ABSTRACT
Introducción: La identificación por cotejo de regis-tros odontológicos representa una metodología científicamente consolidada. La estrategia más co-mún reside en la comparación de odontogramas impresos o digitalizados, aunque se ha cuestionado cierta subjetividad al asentar dicha información. Los recursos imagenológicos constituyen una evidencia más confiable y objetiva, reduciendo el sesgo iden-tificatorio. La obtención de radiografías post mor-tem (PM) reproduciendo en lo posible las técnicas que han generado las imágenes ante mortem (AM) recuperadas, otorga una eficaz modalidad compa-rativa, aumentando su valor probatorio. Materiales y Métodos: Se efectuó la comparación entre radio-grafías panorámicas y periapicales tomadas a 10 pacientes atendidos en un consultorio particular de la ciudad de Quilmes, Provincia de Buenos Aires, don-de se visualizaban tratamientos de endodoncia. Los registros de ambas técnicas de imágenes se realiza-ron sobre los mismos sujetos entre los años 2010 y 2022. Se cotejaron 11 radiografías periapicales y 10 panorámicas, procediéndose a la digitalización de la totalidad de la muestra. Se clasificaron las imágenes de cada persona conforme a la fecha de obtención de las mismas. A las más antiguas se las catalogó con el color verde, representando el material AM, mien-tras que las más recientes se marcaron en color rojo, constituyendo la información PM. Resultados: Teniendo en cuenta los criterios estipulados por la Junta Americana de Odontología Forense (ABFO) se identificaron positivamente 7 casos estudiados, 2 fueron catalogados como identificación posible, en tanto que 1 se clasificó como insuficiente. No se re-gistraron exclusiones. Conclusión: Los tratamientos endodónticos podrían suministrar información pon-derable en procesos de identificación humana en virtud de la escasa probabilidad de sufrir alteracio-nes morfológicas y estructurales por su estratégica localización intradentaria, otorgando posibilidades concretas de establecer la identidad categórica de sujetos desconocidos (AU)
Introduction: Identification by comparison of dental records represents a scientifically consolidated methodology. The most common strategy lies in the comparison of printed or digitised odontograms, although certain subjectivity has been questioned when recording said information. Imaging resources constitute more reliable and objective evidence, reducing identification bias. Obtaining post-mortem (PM) radiographs reproducing the techniques that have generated the recovered ante-mortem (AM) images, provides an effective comparative modality, increasing its evidentiary value. Materials and Methods: A comparison was made between panoramic and periapical radiographs taken to 10 patients treated in a private office in the city of Quilmes, Province of Buenos Aires, where endodontic treatments were visualized. The records of both imaging techniques were carried out on the same subjects between 2010 and 2022. 11 periapical and 10 panoramic radiographs were collected, and the entire sample was digitized. The images of each person were classified according to the date they were obtained. The oldest ones were cataloged with the color green, representing the AM material, while the most recent ones were marked in red, constituting the PM information. Results: Taking into account the criteria stipulated by the American Board of Forensic Odontology (ABFO), 7 cases studied were positively identified, 2 were classified as possible identification, while 1 was classified as insufficient. No exclusions were recorded. Conclusion: Endodontic treatments could provide valuable information in human identification processes due to the low probability of suffering morphological and structural alterations due to their strategic intradental location, providing concrete possibilities of establishing the categorical identity of unknown subjects (AU)
Subject(s)
Humans , Male , Female , Root Canal Therapy/statistics & numerical data , Radiography, Dental/methods , Radiography, Panoramic/methods , Tooth, Nonvital/diagnostic imaging , Societies, Dental/standards , Post and Core Technique/statistics & numerical dataABSTRACT
Se presentan los casos de fracturas verticales sintomáticos que ameritaron la extracción de las órganos dentales afectados en un periodo de cinco meses durante la pandemia por COVID-19 en la ciudad de Chihuahua, México. Material y métodos: Se recolectaron 26 muestras para el estudio, proporcionadas por los cirujanos dentistas integrantes del Grupo de Egresados de la Facultad de Odontología de la Universidad Autónoma de Chihuahua. Resultados: Los resultados muestran diferencias a lo reportado previamente respecto al tipo de diente involucrado, sexo de los pacientes, restauraciones coronales y tratamientos endodóncicos previos. Conclusiones: Se puede suponer que las modificaciones en el estilo de vida de la población, sumadas a la angustia permanente, pueden ser factores que contribuyen a las fracturas dentales (AU)
There are cases of symptomatic vertical fractures that warranted the extraction of affected teeth are presented, over a period of five months during the COVID-19 pandemic in Chihuahua City, Mexico. Material and methods: 26 samples were collected for the study, provided by the dentist who were members of the Graduate Group of the Faculty of Dentistry of the Autonomous University of Chihuahua. Results: The results show differences from what was previously reported regarding the type of tooth involved, sex of patients, coronal restorations and previous endodontic treatments. Conclusions: It can be assumed that changes in the lifestyle of the population, added to permanent distress, may be factors to preserve dental fractures (AU)
Subject(s)
Tooth Fractures/epidemiology , Tooth Root/injuries , Coronavirus Infections , COVID-19 , Root Canal Therapy/statistics & numerical data , Schools, Dental , Bicuspid , Dental Fissures/epidemiology , Photomicrography , Post and Core Technique/statistics & numerical data , Tooth Crown/injuries , Dental Restoration, Permanent/statistics & numerical data , Age and Sex Distribution , Mexico/epidemiology , MolarABSTRACT
BACKGROUND: The authors conducted a retrospective study to evaluate the long-term (18-22 years) clinic results of titanium post and bonded amalgam core restorations with metal-ceramic crowns placed in patients. METHODS: From 1992 through 1996, the authors placed 88 restorations in 66 patients. They measured the ferrule effect in the minor dentin collar area. In 2014, the authors analyzed the following variables: ferrule length, length and thickness of the post, and tooth position. RESULTS: The overall survival of the restorations decreased over time with survival rates of 89.6% after 5 years of follow-up appointments and 64.2% after 18 years of follow-up appointments. There were 42 failures, and the maxillary premolars had the most failures. The teeth with 2 or more millimeters ferrule length had a higher survival rate than those with a 0 to less than 2 mm ferrule length; these results were not statistically significant. CONCLUSIONS: Statistically significant differences were detected according to the location of the tooth. The cores in the anterior teeth were 3.26 times more likely to fail than those in the molars, which presented higher survival rates; maxillary premolars had the most failures (28.5%). Both the metallic post length and its diameter did not influence restoration survival. The ferrule length was not statistically significant. PRACTICAL IMPLICATIONS: The clinical technique to restore endodontically treated teeth that includes a titanium post and bonded amalgam restorations results in greater coronal destruction but shows good long-term results, ease of fabrication, and modest cost in comparison with other techniques.
Subject(s)
Dental Amalgam/therapeutic use , Dental Restoration Failure/statistics & numerical data , Post and Core Technique/statistics & numerical data , Titanium , Adult , Dental Restoration, Permanent/methods , Dental Restoration, Permanent/statistics & numerical data , Female , Humans , Male , Retrospective Studies , Time FactorsABSTRACT
El objetivo de este estudio fue conocer el estado dental de piezas endodonciadas en correlación conlas variables de restauración coronaria, nivel de estudio, condición laboral y acceso a servicios odontológicos. Para ello, se analizó una población de individuos, compuesta por sujetos concurrentes a los cursos de posgrado de Endodoncia del Círculo Odontológico de Córdoba y al servicio de la CátedraB de Endodoncia de la Facultad de Odontología de la Universidad Nacional de Córdoba. Se hicieron tratamientos controlados durante dieciocho meses. La muestra total la conformaron 144 pacientes y se trataron 174 casos. Sólo asistieron a control el 48,6 por ciento de los pacientes, de los cuales se evaluaron 89 dientes. El estudio mostró 37 casos con restauración coronaria definitiva sin fracturas, 52 dientes sinrestauración, 21 con fracturas y 1 se perdió. Se observó un incremento de fracturas en control a los 18 meses. La tasa de fracturas evidenció un mayor porcentaje en pacientes con nivel de estudio alto, menor en pacientes sin trabajo, y mayor en pacientes con trabajo estable y precario. El tipo de atención no se diferenció, pero los porcentajes observados sugieren que los atendidos en asistencia pública tendrían más probabilidad de fracturas. Se observó un mayor porcentaje de restauraciones definitivas enatención privada y menor en consultorios públicos. El elevado porcentaje de inasistencia a controlesmotivó un análisis específico, del cual se pudo concluir que a mayor estabilidad laboral, de estudios yde asistencia privada, mayor fue la asistencia a controles. Estos datos revelan información importantepara establecer políticas públicas de la atención posendodoncia.
The aim of this study was to know the dental state of endodontic pieces in correlation with different variables such as coronary restoration, level of study, employment status and access to dental services.To do so, we analyzed a population composed of subjects who participated in two different graduate courses at the Círculo Odontológico de Córdoba and the Chair B of Endodontics of the Faculty ofDentistry, National University of Córdoba. Treatments were clinically and radiographically controlled for eighteen months. The total sample included 144 patients and 174 treatments. Only 48.6% patients attended the control, 89 teeth of whom were evaluated. The study showed 37 cases with definitivecoronary restoration without fractures, 52 teeth without restoration, 21 with fractures, and 1 was lost.The fracture rate showed an increase in patients with high level of study, a decrease in unemployed patients, and an increase in both patients with stable and precarious work. The kind of attention didnot differ, but the observed percentages suggest that patients treated in public services would be morelikely to suffer from fractures. There was a higher percentage of definitive restorations in private services,and lower in public ones. The high percentage of non-attendance to controls motivated a specific analysis, from which it is possible to conclude that the more job stability, studies and private access todental services, the more the attendance to controls. These data reveal important evidence in order to establish public policies of post-endodontic services.
Subject(s)
Male , Female , Humans , Root Canal Therapy/statistics & numerical data , Post and Core Technique/statistics & numerical data , Crowns , Socioeconomic Factors , Dental Restoration, Permanent/statistics & numerical data , Tooth Loss/prevention & control , Argentina , Health Services Accessibility/statistics & numerical data , Schools, Dental , Data Interpretation, Statistical , Longitudinal Studies , Epidemiology, Descriptive , Prospective Studies , Tooth, Nonvital/diagnostic imagingABSTRACT
Endodontic retreatment often involves remaking restorations. The total cost may steer the treatment towards surgery. The aim of this study was to retrospectively record the reasons for performing apical surgery in an economically deprived patient population. The clinical reasons (59%) for apical surgery were most common, but the nonclinical (financial) reasons (41%) emerged as a major cause. The finding that 41% of the apicoectomies were performed because of nonclinical constraints is a high figure and may not reflect the situation generally. Still, economic factors potentially play a major role in the selection of surgical versus nonsurgical endodontic retreatment.
Subject(s)
Apicoectomy/statistics & numerical data , Vulnerable Populations/statistics & numerical data , Adult , Apicoectomy/economics , Dental Pulp Calcification/epidemiology , Dental Pulp Cavity/injuries , Equipment Failure , Ethnicity , Female , Foreign Bodies/epidemiology , Humans , Male , Middle Aged , New York City/epidemiology , Periapical Diseases/epidemiology , Post and Core Technique/statistics & numerical data , Poverty/statistics & numerical data , Retreatment , Retrospective Studies , Root Canal Filling Materials/adverse effects , Root Canal Preparation/instrumentation , Root Canal Therapy/economics , Root Canal Therapy/statistics & numerical data , Tooth Apex/injuriesABSTRACT
El objetivo de este estudio fue examinar el resultado clínico longitudinal de dientes endodónticamente tratados, rehabilitados con postes colados y una restauración coronaria, durante 44 años. Materiales y Métodos. En 130 pacientes seleccionados al azar, 95 presentaron 297 dientes rehabilitados con un poste colado y una restauración coronaria. El criterio de éxito fue que el diente rehabilitado permaneciera funcional sin patología clínica ni radiográfica. Resultados: Doscientos sesenta y ocho (90%) estaban en función y 29 (10%) habían fracasado. El Indice Kappa de Cohen, fue de 0.78 - 1. Conclusiones. El éxito clínico fue de 90%. La sobrevida media observada de los dientes estudiados fue de 19 años. La tasa de fracaso fue de 10%, siendo la fractura dentaria la falla más prevalente (5% de todos los dientes restaurados)...
The aim of this study was to examine the longitudinal clinical result of the use of cast posts and cores and crown restorations in endodontically treated teeth over a 44-year period. Materials and methods. Out of 130 randomly selected patients, 95 had had 297 teeth rehabilitated with cast posts and cores and crown restorations. The endodontic rehabilitation was considered successful when the tooth remained functional with no clinical or radiographic pathology. Results. The success rate was 90% (268) and the failure rate 10% (29). Cohens Kappa index ranged between 0.78 and 1. Conclusions. In this 44-year retrospective study, the clinical success rate was 90%. The mean survival time of the studied teeth was 19 years. The failure rate was 10%; tooth fractures were the most prevalent failures (5% of all restored teeth)...
Subject(s)
Humans , Tooth, Nonvital/therapy , Post and Core Technique/statistics & numerical dataABSTRACT
STATEMENT OF PROBLEM: Scientific data about the long-term survival of teeth treated with cast post and cores are scarce. Retrospective studies often use different target events for their analyses. A comparison is therefore complicated. For associated tooth-, jaw-, and patient-related factors little evidence exists as to their effect on survival. PURPOSE: The purpose of this study was to extend the knowledge on the survival of teeth treated with cast post and cores for observation periods of more than 10 years. A decrease or increase in survival times according to the presence or absence of associated parameters needs to be evaluated. MATERIAL AND METHODS: A retrospective evaluation was conducted of all cast post and cores inserted in 1 university clinic between January 1992 and June 2011. A Kaplan-Meier survival analysis was carried out by using extraction as the target event. The survival curves for different tooth types, the presence or absence of adjacent teeth, and the prosthetic restoration of the respective jaws were compared by using the log-rank test (α=.05). A Cox regression model was calculated for multivariate analyses. RESULTS: A total of 717 cast post and cores for 343 patients were recorded. The mean survival time was 13.5 years. A statistically significant decrease in survival times was found for canines (11.9 years) and premolars (13.4 years) versus molars (14.1 years), no adjacent teeth (10.6 years) versus at least 1 adjacent tooth (13.8 years), and the restoration with removable dental prostheses (12.5 years) versus fixed dental prostheses and single crowns (13.9 years). The largest reduction in survival time was found for teeth being used as an abutment for a double crown-retained removable partial dental prosthesis (telescopic denture) (9.8 years). Tooth type and adjacent tooth status remained as significant variables within the multivariate Cox regression model. CONCLUSIONS: Cast post and cores have an acceptable long-term survival time. Because different factors may influence survival, considering these factors in treatment planning may increase the long-term success of these restorations.
Subject(s)
Post and Core Technique/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Bicuspid/pathology , Crowns/statistics & numerical data , Cuspid/pathology , Dental Abutments/statistics & numerical data , Denture, Overlay/statistics & numerical data , Denture, Partial, Fixed/statistics & numerical data , Denture, Partial, Removable/statistics & numerical data , Follow-Up Studies , Humans , Longitudinal Studies , Middle Aged , Molar/pathology , Retrospective Studies , Survival Analysis , Time Factors , Tooth Extraction/statistics & numerical data , Young AdultABSTRACT
The aim of this study was to evaluate if clinical experience, whether in relation to length of practice time and/or level of specialization influences the dentist's preference for using posts to restore endodontically treated teeth. A cross sectional study was carried out using a questionnaire with dentists (n = 276) in Pelotas, southern Brazil. Data were collected regarding clinical experience, post-graduate training, and variables related to restorations (posts/cements and use of rubber dam) for endodontically treated teeth. The data were submitted to a descriptive analysis and associations were tested. The response rate was 68%. Cast metal posts (24.53%), glass fiber posts (20.75%) and resin cement (66.67%) were the most commonly selected materials. In relation to rubber dams, 93.05% of the dentists were found not use them to lute posts. There was a significant association between the level of training of post-graduate dentists and the type of post used (p = 0.027), in that dentists without post-graduate training used cast metal posts more frequently, whereas dentists with post-graduate training reported glass fiber posts as their first choice. The results of the study showed that dentists preferred cast metal posts, glass fiber posts and resin cement. Continuing education influenced the decision of the dentists on their choice of dental posts.
Subject(s)
Dental Restoration, Permanent/methods , Post and Core Technique/statistics & numerical data , Practice Patterns, Dentists'/statistics & numerical data , Tooth, Nonvital/therapy , Brazil , Cross-Sectional Studies , Dental Restoration, Permanent/statistics & numerical data , Education, Dental/statistics & numerical data , Female , Glass , Glass Ionomer Cements/therapeutic use , Humans , Male , Resin Cements/therapeutic use , Surveys and Questionnaires , Time FactorsABSTRACT
PURPOSE: This study evaluated the materials used for tooth core restorations by dental students. MATERIALS AND METHODS: The study included all patients treated with a single crown or fixed partial denture by undergraduate dental students during the years 1984 to 1986, 1994 to 1996, and 2004 to 2006. RESULTS: More direct (62%) than indirect (38%) cores were prepared during the total time period evaluated. CONCLUSION: The complication rate of indirect cores compared with direct ones appeared to be higher in single crowns, but not in fixed partial dentures.
Subject(s)
Crowns , Dental Materials , Post and Core Technique , Students, Dental , Composite Resins/chemistry , Crowns/statistics & numerical data , Dental Abutments/statistics & numerical data , Dental Amalgam/chemistry , Dental Materials/chemistry , Dental Pins/statistics & numerical data , Dental Prosthesis Design , Dental Restoration Failure , Denture, Partial, Fixed/statistics & numerical data , Follow-Up Studies , Glass/chemistry , Humans , Longitudinal Studies , Post and Core Technique/statistics & numerical data , Treatment OutcomeABSTRACT
INTRODUCTION: This cross-sectional study determined the prevalence of apical periodontitis in 1086 root canal-treated teeth from an urban Colombian population and evaluated the association of several factors with the periradicular status. METHODS: Periapical radiographs were used for analyses, and teeth were classified as healthy or diseased according to the periradicular status. Other factors were also evaluated for their association with the periradicular conditions, including gender, quality of both endodontic treatment and coronal restoration, apical level of filling, and presence of post restoration. RESULTS: Fifty-one percent of the treated teeth were classified as healthy. Only 33% of the teeth had endodontic treatment rated as adequate. The quality of both endodontic treatment and coronal restoration significantly influenced the periradicular conditions (P < .001). Combined data revealed that teeth with both adequate endodontic treatment and adequate restorations showed significantly better periradicular status than the other combinations (P < .01), except for teeth with adequate treatment and inadequate restoration (P = .08). Canals filled up to 0-2 mm short of the apex had a significantly higher number of teeth rated as healthy than overfilled or underfilled cases (P = .02). Regression analysis showed that the quality of endodontic treatment was the most significant factor influencing the periradicular status (P < .001). Gender and presence of post restoration had no association with the periradicular conditions. CONCLUSIONS: Data from this Colombian population showed a relatively high prevalence of apical periodontitis in root canal-treated teeth. This was largely due to an equally high prevalence of treatments performed under substandard technical quality. The quality of the endodontic treatment was the most determinant factor for healthy periradicular status.
Subject(s)
Periapical Periodontitis/epidemiology , Root Canal Therapy/statistics & numerical data , Tooth, Nonvital/epidemiology , Urban Health/statistics & numerical data , Adult , Colombia/epidemiology , Cross-Sectional Studies , Dental Restoration, Permanent/standards , Dental Restoration, Permanent/statistics & numerical data , Female , Humans , Male , Post and Core Technique/statistics & numerical data , Prevalence , Quality of Health Care , Radiography, Bitewing/statistics & numerical data , Radiography, Dental, Digital/statistics & numerical data , Root Canal Obturation/standards , Root Canal Obturation/statistics & numerical data , Root Canal Therapy/standardsABSTRACT
The purpose of this study was to evaluate the present opinions and the knowledge of Swiss general dentists about current strategies to restore endodontically treated teeth. Between 2009 and 2011, a 17-item questionnaire was given to 95 general dentists at the beginning of continuing education courses related to this topic. The majority of dentists indicated that they restore more than 30 endodontically treated teeth per year. The decision for placing an intracanal post was mainly based on the amount of remaining tooth substance and the type of tooth (anterior tooth, premolar, molar, or abutment for fixed dental prostheses). Most respondents strove for a retention depth of at least two-thirds of the root length and a form-congruent fit between post and post space preparation. In terms of post type, metallic posts were predominantely used, while an increasing application of glass-fiber posts was registered. Regardless of the type of post, composite cements were the most commonly used luting materials. The prevailing strategies for the restoration of endodontically treated teeth are in part in accordance with the current literature. Disagreements with the literature are related to the post length, the desired post fit and the fact that metal screw posts are apparently still in use.
Subject(s)
Dental Restoration, Permanent/methods , Post and Core Technique , Practice Patterns, Dentists'/statistics & numerical data , Tooth, Nonvital/therapy , Adult , Aged , Attitude of Health Personnel , Composite Resins , Crowns , Dental Alloys , Dental Prosthesis Design , Dental Restoration, Permanent/statistics & numerical data , Education, Dental, Continuing , Female , Glass , Humans , Male , Middle Aged , Post and Core Technique/statistics & numerical data , Resin Cements , Retrospective Studies , Surveys and QuestionnairesABSTRACT
This retrospective study investigated the frequency and time history of chipping or facings failure of three-unit and four-unit tooth-supported metal ceramic (MC) fixed partial prostheses (FPDs). Six hundred fifty-four MC FPDs were inserted according to a standardized treatment protocol at the Department of Prosthodontics of the Regensburg University Medical Center between 1984 and 2009. Frequency and time history of chipping or facings failure as well as possible risk factors were evaluated on the basis of historical clinical data. We estimated the survival times of FPDs by means of the Kaplan-Meier analysis. The 5-year survival rate (time to renewal of a FPD) of all MC FPDs was 94%; the 10-year survival rate was 87%. Twenty-eight (4.3%) MC FPDs showed chipping; the 5-year free-of-event rate of chipping was 95%, the 10-year rate was 94%. Possible risk factors had no statistically significant influence on chipping or facings failure. The annual hazard rate of MC chipping in the first year was 0.03, i.e., 3 out of 100 person-years of exposure showed chipping. The annual hazard rates for the next 6 years dropped to 0.009, 0.003, 0.007, 0.004, 0.005, and 0.007. Thus, about 3-9 out of 1,000 person-years of exposure showed chipping. Patients with MC FPD may expect a long survival rate of their restoration. During the first year, the risk of chipping may be higher than during the following years. Despite the long period of experience with MC FPDs, chipping of the facing will still occur.
Subject(s)
Dental Porcelain/chemistry , Dental Restoration Failure/statistics & numerical data , Denture, Partial, Fixed/statistics & numerical data , Metal Ceramic Alloys/chemistry , Bruxism/classification , Dental Cements/chemistry , Denture Design , Denture, Complete/statistics & numerical data , Denture, Partial, Fixed/classification , Denture, Partial, Removable/statistics & numerical data , Female , Follow-Up Studies , Gold Alloys/chemistry , Humans , Male , Post and Core Technique/statistics & numerical data , Retrospective Studies , Risk Factors , Survival AnalysisABSTRACT
Coronal-radicular restoration is the coronal reconstruction of an endodontically treated tooth, with a support on and in the root. The objective of this study is to assess the importance of the carried coronal-radicular restorations in the dental practice in Abidjan. It is about a prospective survey of 100 dental surgeons practicing in the city of Abidjan, pulled at random. The information was collected through a self-interview. As results, 79% of our population knows and performs coronal-radicular restorations especially in the absence of 3 dental walls but at a very low, less of 5/month for 90% of this population. The protocol of realization seems well known and followed for the majority of the pooled practitioners. However, we deplored often absence of radiography in the protocol and also the exclusive use of metal posts. In conclusion, the coronal-radicular restorations are much used in the daily practice in Côte d'Ivoire. The protocol for achieving this type of restoration seems well known and followed by the practitioners according to our study. However, as material all the dentists are still in the screw post (metal post). The adhesive technologies using fiber posts don't seem accessible to our people.
Subject(s)
Post and Core Technique , Practice Patterns, Dentists'/statistics & numerical data , Tooth, Nonvital/therapy , Composite Resins , Cote d'Ivoire , Dental Amalgam , Female , Glass , Humans , Male , Polymers , Post and Core Technique/adverse effects , Post and Core Technique/instrumentation , Post and Core Technique/statistics & numerical data , Prospective Studies , Radiography, Dental/statistics & numerical data , Root Canal Preparation/instrumentation , Surveys and Questionnaires , Tooth Fractures/etiologyABSTRACT
INTRODUCTION: Cemental tears often show characteristics mimicking a periapical or periodontal lesion. This leads to difficulty in the early diagnosis of cemental tears. METHODS: In this multicenter study, 71 teeth with cemental tears being confirmed by direct inspection or histological examination were included. For each case, demographic data, dental history, clinical and radiographic findings, and the results of exploratory surgery were recorded and analyzed. RESULTS: Maxillary or mandibular incisors (76.1%) were most frequently affected by cemental tears. Univariate analysis of predisposing factors found that teeth with cemental tears occurred more commonly in men (77.5%) and patients older than 60 years of age (73.2%). Analysis of clinical characteristics showed that teeth with cemental tears were prone to have abscess formation (66.2%), a deep pocket >6 mm (73.2%), positive vitality test (65.3%), healthy antagonist teeth (84.3%), and moderate to severe attrition (77.9%). About 56.3% of cemental tears could be detected on preoperative radiographs. Further analysis of radiographic findings showed that teeth with cemental tears were more likely to have periodontal bone destruction (85.9%) or periapical bone destruction (64.8%). CONCLUSIONS: Endodontists and dentists may avoid misdiagnosis and unnecessary treatment of teeth with cemental tears if they can properly evaluate the radiographs and pulp vitality of teeth as well as know the predisposing factors and clinical characteristics of teeth with cemental tears in advance.
Subject(s)
Dental Cementum/injuries , Tooth Fractures/diagnosis , Tooth Root/injuries , Age Factors , Aged , Aged, 80 and over , Alveolar Bone Loss/complications , Alveolar Bone Loss/diagnostic imaging , Bicuspid/injuries , Dental Cementum/diagnostic imaging , Dental Occlusion, Traumatic/complications , Feeding Behavior , Female , Humans , Incisor/injuries , Male , Middle Aged , Molar/injuries , Periodontal Abscess/complications , Periodontal Pocket/complications , Post and Core Technique/statistics & numerical data , Radiography , Retrospective Studies , Risk Factors , Root Canal Therapy/statistics & numerical data , Sex Factors , Tooth Attrition/complications , Tooth Fractures/diagnostic imaging , Tooth Root/diagnostic imagingABSTRACT
The aim of this study was to assess the prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults. A total of 1,372 periapical radiographs of endodontically treated teeth were analyzed based on the quality of root filling, status of coronal restoration and presence of posts associated with apical periodontitis (AP). Data were analyzed statistically using odds ratio, confidence intervals and chi-square test. The prevalence of AP with adequate endodontic treatment was low (16.5%). This percentage dropped to 12.1% in cases with adequate root filling and adequate coronal restoration. Teeth with adequate endodontic treatment and poor coronal restoration had an AP prevalence of 27.9%. AP increased to 71.7% in teeth with poor endodontic treatment associated with poor coronal restoration. When poor endodontic treatment was combined with adequate coronal restoration, AP prevalence was 61.8%. The prevalence of AP was low when associated with high technical quality of root canal treatment. Poor coronal restoration increased the risk of AP even when endodontic treatment was adequate (OR=2.80; 95%CI=1.87-4.22). The presence of intracanal posts had no influence on AP prevalence.
Subject(s)
Periapical Periodontitis/epidemiology , Root Canal Therapy/statistics & numerical data , Adolescent , Adult , Brazil/epidemiology , Cross-Sectional Studies , Dental Restoration, Permanent/standards , Dental Restoration, Permanent/statistics & numerical data , Epidemiologic Studies , Humans , Middle Aged , Post and Core Technique/standards , Post and Core Technique/statistics & numerical data , Prevalence , Radiography, Bitewing , Risk Factors , Root Canal Filling Materials/standards , Root Canal Filling Materials/therapeutic use , Root Canal Obturation/standards , Root Canal Obturation/statistics & numerical data , Root Canal Therapy/standards , Young AdultABSTRACT
Outcome 4-6 years after retreatment was assessed for Phases 3 and 4 of the Toronto Study. Of 477 teeth retreated, 333 were lost to follow-up, 18 were extracted, and 126 (41% recall, excluding 124 discontinuers) were examined for outcome of healed (periapical index score, < or = 2; no signs or symptoms) or diseased. When pooled with Phases 1 and 2, 187 of 229 teeth (82%) were healed. Logistic regression identified significant (P < or = .05) preoperative outcome predictors: root filling quality (odds ratio [OR], 4.18; confidence interval [CI], 1.72-10.12; healed: inadequate, 88%; adequate, 66%), perforation (OR, 4.01; CI, 1.28-12.62; healed: absent, 87%; present, 56%), and radiolucency (OR, 3.33; CI, 1.19-9.36; healed: absent, 93%; present, 80%). In teeth with radiolucency, outcome predictors were number of treatment sessions (OR, 12.08; CI, 1.84-infinity; healed: one, 100%; > or = 2, 77%) and previous root filling quality (OR, 7.68; CI, 2.36-26.89; healed: inadequate, 86%; adequate, 50%). Outcome was better in teeth with inadequate previous root filling, without perforation and radiolucency. Suggested significance of number of treatment sessions in teeth with radiolucency requires validation from randomized controlled trials.
Subject(s)
Root Canal Therapy/standards , Cohort Studies , Crowns/statistics & numerical data , Dental Pulp Cavity/diagnostic imaging , Dental Pulp Cavity/injuries , Dental Restoration, Permanent/statistics & numerical data , Dental Restoration, Temporary/statistics & numerical data , Female , Follow-Up Studies , Forecasting , Humans , Male , Middle Aged , Ontario , Periapical Periodontitis/classification , Periapical Periodontitis/diagnostic imaging , Periapical Periodontitis/therapy , Post and Core Technique/statistics & numerical data , Radiography , Retreatment , Root Canal Filling Materials/therapeutic use , Root Canal Obturation/standards , Root Canal Obturation/statistics & numerical data , Root Canal Preparation/standards , Root Canal Preparation/statistics & numerical data , Root Canal Therapy/statistics & numerical data , Tooth Extraction/statistics & numerical data , Treatment Outcome , Wound Healing/physiologyABSTRACT
AIM: To examine the prevalence and technical quality of root fillings and the periapical status of root-filled teeth in a subpopulation of Dakar, Senegal. METHODOLOGY: Full-mouth periapical radiographs were obtained from 208 consecutive adults presenting as new patients to the Dental Service of the University. The occurrence and technical quality of root fillings were assessed for each root according to the apical extent of the root fillings and its density. The periapical status was evaluated using the Periapical Index Scoring System with a PAI > 2 indicating periapical disease. The presence of coronal restorations and posts was also noted. Statistical analysis was performed with the chi-square test with a significance level set at P < 0.05%. RESULTS: Of the 6234 teeth examined, 2.6% were root filled. A PAI > 2 was associated with 56.1% of the filled roots. Only 17.7% of the root fillings were technically acceptable and 26.2% of these were associated with a PAI > 2. In roots with unacceptable root fillings, 62.5% had a PAI > 2. Unacceptable root fillings were associated with a higher prevalence of periapical disease (P < 0.001). A post was seen in 18.9% of the filled roots with 66.2% associated with a PAI > 2. A permanent coronal restoration was present in 78.5% of the filled roots, of which 50.7% had a PAI > 2 vs 75.7% for no permanent restoration. At least one periapical lesion was seen in 59.6% of the subjects. CONCLUSION: The results indicate a low prevalence of teeth with radiographic periapical disease, a low prevalence of root-filled teeth and a high prevalence of unacceptable root fillings.
Subject(s)
Root Canal Obturation/statistics & numerical data , Adolescent , Adult , Aged , Dental Restoration, Permanent/standards , Dental Restoration, Permanent/statistics & numerical data , Female , Humans , Jaw, Edentulous, Partially/epidemiology , Male , Middle Aged , Periapical Diseases/epidemiology , Post and Core Technique/standards , Post and Core Technique/statistics & numerical data , Prevalence , Quality of Health Care , Root Canal Obturation/standards , Senegal/epidemiology , Tooth, Nonvital/epidemiologyABSTRACT
Survival of endodontically treated, post-restored teeth depends on a multitude of factors, all of which are practically impossible to include in a randomized, controlled clinical study. The purpose of this survey was to characterize and analyze reported failures of post-retained restorations to identify factors critical to failure and to type of failure. A questionnaire was mailed to private practitioners in Denmark with a request to complete the questionnaire whenever a patient presented with a failed post-retained restoration. Information was gathered on factors related to the patient, the tooth, the restorative materials, and the techniques. Two-hundred and sixty questionnaires were collected from 171 practitioners over a 3-year period. Functioning time until failure varied between 3 months and 38 years. Mean survival time until failure was 11 years. Of the failed restorations, 61% had functioned for 10 years or less. Fracture of the tooth was the most common type of failure reported, followed by loosening of the post and fracture of the post. Tapered posts implied an increased risk of tooth fracture compared to loosening or fracture of the post, and the relative risk of tooth fracture increased with the functioning time until failure. Fracture of the post was more common among male than female patients. On the basis of this survey of failed post-retained restorations, it was concluded that tapered posts were associated with a higher risk of tooth fracture than were parallel-sided posts.
Subject(s)
Dental Restoration Failure , Post and Core Technique , Adolescent , Adult , Aged , Aged, 80 and over , Composite Resins/chemistry , Denmark , Dental Alloys/chemistry , Dental Amalgam/chemistry , Dental Cements/chemistry , Dental Prosthesis Design , Female , Humans , Male , Middle Aged , Post and Core Technique/statistics & numerical data , Sex Factors , Surface Properties , Surveys and Questionnaires , Time Factors , Tooth Fractures/classification , Tooth, Nonvital/therapyABSTRACT
The purpose of this study was to determine radiographically the prevalence of periapical periodontitis in teeth restored with crown in a Senegalese population. Full mouth periapical radiographs were obtained from 208 consecutive adult patients (6234 teeth) presenting as new patients to the Dental Service of the University. The presence of crown restorations, the periapical status and technical quality of root fillings associated were evaluated. 7.69% (n = 16) of patients had at least one tooth that was crowned. The total number of crowns assessed was 0.95% (n = 59). The molars were the teeth most crowned 40.67% (n = 24) followed by anterior teeth 30.50% (n = 18) and premolars 28.81% (n = 17). All the crowned teeth had previous root canal treatment of which only 16.94% (n = 10) were acceptable. 53 % (n = 32) of the teeth had apical periodontitis (PAI > 2). Unacceptable root fillings were associated with a higher prevalence of periapical disease (p < 0.05). Crown with a post extending more than 4 millimetres from the apex were associated with more periapical lesions 64.28% (p < 0.05). The results indicate a low prevalence of crowned teeth, an absence of vital preparation, a high prevalence of radiographic periapical disease and unacceptable root fillings associated.
Subject(s)
Crowns/adverse effects , Dental Restoration Failure , Periapical Periodontitis/etiology , Root Canal Obturation/adverse effects , Adolescent , Adult , Aged , Crowns/statistics & numerical data , Female , Humans , Male , Middle Aged , Periapical Periodontitis/diagnostic imaging , Post and Core Technique/adverse effects , Post and Core Technique/standards , Post and Core Technique/statistics & numerical data , Radiography , Root Canal Obturation/standards , Root Canal Obturation/statistics & numerical data , Senegal , Young AdultABSTRACT
The aim of this study was to assess the prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults. A total of 1,372 periapical radiographs of endodontically treated teeth were analyzed based on the quality of root filling, status of coronal restoration and presence of posts associated with apical periodontitis (AP). Data were analyzed statistically using odds ratio, confidence intervals and chi-square test. The prevalence of AP with adequate endodontic treatment was low (16.5 percent). This percentage dropped to 12.1 percent in cases with adequate root filling and adequate coronal restoration. Teeth with adequate endodontic treatment and poor coronal restoration had an AP prevalence of 27.9 percent. AP increased to 71.7 percent in teeth with poor endodontic treatment associated with poor coronal restoration. When poor endodontic treatment was combined with adequate coronal restoration, AP prevalence was 61.8 percent. The prevalence of AP was low when associated with high technical quality of root canal treatment. Poor coronal restoration increased the risk of AP even when endodontic treatment was adequate (OR=2.80; 95 percentCI=1.87-4.22). The presence of intracanal posts had no influence on AP prevalence.
O objetivo deste estudo foi avaliar a prevalência e os fatores de risco da periodontite apical (PA) em dentes com tratamento endodôntico em seleta população adulta do Brasil. Um total de 1.372 radiografias periapicais de dentes com tratamento endodôntico foi analisado, considerando-se a qualidade da obturação, o estado da restauração coronária e a presença de pinos intrarradiculares, associados com a PA. Os dados foram analisados estatisticamente empregando-se odds ratio, intervalos de confiança e teste do qui-quadrado. A prevalência de PA associada a tratamento endodôntico adequado foi baixa (16,5 por cento). Este número reduziu-se a 12,1 por cento quando se considerou obturação e restauração coronária adequadas. Os dentes com tratamento endodôntico adequado, porém com restauração coronária inadequada apresentaram prevalência de PA igual a 27,9 por cento. A PA aumentou para 71,7 por cento nos dentes com tratamento endodôntico e restauração coronária inadequados. Quando o tratamento endodôntico inadequado foi combinado com restaurações coronárias adequadas encontrou-se 61,8 por cento de PA. A prevalência de PA foi baixa quando associada com a elevada qualidade técnica do tratamento endodôntico. A restauração coronária deficiente aumentou o risco de PA mesmo na presença de adequado tratamento endodôntico. A presença de pinos intrarradiculares não influenciou a prevalência de PA.