Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 11.244
Filtrar
1.
Mymensingh Med J ; 29(1): 228-233, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915363

RESUMO

Reattachment of a fractured fragment to the remaining tooth is challenging but one of the best treatment protocols in regards to aesthetics, function as well as patients acceptance. If the original tooth fragment is retained following fracture, the natural tooth structures can be reattached using adhesive protocols to ensure reliable strength, durability and aesthetics. This case report will discuss a 13 years old boy with a complicated crown-root fracture of maxillary right central incisor tooth. The procedure used to repair the fracture regarding this case including flap surgery with endodontic treatment. The root canal was filled with a root canal sealer and gutta-percha. After root canal obturation, fragment was reattached with an adhesive tooth reattachment technique. After 6 months evaluation, clinical and radiographic examinations showed a stable re-attachment, good aesthetic and healthy periodontium.

2.
J Endod ; 2020 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-31916974

RESUMO

INTRODUCTION: The purpose of this retrospective study was to determine the clinical and radiographic outcomes of root-end microsurgery in a postgraduate program in endodontics using modern techniques and calcium silicate-based root-end filling materials (ProRoot MTA; Dentsply International, Johnson City, TN, and EndoSequence Root Repair Material [ERRM]; Brasseler USA, Savannah, GA) and to identify any potential prognostic factors that may have affected healing outcomes. METHODS: Clinical records and periapical radiographs were collected from patients who had undergone endodontic microsurgery between 2007 and 2018 in a postgraduate endodontic clinic with a minimum follow-up interval of 6 months. Either ProRoot MTA or ERRM was used as the root-end filling material. Outcomes were categorized into healed, healing, and nonhealing based on clinical and radiographic findings. Healed and healing cases were pooled and considered as successes, whereas nonhealing cases were considered as failures. RESULTS: A total of 129 patients with 142 teeth were included in the final analysis. Seventy-six cases were root-end filled with ProRoot MTA and 66 root-end filled with ERRM. The ProRoot MTA group had a success rate of 92.1%, and the ERRM group had a success rate of 92.4% with no significant difference between the groups (P > .05). Vertical root fracture was found to be the predominant cause of failure. No patient- or treatment-related factor was identified to have any significant impact on healing. CONCLUSIONS: High overall success can be achieved in a postgraduate endodontic program when either ProRoot MTA or ERRM is used as the root-end filling material.

3.
Sci Rep ; 10(1): 434, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31949190

RESUMO

Anatomical features of first maxillary premolars may greatly affect endodontic and following restorative treatments. The aim of this study was to evaluate root canal configuration and root wall thickness of first maxillary premolars using a preexisting CBCT database. A CBCT database of 400 first maxillary premolar was used to study canal configuration, presence of furcation-facing groove on the buccal root and root wall thickness. Root wall thickness was measured from axial CBCT slices at three critical points of the root: The most coronal part of the furcation-facing groove in the buccal root, when present, the CEJ level of the palatal root and 5 mm apically to the CEJ level of the palatal root. Vertucci Type IV configuration was the most common among all teeth, but in single-rooted teeth, Vertucci Type II was predominant. The mean thickness of the buccal root in the area of a furcation-facing groove was 1.1 (±0.2) mm, but in 39% of the cases, it was thinner than 1 mm. The mean thickness of the palatal root at 5 mm from the CEJ was 1.1 (±0.2), but in 28% of the cases, it was thinner than 1 mm. Thickness of root dentin walls of first maxillary premolars varies and may be limited at critical points in both buccal and palatal roots. In case the patient has a previous CBCT scan it may be useful for planning treatment of first maxillary premolars, in order to recognize and avoid potential risks such as furcation-facing groove, thin dentin walls in critical areas and presence of Type II Verucci canal, all of which may dictate less invasive procedures, using smaller files.

4.
Quintessence Int ; 51(2): 100-107, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31942571

RESUMO

OBJECTIVE: The purpose of the present study was to assess the influence of type 2 diabetes mellitus (DM) on the evolution of pulpal and periapical pathology. METHOD AND MATERIALS: Two reviewers independently conducted a systematic search for articles published between 1 January 2001 and 31 December 2018 on MEDLINE/PubMed, ISI Web of Science, and Scopus databases. An additional manual search was also carried out. RESULTS: Ten studies fulfilling the inclusion criteria were included in the review (two longitudinal studies with 1-year follow-up comparing the success of primary root canal treatment between type 2 diabetic patients and non-diabetic patients, and eight cross-sectional studies). Analysis of the ten studies showed that inadequate control of type 2 DM may predispose and influence the inflammatory pulpal and periapical disease evolution. CONCLUSIONS: The present systematic review suggests that there are biologic bases to suggest that type 2 DM may act as a risk factor for developing an endodontic pathology, affecting the course of the disease in terms of susceptibility, prevalence, progression, and tissue healing capacity as a consequence of a disrupted immune response. However, more well-designed clinical investigations carrying out suitable research methodologies are needed to elucidate the influence of type 2 DM on the pulpal and periapical disease evolution.


Assuntos
Diabetes Mellitus Tipo 2 , Doenças Periapicais , Estudos Transversais , Humanos , Estudos Longitudinais , Tratamento do Canal Radicular
5.
Artigo em Inglês | MEDLINE | ID: mdl-31952176

RESUMO

People with masticatory discomfort are unable to consume a balanced diet, which impacts their general health. We studied the relationship between quality of life and dental care associated with masticatory discomfort. Data from Korea's representative 6th Korea National Health and Nutrition Examination Survey (KNHANES) were used. Complex sampling analysis with the stratification variable, clustering variable, and weight was applied. Demographic and dental treatment characteristics and activity limitations were compared through chi-square tests. The comparison of quality of life according to masticatory discomfort was performed using linear regression. The risk of masticatory discomfort was high in people who did not undergo regular oral examinations and preventive and definitive caries treatment and in those who received periodontal, surgical, endodontic, or prosthetic treatments. Generally, people with masticatory discomfort engaged in less activity owing to other disorders like arthritis, rheumatism, and back, neck, and oral disease. People with masticatory discomfort scored low on quality of life. People who received regular oral examinations and preventive care had a low level of masticatory discomfort, and the treated persons had high masticatory discomfort. Therefore, in order to reduce masticatory discomfort, more diverse and active care should be provided for prevention, specifically regular oral examinations.

6.
J Am Dent Assoc ; 2020 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-31937403

RESUMO

BACKGROUND AND OVERVIEW: In this case report, the authors aim to review the standard protocols for endodontic treatment of autotransplanted molars and report on the 5-year follow-up of a clinical transplantation case. CASE DESCRIPTION: The authors transplanted a mandibular third molar into the position of the adjacent second molar. The authors performed extraoral apicoectomy and retrograde restoration after atraumatic extraction of the donor tooth and before transplantation. The authors did not perform conventional orthograde root canal treatment after transplantation. The patient was followed up 5 years after the autotransplantation. Results of follow-up radiography showed a regular root surface without evidence of periapical lesions or root resorption. CONCLUSIONS AND PRACTICAL IMPLICATIONS: If appropriate sterility of the working field is maintained during surgery and a tight apical seal is achieved during the extraoral treatment, orthograde endodontic treatment should be delayed or avoided.

7.
Postgrad Med ; 2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31933403

RESUMO

Objective: A relationship between dentists and medical doctors should be encouraged to reduce cardiovascular risk in cardiac patients with dental infection. The aim of this study was to evaluate the attitudes of cardiologists and cardiovascular surgeons (cardiac specialists) toward managing endodontic infections and oral health in patients with cardiovascular diseases (CVDs).Methods: A survey of 16 questions assessing knowledge of endodontic infection, dental examination, timing of endodontic treatment, and antibiotic prophylaxis was sent to cardiac specialists in Turkey. The participants' responses were compared by means of the chi-square test (p ≤ 0.05).Results: Responses were received from 444 (44.71%) participants. Of all participants, 91.4% agreed that endodontic infections are important diseases that should be treated. Cardiac patients were referred to a dentist by 66.6% of the cardiologists and 80.3% of cardiovascular surgeons (p = 0.002). Almost all participants (97.3%) believed that the heart health of cardiac patients with endodontic infections could be negatively affected by this infection.Conclusion: Although there is not yet any conclusive evidence on whether the presence of an endodontic infection may have an impact on CVDs, this study showed that most cardiac specialists attached importance to endodontic infections.

8.
Int Endod J ; 2020 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-31955439

RESUMO

AIM: To gain information in a laboratory setting about the effect of thermal treatment of epoxy-resin based and zinc oxide eugenol based sealers. METHODOLOGY: AH Plus and Pulp Canal Sealer (PCS) were exposed to thermal treatment at 37°, 47°, 57°, 67°, 77°, 87°, and 97° C for 30 seconds. According to clinically relevant considerations, intracanal sealer temperature are likely not to exceed 60° C during warm vertical root canal filling. Heat application is recommended for less than 30 seconds during continuous wave technique, but might exceed this threshold in complex cases. Furthermore, heat treatment at 97° C was performed for 60 and 180 seconds to simulate inappropriate implementation of warm vertical filling techniques. Specimens were heated inside 2 mL plastic tubes in a thermos-controlled water bath until the temperatures were reached and kept at this temperature for the determined period of time. Afterwards, specimens were cooled to body temperature and physical properties (setting time, flow, film thickness according to ISO 6876) were assessed. Chemical properties (Fourier transformed infrared spectroscopy) were assessed after complete setting of the specimens in an incubator at 37° C and 100% humidity. Statistical analysis of physical properties was performed using Kruskal-Wallis-Test (P = 0.05). RESULTS: The setting time of AH Plus and PCS decreased when temperature and duration of heat application increased. While the setting time of AH Plus decreased from 622 min at 20°C (for 30 seconds) to 381 min at 97°C (for 180 seconds) (P < 0.05), heat treatment of PCS at 97°C for 180 seconds led to an immediate setting of the material. From 20°C (for 30 seconds) to 97 (for 30 seconds), the setting time of PCS decreased from 80.1 h to 41.0 h (P < 0.05). Film thickness and flow were not relevantly influenced by thermal treatment except for PCS at 97°C for 180 seconds. FT-IR spectroscopy did not reveal any chemical changes of either sealer after thermal treatment. CONCLUSIONS: Thermal treatment simulating clinically relevant temperature levels and heating times did not lead to any substantial physical or chemical changes at all temperature levels when heating did not exceed 60 seconds. AH Plus and Pulp Canal Sealer can be considered suitable for warm root filling techniques.

9.
Odontology ; 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31953787

RESUMO

The aim of the present study is to compare the efficacy of additional 100 mg/2 ml tramadol and 40 mg/2 ml lidocaine applications on the anesthetic success of inferior alveolar nerve block (IANB) in mandibular molars with symptomatic irreversible pulpitis (MM-SIP). One hundred and five patients diagnosed with symptomatic pulpitis in the lower first or second molars were included in the study. Patients were randomly divided into three groups (n = 35) composed of control and two experimental groups administered submucosal tramadol and lidocaine. Preoperative pain levels of the patients were measured with Heft-Parker visual analog scale (HP VAS). Following, standard IANB with 2% lidocaine 1: 80,000 was administrated to all groups. After observation of lip numbness, 2 ml of saline in the control group, 100 mg/2 ml tramadol in tramadol group and 40 mg/2 ml (2%, 1: 80,000) lidocaine in lidocaine group were administered submucosally. After 15 min, standard endodontic treatment was initiated and the pain levels measured from access cavity preparation to pulp extirpation were measured with HP VAS. The success rate of pulpal anesthesia was 28.5% in the control group, 45.7% in the submucosal lidocaine group and 48.6% in the tramadol group. There was no statistically significant difference in the success rate between the groups. Additional submucosal administration of 100 mg tramadol did not significantly increase the success of IANB applied with a combination of 2% lidocaine 1:80,000 and epinephrine in MM-SIP compared to control group.

10.
Photodiagnosis Photodyn Ther ; : 101648, 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31904552

RESUMO

BACKGROUND AND OBJECTIVES: Intracanal disinfection plays an important role in endodontic treatment success. Enterococcus faecalis (E. faecalis) is a resistant microorganism responsible for endodontic infections. We aimed to assess the bactericidal effects of three disinfection methods on E. faecalis biofilm. MATERIALS AND METHODS: Fifty-five freshly extracted single-rooted human teeth were evaluated. A barbed broach was used to extract the pulp tissue. No further root canal preparation was performed. Specimens were sterilized with gamma radiation, and inoculated with E. faecalis suspension. They were then incubated for 4 days and 4 weeks. Biofilm formation was confirmed using a scanning electron microscope (SEM). The teeth were randomly assigned to three subgroups (n = 7) to assess the antimicrobial efficacy of the following three disinfection methods against immature (4-day) and mature (4-week) biofilms: the conventional chemomechanical debridement (CCMD), CCMD + light-activated disinfection (LAD; 810 nm, 0.3 W, 120 J/cm2) with indocyanine Green (EmunDo) as photosensitizer and CCMD + diode laser irradiation (810 nm, 2 W). The teeth were then longitudinally split into two halves and the colony count was reported as colony forming units (CFUs) to assess bacterial viability after each disinfection protocol. RESULTS: None of the disinfection methods could completely remove the biofilm. CCMD + LAD caused the highest and CCMD + diode laser caused the lowest reduction in biofilm. Antibacterial efficacy was significantly lower against the mature (4-week) biofilm compared with immature (4-day) biofilm in all groups (P < 0.05). CONCLUSION: All three disinfection methods were effective for partial elimination of E. faecalis biofilm. But CCMD + LAD was significantly more efficacious in decreasing both mature and immature biofilms.

11.
Cien Saude Colet ; 25(1): 365-374, 2020 Jan.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31859883

RESUMO

The aim of this study was to investigate the factors associated with public dental care use by adults in the State of São Paulo, Brazil. A cross-sectional study was conducted with a representative sample of adults aged 35 to 44 years using data from the 2015 Epidemiological Survey of the Oral Health Status of the Population of the State of São Paulo (SBSP-2015). Multivariate logistic regression was performed using variables based on a model proposed by Andersen for predicting access to public dental services. Results: 3,421 (59.9%) adults visited private services and 2,288 (40.1%) visited public services. Prevalence of the use of public dental services was greatest among women (41.8%) and adults with a lower education level (50.2%). Being non-white (OR = 1.32, 95% CI: 1.16, 1.50), lower household income (OR = 2.37, 95% CI: 2.11, 2.65), having had toothache (OR = 1.60, 95% CI: 1.39, 1.83), and need for endodontic treatment (OR = 1.44, 95% CI: 1.12, 1.85) were associated with public dental service use. Predisposing, enabling, and need factors were associated with public dental care use.

12.
Dentomaxillofac Radiol ; 49(1): 20190183, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31530016

RESUMO

OBJECTIVES: To investigate the potential of 9.4T ultrashort echo time (UTE) technology visualizing tooth anatomy and root canal treatment in vitro. In particular, it was evaluated whether the currently achievable resolution is suited presenting all anatomical structures and whether the root canal filling materials are distinguishable in UTE-MRI. METHODS: Four extracted human teeth were examined using 9.4T UTE-MRI prior endodontic treatment (native teeth), after preparation and after obturation procedure. Root canal obturation was performed using warm vertical compaction (Schilder technique) with an epoxy-resin-based sealer. A single gutta-percha cone measured by MRI served as intensity-reference. MRI results were validated with corresponding histologic sections of the teeth. In addition, all teeth were examined at the different stages with CBCT and conventional X-ray. RESULTS: 9.4T UTE-MRI enabled a precise visualization of root canal anatomy of all teeth at a resolution of 66 µm. After obturation, dentin, sealer and gutta-percha cones showed distinct MRI signal changes that allowed clear differentiation of the obturation materials from surrounding tooth structure. The filling materials, isthmal root canal connections and even dentin-cracks that were identified in the MR-images could be verified in histological sections. CONCLUSIONS: 9.4T UTE-MRI is suitable for visualization of root canal anatomy, the evaluation of root canal preparation and obturation with a high spatial resolution and may provide a versatile tool for dental material research in endodontics.


Assuntos
Cavidade Pulpar , Imagem por Ressonância Magnética , Materiais Restauradores do Canal Radicular , Cavidade Pulpar/diagnóstico por imagem , Resinas Epóxi , Guta-Percha , Humanos , Obturação do Canal Radicular
13.
Gen Dent ; 68(1): 41-44, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31859661

RESUMO

The objective of this study was to evaluate the antimicrobial capacity of glycolic acid (GA) at different concentrations as a final irrigant during the preparation of root canals. The sample consisted of 77 extracted single-rooted human teeth with complete root formation, no previous endodontic treatment, and a root length of at least 14 mm. The root canals were prepared in a standardized manner with a rotary file system. During this process, irrigation was performed with 2.5% sodium hypochlorite (NaOCl), and the final irrigant was 17% ethylenediaminetetraacetic acid (EDTA). After the root canal sterilization procedure, Enterococcus faecalis was cultured in a Petri dish, and 70 sterilized root canals were inoculated with a suspension containing 3.0 × 108 colony-forming units (CFUs) per milliliter. The roots were divided into 7 groups (n = 10) according to the following solutions: 0.9% sodium chloride (NaCl); 6% NaOCl; 17% EDTA; 10%, 17%, or 25% GA; or 17% citric acid (CA). The capacity of the different substances to reduce E faecalis was evaluated by counting the CFUs before and after treatment with the final irrigant solutions. Data were subjected to an analysis of variance and the Tukey test at a 5% significance level. The greatest bacterial reduction was observed in the group irrigated with NaOCl (P < 0.05). There were no statistically significant differences among the groups irrigated with GA in different concentrations (P > 0.05), but they all demonstrated greater disinfection capacity than CA and EDTA (P < 0.05). CA showed significantly greater antimicrobial capacity than EDTA (P < 0.05). EDTA showed significantly greater antimicrobial capacity only in relation to NaCl (P < 0.05). At different concentrations, GA demonstrated greater capacity to eliminate E faecalis from root canals than did EDTA.


Assuntos
Anti-Infecciosos , Glicolatos , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Anti-Infecciosos/farmacologia , Cavidade Pulpar , Ácido Edético , Enterococcus faecalis , Glicolatos/farmacologia , Humanos , Preparo de Canal Radicular/métodos , Hipoclorito de Sódio
14.
Gen Dent ; 68(1): 61-64, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31859665

RESUMO

Actinomycosis is caused by gram-positive, branching, filamentous, anaerobic bacteria of the genus Actinomyces. This case report describes treatment of a 35-year-old woman who had a progressive apical lesion after nonsurgical endodontic retreatment of her maxillary left lateral incisor. The area had localized soft tissue swelling, and the tooth was sensitive to percussion. Radiographic evaluation showed a large apical lesion with a clear margin. After treatment options, including extraction, were discussed, the patient chose to preserve the tooth through endodontic surgery. Root-end resection, canal preparation, and filling with calcium-enriched mixture cement were performed. Histopathologic examination of surgical specimens revealed a radicular cyst associated with actinomycosis. At an 18-month follow-up, the patient was symptom free and bone healing was almost completed. Periradicular actinomycosis is one of the most common reasons for the failure of nonsurgical endodontic treatment and retreatment. If a tooth is nonresponsive to nonsurgical endodontic treatments, apical actinomycotic infection should be suspected and a surgical approach should be planned to obtain a successful outcome.


Assuntos
Actinomicose , Apicectomia , Actinomicose/cirurgia , Adulto , Feminino , Humanos , Incisivo , Retratamento , Preparo de Canal Radicular , Tratamento do Canal Radicular , Resultado do Tratamento
15.
J Biomed Mater Res B Appl Biomater ; 108(1): 201-212, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30957440

RESUMO

Dental biomaterials have revolutionized modern therapies. Untreated dental caries remains the major etiological factor for endodontic treatment, and together with a decreasing rate of tooth loss escalates the importance of continuously improving the materials used for endodontic therapies. Endodontic biomaterials are used for vital pulp therapies, irrigation, intracanal medicaments, obturation and regenerative procedures. These materials offer several functions including: antimicrobial activity, mechanical reinforcement, aesthetics, and therapeutic effects. Vital pulp therapies have seen an improvement in clinical results with an incremental approach to build on the strengths of past materials such as calcium hydroxide and calcium silicates. While sodium hypochlorite remains the gold standard for canal irrigation, numerous nanoparticle formulations have been developed to promote sustained antimicrobial action. Gutta-percha based bulk fillers remain the most common materials for root filling. However, while multiple studies focus on the development of novel formulations containing drugs, glass derivatives or ionic-, polymeric-, or drug- loaded nanoparticles, a lack of reliable and long-term clinical evidence obligates further study as experienced clinicians prefer to use what has worked for decades. This review delves in to the biochemistry of the materials to scrutinize their shortcomings, and where opportunity lies to further enhance their efficacy in endodontic practice. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:201-212, 2020.

16.
Int Endod J ; 53(1): 111-121, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31454089

RESUMO

AIM: To investigate the stress distribution and tooth displacement of a maxillary central incisor with various apical root resection lengths and occlusal relationships using finite element (FE) analysis. METHODOLOGY: A maxillary central incisor was scanned by micro-CT. First, the FE intact incisor model with dentine, enamel, pulp and root surrounded by alveolar bone and periodontal ligament was designed based on the micro-CT image data. Then, six FE models with varying lengths of apical root resection were established to simulate the clinical treatment and reveal the clinically applicable limit of apical root resection during endodontic microsurgery. For each model under different loading conditions, the maximum von Mises stress (σ max) at the root apex, root cervix, alveolar bone and periodontal ligament and the maximum tooth displacement (ΔR max) were calculated and compared. RESULTS: In a normal occlusion, more than 6 mm of root resection resulted in a marked increase in the ΔR max values (>10%) and σ max values of alveolar bone (>50%); the stress levels at the root apex increased dramatically when the apical root was resected more than 7 mm. With increased overjet, apical root resection did not change the stress level markedly until it reached 8 mm, but the ΔR max increased markedly (>10%) if the root was resected more than 5 mm. With deep overbites, the σ max increased significantly (>50%) when the root was resected more than 4 mm whilst the ΔR max decreased. With increased overjet and deep overbite, more than 6 mm of resection resulted in a substantial σ max increase (>50%) of alveolar bone and the ΔR max increased markedly (>10%) when the root was resected 8 mm. Additionally, the σ max and the ΔR max values were greater with increased overjet and lower with deep overbites. CONCLUSIONS: Using FE analysis, apical root resection of more than 6 mm resulted in a marked increase of stress distribution and tooth displacement in normal and increased overjet with deep overbite occlusal relationships. In increased overjets or deep overbites, more than 5 mm or 4 mm, respectively, stress distribution and tooth displacement increased markedly.


Assuntos
Incisivo , Ligamento Periodontal , Dentina , Análise de Elementos Finitos , Maxila , Estresse Mecânico , Raiz Dentária
17.
Int Endod J ; 53(1): 19-26, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31454090

RESUMO

AIM: To determine retrospectively the long-term radiographic outcome of root canal treatments and root canal retreatments with unintentional root canal overfilling. METHODOLOGY: A total of 220 root canal treatments (143 primary/77 retreatments) with postoperative unintentional canal overfilling and performed by two endodontists during their 45 years of private practice were included in the study. Lateral condensation techniques and nine different sealers were used. Overfilling was confirmed with a postoperative periapical radiograph and patients were scheduled regularly for recall visits. Average recall time was 4.86 years (maximum = 30 years). Two calibrated observers evaluated the radiographs and determined the long-term outcome using the PAI score pooled in a 3-category scale. The persistence or resorption of the extruded material was registered. The Kappa coefficient (K) was calculated and a logistic regression was used for further analysis. Odds ratios and their 95% CI were estimated. RESULTS: The level of inter-observer agreement was 66.1%. Primary root canal treatments had a significantly (P = 0.015) greater rate of success (91.6%) than retreatments (81.8%). Tooth location (P = 0.019) was the only other factor that significantly affected the outcome. The type of extruded material, and its resorption or persistence did not relate to the outcome. Persistence of extruded material was significantly affected by tooth location and recall time after treatment. CONCLUSION: The outcome of root canal treatment with unintentional canal overfilling was not associated with the type of extruded material or its resorption or persistence. The persistence of extruded material did not relate to a favourable or unfavourable outcome.


Assuntos
Materiais Restauradores do Canal Radicular , Dente , Cavidade Pulpar , Humanos , Retratamento , Estudos Retrospectivos , Tratamento do Canal Radicular , Resultado do Tratamento
18.
J Endod ; 46(1): 12-18, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31843124

RESUMO

INTRODUCTION: The aims of this study were to evaluate the methodological quality of randomized controlled trials (RCTs) recently published in endodontics and to investigate the influences of methodological characteristics on the magnitude of treatment effects. METHODS: PubMed was searched for RCTs published from October 2013 to October 2018 in 3 leading endodontic journals. The methodological quality of the included studies was determined by using the Cochrane Collaboration risk of bias (RoB) tool. The estimates of intervention effects were expressed or calculated as odds ratios and the standardized mean difference for binary and continuous outcomes, respectively. Meta-regression analyses and Monte Carlo permutation tests were performed to identify the association between RoB and intervention effect estimates. RESULTS: A total of 121 RCTs were identified as eligible for the current study. For both the studies with binary and continuous outcome measures, the domain of blinding of participants and personnel had the highest percentage of high RoB. For binary outcomes, methodological deficiencies in allocation concealment tended to produce exaggerated treatment effects. For continuous outcomes, risk regarding blinding of participants and personnel and incomplete outcome data were more likely to provide overestimated trial results. CONCLUSIONS: The methodological quality of RCTs within endodontics is suboptimal, and these methodological deficiencies could exaggerate intervention effect estimates in endodontic RCTs. Better trial methodology and more explicit reporting are needed to improve the reliability of evidence in endodontic RCTs.

19.
Clin Oral Investig ; 2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31797172

RESUMO

OBJECTIVE: Systematic review analyzing the treatment outcomes of cracked teeth that received endodontic treatment is unavailable. The purpose of this study was to examine the treatment outcome of cracked teeth that received root canal treatment and to determine factors that influenced outcome. MATERIALS AND METHODS: The specific PIO questions were as follows: Population: patients who were healthy individuals ≥ 18 years old and required root canal treatment due to cracked tooth; Intervention: root canal treatment with at least 1 year in occlusal function; Outcomes: survival rate and pre-operative factors. Ovid, PubMed, and Cochrane databases were searched in conjunction with hand searching. Pooled survival rates were determined from a meta-analysis of the data retrieved from the articles. All statistics were performed by the Comprehensive Meta-Analysis software. RESULTS: Four articles met the inclusion criteria. The overall tooth survival at 60 months was 84.1% (95%CI, 72.3-91.5%). Although no pre-operative factors had statistical significance, 4 factors had possible clinical significance. Teeth with single crack and teeth with cracks contained within crowns exhibited lower extraction risk, while teeth with pre-treatment periodontal probing > 3 mm and teeth that were terminal abutments showed a greater risk of extraction. CONCLUSION: This systematic review determined the survival rate of endodontically treated cracked teeth to be moderately high. More studies in this area are, however, warranted before definitive conclusions can be derived. CLINICAL RELEVANCE: In view of the relatively high survival rate, endodontic treatment rather than extraction should be considered for cracked teeth.

20.
J Contemp Dent Pract ; 20(9): 1033-1040, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31797825

RESUMO

AIM: Flare-ups following a root canal treatment are still a major problem both to the patient and to the clinician. Its definition, etiology, incidence, and risk factors have been the subject of long-standing debate. We conducted this study to investigate the incidence of flare-ups after a single-visit treatment and to identify the factors associated with the flare-up index (FUI). MATERIALS AND METHODS: All patients treated by postgraduate residents in endodontic specialty at Saint Joseph University of Beirut from June 2018 to January 2019 were invited to participate in the study. After a routine root canal treatment, patients were given a questionnaire to fill after 24 hours-48 hours-7 days, covering a postoperative assessment of symptoms using the visual analogue scale (VAS) and FUI. Patients who experienced a severe postoperative pain and/or swelling were identified and categorized as having a flare-up. RESULTS: A total of 423 patients (age: 39.76 ± 12.428 years) were included in the study. The incidence of flare-up was 1.9%. The mean FUI was 5.94 ± 5.646 and was highly correlated with the VAS score (p < 0.001). The factors that significantly influenced the occurrence of flare-ups were: pulpal diagnosis (p < 0.001), preoperative drug intake (p < 0.001), preoperative symptoms (>24 hours) before treatment (p < 0.001), and tooth type (p = 0.013). CONCLUSION: FUI should be used in further studies to confirm our results since it is a valid quantitative method to assess this clinical phenomenon. CLINICAL RELEVANCE: Endodontists should take into consideration the diagnosis and the history of preoperative symptoms since it plays an important role in predicting the occurrence of flare-ups and the success of the treatment.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA