Prevalence of periapical lesions, root canal treatments and restorations in teeth adjacent to implant- or tooth-supported crowns: A multi-centre cross-sectional study.

AIM: To describe the prevalence of periapical lesions, root canal treatments and coronal restorations on teeth adjacent to either implant- or natural tooth-supported crowns using cone-beam computed tomography (CBCT) assessment compared to nonadjacent teeth. METHODOLOGY: A total of 1249 CBCT volumes were screened by five pre-calibrated observers in 11 health centres. A step-by-step screening protocol was implemented and reviewed every 3 months, and mandatory setting characteristics were established for all CBCT scans using dedicated visualization software. Intra- and inter-rater reliability tests were conducted. The prevalence of periapical lesions, root canal treatments and coronal restorations was recorded on both teeth adjacent and nonadjacent to implant- (predictor 1) or natural tooth-supported crowns (predictor 2). A binary logistic model (Generalizing Estimating Equations test) was used to verify whether the prevalence of periapical lesion, root canal filling and the tooth restorative status are altered when the assessed tooth is adjacent or not to an implant-supported crown (predictor 1); or to a natural tooth-supported crown (predictor 2). Odds ratio and confidence intervals for the dependent variables at both predictors were obtained. The significance level was set at .05. RESULTS: A global sample of 22 899 teeth was included. Compared to nonadjacent teeth, the prevalence of periapical lesion, root canals treatments and restorative procedures when adjacent to implant-supported crowns was 10.7%, 19.6% and 22.9% higher, respectively, and when adjacent to tooth-supported crowns was 19.3%, 35.6% and 37.4% higher respectively. These results were significant only for variables root canal filling and coronal restoration (p < .0001). Odds ratio to present root canal treatment is 2.57 times higher (CI 1.95-3.39, p = .0001) when the tooth is adjacent to implant-supported crown and 4.39 times (CI 3.49-5.53, p = .0001) when adjacent to tooth-supported crown, whilst for restorative procedure, the odds are, respectively, 1.63 (CI 1.29-2.06, p = .0001) and 2.30 (CI 1.92-2.76, p = .0001). CONCLUSIONS: Teeth adjacent to both implant- and natural tooth-supported crowns were associated with a higher frequency of root canal filling and coronal restorations.

Prevalence of Lateral Radiolucency, Apical Root Resorption and Periapical Lesions in Portuguese Patients: A CBCT Cross-Sectional Study with a Worldwide Overview.

OBJECTIVE: Apical periodontitis develops when bacteria, or their by products, migrate from the infected root canal system space to the surrounding apical tissues. The objective of the present multi-center cross-sectional study was to analyze the prevalence of lateral radiolucency, apical root resorption and periapical lesions in 7 districts of Portugal using cone-beam computed tomographic (CBCT) assessment. METHODS: A total of 1,249 CBCT scans, from 11 dental clinics, were screened. Data regarding 22,899 teeth was included. For each tooth the recorded data was the presence of lateral radiolucency, apical root resorption, periapical lesions, previous root canal treatment, missed root canals, length of root canal filling (short, good or overfilling) and type of coronal restoration (intact tooth, non-restored, filling or crown). Differences between districts were tested using chi-squared. A P<0.05 was considered significant. RESULTS: The proportion of lateral radiolucency ranged between 0.0% (Aveiro, Braga and Coimbra) and 0.9% (Lisbon), while the prevalence of apical root resorption ranged from 0.0% (Braga and Coimbra) to 3.0% in Setubal. The nationwide proportion of lateral radiolucency was 0.4%, while for apical root resorption was 1.1%. The prevalence of periapical lesions varied from 4.1% (Braga) and 13.0% (Lisbon) with a nationwide proportion of 10.0%. Significant differences were noted between districts (P<0.05). CONCLUSION: The prevalence of lateral radiolucency and apical root resorption were low in all districts. Root canal filled teeth were associated with higher periapical lesions proportions than non-treated teeth. Independently of the assessed district, the periapical status may be influenced by both quality of the endodontic treatment and coronal restoration.

Receptivity and Feedback to the Online Endodontics Congress Concept as a Learning Option - An International Survey.

OBJECTIVE: The traditional face-to-face or on-site lecturing methods are still among the most common forms of delivering knowledge to students in dental education. However, other innovative learning methodologies have the potential to complement, or even improve, the effectiveness and quality of teaching. The aim of this online survey was to analyze the receptivity of endodontics practitioners to a specific online teaching format of a multi-day congress, mimicking an on-site conference, and perceive whether the participants regarded it as an effective way of acquiring knowledge with application in their clinical practice activity. METHODS: An online questionnaire, composed of 17 items, was sent during the last day of a multi-day online congress. Four strands of information were taken into account: demographics; previous online formation experience; personal involvement in the underway online congress; and overview of the online congress concept. Participation was voluntary and anonymous. Total counts, frequencies and descriptive statistics were generated by using SurveyMonkey software. RESULTS: A total of 1.827 answers were delivered, which represented a return rate of 15.8%. The results indicated that most of the participants agree that online learning could be a good alternative to the traditional on-site learning methodology in improving their practical abilities. In addition, the present survey found that the majority of the attendees support the use of computers as an assisting tool and only 18.0% reported difficulties when using technologies. A high number of practitioners recognized a favourable cost-benefit ratio of using online lessons and stated they would recommend others to participate in online meetings as well. CONCLUSION: Overall, the present results suggest that online learning may be used successfully to improve student's knowledge and enhance their abilities to apply acquired content in clinical situations. Moreover, the participants felt online learning to be effective, engaging and with a favourable cost-benefit ratio.

The Influence of Missed Canals on the Prevalence of Periapical Lesions in Endodontically Treated Teeth: A Cross-sectional Study.

INTRODUCTION: Untreated root canals may have a direct impact on the prognosis of root canal treatment. The objective of this cross-sectional study was to evaluate the association of missed canals with periapical lesions in endodontically treated teeth. METHODS: One thousand one hundred sixty preexisting cone-beam computed tomographic scans from 8 different health centers were assessed between January 2018 and December 2018 by 5 independently calibrated observers. Two thousand three hundred five endodontically treated teeth were identified in a sample of 20,836 teeth (27,046 roots). All endodontically treated teeth were evaluated for the presence or absence of missed root canals and periapical lesions. The z test for proportions was used to analyze differences between groups, and an odds ratio was calculated in order to analyze the association between missed canals and lesions. P < .05 was considered statistically significant. RESULTS: The prevalence of missed canals was 12.0%, and teeth with untreated canals were associated with periapical pathology in 82.6% of the cases. The root presenting with the highest percentage of missed canals (62.8%) was the mesiobuccal root of the maxillary first molar, being associated with periapical lesions in 75.2% of cases. Maxillary molar mesiobuccal roots presenting with a missed canal were 3.1 times more likely to be associated with periapical pathology than maxillary molars with all canals identified and treated. CONCLUSIONS: The association between untreated root canals and the presence of periapical lesions noted in the present study shows that missed canals have a significant impact on treatment prognosis.

Association between Endodontically Treated Maxillary and Mandibular Molars with Fused Roots and Periapical Lesions: A Cone-beam Computed Tomography Cross-sectional Study.

INTRODUCTION: Fused root variations of the root canal system increase the complexity of the inner root canal system anatomy. The aim of the present study was to determine, in in vivo conditions, the proportion of periapical lesions in association with endodontically treated maxillary and mandibular molars with fused roots presenting previous root canal treatment by assessing preexisting data via cone-beam computed tomographic volumes. METHODS: A total of 1160 CBCT scans with an overall sample of 20,836 teeth were screened. A global count of 3701 maxillary molars and mandibular second molars were included in the study. The Cohen kappa test and interclass correlation coefficient tested the intra- and interrater reliability, respectively. The percentage of periapical lesions associated with molars with or without root fusion was determined. Proportions were expressed with 95% confidence intervals (CIs). The z test for proportions was used to analyze differences between subgroups, and an odds ratio was calculated in order to understand the association between periapical lesions and root configuration. RESULTS: Fused molars presented a prevalence of periapical lesions in endodontically treated teeth of 74.0% (95% CI, 65.2%-82.8%), whereas nonfused molars had a proportion of periapical lesions in root canal-treated teeth of 69.5% (95% CI, 65.2%-73.8%; P > .05). Endodontically treated molars with fused roots presented with 1.3 higher odds of being associated with periapical lesions than endodontically treated molars with nonfused roots. CONCLUSIONS: A tendency of a higher proportion of periapical lesions was found in the fused rooted molars with a history of root canal treatment when compared with nonfused teeth; however, no statistically significant difference was noted.