Clinical and Patient-centered Outcomes of Nonsurgical Root Canal Retreatment in First Molars Using Contemporary Techniques.

INTRODUCTION: There have been many recent technical advances in modern endodontics that have the potential to affect treatment outcomes. Reports on treatment outcomes using contemporary techniques are relatively scarce, especially in the field of nonsurgical retreatment. The purpose of this study was to determine the success of nonsurgical root canal retreatment in molars using contemporary endodontic techniques. METHODS: Sixty-three patients referred for retreatment in first molars were enrolled in the study. The retreatment procedures were performed by endodontic residents using a semistandardized treatment protocol. Patients were followed-up at 6, 12, and 24 months. Treatment outcomes were categorized into healed, healing, or nonhealing based on clinical and radiographic criteria. Healed and healing were considered as successes, and nonhealing was considered a failure. Outcomes were also evaluated using patient-centered criteria that included oral health-related quality of life scores and subjective chewing ability. RESULTS: Fifty-two of the 63 patients were available for final analysis. Five cases (9.6%) were determined to be nonhealing at the last follow-up with new or persistent periapical lesions. Thirty-seven (71.2%) patients had complete resolution of apical periodontitis, and the remaining 10 (19.2%) remained asymptomatic and showed radiographic evidence of healing. Oral health-related quality of life scores and chewing ability improved significantly over time (P < .05), with the biggest increase observed within the first week of treatment completion. CONCLUSIONS: This study showed that endodontic retreatment using contemporary techniques significantly improved patients' quality of life and chewing ability over time, with a success rate of 90.4% after 2 years.

Differences in masticatory function in patients with endodontically treated teeth and single-implant-supported prostheses: a pilot study.

Endodontic treatment and dental implants are both viable treatment options to restore a compromised dentition. How these treatments impact patients' ability to chew has not been studied. The purpose of this study was to compare various parameters of masticatory function in patients with endodontically treated teeth and single-implant supported prostheses. Fifty patients were included in this study. Twenty-five patients had mandibular molar root canals, and 25 had single implant-supported prostheses in the mandibular molar region. The natural tooth contralateral to the treated side served as the internal control. Maximum bite force, chewing efficiency, and areas of occlusal contact and near contact (ACNC) were recorded for each subject, along with a questionnaire to evaluate subjective chewing ability. When compared with contralateral controls, dental implants were found to have significantly lower maximum bite forces, reduced chewing efficiency, and smaller ACNC. Endodontically treated teeth were not statistically different than their contralateral controls. These results indicate that endodontically treated natural teeth may provide more effective occlusal contact during masticatory function compared with implant-supported restorations, leading to more efficient mastication.