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PubMed1989

[Combination of orthodontic and endodontic treatment].

Many scientists and researchers have up to now been interested in the subject of the combination of orthodontic and endodontic treatment. The uncertainty of the orthodontic movement upon endodontically treated teeth tends to disappear after the conclusions of long lasting studies proving that the biological tissue reactions that happen during orthodontic movement of endodontically treated teeth are identical with those of healthy teeth which are under orthodontic treatment. In this study we were referred to the accessible bibliography on biological tissue reaction upon the combination of orthodontic and endodontic treatment and we have presented some our cases which are treated by combination of orthodontic and endodontic treatment.

Adolescent↗
PubMed1995

Correction of a large periradicular lesion and mucosal defect using combined endodontic and periodontal therapy: a case report.

The successful treatment of a large endodontically induced periradicular defect and soft tissue fenestration by combined endodontic and periodontal therapy is described. Endodontics was performed on the mandibular left central incisor, the apex was resected, and a retrograde amalgam was placed. The defect was thoroughly debrided and the exposed root surface was planed with curettes. Demineralized freeze-dried bone allograft and a nonresorbable membrane were placed over the defect and the exposed root surface. The membrane was removed in 6 months and there appeared to be bone regeneration with complete closure of the soft tissue fenestration. Endodontic therapy in combination with guided tissue regeneration and bone grafting may provide another modality of treatment for endodontically related hard and soft tissue defects.

Alveolar Bone Loss↗
PubMed1997

Aesthetic considerations in endodontics: internal bleaching.

During endodontic treatment of any tooth, aesthetics must be considered in the same manner as during any other dental treatment. The most common aesthetic challenge associated with endodontics is the discoloration of natural tooth structure. The discoloration may be a result of pulp pathosis, especially pulpal hemorrhage prior to or during treatment, or it may be due to various endodontic and restorative materials placed in the pulp chamber. There are several simple measures that can be utilized during and following endodontic treatment to eliminate or reduce aesthetic deficiency. The learning objective of this article is to discuss internal bleaching of discolored pulpless teeth that have been endodontically treated. The discussion includes the chemical composition of bleaching agents and principles by which they function during the bleaching procedures.

Humans↗
PubMed1988

An evaluation of etiologic factors in 382 patients treated in a postgraduate endodontic program.

A survey was completed to determine and to evaluate the reason for endodontic treatment performed by endodontic residents at the Baltimore College of Dental Surgery, University of Maryland at Baltimore. On the basis of patient data and the reasons for endodontic treatment, as stated by the treating residents, the results showed that necrotic pulp and irreversible pulpitis were the most frequent reasons for endodontic therapy. Other reasons for treatment included restorative considerations, retreatment, and trauma. The majority of cases involved posterior teeth, and the average age of patients was 40.0 years. The frequency by arch demonstrated approximately equal distribution between maxillary (54.8%) and mandibular (45.2%) teeth. A total of 224 (58.6%) of the 382 patients surveyed had preoperative pain.

Adolescent↗
PubMed2005

Fundamentals of endodontics.

Endodontic disease is a highly prevalent (>10% of all dogs) and insidiously painful process that can have significant local and systemic effects. The root canal system is a delicate organ and is prone to inflammation, infection, and partial and complete necrosis. Vital pulp therapy must be performed quickly, gently, and meticulously if it is to be effective. The relatively high rate of failure in direct pulp capping makes regular follow-up radiographs of critical importance to ensure patient health. Once a tooth is dead, there are often no obvious clinical signs; therefore, clinicians must be educated in the diagnosis of the disease processes. Once properly educated, the practitioner must remain vigilant for subtle signs of the disease process. Standard root canal therapy is an effective method of removing the inflammation, infection, and associated discomfort of the endodontically diseased tooth while maintaining its function. Endodontic failure most likely remains hidden unless dental radiology is used. Follow-up radiographs at regular intervals throughout the patient's life are critical for ensuring the long-term success of any endodontic therapy.

Animals↗
PubMed2026

Comprehensive Microbiome Analyses for Regenerative Endodontic Therapy.

INTRODUCTION: Comprehensive microbiome analyses include the study of all microbial taxa, including bacteria, archaea, viruses, and fungi, as well as their functional activities and antibiotic resistance gene expression. Regenerative endodontic therapy presents a clinical situation where the most effective antimicrobial approaches are needed in order to ensure clinical success. METHODS AND RESULTS: In this paper, different contemporary technologies for the identification of endodontic microorganisms, such as with next generation sequencing, and their functional characterization, such as with whole genome sequencing, are described. The role of transcriptomics, as well as resistome analysis, are also discussed. Furthermore, the manner in which all this work and knowledge could be incorporated into clinical endodontics in general, and regenerative endodontic therapy as a special treatment, is outlined. CONCLUSIONS: Comprehensive microbiome analysis can lead to the development of more effective and personalized antimicrobial treatment.

Endodontics↗
PubMed1999

The dental hygienist as a co-therapist in the endodontic practice.

This paper explores the potential contributions to patients, the practice, the endodontist, and the dental hygienist that may be realized by the employment of one or more dental hygienists to serve as endodontic co-therapists in the delivery of endodontic treatment. An endodontic co-therapist is an individual who participates with the endodontist in the assessment, planning, implementation, and evaluation of treatment much like the periodontal co-therapist relationship that exists between periodontists and dental hygienists. Dental hygienists are ideal individuals for this role because of their education in basic, clinical, and behavioral sciences. Suggestions are provided for which services could be delegated by the endodontist to the dental hygienist during each phase of care. Advantages of this contemporary approach to the delivery of endodontic treatment are also addressed.

Dental Hygienists↗
PubMed1999

Quality of obturation in student cases instructed by endodontic versus general dentistry faculty.

Endodontic literature suggests that only about 60% of endodontic therapy meets current technical standards and that general dentists may be making a significant contribution to this compromised care. If so, where in the continuum of dental education does this begin. This study evaluated the quality of obturation in mandibular molars provided on the one hand by 3rd year dental students instructed by endodontic faculty, and on the other hand by 4th year students instructed by general dentistry faculty, versus the quality of obturation achieved by endodontic residents who served as a control for both groups. Final radiographs were chosen from students in all three groups so that there were 22 samples per group. Three evaluators rank-ordered the radiographs. In order of excellence, the results were: (a) residents, (b) 3rd year students, and (c) 4th year students. There was no significant difference between the 3rd year students or the residents, only between residents and 4th year students (p < 0.05). The reasons for this outcome may range from dental school objectives to the private practice procedures of the general dentists who instructed the 4th year students.

Analysis of Variance↗
PubMed1992

Feline endodontics.

One misconception in veterinary medicine is that fractured teeth do not need to be treated, or treatment should consist of extraction only. Two common causes of endodontic disease in the cat are fractures and secondary to cervical line lesions. Endodontic technique can be useful in returning a diseased tooth to normal, pain-free function. Conventional endodontics can be used to treat fractured canine teeth or partially destroyed molars. Surgical endodontics is useful in cases in which an apical seal cannot be established by conventional methods. Pulp capping can preserve a vital tooth as an alternative to extraction.

Animals↗
PubMed1999

Barriers to improving endodontic care: the views of NHS practitioners.

AIMS: Concerns have been expressed about the technical quality of NHS endodontic treatment. Bringing performance into line with guidelines for good practice needs to be underpinned by an understanding of barriers to compliance. To this end, our research involved an exploratory investigation of the factors influencing the behaviour of general dental practitioners in their practice of endodontics. MATERIALS AND METHODS: Subjects 12 dental practitioners, representative of varying levels of professional experience and status, and of compliance with good practice guidelines. Data collection In-depth interviews, following a topic guide. Analysis Identification, abstraction and charting of major themes. FINDINGS: Informants' responses suggested that general dental practitioners' endodontic practice is influenced by a complex web of factors. A key barrier to high quality treatment is the NHS remuneration scheme. Undergraduate and postgraduate education and training are also highly influential on practice. Dentists reported employing a range of strategies to manage the time-cost tensions imposed by the remuneration system. Perceived deficiencies in the content and delivery of postgraduate training were highlighted by our informants. CONCLUSIONS: There was a perception among our informants that the NHS fee structure needs to be revised. Their views suggest that a system which rewards quality rather than volume may be more appropriate, but, we believe, such a system would need to take into account efficiency as well as effectiveness. Modification of the current system of postgraduate training in endodontics is also indicated by the views expressed in the interviews. From the diversity of views and from a critical review of the literature, we conclude that flexibility is the key note in changing practice, with no single strategy likely to be universally appropriate.

Attitude of Health Personnel↗
PubMed2002

Radiographic evaluation of cases referred for surgical endodontics.

AIM: The aim of this study is to test the hypothesis that more patients with failed root-canal treatment or other endodontic problems are referred for periradicular surgery rather than nonsurgical re-treatment. METHODOLOGY: Three sets of 100 periapical radiographs representing typical cases referred for surgical treatment were collected in three departments of oral and maxillo-facial surgery situated in different parts of the Netherlands. Of these, a total of 278 radiographs were evaluated to determine whether endodontic surgery was indicated or whether the primary endodontic treatment or endodontic re-treatment was a realistic option. An oral and maxillo-facial surgeon, an endodontist and a general dental practitioner viewed the radiograph independently under standard conditions. RESULTS: Overall, orthograde root-canal (re-)treatment was considered possible in 63% of the cases. The results differed between the three examiners with the oral surgeon reporting that 41% of cases were amenable to conventional treatment, for the general dental practitioner and the endodontists the figures were 67 and 80%, respectively. CONCLUSIONS: Based on these observations, it is concluded that most of the teeth referred for surgical treatment to an oral surgeon could be treated by orthograde nonsurgical root-canal treatment.

Attitude of Health Personnel↗
PubMed2000

Retreatment decisions--a comparison between general practitioners and endodontic postgraduates.

One of the most subjective areas with regard to interexaminer variations is the dental radiograph. The variations in radiographic interpretation lead to differences in treatment planning decisions. This study compared the endodontic retreatment planning decisions for endodontically treated teeth between 12 general practitioners and 12 endodontic postgraduate students. Utilizing dental radiographs of completed cases, both groups were asked to make treatment choices based on two hypothetical ages of a case: 1 or 3 yr postoperatively. General practitioners chose to initiate treatment at an earlier date and also chose more extensive treatment modalities. The age of the root filling was looked on as more important in treatment planning by the endodontics postgraduates.

Apicoectomy↗
PubMed2001

Benchmarking the endodontic literature on MEDLINE.

The purpose of this study was to identify and quantify the endodontic literature available for clinical decision making. A search strategy based on Medical Subject Headings for endodontics was developed to examine MEDLINE. The identified articles were limited to human subjects and English. Sensitive and specific methodological search filters identified four categories of information: etiology, diagnosis, therapy, and prognosis. The results were then subdivided by year to identify trends. Between 1990 and 1998 MEDLINE identified 3,152 articles published in English on endodontics in humans. The number of articles per year (mean +/- SD) for sensitive and specific searches was etiology (28+/-10, 1+/-2), diagnosis (38+/-11, 1+/-1), therapy (59+/-15, 3+/-3), and prognosis (40+/-13, 10+/-5), respectively. The number of articles in each category increased by 1 to 3% each year. There were 150 articles/yr in endodontics in at least 120 journals cited on MEDLINE on which to base clinical decisions.

Analysis of Variance↗
PubMed2001

Philosophies and practices regarding the management of the endodontic smear layer: results from two surveys.

The purpose of this investigation was to ascertain the prevailing attitudes within the endodontic community regarding smear layer removal. The first survey asked the philosophies and techniques currently being taught to predoctoral dental students and postdoctoral endodontic residents in the United States, whereas the second surveyed some of the members of the American Association of Endodontists currently practicing in the United States. Findings from these surveys revealed that more than three-fourths of the dental students and nearly two-thirds of the endodontic residents are not being taught routine smear layer removal. Slightly more than one-half of endodontists responded they practice smear layer removal. These surveys indicate that there is no clear consensus in the endodontic community, either academically or clinically, as to whether the smear layer should be removed or be allowed to remain before obturation of the root canal space.

Data Collection↗
PubMed1991

Endodontics in the UK 1990: an overview.

The first workshop on endodontics, in 1978, pointed out that the standard of endodontics in the United Kingdom was poor. The British Endodontic Society has subsequently attempted to improve the remuneration in the NHS by conducting and publishing a survey, and also establishing guidelines for minimum acceptable standards. Despite this, in the author's opinion, there has been no improvement. However, four ways of raising the standards of endodontics are proposed.

Education, Dental↗
PubMed1991

British Endodontic Society proposals for recruitment of instructors for 'hands-on' courses for general dental practitioners.

This paper addresses the problem of the insufficient number of instructors available for 'hands-on' endodontic courses for dental practitioners throughout the UK. The Council of the British Endodontic Society proposes the setting up of regional endodontic study clubs. Subsequently, some study club members will be encouraged to present 'hands-on' courses to other practitioners in their region. It is hoped that Area Representatives of the Council, who will organize the study clubs, will be found among the university teachers of endodontics.

Education, Dental, Continuing↗
PubMed2005

The adoption of new endodontic technology amongst Danish general dental practitioners.

AIM: To assess the adoption of new endodontic technology in a population of Danish practitioners. METHODOLOGY: Members of the Copenhagen Dental Association (n = 1156) were approached with a questionnaire concerning the frequency of various endodontic procedures. Three options were available: often, occasionally and never. Responses were anonymous. The statistical analyses were performed as studies of association in two- or three-way contingency tables, and with Goodman-Kruskal's gamma-coefficient as the basic tool chosen. RESULTS: Only data from general practitioners (GPs) in private practice were analysed (n = 956). The response rate was 72%. NiTi hand instruments were often used to negotiate canals by 18%, whilst 10% often used NiTi rotary systems. Electronic apex locators were often employed by 15%. Nineteen per cent reported that warm gutta-percha was often used. A majority (53%) often spend two sessions to instrument a molar, and 20% often needed three or more sessions to finish the shaping phase. To complete a treatment of a nonvital case most practitioners reported to use at least three appointments. Only 4% frequently applied rubber dam. CONCLUSIONS: The adoption of new endodontic technology is at an early stage amongst Danish GPs. A new revised remuneration system might influence the rate of adoption, allowing the practitioners to act more rationally and produce a higher frequency of good-quality root fillings. Progress towards high quality endodontics might be hindered by the nonuse of rubber dam.

Denmark↗
PubMed1976

Role of endodontics in current dental practice.

The findings presented in this statistical study are applicable to a representative sample of dentists in general practice in Illinois. Almost 90% of the respondents in this survey do some or all of their root canal therapy. The majority of those who do some or all of their root canal therapy do so because they enjoy it. Most of the respondents (77.3%) do not take root canal cultures. Kerr's Root Canal Sealer is the most widely used sealer, followed by Kerr's Tubli-Seal and Dr. Wach's sealer, respectively. The preferred technique of filling root canals among the respondents is by means of guttapercha and lateral condensation for most canals and the use of silver points for narrow or constricted canals. A technique that is not taught in any American dental school, the Sargenti N2 technique, is used by almost 20% of the responding dentists. Most of the respondents try to fill the canal 0.5 to 1 mm from the apex. Although dozens of intracanal medicaments exist, the most commonly used one is camphorated parachlorophenol, which is used by more than 50% of the dentists who participated in this survey. A chelating agent is used by almost two fifths of the dentists surveyed and use of such an agent is increasing. More than half the respondents carry out some sort of endodontic surgery in their practice' apicoectomy is the most common endodontic surgery performed. The data show that 48.9% of the dentists who participated in this survey feel that dental schools should devote more time to teaching endodontics, 50.5% believe that the amount of time should remain the same, and only 0.5% feel that the amount of time should be decreased. About 70% of those who feel that the amount of time for teaching endodontics should be increased specified an increase in clinical training.

Education, Dental↗