Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.499
Filtrar
1.
BMC Oral Health ; 24(1): 1075, 2024 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-39266985

RESUMEN

BACKGROUND: The aim of this study was to compare postoperative pain following total pulpotomy (TP) and root canal treatment (RCT) in mature molar teeth with irreversible pulpitis. To compare the traditional pulpitis classification system with the Wolters system in evaluating postoperative pain. METHODS: Eighty mandibular molars with irreversible pulpitis were included and classified according to the Wolters (moderate/severe pulpitis). The teeth were randomly assigned to two groups (RCT or TP). RCT was performed following standardized protocols. TP was performed to the level of the canal orifices, and hemostasis was achieved with 2.5% sodium hypochlorite. A 3 mm layer of MTA was placed as the pulpotomy material. The teeth were restored with glass ionomer cement followed by composite. Pain scores were recorded preoperatively and, at 6, 12, 24, 48, and 72 h and 7 days after the interventions. The data were statistically analyzed using the Mann-Whitney U test, the Friedman test, the Wilcoxon signed-rank test, and the Spearman's correlation test. The significance level was set at 0.05. RESULTS: Sixty-four patients were analyzed at the one-week follow-up and all were diagnosed as irreversible pulpitis according to the AAE; 22 teeth were classified as moderate and 42 teeth were classified as severe pulpitis according to Wolters. There was no significant difference between TP and RCT in pain scores in moderate pulpitis patients (p > 0.05). There was a significant difference between TP and RCT at 24 and 72 h of severe pulpitis; higher pain scores were observed in the RCT (p < 0.05). CONCLUSIONS: In patients with moderate pulpitis, the TP procedure allowed symptom relief more quickly than RCT. In patients with severe pulpitis, TP provided for significantly lower pain scores compared to RCT at both 24 and 72 h. CLINICAL TRIAL REGISTRATION: The study was retrospectively registered with ClinicalTrials.gov (NCT05923619). Date of Registration: 06/16/23.


Asunto(s)
Diente Molar , Dimensión del Dolor , Dolor Postoperatorio , Pulpitis , Pulpotomía , Tratamiento del Conducto Radicular , Humanos , Pulpitis/cirugía , Pulpitis/terapia , Pulpotomía/métodos , Dolor Postoperatorio/etiología , Dolor Postoperatorio/clasificación , Diente Molar/cirugía , Estudios Prospectivos , Femenino , Masculino , Tratamiento del Conducto Radicular/efectos adversos , Tratamiento del Conducto Radicular/métodos , Adulto , Adulto Joven , Materiales de Obturación del Conducto Radicular/uso terapéutico , Estudios de Seguimiento , Silicatos/uso terapéutico , Combinación de Medicamentos , Persona de Mediana Edad , Óxidos/uso terapéutico , Compuestos de Aluminio/uso terapéutico , Cementos de Ionómero Vítreo , Compuestos de Calcio/uso terapéutico , Restauración Dental Permanente/métodos , Resinas Compuestas , Hipoclorito de Sodio/uso terapéutico
2.
BMC Oral Health ; 24(1): 985, 2024 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-39179988

RESUMEN

BACKGROUND: The aim of this study was to investigate the etiologies of non-surgical root canal treatment (NS-RCT) in a Thai population and examine their association with risk factors. METHODS: A cross-sectional observational study was performed to examine the etiologies of NS-RCT and risk factors among Thai-nationality patients treated at a tertiary care dental hospital in Thailand from 2019-2023. Treatment records and radiographs were retrospectively reviewed to identify NS-RCT etiologies, and associated contributing factors were analyzed. Statistical analysis used univariate logistic regression followed by multivariate logistic regression, with a significance level set at P < 0.05. RESULTS: The data from 1500 teeth were analyzed, comprising 59.1% females and 40.9% males, with ages ranging from 7-91 years (mean = 48.56 years). The most prevalent age group was 61-70 years-old. Among the treated teeth, the mandibular first molar was the most frequently involved (13.9%), followed by the maxillary first molar (9.9%) and mandibular second premolar (9.7%). The primary etiologies of NS-RCT were dental caries (53.7%), old and large restorations (7.9%), and attrition (5.9%). Analysis of etiology of NS-RCT due to caries revealed that the most commonly affected sites were the occlusal (32.6%), distal (31.6%), and mesial (17.2%) surfaces. In immature teeth requiring NS-RCT, the predominant etiologies were dens evaginatus (32.1%), dental caries (28.6%), and traumatic injury (21.4%). The association between the etiology of NS-RCT and investigated associated factors were identified. CONCLUSIONS: The etiologies of NS-RCT in the selected Thai population were mainly attributed to dental caries, with additional factors being old and large restorations and attrition. Notably, due to the aging society, the elderly population experiences a higher demand for NS-RCT, particularly due to attrition, non-carious cervical lesions, and erosion. In contrast, in immature teeth, the most common etiologies leading to NS-RCT comprise dens evaginatus, dental caries, and traumatic injuries. The distinct etiological patterns observed in different age groups emphasize the importance of specific oral health prevention programs to address individual needs.


Asunto(s)
Tratamiento del Conducto Radicular , Humanos , Femenino , Tailandia/epidemiología , Masculino , Persona de Mediana Edad , Estudios Transversales , Anciano , Adulto , Adolescente , Niño , Factores de Riesgo , Anciano de 80 o más Años , Tratamiento del Conducto Radicular/estadística & datos numéricos , Tratamiento del Conducto Radicular/efectos adversos , Adulto Joven , Estudios Retrospectivos , Caries Dental/epidemiología , Caries Dental/etiología , Pueblos del Sudeste Asiático
3.
Sci Rep ; 14(1): 19905, 2024 08 28.
Artículo en Inglés | MEDLINE | ID: mdl-39191915

RESUMEN

This randomized clinical trial aims to evaluate cryotherapy as a therapeutic option for pain prevention after endodontic treatment with and without foraminal enlargement, in patients with asymptomatic apical periodontitis.120 teeth of patients with preoperative Visual Analogue Scale score indicating zero were treated. Specimens were randomly allocated into 4 groups: Control, Cryotherapy (ICT), Foraminal Enlargement (FE), and Cryotherapy and Foraminal Enlargement (ICT + FE). Working length was determined with an Electronic Apex Locator (EAL). Cryotherapy groups passed through a final irrigation protocol using 20 ml (2.5 â„ƒ) of cold saline solution delivered at working length for 5 min. In FE groups a #40 K-file was used up to the 0.0 mark on the EAL display. Obturation was performed and postoperative pain was checked at 6, 12, 24, 48, and 72 h and 7 days after endodontic treatment.All experimental groups showed an increase in the level of postoperative pain, which started to decrease after 12 h. Foraminal enlargement caused a statistically significant increase in postoperativepain compared to ICT and control groups within the first 6 h (p < 0.05). Cryotherapy did not influence postoperative pain, regardless of whether or not foraminal enlargement was performed.


Asunto(s)
Crioterapia , Dolor Postoperatorio , Humanos , Dolor Postoperatorio/etiología , Dolor Postoperatorio/terapia , Dolor Postoperatorio/prevención & control , Crioterapia/métodos , Femenino , Masculino , Adulto , Tratamiento del Conducto Radicular/efectos adversos , Tratamiento del Conducto Radicular/métodos , Persona de Mediana Edad , Periodontitis Periapical/cirugía , Periodontitis Periapical/terapia , Preparación del Conducto Radicular/métodos
4.
BMC Oral Health ; 24(1): 794, 2024 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-39004749

RESUMEN

BACKGROUND: This retrospective clinical study was undertaken to comparatively evaluate the number of restorative treatments, endodontic treatments, and tooth extractions performed for patients under general anesthesia due to dental anxiety or special needs between 2015 and 2022 and to examine the pain, bleeding, nausea, and vomiting data of those patients. METHODS: In total, 1165 patients underwent dental treatment under general anesthesia in the faculty hospital. Those under the age of 15 and with no endodontic procedure planned (n = 918) were excluded, followed by those with incomplete data (n = 25) and those without endodontic treatment (n = 25). Patients who underwent at least one endodontic treatment were finally included in the study (n = 184). Patients were divided into two groups: healthy and with special needs. Dental treatments were recorded as endodontic, restorative, and teeth extractions. Endodontic treatments were classified according to the tooth type (premolar, molar, and incisors). The composite restorations were classified as anterior, occlusal (O), occluso-distal (OD) or occluso-mesial (OM), and mesio-occluso-distal (MOD) restorations and patients' post-treatment pain, nausea, vomiting, and bleeding were recorded. The data were analyzed statistically. RESULTS: Among the 184 patients included in the study, 70 (38%) were healthy, and 114 (62%) had special needs. Postoperative bleeding was observed more in patients with special needs (χ2 = 4.189, p < 0.05), whereas pain was observed more in healthy patients (U = 2922.00, p < 0.05). While the number of anterior, O, and MOD restorations was higher in patients with special needs, the number of OD or OM restorations was higher in healthy patients (χ2 = 74.877, p < 0.05). CONCLUSIONS: Patients with special needs undergo a greater number of restorative treatments compared to control patients, which may be associated with the inadequate oral hygiene care of such patients. However, restorative treatment is mostly indicated for such patients in our faculty hospital, which may indicate that a conservative approach is taken. Additionally, the finding that postoperative bleeding was more severe in this group of patients compared to the control group in this study may emphasize the need to consider more possible complications after general anesthesia in these patients.


Asunto(s)
Anestesia General , Dolor Postoperatorio , Tratamiento del Conducto Radicular , Extracción Dental , Humanos , Estudios Retrospectivos , Femenino , Masculino , Adulto , Tratamiento del Conducto Radicular/efectos adversos , Extracción Dental/efectos adversos , Dolor Postoperatorio/etiología , Persona de Mediana Edad , Atención Dental para la Persona con Discapacidad , Ansiedad al Tratamiento Odontológico , Adolescente , Restauración Dental Permanente/métodos , Restauración Dental Permanente/efectos adversos , Adulto Joven , Anciano , Náusea y Vómito Posoperatorios/etiología
5.
J Endod ; 50(9): 1233-1244, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38880472

RESUMEN

INTRODUCTION: This study systematically reviewed literature regarding the effect of different concentrations of sodium hypochlorite (NaOCl) used during root canal treatment (RCT) on postendodontic pain (PEP) and rescue analgesia. METHODS: Following registration with PROSPERO (CRD42023388916), a search was conducted using PubMed, Scopus, Web of Science, and Embase databases. Randomized controlled trials of patients receiving RCT which assessed PEP at different time intervals were included. Following data extraction and Cochrane risk of bias assessment 2, meta-analyses were performed to evaluate PEP during the first 48 hours along with rescue analgesic intake. The certainty of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS: Five randomized controlled trials with 674 patients were included. One study exhibited a low risk of bias, while 4 raised some concerns. Patients treated with low concentrations of NaOCl (≤3%) were significantly less likely to report PEP at 24 hours (OR = 2.32; [95% CI, 1.63-3.31]; P < .05) and 48 hours (OR = 2.49; [95% CI, 1.73-3.59]; P < .05) as compared with high concentrations of NaOCl (≥5%). Furthermore, with low concentrations of NaOCl, significantly lesser moderate-severe PEP was reported at 24 hours (OR = 2.32; [95% CI, 1.47-3.62]; P < .05) and 48 hours (OR = 2.35; [95% CI, 1.32-4.16]; P < .05) and lesser analgesia was needed (OR = 2.43; [95% CI, 1.48-4.00]; P < .05). CONCLUSIONS: While PEP can be influenced by several factors, low certainty evidence suggests that when NaOCl is used as an irrigant during RCT, PEP may be less likely with lower concentrations of NaOCl. Moderate certainty evidence indicates that lesser analgesia may be required with lower concentrations of NaOCl. These results should be cautiously interpreted.


Asunto(s)
Dolor Postoperatorio , Irrigantes del Conducto Radicular , Hipoclorito de Sodio , Humanos , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/etiología , Dolor Postoperatorio/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Irrigantes del Conducto Radicular/administración & dosificación , Irrigantes del Conducto Radicular/efectos adversos , Tratamiento del Conducto Radicular/efectos adversos , Tratamiento del Conducto Radicular/métodos , Hipoclorito de Sodio/administración & dosificación , Hipoclorito de Sodio/efectos adversos
6.
J Oral Rehabil ; 51(9): 1737-1747, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38845175

RESUMEN

BACKGROUND: Trigeminal nerve injury following endodontic treatment, leading to unpleasant sensations or partial sensory loss in the face or oral mucosa, is uncommon but significant when it occurs. OBJECTIVE: This study analysed the pharmacological management of trigeminal nerve injuries (TNI) in a university-based hospital. METHODS: We conducted a retrospective analysis of 47 patients who visited the Department of Orofacial Pain and Oral Medicine at Yonsei University Dental Hospital, Seoul, Korea, after TNI following endodontic procedures in primary clinics. Both objective tests and subjective evaluations, assessed the extent and duration of sensory injury during the initial visit. The patient's initial symptoms, presumed cause of TNI, referral delay (time interval between TNI and the first visit to our clinic), and medications were analysed to determine whether these factors affected the outcomes. RESULTS: Most patients with TNI experienced dysesthesia with hypoesthesia (70.2%). The mandibular molars were predominantly affected (72.3%), with the inferior alveolar nerve (IAN), lingual nerve (LN), both IAN and LN, and maxillary nerve compromised in 83.0, 12.8, 2.1, and 2.1% of cases, respectively. Causes of TNI included local anaesthesia (29.8%), overfilling/over-instrumentation (25.5%), endodontic surgery (17.0%), and unknown factors (27.7%). A shorter referral delay was associated with better outcomes, with an average delay of 8.6 weeks for symptom improvement compared with 44.1 weeks for no change. The medication regimens included steroids, NSAIDs, topical lidocaine, vitamin B complex, Adenosine Triphosphate (ATP), antiepileptics, antidepressants, and opioids administered alone or in combination, with a mean duration of 20.7 weeks. 53.2% of the patients reported improvement in their symptoms, 27.7% experienced no significant change, and 19.1% had unknown outcomes. CONCLUSIONS: Swift referral to an orofacial pain specialist is recommended for effective recovery in cases of TNI arising from endodontic treatment.


Asunto(s)
Tratamiento del Conducto Radicular , Traumatismos del Nervio Trigémino , Humanos , Estudios Retrospectivos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Tratamiento del Conducto Radicular/efectos adversos , Anciano , Resultado del Tratamiento , Anestésicos Locales/administración & dosificación , Adulto Joven , República de Corea
7.
Clin Exp Dent Res ; 10(3): e881, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38798057

RESUMEN

BACKGROUND: In conjunction with post placement in root-filled teeth with periapical healthy conditions, root canal retreatment may be performed to improve the seal of the root canal. Whether root canal retreatment for technical reasons (retreatments in teeth without apical periodontitis (AP)) results in lower frequency of AP is unknown. OBJECTIVE: To examine whether there is a difference in frequency of AP between roots with root canals retreated for technical reasons, and roots with root canals not retreated before post placement, with a minimum follow-up of 5 years. Also, to examine changes in root filling quality following root canal retreatment for technical reasons. METHODS: This retrospective study included radiographs of 441 root-filled roots without periapical radiolucencies at baseline, scheduled for post and core treatment. Follow-up data for a minimum of 5 years were available for 305 roots (loss to follow-up 30.8%), 46 of which were retreated for technical reasons. Two calibrated observers assessed root filling sealing quality and length, respectively, and periapical status according to the Periapical Index. The main outcome of the study, AP, was used as the dependent variable and all analyses were performed at root level. RESULTS: The overall frequency of AP at follow-up was 13.8%. The difference in frequency of AP between retreated (4.3%) and nonretreated (15.4%) root canals was not statistically significant, p = .061. Analyses including only roots with preoperatively inadequate root filling quality showed a statistically significant difference (p = .017) between the two treatment groups (2.4% vs. 22.9%). CONCLUSIONS: Root canal retreatment for technical reasons before post and core placement significantly reduces the frequency of AP in roots with inadequate root filling quality.


Asunto(s)
Periodontitis Periapical , Técnica de Perno Muñón , Humanos , Estudios Retrospectivos , Periodontitis Periapical/terapia , Femenino , Masculino , Persona de Mediana Edad , Adulto , Tratamiento del Conducto Radicular/métodos , Tratamiento del Conducto Radicular/estadística & datos numéricos , Tratamiento del Conducto Radicular/efectos adversos , Retratamiento/estadística & datos numéricos , Anciano , Estudios de Seguimiento
8.
J Am Dent Assoc ; 155(8): 657-666.e2, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38819357

RESUMEN

BACKGROUND: This study aimed to evaluate whether the use of 8.25% sodium hypochlorite (NaOCl), compared with the use of 2.5% NaOCl, leads to higher postoperative pain after endodontic treatment. METHODS: A total of 154 patients were randomly assigned into 2 groups: 8.25% and 2.5% NaOCl. A single-visit endodontic treatment was performed using a standard protocol, varying only the NaOCl concentration. Postoperative pain was assessed using the numeric rating scale at multiple times over 30 days. Overall pain scores over time were explored via multilevel mixed-effects negative binomial regression. The need for pain medication was recorded and compared between groups via the Mann-Whitney U test. RESULTS: The use of 8.25% NaOCl increased postoperative pain scores over time by 3.48 times compared with the use of 2.5% NaOCl (incident rate ratio [IRR], 3.48; 95% CI, 1.57 to 7.67). Furthermore, the 8.25% NaOCl group exhibited higher pain incidence than the 2.5% NaOCl group during the 12-hour through 3-day period, with scores at these times ranging from 2.21 (IRR, 2.21; 95% CI, 1.35 to 3.62) through 10.74 (IRR, 10.74; 95% CI, 3.74 to 30.87) higher. No difference was detected in the number of analgesic capsules administered between groups. CONCLUSIONS: The use of 8.25% NaOCl resulted in higher postoperative pain than the use of 2.5% NaOCl, with pain scores increasing by 3.48 times when this solution was used. Furthermore, the 8.25% NaOCl group exhibited higher pain incidence than the 2.5% NaOCl group during the 12-hour through 3-day period. PRACTICAL IMPLICATIONS: The use of 8.25% NaOCl during endodontic treatment can increase postoperative pain significantly. This clinical trial was registered at the Brazilian Registry of Clinical Trials database (RBR-6vq3hc4).


Asunto(s)
Diente Molar , Dolor Postoperatorio , Periodontitis Periapical , Irrigantes del Conducto Radicular , Tratamiento del Conducto Radicular , Hipoclorito de Sodio , Humanos , Hipoclorito de Sodio/uso terapéutico , Dolor Postoperatorio/tratamiento farmacológico , Método Doble Ciego , Femenino , Masculino , Periodontitis Periapical/cirugía , Periodontitis Periapical/terapia , Adulto , Tratamiento del Conducto Radicular/efectos adversos , Tratamiento del Conducto Radicular/métodos , Irrigantes del Conducto Radicular/uso terapéutico , Irrigantes del Conducto Radicular/efectos adversos , Mandíbula/cirugía , Necrosis de la Pulpa Dental/terapia , Dimensión del Dolor , Persona de Mediana Edad
9.
Dent Med Probl ; 61(2): 293-300, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38686971

RESUMEN

The systematic review aimed to compare and evaluate the effect of resin-based sealers and bioceramic sealers on postoperative pain after endodontic treatment. Two reviewers independently conducted electronic search in PubMed, the Web of Science, ScienceDirect, the Wiley Online Library, SpringerLink, Google Scholar, and the Cochrane Library, employing a complete dual-review process to ensure the inclusion of all relevant studies in the review. The search was carried out until November 2021. After selecting eligible studies, the risk of bias assessment was carried out using the revised Cochrane risk-ofbias tool for randomized trials (RoB 2). A total of 1,931 studies were identified from the electronic search, and finally 10 studies were included after full-text assessment. In all our included studies, the visual analog scale (VAS) was used for recording pain scores. Most of the studies recorded pain intensity starting from 6 h to 7 days. The results showed that there was no significant difference between resin-based sealers and bioceramic sealers in terms of incidence or intensity of postoperative pain at any point in time.


Asunto(s)
Dolor Postoperatorio , Materiales de Obturación del Conducto Radicular , Humanos , Cerámica , Dimensión del Dolor , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/prevención & control , Materiales de Obturación del Conducto Radicular/efectos adversos , Tratamiento del Conducto Radicular/efectos adversos
10.
Eur J Oral Sci ; 132(3): e12986, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38632110

RESUMEN

This systematic review and meta-analysis aimed to determine whether apical patency increases postoperative pain after endodontic therapy. This study explored the degree and incidence of postoperative pain during root canal therapy, as well as the number of required analgesic doses. We searched PubMed, Scopus, Embase, Web of Science, Cochrane Library, and gray literature from the date of database inception until May 2023. RevMan 5.4 software was used for data analysis. Twelve studies were considered eligible for meta-analysis. The mean pain scores on days 1 (mean difference [MD] = -1.69) and 2 (MD = -0.85) differed significantly between the apical patency and non-patency groups. The odds for pain after 24 h were significantly lower (OR 0.59) in the apical patency group than in the non-patency group. Furthermore, the mean number of required analgesic doses was not significantly different between the two groups. In conclusion, apical patency significantly alleviated postoperative pain (low-quality evidence) and reduced the incidence of pain (moderate evidence). However, high-quality randomized controlled trials are required to validate these findings.


Asunto(s)
Dolor Postoperatorio , Tratamiento del Conducto Radicular , Humanos , Dimensión del Dolor , Dolor Postoperatorio/etiología , Dolor Postoperatorio/prevención & control , Tratamiento del Conducto Radicular/efectos adversos , Ápice del Diente
11.
Evid Based Dent ; 25(3): 164-165, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38499698

RESUMEN

INTRODUCTION: Postoperative endodontic pain can negatively influence the quality of life of the patients. Mineral Trioxide Aggregate (MTA) has gained attention as a potential medicament in various endodontic procedures. MTA has been shown to have desirable properties such as biocompatibility, marginal adaptation, and sealing ability compared to other materials. Limited evidence is available about the effectiveness of MTA on the reduction of postoperative pain following endodontic treatment. This article aimed to compare the non-surgical post-endodontic pain-relieving effect of MTA compared with other materials. METHODS: Indexed databases (PubMed/Medline, EMBASE, OVID, Scopus, and Cochrane) were independently searched for relevant manuscripts published up to and until June 2023. Randomized controlled trials (RCTs) with a focus on teeth with pulp pathologies, with or without radiolucency, requiring primary endodontic treatment were included. Risk of bias across individual studies was performed using the Cochrane risk of bias tool for interventions. RESULTS: Out of the initial 169 articles searched, 9 RCTs met the selection criteria. The protocols were like all the studies, but the pain rating scales, filling material, and restoration materials varied. Out of the 9 included studies, in 4 studies MTA significantly reduced postoperative pain levels, 5 studies showed no difference between MTA and other materials, whereas 1 study reported an adverse effect of grey discoloration after MTA. CONCLUSION: The findings of the present review indicate that MTA may reduce postoperative pain following non-surgical endodontic treatment. However, future standardized studies should be conducted to validate the results.


Asunto(s)
Compuestos de Aluminio , Compuestos de Calcio , Combinación de Medicamentos , Óxidos , Dolor Postoperatorio , Ensayos Clínicos Controlados Aleatorios como Asunto , Materiales de Obturación del Conducto Radicular , Silicatos , Humanos , Compuestos de Aluminio/uso terapéutico , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/prevención & control , Compuestos de Calcio/uso terapéutico , Silicatos/uso terapéutico , Materiales de Obturación del Conducto Radicular/uso terapéutico , Óxidos/uso terapéutico , Tratamiento del Conducto Radicular/efectos adversos , Tratamiento del Conducto Radicular/métodos , Odontología Basada en la Evidencia
12.
J Clin Pediatr Dent ; 48(2): 88-92, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38548637

RESUMEN

Two-visit root canal treatment for children reduce the time of visits and the by-chair time in comparison with the three-visit root canal treatment. However, it is not clear whether two-visit root canal treatment increase the risk of complications. This study aimed to evaluate the clinical effects and post-operative pain intensity after the root canal treatment between two-visit and three-visit groups in primary molars from children.106 patients were screened for eligibility, of which 74 went back to the preservation visit. Therefore, 74 primary molars from 74 children that diagnosed with chronic pulp and periodontal tissue diseases in the clinics of pediatric dentistry were retrospectively analyzed, in which 37 in the two-visit group and 37 in the three-visit group. The total effective rate and postoperative pain intensity were assessed after treatment and all statistical data were carried out with SPSS software.The average age of children in the two-visit and three-visit groups was 6.4 and 7.0, respectively, with no significant difference (p = 0.056). The two-visit group consisted of 59.5% male and 40.5% female children, while the three-visit group consisted of 56.8% male children and 43.2% female children (p = 0.813). Two months after treatment, the total effective rate in the three-visit group was 97.30%, a little higher than that in the two-visit group (94.59%), but with no significant difference (p = 0.201). Besides, there was also no significant difference in pain intensity between the two-visit and three-visit groups (p = 0.692). Therefore, there were no significant difference of total effective rate and pain intensity in root canal treatment between the two-visit and three-visit groups in primary molars from children.


Asunto(s)
Cavidad Pulpar , Tratamiento del Conducto Radicular , Niño , Humanos , Masculino , Femenino , Estudios Retrospectivos , Dimensión del Dolor/efectos adversos , Tratamiento del Conducto Radicular/efectos adversos , Dolor Postoperatorio , Diente Primario , Preparación del Conducto Radicular
13.
BMC Oral Health ; 24(1): 400, 2024 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-38553672

RESUMEN

BACKGROUND: Endodontic literature search revealed that no study has been conducted to evaluate the prevalence of apical periodontitis (AP) in root canal treated teeth from an adult Nepalese population of Madhesh Province. Consequently, little is known about the extent and risk factors associated with it. This study aimed to determine AP prevalence in root canal treated teeth from an adult Nepalese subpopulation and to analyze the related risk factors including age, sex, tooth type, type of coronal restoration and quality of root canal treatment and coronal restoration as predictors of AP. METHODS: Digital panoramic radiographs were evaluated. Periapical status of 300 root canal-treated teeth was scored by using the periapical index. The quality of root canal treatment and coronal restorations were categorized as adequate or inadequate through radiographic and clinical evaluation. The data were analyzed using univariate and multivariate logistic regression models. RESULTS: Prevalence of AP in the present study was 31.7%. In 45.7% of the treated teeth, quality of root canal treatment was adequate whereas 46% of the cases had adequate coronal restorations. Multivariate logistic regression analysis revealed statistically significant associations and remarkably increased risk for AP in teeth with inadequate root canal treatment (odds ratio [OR] = 7.92; 95% CI: 3.96-15.82; p < 0.001) whereas lower risk for AP was found in females (OR = 0.51; 95% CI: 0.28-0.90; p = 0.021) and in teeth restored with crown (OR = 0.22; 95% CI: 0.09-0.51; p < 0.001) and filling (OR = 0.18; 95% CI: 0.08-0.42; p < 0.001). Quality of coronal restoration, tooth type and age of the patient were not found to be the predictors of AP. CONCLUSIONS: Within the limits of this study, a high prevalence of AP and poor overall quality of root canal treatment and coronal restoration was found in the subpopulation studied. Quality of root canal treatment, type of coronal restoration and sex of the patient are significant predictors of possible AP development in root canal treated teeth. Substantial efforts are needed to improve the endodontic treatment standards.


Asunto(s)
Periodontitis Periapical , Diente no Vital , Adulto , Femenino , Humanos , Estudios Transversales , Cavidad Pulpar , Nepal/epidemiología , Restauración Dental Permanente/efectos adversos , Tratamiento del Conducto Radicular/efectos adversos , Periodontitis Periapical/epidemiología , Prevalencia , Obturación del Conducto Radicular , Diente no Vital/epidemiología
14.
BMC Oral Health ; 24(1): 327, 2024 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-38475776

RESUMEN

BACKGROUND: Understanding when and why endodontic treatments fail could help clinicians make prognoses and thus improve treatment outcomes. This study was aimed to assess potential predictors of early endodontic treatment failure. We explored factors contributing to the failure of initial root canal treatment were explored, with a specific emphasis on evaluating the influence of the time elapsed since the initial treatment. METHODS: This retrospective cohort study enrolled 1262 patients who sought endodontic treatment at our department and 175 patients were included for analysis. Potential causes of endodontic treatment failure were investigated, such as inadequate obturation quality, inadequate coronal status, the presence of additional untreated canals, anatomical complexity, instrument separation, iatrogenic perforation, cracks, and endodontic-periodontal lesions. The patients were divided into "short-term" and "long-term" groups depending on the time that had passed since the initial treatment (i.e., < 5 and > 10 years, respectively). The causes of failure in the short-term and long-term group were analyzed and compared using logistic regression analyses. Subgroup analysis was performed according to the number of years since the initial treatment in the short-term group to further investigate the association between the time and cause of failure (i.e., < 1, 2, 3, and 4 years, respectively). RESULTS: Untreated additional canals were present in 21.7% of all cases, and in 36.9 and 6.4% of cases in the short-term and long-term groups, respectively. Multivariable analysis showed that the presence of untreated additional canals was significantly associated with short-term compared to long-term failure. Untreated additional canals were also associated with endodontic failure within 1, 2, 3, and 4 years. CONCLUSIONS: The presence of untreated additional canals was a predictor of endodontic failure within 5 years following initial root canal treatment. To optimize long-term prognosis, it is important to detect and treat all root canals during the initial treatment.


Asunto(s)
Cavidad Pulpar , Tratamiento del Conducto Radicular , Humanos , Estudios Retrospectivos , Tratamiento del Conducto Radicular/efectos adversos , Insuficiencia del Tratamiento , Resultado del Tratamiento
15.
Compend Contin Educ Dent ; 45(3): 136-140; quiz 141, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38460137

RESUMEN

At its core, endodontics is a specialty centered on saving patients' teeth. Nonsurgical root canal therapy and nonsurgical retreatment, arguably the "bread and butter" of endodontics, not only facilitate the preservation of the natural dentition, but in many cases, alleviate pain. Most patients arrive for endodontic treatment expecting symptom relief. A small percentage of these patients, however, experience just the opposite. Within 48 to 72 hours, these select patients experience worsening symptoms, including swelling and pain, and may wonder what mishaps may have occurred during their treatment. These symptom exacerbations are referred to as endodontic flare-ups and are well-documented in the literature. In most cases their occurrence does not reflect a lack of practitioner judgment or skill, but rather a biologic event resulting from a shift in the delicate balance of the bacterial communities and inflammatory events at the periapex. This article reviews the pathophysiology and treatment of endodontic flare-ups, thereby informing patient communication strategies surrounding these events, to preserve both the teeth in question as well as patient relationships.


Asunto(s)
Endodoncia , Tratamiento del Conducto Radicular , Humanos , Tratamiento del Conducto Radicular/efectos adversos , Retratamiento , Dolor Postoperatorio , Atención Odontológica
16.
J Endod ; 50(5): 680-686, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38387794

RESUMEN

Nicolau syndrome (NS) is a rare complication resulting from intramuscular injections. It is characterized by severe pain at the injection site and the development of purplish discoloration. Only a limited number of case reports have been published documenting the adverse effects associated with the injection of calcium hydroxide (CH) beyond the apex during endodontic treatment. Here, we present the case of a 16-year-old female with NS after the injection of CH during the root canal treatment. The radiography examination revealed distal occlusion of the right maxillary and facial arteries. This caused a substantial area of skin necrosis to develop on the patient's face, resulting in permanent scarring. NS is associated with the displacement of CH beyond the apex. To minimize the risk of NS, dentists should exercise caution by avoiding forced injection of CH during treatment, particularly when the root canal is actively bleeding.


Asunto(s)
Hidróxido de Calcio , Cara , Necrosis , Sindrome de Nicolau , Tratamiento del Conducto Radicular , Humanos , Femenino , Adolescente , Tratamiento del Conducto Radicular/efectos adversos , Sindrome de Nicolau/etiología , Cara/irrigación sanguínea , Hidróxido de Calcio/uso terapéutico , Hidróxido de Calcio/efectos adversos , Isquemia/etiología , Inyecciones Intramusculares/efectos adversos , Materiales de Obturación del Conducto Radicular/efectos adversos , Materiales de Obturación del Conducto Radicular/uso terapéutico
17.
J Am Dent Assoc ; 155(2): 118-137.e1, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-38325970

RESUMEN

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.


Asunto(s)
Cavidad Pulpar , Tratamiento del Conducto Radicular , Humanos , Tratamiento del Conducto Radicular/efectos adversos , Atención Odontológica/efectos adversos , Pulpotomía/efectos adversos , Dolor Postoperatorio/etiología
18.
J Am Dent Assoc ; 155(1): 39-47, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-38054916

RESUMEN

BACKGROUND: Studies on risk factors affecting tooth retention after endodontic treatment in dental school settings are limited. Understanding these factors is crucial for preserving teeth. The aim of this retrospective study was to evaluate patient- and tooth-level risk factors associated with the survival of endodontically treated teeth. METHODS: Electronic health records of patients who underwent endodontic treatment at the School of Dental Medicine at the University of Pennsylvania from 2017 through 2020 were analyzed. Patient-level factors included age, sex, American Society of Anesthesiologists Physical Status Classification, smoking history, diabetes status, and amoxicillin allergy. Tooth-level factors included position, presence of restorations, and periodontal conditions with preprosthetic treatments. RESULTS: The results of this study indicate that the patient-level factors significantly associated with tooth retention included age, sex, American Society of Anesthesiologists Physical Classification Status, and amoxicillin allergy. Tooth-level factors such as core buildup, full-coverage crown, healthy periodontium, and scaling and root planing were also associated with higher survival rates. Mandibular premolars had higher survival rates than mandibular molars. CONCLUSIONS: This investigation revealed that the tooth retention rate of endodontically treated teeth was 96.2% after initial root canal treatment, 92.4% for nonsurgical re-treatment, and 97.8% for surgical re-treatment. PRACTICAL IMPLICATIONS: The tooth retention of the endodontic treatment was associated with healthy periodontium, tooth structure, tooth position, tooth restoration, and the patient's overall health.


Asunto(s)
Hipersensibilidad , Diente no Vital , Humanos , Estudios Retrospectivos , Diente no Vital/terapia , Coronas , Tratamiento del Conducto Radicular/efectos adversos , Tratamiento del Conducto Radicular/métodos , Factores de Riesgo , Amoxicilina , Hipersensibilidad/etiología
19.
J Endod ; 50(2): 120-128, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37924939

RESUMEN

INTRODUCTION: This study aimed to evaluate postoperative pain intensity following glide-path preparation using the ProGlider (PG) and WaveOne Gold Glider (WOGG) systems in asymptomatic teeth with necrotic pulp and periapical lesions. METHODS: In this randomized clinical trial (ClinicalTrials.gov ID: NCT05955742) maxillary and mandibular molars with asymptomatic apical periodontitis of 78 patients (age, 18-65 years) were included. The patients were randomly divided into 3 groups: control (n = 26), PG (n = 26), and WOGG (n = 26). All the systems were used according to the manufacturer's instructions, and all the root canal treatments were completed by a single operator within 2 sessions. Postoperative pain was assessed using a numerical rating scale at 6, 12, 18, 24, 48, and 72 hours. Analgesics administered and abscess formation were also recorded. Statistical analyses were performed using the Mann-Whitney U, Bonferroni Dunn, Friedman, Chi-square, and Fisher exact tests. RESULTS: The postoperative pain at 12 and 18 hours was lower in the WOGG group than in the other groups (P < .05). The postoperative pain scores at 6 and 24 hours were higher among women than among men (P < .05). The highest postoperative pain scores were observed at 6 hours (P < .05). CONCLUSIONS: The WOGG glide-path file system was associated with less postoperative pain than the other systems. Abscess formation and analgesic use were higher in the PG group than in the other groups. Postoperative pain was greater in women than in men.


Asunto(s)
Absceso , Preparación del Conducto Radicular , Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Masculino , Preparación del Conducto Radicular/efectos adversos , Dolor Postoperatorio/etiología , Diente Molar/cirugía , Tratamiento del Conducto Radicular/efectos adversos , Oro , Cavidad Pulpar/cirugía
20.
J Endod ; 50(3): 310-315, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38141831

RESUMEN

INTRODUCTION: This study investigated endodontically treated teeth that were replaced by dental implants at the University of North Carolina (UNC) at Chapel Hill School of Dentistry. The primary objective of this study was to determine the reasons leading to the extraction of endodontically treated teeth and their subsequent replacement with dental implants. The secondary objective was to evaluate the proportion of these teeth that, according to experienced endodontists, could have been preserved. METHODS: The UNC-Chapel Hill's dental electronic health records between 2004 and 2019 were probed for implant placement that replaced root canal-treated teeth. Preextraction radiographs and clinical charts were examined to ascertain the primary reason related to the extraction and to compile a profile for each case. In cases in which endodontic failure was the primary reason for extraction, radiographs and clinical findings were evaluated by 2experienced endodontists to assess potential treatment options. RESULTS: Between 2004 and 2019, 29.3% (1564 of 5229) of teeth replaced by dental implants at UNC School of Dentistry had undergone root canal treatment, with the mandibular first molar being the most commonly replaced tooth. The leading reasons for extraction were recurrent caries associated with defective restoration (26.6%), fracture of coronal structure (21.5%), vertical root fracture (20.9%), compromised periodontal condition (13.8%), and endodontic failure (2.4%). Two experienced endodontists evaluated extractions due to endodontic failure and concluded that 61.7% of them could have been candidates for endodontic retreatment. CONCLUSION: Substantial loss of tooth structure was the leading cause of extraction of root canal-treated teeth, followed by vertical root fracture and periodontal disease. Although endodontic failure constituted a minor portion of the reasons for extraction, a considerable number of teeth were extracted due to vertical root fractures following root canal treatment. A significant proportion of the extracted teeth due to endodontic failure could have been considered as potential candidates for endodontic retreatment.


Asunto(s)
Caries Dental , Implantes Dentales , Enfermedades Periodontales , Diente no Vital , Humanos , Diente no Vital/diagnóstico por imagen , Estudios Retrospectivos , Tratamiento del Conducto Radicular/efectos adversos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA