitalBeijingChina
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Özbay Y, Kazangirler BY, Özcan C, Pekince A. Detection of the separated endodontic instrument on periapical radiographs using a deep learning-based convolutional neural network algorithm. AUST ENDOD J 2024; 50:131-139. [PMID: 38062627 DOI: 10.1111/aej.12822] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/27/2023] [Accepted: 11/24/2023] [Indexed: 04/07/2024]
Abstract
The study evaluated the diagnostic performance of an artificial intelligence system to detect separated endodontic instruments on periapical radiograph radiographs. Three hundred seven periapical radiographs were collected and divided into 222 for training and 85 for testing to be fed to the Mask R-CNN model. Periapical radiographs were assigned to the training and test set and labelled on the DentiAssist labeling platform. Labelled polygonal objects had their bounding boxes automatically generated by the DentiAssist system. Fractured instruments were classified and segmented. As a result of the proposed method, the mean average precision (mAP) metric was 98.809%, the precision value was 95.238, while the recall reached 98.765 and the f1 score 96.969%. The threshold value of 80% was chosen for the bounding boxes working with the Intersection over Union (IoU) technique. The Mask R-CNN distinguished separated endodontic instruments on periapical radiographs.
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Affiliation(s)
- Yağız Özbay
- Department of Endodontics, Faculty of Dentistry, Karabuk University, Karabuk, Turkey
| | | | - Caner Özcan
- Department of Software Engineering, Karabuk University, Karabuk, Turkey
| | - Adem Pekince
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Karabuk University, Karabuk, Turkey
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El Karim I, Duncan HF, Cushley S, Nagendrababu V, Kirkevang LL, Kruse CL, Chong BS, Shah PK, Lappin M, Lundy FT, Clarke M. An international consensus study to identify "what" outcomes should be included in a core outcome set for endodontic treatments (COSET) for utilization in clinical practice and research. Int Endod J 2024; 57:270-280. [PMID: 38314586 DOI: 10.1111/iej.14008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/08/2023] [Accepted: 11/22/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND Development of a standardized set of topic-specific outcomes known as a Core Outcome Set (COS) is important to address issues of heterogeneity in reporting research findings in order to streamline evidence synthesis and clinical decision making. AIM The aim of the current international consensus study is to identify "what" outcomes to include in the Core Outcome Set for Endodontic Treatments (COSET). Outcomes of various endodontic treatments (non-surgical root canal treatment, surgical endodontics, vital pulp treatment and revitalization procedures) performed on permanent teeth were considered. METHODS A standard validated methodology for COS development and reporting was adopted. The process involved identification of existing outcomes through four published scoping reviews. This enabled creation of a list of outcomes to be prioritized via semi-structured patient interviews, e-Delphi process and a consensus meeting with a range of relevant global stakeholders. Outcomes were prioritized using a 1-9 Likert scale, with outcomes rated 7-9 considered critical, 4-6 are important and 1-3 are less important. Outcomes rated 7-9 by ≥70% and 1-3 by <15% of participants were considered to achieve consensus for inclusion in the COS. The outcomes that did not achieve consensus in the first round were considered for further prioritization in the second Delphi round and consensus meeting. Final decisions about the outcomes to include in COSET were made by voting during the consensus panel meeting using the Zoom Poll function. RESULTS A total of 95 participants including patients contributed to the COS development process. The consensus panel recommended, with strong consensus, eight outcomes shared across all treatment modalities for inclusion in COSET: pain; signs of infection (swelling, sinus tract); further intervention/exacerbation; tenderness to percussion/palpation; radiographic evidence of disease progression/healing; function; tooth survival; and patient satisfaction. Additional treatment specific outcomes were also recommended. DISCUSSION Many of the outcomes included in COSET are patient reported. All should be included in future outcomes studies. CONCLUSION COSET identified outcomes that are important for patients and clinicians and validated these using a rigorous methodology. Further work is ongoing to determine "how" and "when" these outcomes should be measured.
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Affiliation(s)
- Ikhlas El Karim
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Henry Fergus Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Siobhan Cushley
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Venkateshbabu Nagendrababu
- University of Sharjah, College of Dental Medicine, Department of Preventive and Restorative Dentistry, Sharjah, United Arab Emirates
| | | | - Casper Lemvig Kruse
- Centre for Oral Health in Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Bun San Chong
- Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Pratik Kamalkant Shah
- Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Mark Lappin
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Fionnuala T Lundy
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
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Singh KB, Akhtar MS, Nagar R, Agarwal A, Azhar S, Singh V. Comparative Analysis of the Efficacy of Various Retreatment File Systems in the Removal of Gutta-Percha in Retreatment Cases and Time Taken During the Procedure: An In Vitro Cone Beam CT Study. Cureus 2024; 16:e55551. [PMID: 38576634 PMCID: PMC10993640 DOI: 10.7759/cureus.55551] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/01/2024] [Indexed: 04/06/2024] Open
Abstract
Background Removing gutta-percha manually can be a challenging task, especially when addressing densely packed root-filling material, particularly in cases where resin-based sealers are employed for obturation. The use of nickel-titanium (NiTi) rotary instruments not only effectively shapes the root canal but also efficiently removes the endodontic filling from the curved canal during retreatment. Hence, incorporating rotary NiTi instruments in retreatment cases can alleviate fatigue for both patients and operators. Objectives This study aims to compare the efficacy of Neo-Endo retreatment files, R-Endo retreatment files, and K and H files in the removal of endodontic filling material. Additionally, the remnants of gutta-percha in root canals are evaluated using cone beam computed tomography (CBCT). Materials and methods A total of 60 extracted first maxillary molar teeth were selected for this study. Canal preparation was conducted using the step-back method up to an apical size of 40 K-file. The obturation process involved the use of gutta-percha points and AH Plus sealer in a lateral compaction technique. Post-operative CBCT scans were taken. The samples were randomly divided according to the retreatment files used: group I included Neo-Endo retreatment files, group II included R-Endo retreatment files, and group III included conventional K-files and Hedstroem files (H-Files). The retreatment procedure was considered complete when the last instrument easily reached the working-length range and was physically clean. A stopwatch was used to record the time taken by each file to remove the obturating material. T1 represented the total time (including irrigation and change of file) required to reach the apex, while T2 indicated the complete removal of materials from the canal with the last instrument. The overall time recorded (TT) was calculated as T1 + T2. The removal process was analyzed with CBCT scans. Results The Neo-Endo retreatment files removed the filling materials better and more quickly than the other files. Conclusions Despite the presence of residual filling material in all samples, the Neo-Endo retreatment files left the least amount of residual filling material and achieved the shortest completion time.
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Affiliation(s)
- Kapilesh B Singh
- Conservative Dentistry and Endodontics, SMBT Dental College & Hospital, Mumbai, IND
| | - Mohammad Salman Akhtar
- Conservative Dentistry and Endodontics, Teerthanker Mahaveer Dental College & Research Centre, Moradabad, IND
| | - Renuka Nagar
- Conservative Dentistry and Endodontics, Teerthanker Mahaveer Dental College & Research Centre, Moradabad, IND
| | - Abhinay Agarwal
- Conservative Dentistry and Endodontics, Teerthanker Mahaveer Dental College & Research Centre, Moradabad, IND
| | - Saleem Azhar
- Conservative Dentistry and Endodontics, Teerthanker Mahaveer Dental College & Research Centre, Moradabad, IND
| | - Vikas Singh
- Public Health Dentistry, Teerthanker Mahaveer Dental College & Research Centre, Moradabad, IND
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11
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Abella Sans F, Alatiya ZT, Val GG, Nagendrababu V, Dummer PMH, Durán-Sindreu Terol F, Olivieri JG. A laboratory study comparing the static navigation technique using a bur with a conventional freehand technique using ultrasonic tips for the removal of fibre posts. Int Endod J 2024; 57:355-368. [PMID: 38204195 DOI: 10.1111/iej.14017] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/01/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024]
Abstract
AIM There are currently no high-quality studies comparing the static navigation technique with conventional methods of fibre post removal. The aim of this ex vivo study was to compare the effectiveness of fibre post removal between a static navigation technique and a conventional freehand technique using ultrasonics by experienced and inexperienced operators. METHODOLOGY Forty-eight extracted single-rooted human premolars were root-filled. A fibre post was cemented in all 48 teeth, which were then divided randomly into the following groups: static navigation group using burs; static navigation-ultrasonic group; and non-guided group using ultrasonic tips. The following parameters were evaluated for both experienced operators and inexperienced operators: reaching the gutta-percha root filling successfully, the time required to remove the entire post, the occurrence of lateral root perforations, and the amount of root dentine removed. The Kolmogorov-Smirnov test was used to examine the normality of the data; the anova test was used to compare the significant differences among groups; and Tukey tests were used for all two-by-two comparisons. The significance level was set at 0.05. RESULTS In the static navigation group, the gutta-percha was reached significantly more frequently than in the non-guided group (p < .05). The static navigation approach required significantly less time than the non-guided approach to reach the gutta-percha (p < .05). The total removal of posts was significantly different between groups (p < .05), but there was no significant difference between experienced and inexperienced operators in the static navigation group (p > .05). More perforations were associated with the non-guided group than with the other two groups. The total mean loss of dentine in the non-guided group in all directions was 0.39 (±0.17) mm, with 0.25 (±0.09) mm for experienced, and 0.42 (±0.16) mm for inexperienced operators. CONCLUSION When compared to a conventional ultrasonic technique for the removal of fibre posts, the static navigation method using burs resulted in less dentine removal, more rapid access to the gutta-percha root filling, less overall time to remove the posts, and fewer complications. When using static navigation, there was no difference in performance between experienced and inexperienced operators.
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Affiliation(s)
- Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Zeena Tariq Alatiya
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Gonzalo Gómez Val
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Venkateshbabu Nagendrababu
- University of Sharjah, College of Dental Medicine, Department of Preventive and Restorative Dentistry, Sharjah, United Arab Emirates
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Cabanillas-Balsera D, Areal-Quecuty V, Cantiga-Silva C, Cardoso CDBM, Cintra LTA, Martín-González J, Segura-Egea JJ. Prevalence of apical periodontitis and non-retention of root-filled teeth in hypertensive patients: Systematic review and meta-analysis. Int Endod J 2024; 57:256-269. [PMID: 38051279 DOI: 10.1111/iej.14007] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Several studies have suggested a relationship between AP, as well as the loss of root-filled teeth (RFT), and hypertension (HTN). OBJECTIVES The aims of this systematic review and meta-analysis were to investigate the prevalence of AP, and non-retention of RFT, in hypertensive patients. METHODS A search was performed in PubMed/MEDLINE, Web of Science, Scopus and EMBASE. The inclusion criteria established were studies published until February 2023, comparing hypertensive subjects with controls, assessing the prevalence of AP and/or providing data on the prevalence of non-retained RFT. Meta-analysis was performed using the RevMan (analyst) tool to determine the pooled prevalence of AP and loss of RFT. Risk of bias was assessed using the Cochrane Risk-of-Bias tool. The quality of evidence was assessed by GRADE. RESULTS The search strategy identified 454 articles, and only eight met the inclusion criteria. Six studies had analysed the association between AP and HTN and two studies had analysed the association between non-retention of RFT and HTN. Meta-analysis showed and overall OR = 1.71 (95% CI = 0.92-3.16; p = .09) for the prevalence of AP among patients with HTN. The prevalence of non-retention of RFT among patients with HTN has an overall OR = 1.78 (95% CI = 1.60-1.98; p = .000001). The risk of bias in the individual studies was low or moderate, and the quality of the overall evidence has shown a level of certainty very low. DISCUSSION There is no association between the prevalence of AP and HTN. In addition, hypertensive patients have significantly increased odds of losing RFT. Given the high prevalence of hypertension, it is very common to perform root canal treatments on hypertensive patients. It is imperative to communicate this heightened risk to patients and recommend periodic monitoring of oral health and hypertension, paying special attention to this subset of patients. REGISTRATION PROSPERO CRD42022302385.
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Affiliation(s)
- Daniel Cabanillas-Balsera
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Victoria Areal-Quecuty
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Cristiane Cantiga-Silva
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Carolina de Barros Morais Cardoso
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Jenifer Martín-González
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Juan J Segura-Egea
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, Sevilla, Spain
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Timponi Goes Cruz A, Antoniw Klemz A, Ribeiro Rosa EA, Soares Grecca F, Mattos B, Piasecki L, Machado R, Ignácio SA, da Silva Neto UX. Cleaning and disinfection of the root canal system provided by four active supplementary irrigation methods. Sci Rep 2024; 14:3795. [PMID: 38361036 PMCID: PMC10869831 DOI: 10.1038/s41598-024-53375-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/31/2024] [Indexed: 02/17/2024] Open
Abstract
This in vitro study evaluated the bacterial reduction provided by the EndoActivator (EA), Easy Clean (EC), passive ultrasonic irrigation (PUI), and XP-Endo Finisher. Eight-four mesial roots of mandibular first molars were instrumented, inoculated with Enterococcus faecalis, and divided into four groups (n. 20). Bacterial reduction in the main canals and dentinal tubules were respectively determined by MTT assays and Live/Dead BackLight technique through confocal laser scanning microscopy (CLSM) at 50, 100, and 150 µm in-depth (n. 10 per group). Statistical analyses were conducted following a significance level of 95% (P < 0.05). A significant statistical difference was just identified between XPF and EC in the main canals. In the dentinal tubules from the main root canals, at 100 and 150 µm in-depths, significant statistical differences were only observed between XPF and EC (P = 0.027) for the former and between XPF and EC (P = 0.011) and XPF and PUI (P = 0.021) for the latter. In the dentinal tubules from the isthmus, at 100 µm in-depth, statistically relevant differences did occur between XPF and EC (P = 0.038) and EC and EA (P = 0.029). At 150 µm in-depth, these differences were only significant by comparing XPF and PUI (P = 0.025) and XPF and EC (P = 0.036). Although no irrigation method could thoroughly disinfect the RCS, bacterial reduction indexes were generally better after using XPF.
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Affiliation(s)
- Alessandra Timponi Goes Cruz
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Adriane Antoniw Klemz
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Edvaldo Antônio Ribeiro Rosa
- Department of Biosciences, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Fabiana Soares Grecca
- Department of Endodontics, College of Dentistry, Federal University of Rio Grande do Sul-UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bianca Mattos
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Lucila Piasecki
- Department of Periodontics & Endodontics, College of Dentistry, University at Buffalo, Buffalo, NY, USA
| | - Ricardo Machado
- Clinical practice limited to Endodontics, Navegantes, Santa Catarina, Brazil.
| | - Sérgio Aparecido Ignácio
- Department of Statistics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
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Chawla S, Kumar T, Mittal S, Keshav V, Gilhotra V, Kaur P. A Comparative Evaluation of Fracture Resistance of Endodontically Treated Teeth Using Different Post-Obturation Restorative Materials: An In Vitro Study. J Pharm Bioallied Sci 2024; 16:S343-S345. [PMID: 38595597 PMCID: PMC11000872 DOI: 10.4103/jpbs.jpbs_554_23] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 04/11/2024] Open
Abstract
This in vitro study was conducted to evaluate and compare the fracture resistance of endodontically treated teeth using different post-obturation restorative materials. Seventy-five non-carious extracted human teeth were collected. Access opening, chemicomechanical preparation, and obturation were done. Teeth were randomly divided into various groups depending on the type of post-endodontic restoration: group I-control group, group II-Tetric-N-Flow Bulk Fill, group III-Tetric-N-Flow Bulk Fill + everX Posterior, group IV-P60, and group V-P60 + everX Posterior. The fracture resistance of each sample was measured using the universal testing machine. Results The results obtained were subjected to statistical analysis. This demonstrated that group III (Tetric-N-Flow Bulk Fill + everX Posterior) was shown to be the most effective group followed by group V (Filtek P60 + everX Posterior) out of all of the other restorative experimental groups. Conclusion Tetric-N-Flow Bulk Fill + everX Posterior showed maximum fracture resistance among the experimental groups.
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Affiliation(s)
- Simran Chawla
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Tarun Kumar
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Sunandan Mittal
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Vanita Keshav
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Vidushi Gilhotra
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Prabhprit Kaur
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
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15
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Signor B, Poli Kopper PM, Aspesi M, Münchow EA, Scarparo RK. Postoperative pain after single-visit root canal treatment or vital pulp therapy: A systematic review and meta-analysis. J Am Dent Assoc 2024; 155:118-137.e1. [PMID: 38325970 DOI: 10.1016/j.adaj.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/06/2023] [Accepted: 11/05/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND This systematic review aimed to investigate whether vital pulp therapy and root canal treatment (RCT) promote different postoperative pain. STUDIES REVIEWED The authors searched PubMed, Cochrane Library, Embase, and Latin American and Caribbean Health Sciences Literature databases for studies published through June 30, 2022. The authors included randomized clinical trials if they reported on the assessment of postoperative pain after direct pulp capping, partial pulpotomy, pulpotomy, or single-visit RCT. The authors assessed the frequency of no, mild, moderate, and severe postoperative pain. They conducted meta-analyses to compare postoperative pain after full pulpotomy (PULP) and RCT. RESULTS The qualitative synthesis included 57 studies, and the authors conducted meta-analysis of 3. PULP leads to more asymptomatic cases (relative risk [RR], 1.06; 95% CI, 1.01 to 1.11; P < .01; I2 = 67%) and to a lower occurrence of mild (RR, 0.89; 95% CI, 0.79 to 0.99; P < .04; I2 = 37%) and moderate (RR, 0.70; 95% CI, 0.51 to 0.95; P < .02; I2 = 57%) postoperative pain than RCT. The frequency of severe pain was very low for both vital pulp therapy and RCT. Moderate to severe postoperative pain was more common at 48 hours through 72 hours after RCT and up to 36 hours after PULP. Pain intensity after PULP was higher using calcium-enriched material compared with using mineral trioxide aggregate at 12, 18, and 36 hours (P < .001). PRACTICAL IMPLICATIONS PULP showed a significantly higher incidence of no pain and a lower incidence of mild and moderate pain than single-visit RCT. Clinical decisions for RCT or PULP should not be based on differences in postoperative pain. When analgesia is indicated, it probably should be limited to a short time after PULP.
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16
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Singh T, Bathla S, Dutta SK, Thakkar R, Vohra V, Singh K. Comparative Evaluation of Sealing Ability of Different Type of MTA as Root-End Filling Materials Using Dye Penetration Technique - An In Vitro Study. J Pharm Bioallied Sci 2024; 16:S339-S342. [PMID: 38595542 PMCID: PMC11000896 DOI: 10.4103/jpbs.jpbs_552_23] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/15/2023] [Accepted: 08/20/2023] [Indexed: 04/11/2024] Open
Abstract
Introduction The main goal of the root-end filling material is to create a hermetic seal to protect against microbes and their by-products. Excellent biocompatibility and sealing ability are characteristics of MTA developed by Torabinejad et al. This study aimed to compare the sealing ability of different type MTA as root-end filling material using dye penetration technique. Material and Method One-twenty (N = 120) extracted human maxillary anterior teeth were decontaminated, cleaned, and decoronated. Endodontic treatment and root-end resection were done. Then root-end cavity was prepared and filled with tested materials (N = 30). A calibrated stereomicroscope was used to evaluate linear measurement. All data were tabulated and statistically analyzed with a level of significance set at P < .05. Result This order of increasing microleaks was observed: MTA Angelus < MTA Plus < PRO-Root MTA < Control group. There was a statistically significant difference in mean microleakage in MTA Angelus and MTA Plus groups (P = 0.040). MTA Angelus shows the least microleakage among all the bioceramic material groups. Conclusion Although the sealing ability of MTA Angelus is superior to MTA Plus, PRO-Root MTA. MTA Plus, PRO-Root MTA could be considered an acceptable alternative to MTA Angelus in peri-radicular surgeries.
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Affiliation(s)
- Tanu Singh
- PhD Scholar, Faculty of Dental Sciences, Department of Conservative Dentistry and Endodontics, Bareilly International University, Bareilly, Uttar Pradesh, India
| | - Saurav Bathla
- Post Graduate Student, Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Saurav K. Dutta
- Post Graduate Student, Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Radhika Thakkar
- B.D.S., M.P.H, Resident, Eastman Institute for Oral Health, University of Rochester, NY, United States
| | - Varun Vohra
- BDS, National Dental College and Hospital, Dera Bassi, Punjab, India
| | - Kanwarpreet Singh
- Department of Conservative and Endodontics, Yamuna Institute of Dental Sciences, Yamunanagar, Haryana, India
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Nasr El-Din S, Hassan R. The efficacy of various irrigation techniques on the removal of double antibiotic paste from simulated immature roots and the amount of apically extruded debris. BDJ Open 2024; 10:2. [PMID: 38182568 PMCID: PMC10770069 DOI: 10.1038/s41405-023-00183-3] [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: 11/03/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE This study evaluated the effect of the XP-Endo Finisher (XPF), passive ultrasonic irrigation (PUI) and conventional irrigation using side-vented needle (SVN) on the amount of apically extruded debris and canal cleanliness following the removal of double antibiotic paste (DAP) from immature root canal models. MATERIAL AND METHODS Forty-eight extracted mandibular premolars were drilled using peeso drills to simulate immature apices. The canals were filled with DAP and were randomly assigned into 3 groups according to the DAP removal method: XPF, PUI, and SVN (n = 16). The amount of extruded debris was assessed with an analytical balance then roots were split longitudinally and imaged using stereomicroscope to evaluate the residual medicament. Data were statistically analyzed using Kruskal-Wallis and Dunn's test. Spearman's correlation coefficient was used to determine significant correlation between extruded debris and the residual DAP scores. RESULTS There was no significant difference between debris extrusion values for all groups (P value 0.237). For canal cleanliness, the amount of remaining DAP was significantly lower in the XPF and PUI compared to SVN (P value < 0.001). A non-significant positive (direct) correlation was found between the amounts of apically extruded debris and residual DAP scores (P value 0.087). CONCLUSION XPF and PUI were associated with better canal cleanliness during removal of DAP, no difference could be found between the three irrigation techniques regarding the debris extrusion.
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Affiliation(s)
| | - Reham Hassan
- Faculty of Dentistry, The Egyptian Russian University, Badr city, Egypt.
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18
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Coaguila-Llerena H, Ochoa-Rodríguez VM, Passos Barbieri I, Ramos SG, Faria G. Calcium hypochlorite cytotoxicity mechanism in fibroblasts and effect on osteoblast mineralization. Int Endod J 2024; 57:64-77. [PMID: 37814380 DOI: 10.1111/iej.13983] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 05/25/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023]
Abstract
AIM To determine the cytotoxicity mechanism of 2.5% calcium hypochlorite [Ca(OCl)2 ] in L929 fibroblasts and the effect of this solution on human osteoblast-like cells (Saos-2) mineralization, compared to that of 2.5% sodium hypochlorite (NaOCl). METHODOLOGY L929 fibroblasts were exposed to Ca(OCl)2 and NaOCl at different dilutions for 10 min. Cell metabolism was assessed by methyl-thiazole-tetrazolium (MTT); lysosome integrity, by neutral red (NR) assay; type of cell death, by flow cytometry (apoptosis/necrosis); cytoskeleton, by actin and α-tubulin fluorescence and cell ultrastructure, by transmission electron microscopy (TEM). The alkaline phosphatase (ALP) activity and mineralized nodule formation were determined in Saos-2 by thymolphthalein release and alizarin red staining (ARS), respectively. The data were analysed by two-way anova and Bonferroni's post-test (α = .05). RESULTS Ca(OCl)2 promoted higher cell viability and a lower percentage of apoptosis and necrosis than NaOCl (p < .05). Ca(OCl)2 and NaOCl decreased cell metabolism and lysosome integrity, induced the breakdown of microtubules and actin filaments, promoted alterations of rough endoplasmic reticulum and disruption of mitochondrial cristae. Additionally, Ca(OCl)2 did not induce ALP activity and had no effect on mineralized nodules formation. CONCLUSIONS Although Ca(OCl)2 and NaOCl promoted the same cytotoxicity mechanism, Ca(OCl)2 was less cytotoxic than NaOCl. As for ALP activity, no differences were observed between NaOCl and Ca(OCl)2 . The production of mineralized nodules induced by Ca(OCl)2 was lower than those induced by NaOCl, but was not different from those induced by the control group.
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Affiliation(s)
- Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - Victor Manuel Ochoa-Rodríguez
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - Isadora Passos Barbieri
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - Simone Gusmão Ramos
- Department of Pathology, Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, Brazil
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
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Alzahrani O, Komo H, Howait M. Healing and Spontaneous Realignment of Displaced Roots With Periapical Granuloma After Microsurgical Endodontic Treatment (Three Years' Follow-up): A Case Report. Cureus 2024; 16:e52020. [PMID: 38205085 PMCID: PMC10777889 DOI: 10.7759/cureus.52020] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2024] [Indexed: 01/12/2024] Open
Abstract
Endodontic therapy aims to treat or prevent apical periodontitis, a condition characterized by inflammation of the periapical tissues at the apex of the tooth root. This case study demonstrates the successful nonsurgical and surgical management of a large periapical lesion involving the lower central incisors with root displacement induced by a periapical granuloma. A patient was referred from the maxillofacial department for endodontic treatment due to persistent pain and swelling in the lower anterior region started two months ago. Upon arrival, a clinical examination and radiographic assessment were performed using cone-beam computed tomography (CBCT). The CBCT scan revealed a significant radiolucent area measuring (10x8) mm extending from the lower left lateral incisor to the right central incisor. The lower left central incisor was necrotic and tender to palpation and percussion. A nonsurgical root canal was performed followed by an apicectomy using mineral trioxide aggregate (MTA) to facilitate healing of the periapical lesion. Histopathological examination of the lesion confirmed the diagnosis of periapical granuloma. At follow-up 1, 2, and 3 years' visits, the periodontal assessment was performed and found to be free of pain upon percussion or palpation. No other clinical or radiological signs or symptoms were identified except for a small radiolucent area mesially adjacent to the root of the lower left central incisor. The development of materials such as MTA has significantly improved the prognosis of cases with large periapical lesions. In this case, healing and spontaneous realignment of the root were observed after three years.
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Affiliation(s)
- Omar Alzahrani
- Department of Advanced General Dentistry, Faculty of Dentistry, King Abdulaziz University Dental Hospital, Jeddah, SAU
| | - Hisham Komo
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, King Abdulaziz University Dental Hospital, Jeddah, SAU
| | - Mohammed Howait
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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Liu H, Shen Y. Endodontic Treatment of a Maxillary First Molar With Two Separate Palatal Roots: A Case Report. Cureus 2024; 16:e51907. [PMID: 38333498 PMCID: PMC10850443 DOI: 10.7759/cureus.51907] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Maxillary first molars exhibit considerable anatomical variation, with a single palatal root being the most common occurrence, while two palatal roots are notably less frequent. This case report details the endodontic treatment of a maxillary first molar with two separate palatal roots. It highlights the critical importance of recognizing these anatomical variations and their unique challenges during endodontic procedures. This report emphasizes the essential role of advanced diagnostic methods, such as cone-beam computed tomography, and the use of microscopic techniques in identifying and treating such cases.
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Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, CAN
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vacnouver, CAN
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21
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Yang X, Zhang Y, Chen X, Huang L, Qiu X. Limitations and Management of Dynamic Navigation System for Locating Calcified Canals Failure. J Endod 2024; 50:96-105. [PMID: 37890613 DOI: 10.1016/j.joen.2023.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/28/2023] [Accepted: 10/01/2023] [Indexed: 10/29/2023]
Abstract
Nonsurgical endodontic teeth treatment with severe pulp canal obliteration poses challenges, primarily locating canals. By combining 3-dimensional reconstruction and spatial location registration, the dynamic navigation technique uses an optical tracking system to guide the clinician to drill in real time according to the predesigned path until access to the canal is established. Several in vitro studies and case reports have shown that calcified canal location with dynamic navigation system (DNS) is more accurate and efficient, yet the technique has limitations. In 4 cases with 7 teeth, this work presents manipulation process and clinical outcomes of DNS helping in calcified canal location. We performed handpiece adaptation and elucidated the failure to locate the canals with DNS in 2 teeth, resulting in canal geometry alteration and canal path deviation. Subsequently, the more experienced endodontist located the canals by combining cone-beam computed tomographic imaging and dental operating microscopy. All patients were completely asymptomatic after treatment. At the 1-year follow-up visit, the bone healing of periapical lesions progressed well according to the periapical radiography or cone-beam computed tomographic imaging. These findings indicate that DNS is a promising technique for locating calcified canals; however, it needs to be refined before clinical use.
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Affiliation(s)
- Xiaoxia Yang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yinchun Zhang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Xuan Chen
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China.
| | - Lei Huang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Xiaoling Qiu
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China.
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22
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Kadam AS, Merwade S, Kumar Neelakantappa K, Naik SB, Brigit B, Bhumralkar SS, Naik BH. Effect of Laser Photobiomodulation on Postoperative Pain in Endodontics: A Systematic Review. Photobiomodul Photomed Laser Surg 2024; 42:11-19. [PMID: 38252493 DOI: 10.1089/photob.2023.0129] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
Abstract
Objective: Photobiomodulation therapy has proven benefits in various dental treatments. The current systematic review aims to explore the role of laser photobiomodulation in modulating postoperative pain followed by endodontic treatment. Methods: In this systematic review, randomized controlled clinical trials on low-level laser therapy/photobiomodulation in endodontic therapy were analyzed. Database search was performed in PubMed/Medline, Web of Science, Scopus, and Cochrane Library, followed by literature search in Google Scholar. Results: A total of 12 studies were included as per the set criteria. The included studies utilized diode laser (808-970 nm) and indium gallium aluminum. All the included studies evaluated postendodontic pain after root canal therapy and endodontic surgery. A majority of the included studies showed significant benefits of photobiomodulation in postoperative pain management in endodontic therapy.Heterogeneity of the laser parameters and lack of power calculations for sampling among the included studies preclude solid recommendation of use of photobiomodulation therapy (PBMT) for postendodontic pain management. Conclusions: Although PBMT has proven potential benefits being a possible adjunct in postoperative pain management in endodontic therapy, it requires robust standardized randomized control trials to confirm the results of the systematic review.
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Affiliation(s)
- Ashwini Suresh Kadam
- Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute, Fort, India
| | - Seema Merwade
- Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute, Fort, India
| | - Kiran Kumar Neelakantappa
- Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute, Fort, India
| | - Savitha B Naik
- Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute, Fort, India
| | - Biji Brigit
- Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute, Fort, India
| | - Shriya Sunil Bhumralkar
- Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute, Fort, India
| | - Bhargavi H Naik
- Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute, Fort, India
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23
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Salminen A, Määttä A, Mäntylä P, Leskelä J, Pietiäinen M, Buhlin K, Suominen A, Paju S, Sattler W, Sinisalo J, Pussinen P. Systemic Metabolic Signatures of Oral Diseases. J Dent Res 2024; 103:13-21. [PMID: 37968796 PMCID: PMC10734208 DOI: 10.1177/00220345231203562] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
Systemic metabolic signatures of oral diseases have been rarely investigated, and prospective studies do not exist. We analyzed whether signs of current or past infectious/inflammatory oral diseases are associated with circulating metabolites. Two study populations were included: the population-based Health-2000 (n = 6,229) and Parogene (n = 452), a cohort of patients with an indication to coronary angiography. Health-2000 participants (n = 4,116) provided follow-up serum samples 11 y after the baseline. Serum concentrations of 157 metabolites were determined with a nuclear magnetic resonance spectroscopy-based method. The associations between oral parameters and metabolite concentrations were analyzed using linear regression models adjusted for age, sex, number of teeth, smoking, presence of diabetes, and education (in Health-2000 only). The number of decayed teeth presented positive associations with low-density lipoprotein diameter and the concentrations of pyruvate and citrate. Negative associations were found between caries and the unsaturation degree of fatty acids (FA) and relative proportions of docosahexaenoic and omega-3 FAs. The number of root canal fillings was positively associated with very low-density lipoprotein parameters, such as diameter, cholesterol, triglycerides, and number of particles. Deepened periodontal pockets were positively associated with concentrations of cholesterol, triglycerides, pyruvate, leucine, valine, phenylalanine, and glycoprotein acetyls and negatively associated with high-density lipoprotein (HDL) diameter, FA unsaturation degree, and relative proportions of omega-6 and polyunsaturated FAs. Bleeding on probing (BOP) was associated with increased concentrations of triglycerides and glycoprotein acetyls, as well as decreased proportions of omega-3 and omega-6 FAs. Caries at baseline predicted alterations in apolipoprotein B-containing lipoproteins and HDL-related metabolites in the follow-up, and both caries and BOP were associated with changes in HDL-related metabolites and omega-3 FAs in the follow-up. Signs of current or past infectious/inflammatory oral diseases, especially periodontitis, were associated with metabolic profiles typical for inflammation. Oral diseases may represent a modifiable risk factor for systemic chronic inflammation and thus cardiometabolic disorders.
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Affiliation(s)
- A. Salminen
- Oral and Maxillofacial diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A.M. Määttä
- Oral and Maxillofacial diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - P. Mäntylä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Odontology Education, Kuopio University Hospital, Kuopio, Finland
| | - J. Leskelä
- Oral and Maxillofacial diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - M. Pietiäinen
- Oral and Maxillofacial diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - K. Buhlin
- Oral and Maxillofacial diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - A.L. Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Odontology Education, Kuopio University Hospital, Kuopio, Finland
- Department of Public Health and Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - S. Paju
- Oral and Maxillofacial diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - W. Sattler
- Division of Molecular Biology and Biochemistry, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - J. Sinisalo
- HUCH Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Finland
| | - P.J. Pussinen
- Oral and Maxillofacial diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
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24
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Mosquera-Barreiro C, Ruíz-Piñón M, Sans FA, Nagendrababu V, Vinothkumar TS, Martín-González J, Martín-Biedma B, Castelo-Baz P. Predictors of periapical bone healing associated with teeth having large periapical lesions following nonsurgical root canal treatment or retreatment: A cone beam computed tomography-based retrospective study. Int Endod J 2024; 57:23-36. [PMID: 37974453 DOI: 10.1111/iej.13993] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
AIM Several factors influence the condition of the periapical tissues associated with root filled teeth. The primary objective of this study was to retrospectively evaluate the extent and speed of bone healing of large periapical lesions associated with nonsurgical root canal treatment or retreatment. The secondary objective was to analyse the relationship between the time to complete healing when analysed using cone beam computed tomography (CBCT) and other possible predictors that affect healing. METHODOLOGY Seventy-nine patients were treated during the years 2013-2020 with large periapical lesions of endodontic origin (10-15 mm) as observed on intraoral periapical radiographs (IOPAR) were included. IOPAR and CBCT were available before treatment and during the follow-up (IOPAR every 6 months and CBCT every 12 months). The volume of periapical lesions was calculated by OsiriX Lite software. Variables such as initial volume of the lesion, age, gender, type of treatment or type of root canal filling were compared to identify the differences between healed and unhealed lesions. Pearson's Chi-square test was used for categorical variables, the t-test for age and the Wilcoxon test for initial volume of the lesion. The association between time to healing and the variables was assessed using univariate analysis and multivariate analysis. The Wilcoxon test was used to observe the association of healing time with categorical variables and the correlation index was measured with the quantitative variables. RESULTS Of the 79 cases analysed, 60 lesions (76%) were completely healed as verified by CBCT in a mean healing time of 19 months, of which 60% healed fully between 12 and 18 months. Increase in age of patient and larger initial volume of the lesion were associated with a significantly longer healing time (p < .001). Gender, filling material and type of treatment did not have a significant effect on the healing process (p > .05). CONCLUSIONS Clinicians should be aware that periapical lesions in older patients and larger areas of bone loss take longer to heal. CBCT monitoring of large periapical lesions is critical and it can help clinicians in the decision-making process.
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Affiliation(s)
- Carolina Mosquera-Barreiro
- Surgery and medical surgical specialties. International theoretical-practical Master of Endodontics, Dentistry Restorative and Aesthetics, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Manuel Ruíz-Piñón
- Surgery and medical surgical specialties. International theoretical-practical Master of Endodontics, Dentistry Restorative and Aesthetics, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, University of Sharjah, College of Dental Medicine, Sharjah, United Arab Emirates
| | - Thilla Sekar Vinothkumar
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Jenifer Martín-González
- Endodontic Section, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Benjamín Martín-Biedma
- Oral Sciences Research Group, Endodontics and Restorative Dentistry Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Pablo Castelo-Baz
- Oral Sciences Research Group, Endodontics and Restorative Dentistry Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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25
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Liu H, Shen Y. Locating and Treating Three Calcified Canals in a Mandibular First Molar With Radix Entomolaris and Five Canals: A Case Report. Cureus 2024; 16:e52931. [PMID: 38406086 PMCID: PMC10893908 DOI: 10.7759/cureus.52931] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
The success of root canal treatment is highly contingent on the comprehensive shaping, cleaning, and filling of the entire root canal system. Failure to address one or more canals often results in an increased likelihood of post-treatment apical periodontitis. Typically, mandibular first molars feature two roots and three canals, but they may also exhibit anatomical variations, such as a mesial middle canal or radix entomolaris (RE). This article presents a case where three calcified canals in a mandibular first molar with RE and five canals were successfully located and treated.
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Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological & Medical Sciences, University of British Columbia, Vancouver, CAN
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological & Medical Sciences, University of British Columbia, Vacnouver, CAN
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26
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Friedlander L, Hunt G, Chandler N, Daniel B. Students' experience and perceptions of undergraduate endodontic education in New Zealand. AUST ENDOD J 2023; 49:492-502. [PMID: 37367204 DOI: 10.1111/aej.12770] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
This study investigated the clinical experience and perceptions of New Zealand graduating dental students (2019 and 2020) towards endodontic teaching and their clinical learning outcomes using an online survey and clinical scenarios. Quantitative data were analysed using SPSS software, and qualitative data were analysed thematically. Responses were similar for both cohorts (response rates 74%, 2019; 73%, 2020). Endodontic teaching was valuable and interesting but difficult compared with other disciplines. Molar endodontics, finding canals and managing posture were challenging. Students felt more confident and less anxious when supervised by clinicians experienced in endodontics. Time management was the most anxiety-inducing factor and significantly related to clinical experience (p < 0.001). Overall, students appropriately applied knowledge in most areas of endodontics while holistic problem-solving in complex scenarios was variable. Maximising clinical experience and supervision from teachers experienced in endodontics are important for learning, improving confidence and reducing anxiety.
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Affiliation(s)
- Lara Friedlander
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Gabrielle Hunt
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Nicholas Chandler
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Ben Daniel
- Higher Education Development Centre, University of Otago, Dunedin, New Zealand
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27
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Abstract
Traumatic dental injuries pose a variety of complex ongoing issues to the dental practitioner. As dental injuries are commonly experienced at a young age, the treatment often takes place during adolescence or early in adulthood years at crucial development stages and very early in the life of the permanent successor. Therefore, the ability to correctly diagnose the injury, and follow an appropriate management plan should increase practitioners' ability to improve both the outcomes of dental trauma and long-term prognosis of the tooth.The consequences of dental trauma can be explored by taking into consideration the type of injury, which enables an assessment of the degree of insult to the pulpal tissues, neurovascular bundle, periodontal ligament and cemental cells. This has a direct influence on post-trauma complications. Early intervention, where indicated, and appropriate follow-up utilising international guidelines is imperative to identify changing diagnoses and act accordingly. This review paper will discuss the classification of traumatic injuries and their associated outcomes with management strategies for emerging disease including potential endodontic and restorative complexities and when to refer to secondary care.
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Affiliation(s)
- Lorna Gladwin
- Lorna Gladwin BDS, MFDS RCSEng, PGCertClinical Dentist in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK
- James Darcey BDS, MSc, MDPH, MFGDP, MEndo, FDS Rest Dent RCSEd Consultant and Honorary Lecturer in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK
| | - James Darcey
- Lorna Gladwin BDS, MFDS RCSEng, PGCertClinical Dentist in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK
- James Darcey BDS, MSc, MDPH, MFGDP, MEndo, FDS Rest Dent RCSEd Consultant and Honorary Lecturer in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK
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28
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Liu X, He G, Qiu Z, Chen F, Wang J, Huang Z, Zhang P, Zhang J, Zhong L, Ding C, Chen X. Diabetes Mellitus Increases the Risk of Apical Periodontitis in Endodontically-Treated Teeth: A Meta-Analysis from 15 Studies. J Endod 2023; 49:1605-1616. [PMID: 37506763 DOI: 10.1016/j.joen.2023.07.016] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 06/11/2023] [Accepted: 07/02/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION At present, the incidence of diabetes mellitus (DM) is gradually increasing globally. In clinical practice, many patients with diabetes with apical periodontitis (AP) have poor and slow healing of periapical lesions. However, the potential relationship between the 2 is still unclear and controversial. The consensus is that DM can be deemed a risk factor for AP in endodontically-treated teeth. Therefore, we pooled existing studies and carried out a meta-analysis to explore the potential association between the 2. METHODS Studies that met the inclusion criteria were selected from the database, and relevant data were extracted. Stata SE 17.0 software was used to analyze the relevant data, and the Newcastle-Ottawa Scale was used to assess the literature's quality. The pooled odds ratio (OR) with a 95% confidence interval (CI) was used to determine the strength of the association between DM and the prevalence of AP after root canal treatment (RCT). RESULTS After searching, 262 relevant studies were retrieved, fifteen of which met the inclusion criteria. A total of 1087 patients with 2226 teeth were included in this meta-analysis. According to the findings, diabetics showed a higher prevalence of AP after RCT than controls at the tooth level (OR = 1.51, 95% CI = 1.22-1.87, P < .01). At the patient level, DM increased the probability of developing AP in RCT teeth more than 3 times (OR = 3.38, 95% CI = 1.65-6.93, P < .01). Additionally, subgroup analysis was performed by blood glucose status, preoperative AP, and study design. Except for the status of blood glucose, the results were significant in the other 2 groups (P < .05). CONCLUSIONS Available scientific evidence suggests that DM may increase the risk of AP in endodontically-treated teeth. In teeth with preoperative AP, DM might promote the development of AP.
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Affiliation(s)
- Xinyue Liu
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Guiying He
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Zhengjie Qiu
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Feng Chen
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Jiapeng Wang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Zheng Huang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Pengtao Zhang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Jian Zhang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; College of Materials, Chemistry and Chemical Engineering, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Liangjun Zhong
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Cheng Ding
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China.
| | - Xing Chen
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China.
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29
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Gliga A, Săndulescu M, Amza O, Stănescu R, Imre M. Dental pathologies of endodontic origin and subsequent bacterial involvement - a literature review. Germs 2023; 13:373-380. [PMID: 38361538 PMCID: PMC10866160 DOI: 10.18683/germs.2023.1407] [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: 10/18/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 02/17/2024]
Abstract
Dental pathologies of endodontic origin are varied in nature, and include infectious and non-infectious causes. Through this review, we aim to provide a deeper understanding of the role of bacterial involvement and in the pathogenesis of endodontic pathologies, by reviewing the relevant literature on the most common bacterial species involved, and their capacity to organize as biofilms. Furthermore, we focus on the most important recent updates in the management of endodontic infections, from a multidisciplinary perspective.
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Affiliation(s)
- Alexandru Gliga
- DDS, PhD student, Department of Endodontics, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest 010221, Romania
| | - Mihai Săndulescu
- DDS, PhD, Associate Professor, Department of Implant Prosthetic Therapy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest 010221, Romania
| | - Oana Amza
- DDS, PhD, Associate Professor, Department of Endodontics, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest 010221, Romania
| | - Ruxandra Stănescu
- DDS, PhD, Assistant Lecturer, Department of Implant Prosthetic Therapy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest 010221, Romania
| | - Marina Imre
- DDS, PhD, Professor, Department of Prosthodontics, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, Bucharest 010221, Romania
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30
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Brochado Martins JF, Jautze A, Georgiou AC, Tulp BMT, Crielaard W, van der Waal SV. Well-being, postoperative pain and outcome after clinical application of a novel root canal irrigation fluid-RISA-in teeth with apical periodontitis: A first-in-human study. Int Endod J 2023; 56:1488-1498. [PMID: 37771316 DOI: 10.1111/iej.13977] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/31/2023] [Indexed: 09/30/2023]
Abstract
AIM The aim of the study was to assess the tolerance to the new root canal irrigation fluid RISA after root canal treatment (RCT) by evaluating the subject's postoperative well-being, postoperative pain (PP) and treatment outcome. METHODOLOGY A single-arm prospective study with 16 subjects (17 teeth) diagnosed with asymptomatic apical periodontitis. Endodontic treatment in one session performed using RISA for root canal irrigation. Well-being was assessed on the same day and after 24 h by telephone. For pain intensity, a visual analogue scale was used at 0-5 days. Clinical and radiographic evaluations were performed at ≥12 months. Well-being, occurrence of PP and outcome were qualitatively reported. Friedman test for paired samples and Spearman correlation coefficient were used. Significance was set at p < .05. RESULTS At the same day and after 24 h, 14/16 subjects felt 'good'. 9/16 presented intra- or extra-oral swelling. The frequency of PP ≥36 (weak) was 82.4%. On the same day, 1 and 2 days postoperatively, there was more pain compared with preoperative pain p < .05. At Day 3, PP equalled preoperative pain (p > .05). 62.5% of subjects needed analgesics Day 0-2. The recall rate was 94.1%, and resolution of apical periodontitis was observed in 87.5%. CONCLUSIONS The well-being of subjects was good, and the overall PP intensity was low. However, postoperative intra- and extra-oral swelling occurred often. At the recall visit, the effectiveness of the RCT with RISA appeared high (87.5%). The encouraging outcome results plus the fact that RISA has a broader action range than NaOCl in vitro, justify further work on the RISA solution. To reduce postoperative swelling, it is advised to further investigate the optimal way of application of RISA in the laboratory before clinical application is recommended.
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Affiliation(s)
- João Filipe Brochado Martins
- Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Anthony Jautze
- Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Athina Christina Georgiou
- Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Birgitte Maria Theresia Tulp
- Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Wim Crielaard
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Suzette Veronica van der Waal
- Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
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31
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Wang Y, Hofmann M, Ruf S, Zhang J, Huang Q. Intentional replantation and dental autotransplantation of mandibular posterior teeth: Two case reports. Medicine (Baltimore) 2023; 102:e35822. [PMID: 37986277 PMCID: PMC10659724 DOI: 10.1097/md.0000000000035822] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/06/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Intentional replantation and dental autotransplantation are 2 similar techniques both involving atraumatic tooth extraction, visualization of the root, and replantation. They are considered as the last resort for unsalvageable teeth. The author aims to describe 2 mandibular posterior teeth with serious periapical lesions which are resolved by intentional replantation and dental autotransplantation, respectively. CASE SUMMARY In case 1, a 45-year-old male patient received root canal treatment because of a cracked mandible right first molar with periapical lesions. An endodontic file was separated in the apical third of the mesiolingual root canal. After conventional canal filling of the other root canals, the molar was atraumatically extracted. The separated instrument was removed, the mesiolingual root received a retrograde filling and the molar was replanted. At the 3-month follow up, the patient was asymptomatic and the X-ray picture showed no detectable root resorption and ankylosis. In case 2, a 29-year-old woman reported discomfort during occlusal loading after a root canal treatment and a coronal restoration of the mandibular right first molar. Radiographs showed a low-density shadow in the mesial apical and in the root furcation area of the mandibular first molar so the patient was diagnosed as chronic periapical periodontitis. After the removal of the affected tooth, the extraction socket was thoroughly debrided and irrigated. The intact mandibular right third molar with similar dimensions was extracted by minimally invasive procedure and transplanted. The donor tooth was fixed by a fiber-splint for 1 month and a root canal treatment was performed 2 weeks after surgery. After 1 year, clinical and radiographical examination revealed functional and periodontal healing. CONCLUSIONS These 2 reports present the successful management of intentional replantation and dental autotransplantation. Both procedures are recommended after nonsurgical endodontic treatment, especially when apical microsurgery is not an option, for example because of difficult accessibility or patient preference.
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Affiliation(s)
- Yao Wang
- Department of Orthodontics, Faculty of Medicine, Justus Liebig University Giessen, Giessen, Germany
| | - Maria Hofmann
- Department of Paediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Giessen, Germany
| | - Sabine Ruf
- Department of Orthodontics, Faculty of Medicine, Justus Liebig University Giessen, Giessen, Germany
| | - Jian Zhang
- Department of Oral and Maxillofacial Surgery, Wuxi Stomatology Hospital, Wuxi, China
| | - Qiuju Huang
- Department of Endodontics, Wuxi Stomatology Hospital, Wuxi, China
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Heyder M, Reise M, Burchardt J, Guellmar A, Beck J, Schulze-Späte U, Sigusch B, Kranz S. Photodynamic Suppression of Enterococcus Faecalis in Infected Root Canals with Indocyanine Green, Trolox TM and Near-Infrared Light. Pharmaceutics 2023; 15:2572. [PMID: 38004551 PMCID: PMC10674481 DOI: 10.3390/pharmaceutics15112572] [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: 10/04/2023] [Revised: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
Recently, our group showed that additional supplementation of Trolox™ (vitamin E analogue) can significantly enhance the antimicrobial photodynamic effect of the photosensitizer Indocyanine green (ICG). Up to now, the combined effect has not yet been investigated on Enterococcus faecalis in dental root canals. In the present in vitro study, eighty human root canals were inoculated with E. faecalis and subsequently subjected to antimicrobial Photodynamic Therapy (aPDT) using ICG (250, 500, 1000 µg/mL) and near-infrared laser light (NIR, 808 nm, 100 Jcm-2). Trolox™ at concentrations of 6 mM was additionally applied. As a positive control, irrigation with 3% NaOCl was used. After aPDT, root canals were manually enlarged and the collected dentin debris was subjected to microbial culture analysis. Bacterial invasion into the dentinal tubules was verified for a distance of 300 µm. aPDT caused significant suppression of E. faecalis up to a maximum of 2.9 log counts (ICG 250 µg/mL). Additional application of TroloxTM resulted in increased antibacterial activity for aPDT with ICG 500 µg/mL. The efficiency of aPDT was comparable to NaOCl-irrigation inside the dentinal tubules. In conclusion, ICG significantly suppressed E. faecalis. Additional application of TroloxTM showed only minor enhancement. Future studies should also address the effects of TroloxTM on other photodynamic systems.
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Affiliation(s)
| | | | | | | | | | | | | | - Stefan Kranz
- Department of Conservative Dentistry and Periodontology, University Hospital Jena, An der Alten Post 4, 07743 Jena, Germany; (M.H.); (M.R.); (J.B.); (A.G.); (J.B.); (U.S.-S.); (B.S.)
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Shah T, Ramesh S, Sugumaran S, Choudhari S. Endodontic retreatment efficacy with and without solvents: A systematic review. J Conserv Dent Endod 2023; 26:610-615. [PMID: 38292751 PMCID: PMC10823971 DOI: 10.4103/jcde.jcde_86_23] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/06/2023] [Accepted: 09/18/2023] [Indexed: 02/01/2024]
Abstract
Introduction This systematic review investigates the crucial need for solvent use in root canal retreatment, as it effectively removes filling materials, reduces apical debris extrusion, and alleviates postoperative pain, ultimately enhancing treatment success. The review aims to assess the success rates, compare outcomes, explore benefits and drawbacks, and identify subgroups where solvent use may be more effective during root canal retreatment. Materials and Methods The search was performed in PubMed Central, Scopus, Cochrane, LILAC, ScienceDirect, Google Search, Web of Science, and manually using the search items alone and in combination by means of PUBMED search builder. The studies were assessed for eligibility according to the eligibility criteria by two independent reviewers. Groups containing solvent with nonsolvent groups and randomized control trials were included and in vitro studies, retrospective studies, and animal studies were excluded from the study. Quality assessment was performed using the risk of bias (RoB) 2.0 tool. Results Out of the 596 articles obtained, 14 were shortlisted for full-text reading and finally two articles were included in the study. The studies were assessed for quality, and data were extracted in a tabulated form. Overall RoB is low, but due to the lack of homogeneity, meta-analysis could not be conducted. Conclusion The use of solvent does not cause any significant difference in the postoperative pain levels or analgesic intake for retrieval of gutta-percha in cases of root canal retreatment. Due to the limited number of studies available and the lack of clinician-related outcomes such as time taken to retrieve the gutta-percha, these results should be taken into consideration with caution.
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Affiliation(s)
- Tanvi Shah
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Sindhu Ramesh
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Surendar Sugumaran
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Sahil Choudhari
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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Meire MA, Bronzato JD, Bomfim RA, Gomes BPFA. Effectiveness of adjunct therapy for the treatment of apical periodontitis: A systematic review and meta-analysis. Int Endod J 2023; 56 Suppl 3:455-474. [PMID: 36156804 DOI: 10.1111/iej.13838] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 09/22/2022] [Accepted: 09/22/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Adjunct therapy refers to any intracanal procedure going beyond chemomechanical preparation with instruments and traditionally delivered irrigants (excluding interim dressings). It is not clear whether and which of these adjunct therapies have a significant impact on the outcome of root canal treatment [healing of apical periodontitis (AP) and other patient-related outcomes]. OBJECTIVES This systematic review aimed to analyse available evidence on the effectiveness of adjunct therapy for the treatment of AP in permanent teeth, according to a population, intervention, comparison, outcome, time and study design framework formulated a priori by the European Society of Endodontology. METHODS Five electronic databases (PubMed, Embase, Scopus, Cochrane and Web of Science) were searched up to October 2021 to identify clinical studies comparing adjunct therapy to no adjunct therapy in adult patients with AP. Animal studies, reviews, studies with less than 10 patients per arm and studies with a follow-up time of less than 1 year, or less than 7 days for postoperative pain, were excluded. The quality of the included studies was appraised by the appropriate tools [Risk of Bias 2 (RoB2) for randomized clinical trials (RCTs) and Newcastle-Ottawa Scale for observational studies]. Meta-analysis was performed using a random-effects model. The certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS Fourteen studies (13 RCTs and one retrospective cohort) fulfilled the inclusion criteria for this review. They evaluated different types of adjunct therapy: antimicrobial photodynamic therapy (aPDT; three studies), diode laser canal irradiation (3), Nd:YAG laser canal irradiation (2), Er;Cr:YSGG laser canal irradiation (1), ozone therapy (2) and ultrasonically activated irrigation (UAI) (4). Radiographical healing was reported in seven studies, but meta-analysis was only possible for UAI (two studies), showing no statistically significant difference in healing after 12 months. Pain after 7 days was reported in seven studies. Meta-analysis on three studies that used aPDT and on two studies using diode laser irradiation showed no significant difference in the prevalence of pain after 7 days between the control and adjunct therapy. According to RoB2 tool, six studies had a high risk of bias, five studies had some concerns, and two studies low risk of bias. The GRADE assessment revealed a very low strength of evidence for diode laser, and low strength of evidence for PDT, ozone and UAI studies. DISCUSSION The included studies displayed significant heterogeneity in terms of type of adjunct therapy, technical details per adjunct therapy, outcome reporting and several combinations of these, limiting the potential for meta-analysis. CONCLUSIONS There is insufficient evidence to recommend any adjunctive therapy for the treatment of apical periodontitis. REGISTRATION Prospero CRD42021261869.
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Affiliation(s)
- Maarten A Meire
- Section of Endodontology, Department of Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Juliana D Bronzato
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, Brazil
| | - Rafael A Bomfim
- Department of Community Health, School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Brenda P F A Gomes
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, Brazil
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Ajaj R, Alsulaiman M. Assessment of Decision-Making and Material Selection for Vital Pulp Therapy in Deep Carious Lesions: A Study at the Faculty of Dentistry, King Abdulaziz University. Cureus 2023; 15:e47463. [PMID: 38021766 PMCID: PMC10662211 DOI: 10.7759/cureus.47463] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
PURPOSE The purposes of this study were to assess decision-making, material selection, and management of deep carious lesions in permanent teeth requiring vital pulp therapy (VPT); investigate the intradepartmental and interdepartmental consensus in the management of those cases; and correlate this study's results to the current scientific literature, clinical experience, and postgraduate training among staff and postgraduate students at the Faculty of Dentistry, King Abdulaziz University. MATERIALS AND METHODS The survey included faculty from pedodontics, endodontics, and restorative/operative dentistry; postgraduate students; and interns, excluding specific categories such as retired faculty, external trainers, non-faculty hospital specialists, general practitioners, students, interns outside the institution, and other departments. An anonymous electronic questionnaire was developed and validated. Ethical approval was obtained, and the questionnaire was distributed to all 148 English-proficient members of the targeted population via email and WhatsApp, accompanied by a cover letter. The questionnaire encompassed demographic, education, experience, assessment, decision-making, and management sections. Data were collected and analyzed using Microsoft Excel, with results presented using categorical variables, Pareto charts, and statistical tests. RESULTS There were 86 responses, representing 58% of the target population, with the key findings including the prominence of "Pre-operative vitality test result" as the most important factor in assessing deep carious lesions, with no significant differences among specialties. The (one-step and one-visit) management approach was preferred by 50% of participants, with no significant specialty differences. For deep carious lesions without pulpal exposure, glass ionomer (GI)/resin-modified glass ionomer (RMGI) base was the top choice, with no variation among all specialties. In cases with pulpal exposure, the one-visit approach (direct pulp capping (DPC), base, and restoration) was the most favored, with no specialty differences. Material availability significantly influenced decision-making, with no specialty variations. CONCLUSION The study highlights the crucial role of pre-operative vitality tests in assessing deep carious lesions for VPT or root canal treatment (RCT). Participants generally favored VPT for cases with normal pulp vitality, with some departmental variation. Controlling bleeding post-pulpal exposure was a central concern. Mineral trioxide aggregate (MTA) was the most commonly used VPT material, followed by Ca(OH)2 and Biodentine. Factors such as treatment access, patient compliance, remaining dentin thickness, and oral hygiene had minimal impact on treatment choice. Limited availability of VPT materials was the primary reason for non-use. The survey's acceptable response rate raises concerns about potential non-response bias, though limitations include a lack of data on non-responders. Nevertheless, the survey's strength lies in its comprehensive coverage of key clinical aspects, engaging professionals from diverse specialties and educational levels who are collectively interested in addressing deep caries cases.
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Affiliation(s)
- Reem Ajaj
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Mona Alsulaiman
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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Rossi-Fedele G, Ng YL. Effectiveness of root canal treatment for vital pulps compared with necrotic pulps in the presence or absence of signs of periradicular pathosis: A systematic review and meta-analysis. Int Endod J 2023; 56 Suppl 3:370-394. [PMID: 36107038 DOI: 10.1111/iej.13833] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/30/2022] [Accepted: 09/12/2022] [Indexed: 10/20/2023]
Abstract
BACKGROUND Preoperative pulpal status may influence the outcomes of root canal treatment (RCTx) according to various measures used. OBJECTIVES To compare the effectiveness of RCTx of teeth with a vital pulp versus a necrotic pulp, using a range of clinical and patient-related outcomes proposed for the development of S3-level clinical practice guidelines. METHODS A search was conducted in the PubMed-MEDLINE, Scopus, EMBASE, Google scholar databases and available repositories, followed by hand searches, until 29 March 2022. Clinical studies published in the English language comparing the stipulated outcomes of RCTx of teeth with vital versus necrotic pulp were included. The Newcastle-Ottawa Scale was adapted to assess study quality. Effects of pulpal status were estimated and expressed as risk ratio (RR) using fixed- and random-effect meta-analyses. The quality of evidence was assessed through the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS Twenty-eight studies published between 1961 and 2021 were included. Five studies have investigated the "tooth survival" outcome, four reported pulpal status was not a significant predictor, consistent with meta-analysis findings (RR: 1.00; 95% CI: 1.00, 1.00; n = 3). Seven studies reported pulpal status had no significant influence on postoperative pain, regardless of duration after treatment. Sixteen studies have analysed "periapical health," and 11 revealed pulpal status had no significant influence. Meta-analyses revealed the influence was not significant if preoperative periapical radiolucency was absent (RR: 0.95; 95% CI: 0.90, 1.00; n = 9) but significant if it was present (RR: 1.12; 95% CI: 1.05, 1.19; n = 11). Most studies were classified as "some concerns" (n = 17) to "low" (n = 9) risk of bias RoB. DISCUSSION Evidence is limited and only available for three outcomes when comparing the effectiveness of RCTx in permanent teeth with vital pulp versus pulp necrosis. Nevertheless, the quality of available evidence was moderate to high. The "periapical health" data heterogeneity could be explained by preoperative radiolucency, thus RCTx was found more effective for prevention than the resolution of apical periodontitis. CONCLUSIONS There was no significant difference in the "tooth survival," "postoperative pain" and "evidence of apical radiolucency" outcomes of RCTx in teeth with vital or necrotic pulps. REGISTRATION PROSPERO database (CRD42021260280).
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Affiliation(s)
| | - Yuan-Ling Ng
- Unit of Endodontology, UCL Eastman Dental Institute, University College London, London, UK
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González Sánchez JA, Munill Ferrer M, Suresh N, Nagendrababu V, Dummer PMH, Garcia-Font M, Abella Sans F. Successful Root Canal Treatment of an Atypical Mandibular Canine with a Boomerang-shaped Root and Canal System with a Large Periapical lesion-A Case Report with 9-year Follow-up. J Endod 2023; 49:1369-1375. [PMID: 37468060 DOI: 10.1016/j.joen.2023.07.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/04/2023] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
AIM This report describes an atypical mandibular canine with a single boomerang-shaped root and root canal system with a large periapical lesion managed by root canal treatment. METHODS The chief complaint of a 16-year-old male was acute pain and an abnormal sensation in the right mandibular canine (tooth #27). The clinical examination revealed that tooth #27 had an unusual coronal morphology. The buccal aspect of the tooth resembled that of a normal canine but was significantly broader than expected. On the lingual aspect of the crown; however, there was an unusual cusp-like structure with ridges that was slightly less prominent than the buccal incisal tip. The intraoral periapical radiographs revealed a complex root with an obvious cow horn-shaped canal mesially and distally, but with the suggestion of a root structure joining the mesial and distal extensions. A large periapical lesion was present. Computed tomography revealed the presence of a single root and canal system shaped like a boomerang. Root canal treatment was performed and the patient was followed-up for 9 years. RESULTS Following root canal treatment, the patient had no symptoms, no mobility, no periodontal pockets, or root resorption. At 9 years, the cone beam computed tomography images confirmed that satisfactory healing of the periapical tissues had occurred. CONCLUSION The mandibular right canine had a unique boomerang-shaped root and canal system. Effective shaping and cleaning of the complex canal shape plus thermoplastic root filling aided the successful healing of the periapical lesion.
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Affiliation(s)
| | | | - Nandini Suresh
- Faculty of Dentistry, Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research (MAHER), TamilNadu, India
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, University of Sharjah, College of Dental Medicine, Sharjah, United Arab Emirates
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Marc Garcia-Font
- Department of Endodontics, Universitat International de Catalunya, School of Dentistry, Barcelona, Spain
| | - Francesc Abella Sans
- Department of Endodontics, Universitat International de Catalunya, School of Dentistry, Barcelona, Spain.
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Tomson PL, Vilela Bastos J, Jacimovic J, Jakovljevic A, Pulikkotil SJ, Nagendrababu V. Effectiveness of pulpotomy compared with root canal treatment in managing non-traumatic pulpitis associated with spontaneous pain: A systematic review and meta-analysis. Int Endod J 2023; 56 Suppl 3:355-369. [PMID: 36209498 DOI: 10.1111/iej.13844] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pulpitis characterized by spontaneous pain can result in debilitating pain. Dogma has existed to offer only have two treatment options, namely root canal treatment (RCT) or extraction, although pulpotomy has always remained a potential treatment modality. OBJECTIVE This review aimed to answer the following research question: 'Does pulpotomy (partial or full) (I) result in better patient and clinical reported outcomes (O), compared with RCT (C) in permanent teeth with pulpitis characterized by spontaneous pain (P) evaluated at various time intervals?' (T). METHODS Two authors independently performed study selection, data extraction and risk of bias assessment. The literature search was conducted in the following electronic databases: Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Central Register of Controlled Trials. English language clinical trials comparing the patient and clinical reported outcomes between RCT and pulpotomy were included. The meta-analysis was performed on a fixed-effect model and the quality of evidence assessed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. RESULTS Two randomized clinical trials were included. Amongst two trials, one has published four reports at different time points involving the same cohorts. The meta-analysis revealed no difference in postoperative pain (Day 7) between RCT and pulpotomy (OR = 0.99, 95% CI 0.63-1.55, I2 = 0%) and quality of evidence was graded as 'High'. Clinical success was high at year 1, 98% for both interventions, however, decreased over time to 78.1% (pulpotomy) and 75.3% (RCT) at 5 years. DISCUSSION Pulpotomy is a definitive treatment modality that is as effective as RCT. This could have a significant impact on treatment of such patients affording the advantages of retaining a vital pulp and preventing the need for RCT. CONCLUSION This review could only include two trials, hence there is insufficient evidence to draw robust conclusions. The clinical data accumulated so far suggests no difference in pain between RCT and pulpotomy at Day 7 postoperatively and a single randomized control trial suggests that the clinical success rate for both treatment modalities is similar long term. There is a need for more well-designed trials by different research groups to develop a stronger evidence base in this area. REGISTRATION PROSPERO database (CRD42021259744).
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Affiliation(s)
- Phillip L Tomson
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Juliana Vilela Bastos
- Department of Restorative Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Jelena Jacimovic
- Central Library, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Jakovljevic
- Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Shaju Jacob Pulikkotil
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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Pires CRF, Souza-Gabriel AE, Pelozo LL, Cruz-Filho AM, Sousa-Neto MD, Silva RG. Guided endodontics of calcified canals: The drilling path of rotary systems and intracanal dentin wear. AUST ENDOD J 2023; 49 Suppl 1:64-70. [PMID: 36106713 DOI: 10.1111/aej.12684] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/03/2022] [Indexed: 11/26/2022]
Abstract
This study evaluated the drilling path (mm) and the dentin wear (mm3 ) of two instruments used during guided endodontic access. Twenty mandibular incisors with calcified canals were selected using cone-beam computed tomography (CBCT) and fixed in articulated models. Preoperative CBCT scans were performed in combination with intraoral scanning, and the images were reconstructed in the Blue Sky Bio software for access planning and printing the guides. The access cavity was drilled with 1.0-mm-diameter bur (DSP) and 0.8-mm-diameter bur (Munce). Postoperative CBCT was performed, and the images obtained preoperative and postoperative were superimposed for the analyses. Data were analysed by a t-test and linear regression (α = 0.05). No difference was found in the drilling path (p = 0.422). However, the Munce bur had higher dentin wear than the DSP bur (p = 0.011). A positive linear correlation (R2 = 0.859) was found between the factors.
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Affiliation(s)
| | | | - Laís Lima Pelozo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Antônio Miranda Cruz-Filho
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ricardo Gariba Silva
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Hu J, Zhu Y, Deng S, Wang Z, He F. Outcome of root canal treatment using warm vertical compaction with bioceramic and resin-based sealers: A randomised clinical trial. AUST ENDOD J 2023; 49 Suppl 1:170-178. [PMID: 36378149 DOI: 10.1111/aej.12713] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/24/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022]
Abstract
This study aimed to compare the effect of a bioceramic sealer (iRoot SP) and a resin-based sealer (AH Plus) on the outcome of root canal treatment in a 2-year follow-up. Seventy-six teeth with irreversibly or necrotic pulp were recruited. After instrumentation and disinfection, the root canals were obturated using warm vertical compaction with iRoot SP (n = 43) or AH Plus (n = 33). Patients were followed up by clinical and radiographic examination at 6 12 and 24 months with recall rates of 84.2%, 65.8% and 48.7%, respectively. During each recall session, the success rates were 80%, 85.2% and 85% in the iRoot SP group and 82.8%, 91.3% and 88.2% in the AH Plus group. The success rates of the two groups did not differ significantly (p > 0.05). The bioceramic sealer resulted in a similar clinical performance and success rate to the resin-based sealer in endodontic treatment during a 2-year follow-up.
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Affiliation(s)
- Jinghao Hu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yunjie Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Zeji Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
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Jose J, Teja KV, Silva EJNL, Janani K, Siddique R, Rossi-Fedele G. Centric versus eccentric engine-driven endodontic instrument design for microbial load reduction-A systematic review and meta-analysis of randomised clinical trials. AUST ENDOD J 2023; 49 Suppl 1:515-527. [PMID: 36514265 DOI: 10.1111/aej.12726] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/09/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022]
Abstract
This systematic review assessed the clinical influence of centric and eccentric engine-driven instrument design for reduction in microbial load in infected root canal system. The literature search was conducted in electronic databases (PubMed, Cochrane Library, Scopus, Lilacs and Google Scholar) and grey literature till June 2022. The search strategy followed the PRISMA 2020 guidelines. Qualitative and quantitative synthesis was conducted based on the guidelines of the Cochrane Handbook. The risk of bias was assessed using the revised Cochrane criteria and quality of evidence was conducted using the Grading of Recommendation Assessment, Development and Evaluation tool. Out of 28 papers, only five papers met the inclusion criteria of this review. Studies showed reduction in microbial load after instrumentation using centric or eccentric instruments with no statistically significant difference in the meta-analysis. In conclusion, there is low-grade evidence suggesting that microbial reduction is similar using centric and eccentric instruments.
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Affiliation(s)
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Duque de Caxias, Brazil
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Krishnamachari Janani
- Department of Conservative Dentistry and Endodontics, SRM Dental College, Chennai, India
| | - Riluwan Siddique
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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Lin Q, Li Z, Liu M. Analyze the clinical effect of YAG laser combined with sodium hypochlorite in root canal treatment of pulpitis. Immun Inflamm Dis 2023; 11:e975. [PMID: 37773711 PMCID: PMC10521375 DOI: 10.1002/iid3.975] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/15/2023] [Accepted: 07/30/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVE To compare and analyze the clinical therapeutic effects of sodium hypochlorite combined with Nd: YAG laser and sodium hypochlorite alone for root canal disinfection in patients with pulpitis. METHODS Patients with pulpitis were divided into control group and observation group according to random number table method. Both groups received root canal treatment, while the control group received root canal irrigation with 1% sodium hypochlorite. The observation group was irrigated with 1% sodium hypochlorite combined with Nd: YAG laser. Periodontal index, inflammatory index, life quality score and bacterial infection clearance rate of the two groups were compared before and 3 months after treatment. RESULTS The total effective rate of the observation group was 95.35%, which was higher than that of the control group 79.07% (p < .05). After 3 months of treatment, the periodontal index and inflammation level of both groups decreased, and the observation group was lower than that in the control group (p < .05). The life quality score and infection clearance rate of observation group were significantly higher than control group (p < .05). CONCLUSION Compared with root canal irrigation with 1% sodium hypochlorite alone, sodium hypochlorite combined with Nd: YAG laser for root canal disinfection can significantly improve the therapeutic effect, relieve inflammatory reaction, and decrease bacterial infection.
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Affiliation(s)
- Qiaolin Lin
- Department of StomatologyShijiazhuang Fourth HospitalShijiazhuangChina
| | - Zhixin Li
- Department of StomatologyShijiazhuang Fourth HospitalShijiazhuangChina
| | - Mingming Liu
- Laboratory CenterThe First Hospital of Hebei Medical UniversityShijiazhuangChina
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Meyfarth SRS, Tavares JDS, Guimarães LDS, Silva EAB, Gaio DC, Ecker MB, Brancher JA, Küchler EC, Silva-Sousa AC, de Sousa-Neto MD, Antunes LAA, Antunes LS. Association between single-nucleotide polymorphisms in serotonin receptor 2A and melatonin receptor 1A genes and pain after root canal treatment. Int Endod J 2023; 56:1077-1091. [PMID: 37323077 DOI: 10.1111/iej.13946] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/17/2023]
Abstract
AIM This study aimed to investigate whether single-nucleotide polymorphisms (SNPs) in the genes encoding 5-HTR2A (5-Hydroxytryptamine (serotonin) receptor 2A) and MTNR1A (melatonin receptor 1A) may contribute to postoperative pain perception after root canal treatment. We hypothesised that SNPs in HTR2A and MTNR1A genes were associated with postoperative pain after root canal treatment. METHODOLOGY This genetic cohort study enrolled patients with single-rooted teeth diagnosed with pulp necrosis and asymptomatic apical periodontitis before root canal treatment. Root canal treatment was performed in one session using a standardized protocol. Postoperative pain and tenderness were assessed using a visual analogue scale (recorded every day for 7 days and on the 14th and 30th days after root canal treatment). Genomic DNA was extracted from saliva and used to genotype the SNPs in HTR2A (rs4941573 and rs6313) and MTNR1A (rs6553010, rs6847693 and rs13140012) using real-time polymerase chain reaction. Genotypes were compared using univariate and multivariate Poisson regression with generalized estimating equations (p < .05). RESULTS In total, 108 patients were enrolled in this study. The SNPs rs6553010 (MTNR1A), rs4941573 and rs6313 (HTR2A) were associated with an increased risk of developing pain after root canal treatment (p < .05). CONCLUSIONS This study suggests that SNPs in HTR2A and MTNR1A influence pain response after root canal treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Alice Corrêa Silva-Sousa
- Restorative Dentistry Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel Damião de Sousa-Neto
- Restorative Dentistry Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Lívia Azeredo Alves Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, Brazil
- Clinical Research Unit, Fluminense Federal University, Rio de Janeiro, Brazil
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil
- Specific Formation Department, School of Dentistry of Nova Friburgo, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Leonardo Santos Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, Brazil
- Clinical Research Unit, Fluminense Federal University, Rio de Janeiro, Brazil
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil
- Specific Formation Department, School of Dentistry of Nova Friburgo, Fluminense Federal University, Rio de Janeiro, Brazil
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44
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Cai M, Abbott P, Castro Salgado J. pH changes in radicular dentine associated with calcium hydroxide and corticosteroid/antibiotic pastes. AUST ENDOD J 2023; 49 Suppl 1:273-279. [PMID: 29756400 DOI: 10.1111/aej.12280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2018] [Indexed: 11/27/2022]
Abstract
The aim was to compare hydroxyl ion diffusion through dentine following placement of calcium hydroxide and Ledermix paste. Thirty-six teeth were divided into one control (n = 6) and three experimental (n = 10) groups - (i) Pulpdent paste; (ii) Pulpdent/Ledermix pastes; (iii) Ledermix paste and (iv) Saline. pH was measured in inner and outer dentine cavities over 12 months. Inner dentine time to maximum pH (Tmax ) was 1 week for Pulpdent and 2 weeks for Pulpdent/Ledermix. Pulpdent's outer dentine Tmax was 4 weeks and Pulpdent/Ledermix was 10 weeks. After day 1, Pulpdent pH was higher and this continued for 12 months. Pulpdent's outer dentine pH was higher than Ledermix and controls, but not significantly different from Pulpdent/Ledermix. Pulpdent/Ledermix had significantly higher pH than controls and Ledermix from day 5 until 10 months when Pulpdent/Ledermix outer dentine pH decreased and became similar. In all groups, pH reduced after 3 months.
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Affiliation(s)
- Michael Cai
- UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Paul Abbott
- UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
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45
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Alsultan M, Srivastava S, Javed MQ, Khan M, Ulfat H. Influence of Root Canal Treatment on Oral-Health-Related Quality of Life (OHRQoL) in Saudi Patients: A Cross-Sectional Study. Cureus 2023; 15:e45035. [PMID: 37829939 PMCID: PMC10566411 DOI: 10.7759/cureus.45035] [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] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
Objective This cross-sectional study aimed to assess the influence of root canal treatment on the oral-health-related quality of life (OHRQoL) of patients in the Kingdom of Saudi Arabia (KSA). The data on KSA's population are significantly limited, highlighting the significance of additional research to be carried out in this particular field. Methods The study was conducted at the dental clinics of the College of Dentistry, Qassim University, from January to June 2022. A total of 112 patients who had undergone endodontic therapy (ET) for teeth with irreversible pulpitis were included. Demographic data and treatment procedures were recorded. The patients' responses to the OHIP-14 questionnaire were analyzed to assess their OHRQoL. The scores were converted into qualitative categories (good, moderate, poor) for classification. Results The majority of patients (59.8%) reported a good OHRQoL after ET. Physical pain was the only variable where more than 50% of patients reported experiencing pain. Older age and smoking status were significantly associated with a poorer OHRQoL. However, no significant gender differences in OHRQoL were observed. Conclusion ET had a positive impact on the OHRQoL of patients in Saudi Arabia. The study highlights the importance of considering patient-centered outcomes, such as OHRQoL, in assessing the success of root canal treatment. Further research with longitudinal designs and randomized controlled trials is needed to better understand the long-term effects of root canal treatment on patients' OHRQoL and to compare them with other dental treatments.
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Affiliation(s)
- Montaha Alsultan
- Department of Conservative Dentistry, College of Dentistry, Qassim University, Buraidah, SAU
| | - Swati Srivastava
- Department of Conservative Dentistry, College of Dentistry, Qassim University, Buraidah, SAU
| | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, SAU
| | - Mansoor Khan
- Department of Operative Dentistry, Foundation University College of Dentistry, Foundation University, Rawalpindi, PAK
| | - Hamza Ulfat
- Department of Operative Dentistry, Heavy Industries Taxila Education City-Institute of Medical Sciences (HITEC-IMS) Dental College, Taxila, PAK
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Plataniotis E, Abbott P. A comparison of hydroxyl ion diffusion through root dentine from various calcium hydroxide preparations. AUST ENDOD J 2023; 49 Suppl 1:280-287. [PMID: 29808602 DOI: 10.1111/aej.12281] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2018] [Indexed: 11/30/2022]
Abstract
Different calcium hydroxide [Ca(OH)2 ] formulations are available. The aim was to assess differences in hydroxyl ion release with different formulations. Sixty-six teeth were divided one control (n = 6) and four experimental (n = 15) groups: (i) Pulpdent Paste; (ii): DT Temporary Dressing; (iii): Ca(OH)2 powder/saline; (iv): Ca(OH)2 points; (v): no medicament. pH was measured in inner dentine and outer dentine cavities over 12 weeks. Inner dentine pH rose rapidly for all groups except the points and controls. Peak pH was reached by day 2 before dropping and stabilising (8.0-9.2). Outer dentine pH rose steadily until day 21 for aqueous solutions and then stabilised (8.0-8.5). The points had minimal pH increase for the entire period. There were no significant differences in hydroxyl ion release between the aqueous solutions. Type of paste base did not affect release and diffusion of hydroxyl ions which continued for 84 days.
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Affiliation(s)
| | - Paul Abbott
- UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
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Singi SR, Ikhar A, Sibal A, Reche A, Madhu PP. Unveiling Hidden Canals: Middle Mesial Canal Prevalence in Mandibular First Molars Using Cone-Beam Computed Tomography Analysis in Central India. Cureus 2023; 15:e45944. [PMID: 37885509 PMCID: PMC10599634 DOI: 10.7759/cureus.45944] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Background The most frequent reason involving failure of root canal treatment in molar teeth is the inability to locate additional canals. While much research has been conducted on the morphology of mandibular molars, little is known about isthmuses and middle mesial (MM) canals in the Indian population. The primary aim of the present research was to determine the prevalence of MM canals and isthmuses of mandibular first molars in the Central India population using cone-beam computed tomography (CBCT) images. Methodology CBCT of 140 mandibular first molar teeth was analyzed from the institutional database images in the coronal, sagittal, and axial planes. Data concerning the number of root canals, the presence of middle mesial canals, and the presence of isthmus were noted. Information collected was transferred into an Excel sheet and analyzed using the Statistical Package for Social Sciences (IBM Corp., Armonk, NY, USA). Results Eight images (5.71%) revealed the presence of middle mesial canals with no statistically significant occurrence. The incidence of isthmi in the mandibular first molar was 84.3%, and the presence of isthmi in the coronal third was about 38.6%. This showed a considerable presence. Conclusion There is incidence of the middle mesial canal, which emphasizes the need to locate extra canals in patients undergoing root canal endodontic treatment. The implementation of CBCT will help identify the extra canal before the treatment. This will help ultimately in providing better patient care.
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Affiliation(s)
- Shriya R Singi
- Department of Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Anuja Ikhar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Akash Sibal
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Amit Reche
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Priyanka P Madhu
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
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48
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Skitioui M, Seck A, Niang SO, Fikhar A, Touré B. The treatment of mature permanent teeth with irreversible pulpitis by cervical pulpotomy: A systematic review. AUST ENDOD J 2023; 49 Suppl 1:488-493. [PMID: 36149016 DOI: 10.1111/aej.12694] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 07/08/2022] [Accepted: 09/09/2022] [Indexed: 01/13/2023]
Abstract
Pulpotomy has been used in primary teeth and immature permanent teeth. However, with the advent of new bioactive material, the procedure is shifting towards permanent teeth with mature apices of roots. The objective of this systematic review was to evaluate the success of pulpotomy on mature permanent teeth with acute irreversible pulpitis and to compare it with root canal treatment or between the effectiveness of the bioactive material used. The following databases were searched: PubMed, Cochrane Library: Cochrane Central Register of Controlled Trials, Embase, ClinicalTrials.gov, International Clinical Trials Registry Platform. After using the keywords predefined, the electronic search yielded a total of 86 articles. After undergoing a thorough screening and eligibility process, only four articles were finally selected. Unexpectedly, pulpotomy demonstrated a better tendency for success in such cases over the years. This shows that pulpotomy is not inferior to root canal treatment for permanent treatment of irreversible pulpitis. In addition, the results obtained showed that pulpotomy is rapid, biologically reliable and more cost-effective in all situations compared to root canal therapy. Complete pulpotomy appears to have a high success rate as a permanent treatment of irreversible pulpitis and could be considered as an alternative to root canal therapy. Pulpotomy is not inferior to root canal treatment for a permanent treatment of irreversible pulpitis. In addition, the results obtained have shown that complete pulpotomy is faster and more profitable in all situations compared to root canal treatment. Furthermore, with the advent of new so-called bioactive materials, the use of this therapeutic is increasingly considered. This is why a review based on studies of reliable articles is above all necessary to be able to generalise the indication of this therapy.
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Affiliation(s)
- Mohamed Skitioui
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco
| | - Anta Seck
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, University Cheikh Anta Diop, Dakar, Senegal
| | - Seydina Ousmane Niang
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, University Cheikh Anta Diop, Dakar, Senegal
| | - Anass Fikhar
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, Mohammed V University in Rabat, Rabat, Morocco
| | - Babacar Touré
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco
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Tadano JPG, Bueno CEDS, Silveira CFDM, Yamanaka TB, Piai GG, Duarte MAH, Vivan RR, De Martin AS. Effect of different activation methods on the intratubular penetration of CaOH 2 paste: Ex-vivo analysis by confocal laser scanning microscopy. AUST ENDOD J 2023; 49 Suppl 1:18-26. [PMID: 36093994 DOI: 10.1111/aej.12685] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/28/2022] [Accepted: 09/01/2022] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the maximum penetration depth (MPD) and penetration area (PA) of CaOH2 paste agitated by different methods and to measure the pH after performing these methods. Fifty-five mandibular premolars were divided into control, GL and 4 experimental groups, GEC, GXP, GEDDY and GI (n = 11), where the paste was agitated with Easy Clean, XP-endo Finisher, EDDY and Irrisonic, respectively. The canals were instrumented and irrigated with NaOCl. The paste was manipulated with propylene glycol and rhodamine B dye. Root sections were examined using confocal laser scanning microscopy. There was no difference between groups regarding PA (p > 0.05). At 5 mm, MPD was greater in GEC than in GL or GEDDY, and greater in GI than in GL (p < 0.05). At 2 mm, MPD was greater in GEC than in the other groups (p < 0.05). In conclusion, both Easy Clean and Irrisonic promoted deeper paste penetration and were associated with higher pH levels.
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Affiliation(s)
- João Pedro Gasparin Tadano
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | | | | | - Tainara Bielecki Yamanaka
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Gabriela Gonçalez Piai
- Department of Restorative Dentistry, Endodontics and Dental Materials, School of Dentistry of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
| | - Marco Antônio Húngaro Duarte
- Department of Restorative Dentistry, Endodontics and Dental Materials, School of Dentistry of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rodrigo Ricci Vivan
- Department of Restorative Dentistry, Endodontics and Dental Materials, School of Dentistry of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
| | - Alexandre Sigrist De Martin
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
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Iandolo A, Pisano M, Buonavoglia A, Giordano F, Amato A, Abdellatif D. Traditional and Recent Root Canal Irrigation Methods and Their Effectiveness: A Review. Clin Pract 2023; 13:1059-1072. [PMID: 37736930 PMCID: PMC10514886 DOI: 10.3390/clinpract13050094] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 08/15/2023] [Revised: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 09/23/2023] Open
Abstract
According to contemporary dental standards, the primary goal of endodontic therapy is the chemo-mechanical cleaning of the complex root canal system. Watering root canals with approved solutions and activating them are essential parts of this operation. This review outlines various irrigant activation methods for root canal therapy. Specifically, a comparison among the methods of manual dynamic activation, sonics (subsonic, sonic, and ultrasonic), internal heating, and lasers, was conducted. The results in this work were gathered using Scopus, Web of Science, Google Scholar, and PubMed databases by searching the following keywords: sodium hypochlorite, cleaning, activation, and irrigation methods. The present work concluded that the use of irrigant activation has a greater benefit than its absence. Regardless, it is impossible to point to a single effective activation method.
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Affiliation(s)
- Alfredo Iandolo
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Massimo Pisano
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Alessio Buonavoglia
- Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, 40125 Bologna, Italy;
| | - Francesco Giordano
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Alessandra Amato
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Dina Abdellatif
- Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria 21531, Egypt;
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