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Journal of Endodontics Jun 2022The aims of this observational study were to determine if endodontists' practices in early 2021 experienced changes in patient characteristics compared with a comparable... (Observational Study)
Observational Study
INTRODUCTION
The aims of this observational study were to determine if endodontists' practices in early 2021 experienced changes in patient characteristics compared with a comparable prepandemic period and to determine whether the changes reported during the initial outbreak of coronavirus disease 2019 (COVID-19) in 2020 were reversed 1 year later.
METHODS
Demographic, diagnostic, and procedural data of 2657 patient visits from 2 endodontist private offices from March 16 to May 31 in 2019, 2020, and 2021 were included. Bivariate analyses and multiple logistic regression models were used to examine the impact of ongoing COVID-19 pandemic on patient data.
RESULTS
Bivariate analyses showed that patients' self-reported pain levels and the number of visits with irreversible pulpitis in 2021 were higher than 2019 (P < .05). Patients' self-reported pain, percussion pain, and palpation pain levels in 2021 were less than 2020 (P < .05). Multiple logistic regression analyses showed that endodontists' practices in 2021 had an increase in the number of nonsurgical root canal treatments (odds ratio [OR] = 1.482; 95% confidence interval [CI], 1.102-1.992), and apicoectomies (OR = 2.662; 95% CI, 1.416-5.004) compared with 2019. Compared with the initial outbreak in 2020, endodontists' practices in 2021 had visits with older patients (OR = 1.288; 95% CI, 1.045-1.588), less females (OR = 0.781; 95% CI, 0.635-.960), more molars (OR = 1.389; 95% CI, 1.065-1.811), and less pain on percussion (OR = 0.438; 95% CI, 0.339-0.566).
CONCLUSIONS
The ongoing COVID-19 pandemic was associated with an increase in the number of nonsurgical root canal treatments. Some of the changes observed during the initial outbreak in 2020, including objective pain parameters, returned to normal levels 1 year later.
Topics: COVID-19; Disease Outbreaks; Endodontics; Female; Humans; Pain; Pandemics
PubMed: 35307515
DOI: 10.1016/j.joen.2022.03.004 -
Journal of the American Veterinary... Dec 2012To document the short- and long-term outcomes of surgical endodontic treatment in dogs in a clinical setting.
OBJECTIVE
To document the short- and long-term outcomes of surgical endodontic treatment in dogs in a clinical setting.
DESIGN
Retrospective case series.
ANIMALS
15 dogs that underwent surgical endodontic treatment.
PROCEDURES
Medical records of dogs that underwent surgical endodontic treatment at 3 institutions from January 1995 to December 2011 were reviewed. Information extracted included signalment, history, initial clinical signs, physical and radiographic examination findings, treatment, and outcome. Outcome was determined through evaluation of the pre- and postoperative radiographs as well as clinical and radiographic findings at follow-up evaluations. On the basis of radiographic findings, treatment was considered successful if the periapical lesion and bone defect created by surgery had completely healed and no new root resorption was detected; a treatment was considered to have no evidence of failure if the periapical lesion remained the same or had not completely resolved and root resorption was static.
RESULTS
15 dogs were treated by means of apicoectomy and retrograde filling following a failed or complicated orthograde root canal treatment. The mean long-term follow-up time was 15.2 months (range, 3 to 50 months). On radiographic evaluation, 10 of 15 dogs had successful resolution of the periapical disease; 5 dogs had no radiographic evidence of failure of endodontic treatment. All dogs were considered to have a successful clinical outcome.
CONCLUSIONS AND CLINICAL RELEVANCE
Surgical endodontic treatment was an effective option for salvaging endodontically diseased but periodontally healthy teeth of dogs in which orthograde treatment was unsuccessful and nonsurgical retreatment was unlikely to succeed.
Topics: Animals; Dental Pulp Diseases; Dog Diseases; Dogs; Female; Male; Retrospective Studies; Root Canal Therapy; Treatment Outcome
PubMed: 23216039
DOI: 10.2460/javma.241.12.1633 -
Journal of Endodontics Jun 2022Some evidence suggests that teeth treated with endodontic surgery and considered to have healed over the short term are seen to relapse when evaluated again after 3 or...
INTRODUCTION
Some evidence suggests that teeth treated with endodontic surgery and considered to have healed over the short term are seen to relapse when evaluated again after 3 or more years. However, long-term evidence is limited. This study compares healing after endodontic microsurgery over long-term (5-9 years) vs middle-term (1-4 years) follow-up and assesses the influence of different healing predictors over time.
METHODS
A retrospective study was made, comparing the endodontic microsurgery healing rates after 1-4 vs 5-9 years of follow-up. Healing was assessed based on clinical and radiographic parameters. Simple binary logistic regression models were used to analyze the influence of patient age and gender, the type of tooth, previous radiographic lesion size, apical extent of previous root canal filling, the presence of a post, type of restoration, and interproximal bone level upon the endodontic microsurgery healing rate. A sensitivity analysis was used excluding cases of vertical root fracture. Two calibrated observers independently evaluated the periapical radiographs.
RESULTS
A total of 332 patients (60% women and 40% men) were included in the study. Of the 332 analyzed teeth, 198 were subjected to middle-term follow-up (1-4 years), with a healing rate of 86.9%, while 134 were subjected to long-term follow-up (5-9 years), with a healing rate of 67.2%. There were no statistically significant differences in terms of gender, age, type of tooth, size of the lesion, apical extent of previous root canal filling, presence of a post, or type of restoration. The regression models identified 2 statistically significant associations: cohort and interproximal bone level (P < .05).
CONCLUSIONS
A success rate of 86.9% was recorded after 1-4 years of follow-up, vs 67.2% after 5-9 years. Excluding cases of vertical root fractures, in the shortest follow-up cohort (1-4 years), the healing rate was 92.5%, vs 82.6% in the cohort with longer follow-up (5-9 years). The prognosis was influenced by the crestal bone level in relation to the cementoenamel junction of the tooth, being significantly poorer when probing depth was >3 mm mesial or distal to the treated tooth.
Topics: Female; Follow-Up Studies; Humans; Male; Microsurgery; Retrospective Studies; Root Canal Filling Materials; Root Canal Therapy; Treatment Outcome
PubMed: 35292312
DOI: 10.1016/j.joen.2022.03.001 -
Dental Research Journal 2023This study aimed to evaluate the reaction of the periapical tissue to Cold ceramic and mineral trioxide aggregate (MTA) following periapical endodontic surgery.
BACKGROUND
This study aimed to evaluate the reaction of the periapical tissue to Cold ceramic and mineral trioxide aggregate (MTA) following periapical endodontic surgery.
MATERIALS AND METHODS
In this experimental study, a total of 12 mandibular first, second, and third premolars of two male dogs were selected. All procedures were performed under general anesthesia. The access cavities were prepared, and the length of canals was determined. Root canal treatment was performed. A week later, periradicular surgery was performed. After osteotomy, 3 mm of the root end was cut. Then, a 3-mm cavity was created by an ultrasonic. The teeth were randomly divided into two groups ( = 12). The root-end cavities were filled with MTA in the first group and with Cold ceramic in the second group. After 4 months, the animals were scarified. Histological evaluation of the periapical tissues was performed. Data were analyzed using SPSS 22 and Chi-square test and = 0.05.
RESULTS
The findings showed 87.5% and 58.3% cementum formation in MTA and Cold ceramic groups, respectively, indicating a significant difference ( < 0.001). In addition, the results showed 91.7% and 83.3% bone formation in MTA and Cold ceramic groups, respectively, but the difference was not statistically significant ( = 0.6). Furthermore, the findings revealed 87.5% and 58.3% periodontal ligament (PDL) formation in MTA and Cold ceramic groups, respectively ( = 0.05).
CONCLUSION
Cold ceramic was able to induce the regeneration of cementum, bone, and PDL; hence, it can be considered as a biocompatible root-end filling material in endodontic surgery.
PubMed: 37388307
DOI: No ID Found -
Journal of Pharmacy & Bioallied Sciences Feb 2024In this systematic review, we assessed whether the effects of the usage of various devices help with magnification in endodontics and whether they resulted in any...
AIM
In this systematic review, we assessed whether the effects of the usage of various devices help with magnification in endodontics and whether they resulted in any significant changes in the clinical result of treatment.
MATERIALS AND METHODS
An exhaustive search was performed across MEDLINE and Cochrane Registers for various clinical studies, which were focused on comparing regenerative endodontic treatment based on the usage of magnification devices. Various terms were used to search these clinical trials such as microscope, regenerative endodontic surgery, apicoectomy, endoscope, and loupes.
RESULTS
After scrutinizing the studies, around three clinical trials based on magnification in endodontic surgeries were included in the present review. It was observed that no statistically noteworthy betterment of treatment outcome was seen in patients treated with either of the magnification devices such as loupes and microscope.
CONCLUSION
It was evident that these magnification devices can alter the effectiveness of regenerative endodontic treatment in a very minimal way. However, we believe that more randomized clinical studies should be conducted in this area.
PubMed: 38595596
DOI: 10.4103/jpbs.jpbs_555_23 -
Journal of Dental Sciences Jan 2022
PubMed: 35028089
DOI: 10.1016/j.jds.2021.07.002 -
BMC Oral Health Jan 2024High technical thresholds, long operative times, and the need for expensive and specialized equipment impede the widespread adoption of endodontic microsurgery in many...
BACKGROUND
High technical thresholds, long operative times, and the need for expensive and specialized equipment impede the widespread adoption of endodontic microsurgery in many developing countries. This study aimed to compare the effects of a simplified, cost-effective, and time-efficient surgical approach involving orthograde obturation using biological ceramic material greater than 6 mm combined with apicoectomy for single-rooted teeth with short lengths with those of the conventional and current standard methods.
MATERIALS AND METHODS
Forty-five premolars equally categorized into three groups: conventional surgery group, standard surgery group, and modified surgery group. A µCT scan was used to calculate the volume of voids. A micro-leakage test and scanning electron microscope (SEM) were performed to assess the sealing effect. Additionally, four cases of chronic periapical periodontitis in the anterior region were selected, and the patients received either the modified approach or the standard surgery for endodontic microsurgery.
RESULTS
The volumes of voids in the apical 0-3 mm of the modified group and the standard group were comparable. The micro-leakage test and SEM examination demonstrated closely bonded fillings in the dentinal walls in both the modified surgery group and standard surgery group. The outcomes of the preliminary application of this modified procedure on patients were successful at the time of the follow-up cutoff.
CONCLUSIONS
The modified surgery group exhibited similar root canal filling and apical sealing abilities with the standard procedure for single-rooted teeth with short lengths (< 20 mm). The preliminary application of this modified surgical procedure achieved favorable results.
Topics: Humans; Root Canal Obturation; Tooth Root; Apicoectomy; Bicuspid; Periapical Periodontitis; Root Canal Filling Materials
PubMed: 38297251
DOI: 10.1186/s12903-024-03879-6 -
Clinical Oral Investigations Nov 2016The primary objective of the present radiographic study was to analyse the resection angle in apical surgery and its correlation with treatment outcome, type of treated...
OBJECTIVES
The primary objective of the present radiographic study was to analyse the resection angle in apical surgery and its correlation with treatment outcome, type of treated tooth, surgical depth and level of root-end filling.
MATERIALS AND METHODS
In the context of a prospective clinical study, cone beam computed tomography (CBCT) scans were taken before and 1 year after apical surgery to measure the angle of the resection plane relative to the longitudinal axis of the root. Further, the surgical depth (distance from the buccal cortex to the most lingual/palatal point of the resection plane) as well as the level of the root-end filling relative to the most coronal point of the cut root face was determined. Treated teeth were categorized into four groups (maxillary and mandibular anterior and posterior teeth). The final material comprised 62 treated roots in 55 teeth.
RESULTS
The mean calculated resection angle of all roots was 17.7° ± 11.4° (range -9.6° to 43.4°). Anterior maxillary roots presented the highest mean angle (25.8° ± 10.3°) that was significantly different from the mean angle in posterior maxillary roots (10.7° ± 9.4°; p < 0.001) and from the mean angle in posterior mandibular roots (15.1 ± 9.8°; p < 0.05). In roots with a shallow resection angle (≤20°), the rate of healed cases was higher than in roots with an acute resection angle (>20°), however without reaching statistical significance (p = 0.0905). Angles did not correlate either with the surgical depth or with the retrofilling length.
CONCLUSIONS
Statistically significant differences were observed comparing resection angles of different tooth groups. However, the angle had no significant effect on treatment outcome.
CLINICAL RELEVANCE
Contrary to common belief, the resection angle in maxillary anterior teeth was greater than in the other teeth. The surgeon is advised to pay attention to the resection angle when bevelling maxillary anterior teeth in apical surgery.
Topics: Adult; Aged; Apicoectomy; Cone-Beam Computed Tomography; Female; Humans; Male; Middle Aged; Prospective Studies; Tooth Root; Treatment Outcome
PubMed: 26696114
DOI: 10.1007/s00784-015-1695-x -
Annals of Medicine and Surgery (2012) Aug 2023A significant percentage of lesions of endodontic origin require surgical management due to the possible diagnosis of odontogenic cysts and tumors in the maxilla and...
UNLABELLED
A significant percentage of lesions of endodontic origin require surgical management due to the possible diagnosis of odontogenic cysts and tumors in the maxilla and mandible. Ossifying fibroma is a benign fibro-osseous lesion that typically presents as a painless, slow-growing, and expansile lesion that appears as a well-demarcated lesion with a variable degree of internal calcification on radiography. Treatment results in a large osseous defect, utilization of a graft to fill the void accelerates healing and prevents complications that may result from failure to fill by the host response.
CASE PRESENTATION
Following endodontic surgery placement of osseous graft material via Guided Tissue Regeneration to fill the defect aids to accelerate fill of the defect on a healthy 26-year-old female patient. A case discussing the one-step treatment of an ossifying fibroma of the anterior part of the mandible following endodontic microsurgery with associated retrograde fill of the apex, then site grating with biphasic calcium sulfate (Bond Apatite) used in regeneration of the osseous defect related to the lesion and resulting surgery.
CLINICAL DISCUSSION
Histologically, the ossifying fibroma is dominated by connective tissue containing cell rich areas with a few fragments of fibrosis. Moreover, in the connective tissue numerous small fragments of spongy and compact bone with areas of partial necrosis present and a significant number of inflammatory cells are observed. Surgical removal of the cyst with thorough curettage of the osseous walls and grafting of the defect provides predictable healing and the desired clinical results sought. Utilization of the biphasic calcium sulfate graft material allows the elimination of the need to overlay the area with a membrane before the flap due to its hard set and the prevention of soft tissue ingrowth into the graft material during the healing phase. Additionally, the hard set of the material allows tenting of the area to maintain the desired volume and ridge contour. Conversion of the graft material depending on the volume placed to host bone occurs over a 3-6 month period.
CONCLUSION
The case report presented, as well as the authors experience mimics the literature on biphasic calcium sulfate in its use as an osseous graft material and is an effective method for the repair of osseous defects that result from the removal of tumors and cysts of the maxilla and mandible. Treatment of an ossifying fibroma is an ideal application of the use of this biphasic calcium sulfate material allowing tenting of the surgical site over the defect created after cyst removal without the need for resorbable collagen membranes. This simplifies its use and decreases material costs that may hamper patient acceptance of treatment without a decrease in expected clinical results.
PubMed: 37554914
DOI: 10.1097/MS9.0000000000001068 -
Romanian Journal of Morphology and... 2013This study reports the case of a 14-year-old girl in good state of health who presented with the apical third of the buccal root of the first upper right premolar that... (Review)
Review
BACKGROUND
This study reports the case of a 14-year-old girl in good state of health who presented with the apical third of the buccal root of the first upper right premolar that penetrated the alveolar buccal plate and overlying mucosa, being exposed to the oral environment. The treatment rationale is presented and compared with other therapeutic options described in the literature.
METHODS
Endodontic treatment and root end resection in association with a guided tissue regeneration protocol were recommended to preserve the tooth.
RESULTS
The evolution was favorable after surgery while the alveolar and mucosal defects were corrected through tissue regeneration and remodeling. A two-year follow-up period with every six months radiographic evaluation was considered.
CONCLUSIONS
The therapeutic approach gave satisfactory results. The literature describes conservative treatment modalities in cases with mucosal fenestrations affecting permanent teeth.
Topics: Adolescent; Apicoectomy; Bicuspid; Female; Humans; Jaw Diseases; Mouth Mucosa; Radiography; Tooth Root
PubMed: 23771095
DOI: No ID Found