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PubMed2003

In vitro infrared thermographic assessment of root surface temperature rises during thermafil retreatment using system B.

The purpose of this in vitro study was to measure the temperature rise on the outer root surface during retreatment of Thermafil using the System B HeatSource. Twenty extracted human maxillary premolars were filled with Thermafil with plastic carriers and divided into two groups of 10 teeth each. In group 1, Thermafil obturators were retrieved using System B HeatSource fitted with a medium plugger at a temperature of 225 degrees C. The plugger was placed first on the buccal, then on the lingual of the plastic carrier for 5 s each. This melted the gutta-percha and softened the plastic carrier. In group 2, Thermafil obturators were retrieved in the same manner except that the heated plugger was placed for 8 s. The temperature changes on the outer root surfaces were recorded using a thermal imaging camera. Thermafil retreatment in vitro using a System B HeatSource causes temperature rises ranging from 26.7 degrees C to 46.0 degrees C. This finding could possibly have implications for creating injury of the periodontal tissues.

Bicuspid↗

PubMedDate not supplied

The effect of Helicobacter pylori retreatment with ranitidine bismuth citrate, clarithromycin, and metronidazole depends on the first-line therapy.

BACKGROUND: Helicobacter pylori eradication rates seem to decrease. This study evaluates the effect of retreatment with ranitidine bismuth citrate (RBC) 400 mg B.I.D., clarithromycin (C) 500 mg B.I.D., and metronidazole (M) 500 mg every morning and 1,000 mg every evening for 14 days [RBC.C.M]. STUDY: Nine gastroenterologic units included patients with unsuccessful eradication of H. pylori in a preceding randomized trial. Previous treatment was either omeprazole (O) 20 mg, C 250 mg, and M 500 mg [O.C.M] or RBC 400 mg, tetracycline (T) 1,000 mg, and M 500 mg [RBC x T x M]; all drugs were given twice daily for 7 days. RESULTS: Twenty-six H. pylori-positive patients were included (nine males, 17 females; mean age, 54 years; range, 39-74 years). The eradication rates in the groups previously treated with O.C.M and RBC.T.M were three of nine (33%) (95% CI = 12-65) and 15 of 17 (88%) (95% CI = 66-97) respectively (p = 0.008). The corresponding results in a "per-protocol" analysis were three of eight (38%) (95% CI = 13-69) and 10 of 10 (100%) (95% CI = 72-100), respectively (p = 0.007). A side effect score was 21.8 compared with 8.3 in the previous study (p < 0.001). CONCLUSIONS: The effect of a retreatment regimen depends on the preceding treatment. The RBC x C x M regimen is effective in nonresponders to RBC x T x M, but it seems unsuitable after failure of the O x C x M regimen.

Adult↗

PubMed2004

Nonsurgical retreatment.

With all the potential for endodontic success, the fact remains clinicians are confronted with posttreatment endodontic disease. When the elected treatment plan is endodontic nonsurgical retreatment, then the goal is to access the pulp chamber and remove materials from the root canal space and if present, address deficiencies or repair defects that are pathologic or iatrogenic in origin. This article provides a literature review with clinical recommendations for one important group of retreatment issues: the removal of posts and broken instruments.

Dental Instruments↗

PubMed2006

Detectability of residual Epiphany and gutta-percha after root canal retreatment using a dental operating microscope and radiographs--an ex vivo study.

AIM: To compare the detectability of residual Epiphany and gutta-percha after root canal retreatment using a dental operating microscope and radiographic examination with the residual area measured after rendering the roots transparent. METHODOLOGY: Sixty extracted single-rooted maxillary central incisor teeth were enlarged to apical size 40. Thirty canals were filled using vertically compacted Epiphany, the remainder were filled with vertically compacted gutta-percha and AH Plus sealer. After re-instrumentation to apical size 50, radiographs of the roots were taken in buccolingual and mesiodistal direction. Residual filling material was categorized by three observers using the radiographs and a dental operating microscope. The area of remaining material that was made visible by radiographs was measured with the aid of a computer image analysis programme. After clearing the roots, areas of residual filling material on the root canal wall were measured using a microscope. RESULTS: Computer image analysis of the radiographs showed significantly smaller areas of remaining gutta-percha and Epiphany compared with the analysis of the transparent teeth that revealed only one absolutely clean root (Epiphany). Especially in the gutta-percha group, the scores determined by the observers using radiographic examination gave an over-optimistic impression of cleanliness compared with the scores determined by the visualization through the microscope. CONCLUSION: Especially for remaining gutta-percha, the operating microscopes provided better detection of residual root filling material in retreated maxillary incisor teeth.

Dental Pulp Cavity↗

PubMed2006

Root canal treatment in Denmark is most often carried out in carious vital molar teeth and retreatments are rare.

AIM: To study the reasons given by a representative sample of Danish general dental practitioners (GDPs) for undertaking root canal treatment and, to investigate their confidence in performing root canal treatment on molar teeth. METHODOLOGY: A questionnaire was sent to 600 Danish GDPs randomly selected from the roster of the Danish Dental Association. They were asked to recall various factors about their experience of the last root filling they completed, including the reason for treatment and the pulp diagnosis. Self-assessments on 100-mm visual analogue scales (VAS) were reported concerning the confidence in performing root canal treatment of a molar. End-point definitions were 'very easy' (0) and 'very difficult' (100), respectively. Time reports of molar treatments were given in categorized groups. RESULTS: The most frequent reason for performing root canal treatment was caries within the tooth involved (55%). The majority of treatments involved teeth with vital pulps (54%). Retreatments were carried out in 2% of the cases. The confidence in performing root canal treatment varied but was relatively high, expressed as VAS-values below 50. The creation of an aseptic working field was regarded as the most difficult procedure followed by root canal preparation. Fifty-six percent of the responders stated a time frame of 46-75 min to complete root filling in a molar tooth. CONCLUSIONS: Root canal treatment in Denmark was reported to be undertaken most often because of caries. Treatment was typically performed in molar teeth with vital pulp. Even though apical periodontitis was frequently noted in root filled teeth, retreatments were rare. From a subjective perspective root canal treatment was not considered to be very difficult and was carried out relatively rapidly.

Analysis of Variance↗

PubMed2004

Uncontrolled trial of sparfloxacin in retreatment of pulmonary tuberculosis.

OBJECTIVE: The aim of the present report was to study the role of sparfloxacin in retreatment of pulmonary tuberculosis. METHODOLOGY: Sixteen patients with sputum-smear-positive pulmonary tuberculosis were given sparfloxacin (200 mg daily), along with isoniazid and para-aminosalicylic acid plus additional drugs where indicated. They were followed up and assessed by sputum-smear microscopy and chest X-ray regularly for the entire duration of follow up, which ranged from 15 to 18 months. RESULTS: Twelve patients completed treatment and achieved a satisfactory response in the form of persistent sputum negativity and radiologically quiescent disease. Two patients defaulted after 6 months and one patient discontinued medications because of severe gastrointestinal intolerance. One patient died before completion of the treatment as a result of the sequelae of the disease. CONCLUSIONS: Sparfloxacin can be used as a companion drug along with other drugs in retreatment of pulmonary tuberculosis. The advantages of this drug are a high safety profile, low cost of treatment and easy availability, which are important determinants, especially in developing countries.

Adult↗

PubMed2001

Retreatment of Helicobacter pylori infection after initial treatment failure.

OBJECTIVES: Helicobacter pylori treatment regimens fail to cure the infection in at least 10-20% of patients undergoing initial treatment. Retreatment strategies for patients who have failed initial treatment for H. pylori infection remain poorly described. METHODS: The literature describing the frequency of H. pylori treatment failure and factors leading to failure is reviewed. The role of antibiotic resistance is discussed and clinical studies assessing success rates according to antibiotic resistance are described. Clinical trials evaluating the treatment success rates for a second episode of treatment are discussed. RESULTS: The literature describing retreatment of failed H. pylori infection remains limited. The existing data support the use of bismuth-based quadruple therapy or ranitidine bismuth citrate (RBC)-based triple therapy as the preferred agents after initial treatment failure. CONCLUSION: Further studies are needed to better define the optimal second treatment regimen after failed H. pylori treatment.

Anti-Ulcer Agents↗

PubMed2006

Endodontic retreatment of a maxillary second molar with three separate buccal roots.

A rare case of a four-rooted maxillary second molar in a 39-year-old male patient is reported. After clinical and radiographic examination, two separate mesio-buccal roots were detected, and a treatment plan consisting treatment of the mesio-buccal roots and retreatment of the disto-buccal and palatal roots was made to resolve the previous treatment failure. The tooth was treated by orthograde endodontic retreatment in two visits. Mesio-buccal canals that were located in the separate mesio-buccal roots (which were missed in previous treatment) were found and treated. The case report underlines the importance of complete knowledge about root canal morphology and possible variations, coupled with full clinical and radiographic examination, in order to increase the ability of clinicians to treat difficult cases.

Adult↗

PubMed1998

Retreatment of children after surgery for acquired esotropia: reoperation versus botulinum injection.

AIMS: Two viable options were compared, reoperation and botulinum toxin injection, in the management of children who need retreatment after surgery for acquired esotropia. METHODS: 47 strabismic children previously operated to correct an acquired esotropia were randomised to reoperation or botulinum toxin injection. Reoperation was undertaken in 24 of these patients and botulinum toxin injection in 23 of them. The percentage net change in distance deviation, the percentage of patients with successful motor outcome, detectable fusion, and stereopsis were compared 1 year after retreatment and at last visit (average follow up: 2.9 years in reoperation group, and 2.7 years in botulinum group). The motor success rate relative to time elapsed from initial surgery was evaluated. RESULTS: There was no significant difference in the motor and sensory outcomes between patients reoperated and treated with botulinum injection. The frequency of correction to within 8 prism dioptres of orthotropia was, respectively: 75% versus 69.56% at 1 year; 70.83% versus 60.86% at last visit. Botulinum injection could be more effective when performed within 3 months of initial surgery. CONCLUSIONS: Botulinum injection is a rapid and safe procedure that may be as effective as reoperation in the management of children who need a secondary procedure after surgery for acquired esotropia.

Botulinum Toxins↗

PubMedDate not supplied

Root canal retreatment: I. Case assessment and treatment planning.

Root canal retreatment is often the preferred method of treating a tooth in which root canal treatment has failed. Part one of this two-part article discusses reasons for failure of root canal treatment, case assessment and treatment planning. Part two describes some of the practical techniques that are available to the practitioner and the rationale for root canal retreatment.

Dental Pulp Cavity↗

PubMed2004

Root canal retreatment: 2. Practical solutions.

Root canal retreatment is often the preferred method of treating a tooth in which root canal treatment has failed. Part two of this two-part article discusses the rationale for root canal retreatment and practical techniques and equipment that are available to practitioners.

Dental Pulp Cavity↗

PubMed1997

Retreatment tuberculosis cases. Factors associated with drug resistance and adverse outcomes.

STUDY OBJECTIVE: Risk factors associated with treatment failure and multidrug-resistant tuberculosis (MDR-TB) were examined among HIV-seronegative patients who were previously treated for tuberculosis (TB). DESIGN: Prospective, cohort study of patients referred to the study hospital for retreatment of TB between March 1986 and March 1990. PATIENTS: The patients belonged to three groups, according to outcomes following their previous treatment: 37 patients who abandoned treatment or suffered relapse after completion of therapy (group A), 91 patients who failed to respond to the first-line drug regimen (group B), and 78 patients who failed to respond to the second-line drug regimen (group C). RESULTS: Patients with Mycobacterium tuberculosis strains resistant to rifampin and isoniazid were found in 2 (6%) in group A, 29 (33%) in group B, and 49 (65%) in group C. Cure was achieved in 77% in group A, 54% in group B, and 36% in group C. Death occurred in none of the patients in group A, 8% in group B, and 24% in group C. In a multivariate logistic regression analysis, unfavorable response (failure to sterilize sputum culture, death, and abandonment) was significantly associated with infection with a multidrug-resistant M tuberculosis strain (p = 0.0002), cavitary disease (p = 0.0029), or irregular use of medications (p < 0.0001). CONCLUSIONS: These observations show that a previous treatment outcome and current clinical and epidemiologic histories can be used to predict the development of MDR-TB and adverse outcomes in patients undergoing retreatment for TB. Such information may be useful for identifying appropriate patient candidates for programs such as directly observed therapy.

Adult↗

PubMed2006

Peginterferon alfa-2a (40KD) (PEGASYS) plus ribavirin (COPEGUS) in retreatment of chronic hepatitis C patients, nonresponders and relapsers to previous conventional interferon plus ribavirin therapy.

Peginterferon alfa plus ribavirin is currently the treatment of choice for chronic hepatitis C. Peginterferon alfa-2a (40KD) plus ribavirin has given an overall sustained virological response of 18% in F3/F4 previous nonresponder US patients. We evaluated the effectiveness of peginterferon alfa-2a (40KD) plus ribavirin in Brazilian patients who were relapsers or nonresponders to previous interferon-based therapy. One-hundred-thirty-four patients with biopsy-proven chronic hepatitis C, HCV RNA positive, elevated ALT and who were either relapsers (n=37) or nonresponders (n=97) to at least 24 weeks of conventional interferon/ribavirin therapy were retreated with peginterferon alfa-2a (40KD) 180mg/qw and ribavirin 800 mg bid for 48 weeks. Efficacy was assessed as virological response (defined as undetectable HCV RNA) at the end of treatment (EoT) and at the end of follow-up (SVR - Sustained Virological Response). Safety assessments consisted of clinical and laboratory evaluations. In the patient sample, 72% were genotype 1 and 34% were cirrhotic. In an intention-to-treat analysis, relapser patients showed 78% EoT response and 51% SVR. Nonresponders showed 57% EoT response and 26% SVR. Positive predictive factors of SVR were non-1 genotype and relapser state. Six percent of the patients interrupted treatment because of adverse events and 45% had dose reduction (mainly associated with leucopenia and anemia). Brazilian patient relapsers and nonresponders to conventional interferon and ribavirin treatment can achieve a sustained virological response when retreated with peginterferon alfa-2a (40KD) and ribavirin. The safety profile is similar to that of naive patients.

Adult↗

PubMed2005

A furazolidone-based quadruple therapy for Helicobacter pylori retreatment in patients with peptic ulcer disease.

PURPOSE: Many of the currently used eradication regimens against Helicobacter pylori fail to cure the infection either due to antimicrobial resistance or to poor patient compliance. The infection leads to increased risk of developing potentially severe complications, such as gastric cancer. This study was aimed at assessing the efficacy and safety of a quadruple therapy with furazolidone for H. pylori retreatment. METHODS: Patients who had failed one or more eradication regimens against H. pylori infection underwent upper gastrointestinal endoscopy. Biopsy specimens were taken from the gastric antrum and corpus for histology and for a urease test and. Patients received omeprazole 20 mg, bismuth citrate 240 mg, tetracycline 500 mg, and furazolidone 200 mg, all twice daily for 7 days. Therapeutic success was evaluated by endoscopy and biopsies 8 weeks after the end of treatment. RESULTS: Sixty two patients were enrolled, and 58 completed the study. Under this protocol, H. pylori eradication was achieved in 39/58 patients (67%). Mild adverse events were reported. CONCLUSION: The short quadruple therapy course with furazolidone is well tolerated, inexpensive, and effective in retreatment for H. pylori infection. It is a good option for developing countries.

Adolescent↗

PubMed2000

[Test your decision-making. When to do endodontic retreatment? Results of a study].

The goals of this survey were to determine the most frequent therapeutic option and to evaluate the consensus among a sample of Belgian practitioners managing the same simulated cases of root treated teeth. On average, conservative options (nonsurgical retreatment 35.27% and no retreatment 29.61%) are the most selected alternatives. Surgical options and extraction respectively constitute 21.18% and 13% of the treatment propositions. As expected, the presence of radiographic and/or clinical signs resulted in a more aggressive attitude, but the presence of symptoms does not seem to be a valid reason for reintervention. The results of the study demonstrate considerable interindividual variations in clinical management of root treated teeth, regardless of personal factors, such as gender, years of experience and graduation institution. Even if a consensus appears within a group of professionals, it is not necessarily applied by a majority of practitioners; this contributes certainly to the explanation of the geographical or institutional variations noted in the medical practices.

Adult↗

PubMed2003

Why endodontic retreatment is less successful than primary root canal therapy.

Endodontic retreatment has been proven less effective than conventional root treatment. Factors dictating this include difficulty in accessing the root canal system in retreatment cases, problems in negotiating a highly resistant micro flora and unfavourable anatomy. Patients should, therefore, be counselled on the possibility of failure necessitating surgical procedures and possibly extraction. However, despite these mitigating factors success is still a realistic goal in the majority of cases.

Dental Restoration Failure↗

PubMed2003

Endodontic retreatment: explaining success rates and illustrated cases.

Endodontic retreatment is less successful than conventional root treatment. Factors governing this include difficulty in accessing the root canal system in retreatment cases, problems in negotiating a highly resistant microflora and unfavourable anatomy. However, despite these mitigating factors success is still a realistic goal in the majority of cases.

Dental Instruments↗

PubMed2004

Nonsurgical endodontic retreatment.

The purpose of this clinical article is to emphasize that although there is enormous potential for endodontic success, clinicians are, at times, confronted with post-treatment disease. A rationale for endodontic treatment is followed by the goals of nonsurgical retreatment. The focus of this article is to identify the various nonsurgical retreatment categories and provide an overview of the concepts, armamentarium and techniques available to disassemble roots, address deficiencies or repair defects that are pathological or iatrogenic in origin.

Humans↗