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At least 451 records · Page 25Linked to original sources
PubMed2005

Endodontic surgery with ultrasonic retrotips: one-year follow-up.

OBJECTIVE: The purpose of this prospective clinical study was to monitor the outcome of ultrasonic root-end preparation, in relation to tooth type and location, presence of post restoration and type of retrotip. STUDY DESIGN: Teeth treated surgically showed a periradicular lesion of strictly endodontic origin. Fifty teeth were included in the study, according to specific selection criteria. Cases were followed for a period of 1 year and then classified in 3 groups (success, uncertain healing, and failure) according to radiographic and clinical criteria. RESULTS: Of the 46 teeth evaluated at 1-year follow-up, 42 teeth (91.3%) successfully healed, 1 tooth had uncertain healing, and 3 failed. We found no statistically significant differences in treatment results related to the type of tooth, tooth location, post restoration, and type of retrotip. CONCLUSION: Adherence to a strict endodontic surgical protocol and the use of contemporary techniques and materials can lead to a predictable outcome.

Adult↗
PubMed2005

Postoperative pain after root-end resection and filling.

OBJECTIVE: To evaluate the pain experience following root-end resection and filling with Mineral Trioxide Aggregate or Intermediate Restorative Material. STUDY DESIGN: Referred adult patients recruited using strict entry criteria were randomly allocated to receive either material. A standardized surgical technique was employed. Postoperative instructions and a pain questionnaire were given to each patient to record the severity of their pain at 3 time intervals-3-5 hours, 24 hours, and 48 hours after surgery-on a standard visual analog scale (VAS). Patients were also asked to record consumption of any self-prescribed analgesics, the type, and dosage. RESULTS: At 3-5 hours after surgery, regardless of the material used, 90% of all patients experienced some level of postoperative pain. Twenty-four hours after surgery 82% of patients experienced pain, as did 72% after 48 hours. Thirty-seven percent of patients did not take any analgesics at all. In order of popularity, the analgesics taken were ibuprofen, acetaminophen, and acetaminophen plus codeine phosphate. The VAS measurements were reduced over time in both treatment groups (P < .001). There was no statistically significant difference in the proportion of subjects taking analgesics in each treatment group. Patients who used analgesics showed higher median VAS measurements at all time periods (P < .05). CONCLUSIONS: There was no significant difference in the pain experienced by both treatment groups. The postoperative pain was of a relatively short duration, at its maximum intensity early in the postoperative period but progressively decreased with time. Even if pain relief medication was needed, nonprescription analgesics were adequate and effective.

Adult↗
PubMed2005

Observations on healing following endodontic surgery in nonhuman primates (Macaca fascicularis): effects of rhBMP-2.

OBJECTIVES: The potential of recombinant human bone morphogenetic protein-2 (rhBMP-2) to enhance bone healing following endodontic surgery was tested. The pattern and timing of de novo bone formation and cementum regeneration, and the potential for root resorption and ankylosis to accompany bone formation were evaluated. STUDY DESIGN: Pulpal infections were induced in maxillary and mandibular incisor teeth in young adult Cynomolgus monkeys. The teeth received conventional endodontic treatment immediately followed by surgical root resection. In a randomized split-mouth design, contralateral apical bone defects received rhBMP-2 in absorbable collagen sponge (ACS) carrier or served as sham-surgery controls to provide histological and radiographic evaluations following 1 (mandibular incisors) and 4.5 (maxillary incisors) month(s) postsurgery. RESULTS: At 1 month postsurgery trabecular bone filled the apical bone defects. The newly formed bone appeared considerably more mature and had assumed characteristics of the contiguous resident bone at 4.5 months postsurgery. The resected root tips were almost completely covered by new cementum with a maturing functionally oriented periodontal ligament. Localized inflammatory infiltrates were associated with the filled root canals and extruded root-filling material. Root resorption and ankylosis were not observed. There were no apparent differences in healing patterns between sites implanted with rhBMP-2/ACS and those serving as sham-surgery controls. CONCLUSIONS: Under conditions where the influence of infectious elements and irritation caused by root filling material are minimized, bone formation and cementum regeneration appears rapid following endodontic surgery. rhBMP-2/ACS did not offer an obvious benefit above and beyond that of the native osteogenic potential in this animal model.

Alveolar Bone Loss↗
PubMed2006

Etodolac versus dexamethasone effect in reduction of postoperative symptoms following surgical endodontic treatment: a double-blind study.

OBJECTIVE: The purpose of this prospective study was to analyze the effect of etodolac versus dexamethasone in reducing postoperative pain in patients who had surgical endodontic treatment using a strict protocol. STUDY DESIGN: The study consisted of 90 patients (38 males and 52 females) referred for surgical endodontic treatment. All procedures were performed using a microsurgical technique with a strict protocol. Patients were randomly premedicated with placebo or with one of both protocols: either a single dose of oral dexamethasone, 8 mg, preoperatively and 2 single doses, 4 mg, 1 and 2 days postoperatively, or a single dose of etodolac, 600 mg, and 2 single doses, 600 mg, 1 and 2 days postoperatively. Pain was recorded at 8, 24, and 48 hours, as well as 7 days postoperatively, on a 1-10 scale. The influence of different variables on postoperative sequelae was analyzed. RESULTS: On a 1-10 scale, the mean values of pain report recorded were 3.8 +/- 2.9 (8 hours postoperatively), 2.93 +/- 2.4 (24 hours), 2.31 +/- 2.2 (48 hours), and 1.4 +/- 0.9 (7 days postoperatively). One day postoperatively, 41.8% of the patients reported no or very mild pain (score 1 or 2), whereas after 7 days, 87.9% reported no or very mild pain (score 1 or 2). Both etodolac and dexamethasone had a significant effect of reducing postoperative pain in patients who had surgical endodontic procedure compared with placebo (P < or = .001). CONCLUSION: Postoperative pain following endodontic surgical treatment is not uncommon. Etodolac as well as dexamethasone might serve as a pain relief measure for postoperative pain in these patients.

Adolescent↗
PubMed2007

Periapical surgery and the maxillary sinus: radiographic parameters for clinical outcome.

OBJECTIVE: To find out whether conventional periapical radiographs can be used to determine the risk of creating an oroantral communication (OAC) while performing periapical surgery on maxillary premolars and molars. STUDY DESIGN: One hundred thirteen periapical radiographs of maxillary premolars and molars with periapical radiolucencies indicating chronic apical periodontitis were retrospectively analyzed and classified. The surgery reports were evaluated for occurrence of perforation of the maxillary sinus and postoperative complications. RESULTS: Perforation of the sinus membrane (also referred to as the Schneiderian membrane) occurred in 12 cases (9.6%). Exposure of the membrane without rupture occurred in 15 cases (12%). It was found that the distance between the apex or the periapical lesion and the sinus floor did not serve as a predictor of a possible sinus membrane rupture. On the other hand, if the radiograph showed a distinct distance between the lesion and the sinus floor, there was an 82.5% probability that OAC would not occur. Additionally, a blurred radiographic outline of the periapical lesion did not indicate an increased risk of sinus membrane rupture. CONCLUSION: Conventional periapical radiographs cannot be used as predictors for perforation of the maxillary sinus during periapical surgery. However, radiographs with a specific distance between the periapical lesion and the sinus floor point toward a very low risk of accidental sinus perforation during periapical surgery.

Adult↗
PubMed1994

Apical dentin permeability and microleakage associated with root end resection and retrograde filling.

This study evaluated the apical leakage associated with various depths of retrograde fillings placed in root apices which had been resected at one of three different angles. Leakage was assessed with a hydraulic conductance apparatus. Teeth were divided into groups corresponding to the angle of apical resection (0, 30, and 45 degrees to the long axis of the root) and apical leakage was determined following incremental increases in the depth of the retrograde filling (Ketac Silver). Increasing the depth of the retrograde filling significantly decreased apical leakage; there was also a significant increase in leakage as the amount of bevel increased. Both the permeability of resected apical dentin and microleakage around the retrograde filling material had a significant influence on apical leakage.

Apicoectomy↗
PubMed1994

A comparison of the apical seals achieved using retrograde amalgam fillings and the Nd:YAG laser.

The purpose of this in vitro study was to compare the apical seals achieved using retrograde amalgam fillings or the Nd:YAG laser. Freshly extracted teeth were randomly separated into groups that would have their apices treated either with a Nd:YAG laser or retrograde amalgam. After instrumentation and obturation, bacterial reservoirs were prepared in the coronal portion of canals. Teeth to receive retrofillings had their apices prepared and amalgams placed. Teeth to be lasered had no apical preparations. Teeth and culture media were then sterilized by irradiation. Streptococcus salivarius was deposited in the opened bacterial reservoirs. At intervals, culture media with an indicator in culture chambers was observed for color change. Specimens that demonstrated color change were cultured for S. salivarius. Under the conditions of this in vitro study, no statistically significant difference was found in bacterial leakage between the laser-treated group and the retrograde amalgam group.

Apicoectomy↗
PubMed1996

Incomplete healing (scar tissue) after periapical surgery--radiographic findings 8 to 12 years after treatment.

Twenty-four cases treated by periapical surgery--which 2 to 6 yr after surgery were classified radiographically as incomplete healings (scar tissue)--were further followed, extending the observation period to 8 to 12 yr. One case healed completely, 1 failed, and 22 were still recorded in the same healing group. All the 22 scar tissue cases were characterized by a reduction of the defect in bone. In 13 cases, continuous periodontal structures were seen and the defect thereby separated from the root. The findings support the conclusion that cases clearly showing features of incomplete healing (scar tissue) at the regular follow-up 1 yr after surgery can be regarded as successes. They need not be recorded for further systematic control. A general follow-up program for apicectomy cases is suggested.

Apicoectomy↗
PubMed1994

Longitudinal evaluation of the seal of IRM root end fillings.

IRM has been recommended for root end filling during endodontic surgery. This study evaluated the seal of IRM root end fillings prepared with various powder to liquid ratios (P:L) at extended time intervals using a fluid filtration method. The P:L of IRM evaluated included 2, 3, 4, 5, and 6 g/ml and the P:L which resulted from the manufacturer's recommended scoop and dropper. Ten teeth were evaluated for microleakage for each group at 1, 2, 3, 4, 8, and 12 wk after insertion. There were no significant differences in the microleakage of any of the various P:L groups at weeks 3, 8, and 12. These results suggest that higher P:L of IRM than those previously recommended for temporary restorations and for endodontic access preparations may be acceptable for root end fillings. IRM of higher P:L has other advantages such as ease of placement and decreased setting time, toxicity, and solubility.

Analysis of Variance↗
PubMed1994

Analysis of a referral-based endodontic practice: Part 2. Treatment provided.

Little information exists in the dental literature regarding the range of treatment provided by specialist endodontists. This study was undertaken to analyze the range and incidence of treatment procedures performed on 2000 patients referred to a specialist endodontist in Perth, Western Australia. There were 312 people that did not require endodontic treatment, resulting in 1688 patients having treatment on 2221 teeth. Routine treatment without complications was provided to 313 teeth (14%) while a total of 451 teeth (20.3%) had calcified or blocked canals. Endodontic retreatment was necessary in 815 teeth (36.7%), 210 teeth (9.4%) had posts removed, and 236 (10.6%) had endodontic surgery. Perforations were present in 119 teeth (5.4%) and these were treated either conservatively (81 teeth, 3.6%) or with surgery (38 teeth, 1.7%). Dental trauma was the reason for referral of 258 patients who required treatment on 217 teeth (9.8%). The wide range of treatment procedures required indicates that endodontists must be highly skilled in all aspects of the discipline.

Apicoectomy↗
PubMed1993

Postsurgical endodontics.

Apical surgery is known to be an effective and practical way of treating endodontic failures. However, in spite of seemingly proper root end management, surgical failures may occur as a result of lateral canal, dentinal tubule, end retrograde leakage. Since surgical retreatment of such failures would likely result in failure, the alternative of a nonsurgical retreatment should be carefully considered. An understanding of the relationship which exists between the quality of the orthograde treatment and the surgical prognosis is necessary to properly direct the course of treatment.

Adult↗
PubMed1995

Longitudinal evaluation of the microleakage of dentin bonding agents used to seal resected root apices.

A material that bonds to dentin and seals both the root canal and exposed dentinal tubules would be desirable following root resection. The purpose of this study was to measure the sealing ability of four dentin bonding agents on the resected root end. The bonding systems evaluated were Amalgambond (AMB), Scotchbond Multi-Purpose (SMP), Prisma Universal Bond 3 (PUB 3), and All-Bond 2 (AB2). All materials were applied directly to the resected root end without a class I preparation. One-half of the roots in each group were contaminated with human blood before bonding. Microleakage was measured using fluid filtration at various time intervals from 1 to 24 wk. Results indicated that all dentin bonding agents significantly reduced apical microleakage compared with prebonded controls at all time intervals. Blood contamination did not adversely affect the sealing ability of AMB, PUB 3, or SMP. The blood-contaminated AB2 group displayed significantly greater microleakage after 12 and 24 wk than the uncontaminated roots.

Analysis of Variance↗
PubMed1995

Surgical apical repair with super-EBA cement: a one-visit alternative treatment to apexification.

This article presents an alternative one-visit treatment to conventional apexification. Time, patient compliance, and multiple office visits are required to complete an apexification successfully. In the technique described, the root canal system is instrumented and filled followed by immediate periradicular manipulation and apical repair with Super-EBA cement. Cases presented in this pilot study have a recall period ranging from 5 to 14 months. It is our contention that the results of this technique are highly predictable, with the added advantage that unsalvageable situations (e.g., vertical root fracture) can be assessed right away. In both instances, the patient will receive the precise prognostic assessment and treatment. Thus, patients are returned to their restorative dentists with minimal delay.

Adolescent↗