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At least 19 recordsLinked to original sources

[The significance of endodontic therapy before an endodontic surgery].

Conventional Endodontic therapy is the treatment of choice for pulp disease and periapical lesions due to pulp necrosis. Although the percentage of success of endodontic therapy is fairly high, in several cases endodontic therapy cannot perform accurately, or it is impossible to undertaken so as to avoid extraction of tooth. Before an endodontic surgery is performed a conventional endodontic therapy must be attempted because this increases prognosis and reduces the possibilities of failure. The possible presence of lateral canals, communication between periodontal ligament and infected canals through dentinal tubules and the potential hermetic reverse filling, are ones of the main factors which support the necessity of endodontic therapy. Apart from these, many cases have been reported where the basic factor of endodontic surgery failure was not the awkward operations, but the absence of the root canal filling. In this paper authors describe the basic steps and techniques which must be followed so as to avoid the failure of endodontic surgery.

Apicoectomy↗

Exploiting molecular methods to explore endodontic infections: Part 2--Redefining the endodontic microbiota.

The second part of this review discusses the application of molecular methods in endodontic microbiology research for a comprehensive characterization of the microbiota associated with different types of endodontic infections. Despite their recent introduction in endodontic research, molecular methods have already given a significant contribution to the understanding of endodontic infections and the future holds the perspective of a still better refinement of the knowledge about these infections. Molecular methods have revealed a higher complexity of the endodontic microbiota than previously reported by cultivation approaches. In addition to detecting some cultivable species in increased prevalence, molecular methods have also expanded the list of putative endodontic pathogens by inclusion of some fastidious bacterial species or even uncultivated bacteria that have never been previously found in endodontic infections.

DNA Probes↗

On decision making in endodontics. A study of diagnosis and management of periapical lesions in endodontically treated teeth.

In radiographic evaluation of the results of endodontic therapy the development or persistence of periapical radiolucencies often serve as criterion for therapeutic failure. However, using three endodontists and three oral radiologists as observers the present study found consensus only in 27% of cases classified as having periapical radiolucencies. By applying signal-detection theory to periapical radiographic diagnosis, the variations among observers were explained by their adoption of different criteria of periapical disease resulting in different positions on a receiver-operating-characteristic (ROC) curve. The potential of reducing the interexaminer variation through two different calibration programs was investigated. Even though both methods resulted in increased examiner agreement the benefits seemed limited. It was argued that this is due to the complex structure of the decision making process. Among a group of well-experienced general practitioners substantial variations in attitudes to treatment of periapical lesions in endodontically treated teeth was demonstrated. From decision theory and endodontic teaching paradigms a hypothesis was evolved explaining the variations in treatment with variations in subjective probabilities of disease and expected complications. However, this hypothesis could not be confirmed in groups of endodontists and general practitioners. Instead the decision makers seemed to rely on a limited number of heuristic principles. From a normative point of view clinical management of periapical lesions in endodontically treated teeth was approached by using formal decision analysis. Temporal and logical display of decision alternatives, values of probabilities and utilities of the different outcomes are the features of such an analysis. In the concluding part of the study this method was used to calculate optimal decision strategy for an endodontic recall program. It was demonstrated that patients should be examined one year after endodontic treatment. Patients with signs of periapical disease are reexamined after a further three years. At this moment a mild suspicion of periapical pathosis will lead to retreatment of a tooth.

Costs and Cost Analysis↗

Molecular analysis of Filifactor alocis, Tannerella forsythia, and treponema denticola associated with primary endodontic infections and failed endodontic treatment.

The aim of this study was to investigate the presence of strict anaerobes such as Filifactor alocis, Tannerella forsythia, and Treponema denticola in primary and secondary root-infected canals with periapical lesions by molecular analysis and the association of these species with specific endodontic signs and symptoms. Microbial samples were taken from 100 root canals, 50 with necrotic pulp tissues (NPT, primary infection), and 50 with failed endodontic treatment (FET, secondary infection). DNA was extracted from the samples, which were analyzed for the presence of three endodontic pathogens using species-specific primers and PCR. F. alocis were isolated from 23 canals with NPT and 12 canals with FET; T. forsythia from 12 canals with NPT and three canals with FET; T. denticola from 19 canals with NPT and 12 canals with TEP. Suggested associations were found between primary infection and the presence of F. alocis and T. forsythia (both p < 0.05). In particular, associations were found between: pain and F. alocis; swelling and F. alocis; tenderness to percussion and T. forsythia; mobility and T. forsythia and T. denticola; wet canals and F. alocis, T. forsythia, and T. denticola; purulent exsudate and F. alocis, T. forsythia and T. denticola; abscess and F. alocis, T. forsythia, and T. denticola (all p < 0.05). The findings of this study indicated that F. alocis, T. forsythia, and T. denticola seem to be associated with endodontic signs and symptoms. Additionally, F. alocis and T. forsythia were detected more frequently in teeth with necrotic pulp than in teeth with failing endodontic treatment.

Bacteroides↗

Relative frequency of teeth needing endodontic treatment in 3350 consecutive endodontic patients.

A survey covering 8 years and 3350 consecutive endodontic patients (1958 men (58%) and 1392 women (42%)) was conducted to determine the frequency of endodontic treatment for each tooth. At the time of initial examination, 3672 teeth required root canal therapy. Three hundred twenty-two patients needed endodontic therapy on multiple teeth. Posterior teeth were most frequently treated, 80.1% of the total with molars requiring 52.6% of the needed endodontic treatment. The mandibular first molar was treated most often, 18.8% of the time, followed by the maxillary first molar (13.5%) and the mandibular second molar (12.0%). The number of endodontically treated maxillary and mandibular teeth was similar, 50.8% and 49.2%, respectively.

Bicuspid↗

[Teaching of endodontics in the 11-member nations of the European Endodontic Society].

This study was commissioned in 1984 by the Council of the European Society of Endodontology (E.S.E.) in order to discover the extent of endodontic teaching in undergraduate curricula, the methods used in the teaching of the subject and the clinical technique favoured by each school. The survey was conducted with the co-operation of the Country Representatives in eleven out of the fourteen member countries. Each representative was sent a questionnaire and asked to translate it, if necessary, into the appropriate language/languages. These translated questionnaires were sent to the Head of the department responsible for endodontic teaching in each school of that country. The questionnaire inquired into the following subjects: 1) Type of school and teaching arrangements; 2) Teaching concepts; 3) Operative procedures. This study confirmed that endodontic teaching in the schools of the eleven countries that contributed to the survey was fundamentally similar and conformed to what is generally accepted as the conventional approach to the endodontic treatment.

Education, Dental↗

Endodontic applications of guided tissue regeneration in endodontic surgery.

There are several possible causes of failure following nonsurgical and surgical endodontic treatments. Many of the causes of these failures can be attributed to the presence of endodontic-periodontic bone loss around roots. The development of guided-tissue regeneration (GTR) procedures in periodontal therapy has let to the successful treatment of some types of periodontal bone loss. These GTR procedures can be adapted for use in endodontic surgery to produce success in cases that previously presented a poor prognosis. this study categorizes all of the different clinical situations in which GTR procedures can be used to treat endodontically related bone loss. Case reports of several categories are presented.

Alveolar Bone Loss↗

Endodontic management of combined endodontic-periodontal lesions.

Endodontic-periodontal lesions can provide many challenges to clinicians. Although there may be difficulties in establishing a correct diagnosis, this is the most important phase of their management as the diagnosis will determine the type and sequence of treatment required. In general, if the root canal system is infected, endodontic treatment should be commenced prior to any periodontal therapy in order to remove the intra-canal infection before any cementum is removed. This avoids several complications and provides a favourable situation for tissue repair. The endodontic treatment can be completed before periodontal treatment is provided except where there is a "combined endodontic-periodontal lesion with communication"--in these cases, the root canals should be medicated until the periodontal treatment has been completed and the overall prognosis has been reassessed as being favourable. The use of non-toxic intra-canal therapeutic medicaments is essential to destroy bacteria and to encourage tissue healing.

Animals↗

Orascopic endodontics: changing the way we "think" about endodontics in the 21st century.

Orascopic endodontics has helped bring visualization to what has literally been a "blind" specialty. The ease of operation and better operating ergonomics of fiber optic instrumentation has allowed the endodontist to identify and treat endodontic etiology more efficiently. The metamorphosis of understanding endodontics from an in vivo perspective is changing the way we "think" about the practice of endodontics. Prior to intracanal visualization, the cognitive process of determining when the canal was ready for obturation was merely an educated guess based on years of in vitro instrumentation research and postoperative follow-up studies.

Aged↗

[Rational basis for resumption of treatment in endodontics. Should it be "down to the root" in order to be satisfied in endodontics?].

Any endodontic treatment showing a symptomatology should be retreated or corrected. Should we start the asymptomatic treatments over again when the x-ray does not show a filling that is complete, hermetically sealed, biological and under control? When the case arises, the decision to resume the treatment will depend on the state of the crown restoration: should it be redone for any reason? 1. When the crown filling does not need to be removed and redone, watchful waiting is recommended. 2. When the crown filling is deficient, and has to be redone, it would be advisable to resume or try to resume all the canal treatments that are not hermetically sealed, when an opening to the canal has to be worked out. Several experiences show that the rate of success of endodontic treatments that have been resumed is lower than that of endodontic treatments that have been carried out for the first time. Should radiographically inadequate but asymptomatic endodontic treatments not be resumed, it would result in problems only in a very small number of cases, as long as the state of intracanal balance is not broken.

Decision Trees↗

[Relapse after endodontic treatment: endodontic retreatment or apex resection?].

In many cases, unsuccessful endodontic treatment is followed by apicoectomy. Endodontic retreatment, however, could be an appropriate alternative for apicoectomy more frequently. In this paper indications, specific problems and treatment methods are presented for endodontic retreatment, apicoectomy and intentional replantation.

Apicoectomy↗

[Clinico statistical study of the dental education and dental care in the clinic of endodontics. 1. Endodontic therapy of pulpless teeth].

In this clinico statistical study we tried to evaluate the program of education and the dental care provided by the clinic of Endodontics of the Athens University Dental School. The material for this study was the data from 2726 pulpless teeth. The endodontic treatment was done by the students of the 5th year at the Department of Endodontics during the year 1983-1987. The statistical analysis of the material of all the cases was based on: the possibility of perfect obluration of the root canal and the existence of periapical lesions in relation to the teeth group, the jaw and the age of the patient. The evaluation of the results proved that the education and treatment were satisfactory in quantity and quality. It was also found that the success of the obturation depended on the teeth group and had nothing to do with age. It was also found that the biggest percentage of periapical lesions concerned the anterior teeth.

Adult↗

Cleaning of endodontic files, Part I: The effect of bioburden on the sterilization of endodontic files.

Ninety-two new endodontic files were randomly assigned to five groups with varying parameters of contamination, cleaning method, and sterilization (steam or chemical). Files were instrumented in bovine teeth to accumulate debris and a known contaminant, Bacillus stearothermophilus. Positive controls produced growth on both T-soy agar plates and in T-soy broth. Negative controls and experimental files (some with heavy debris) failed to produce growth. The results showed that there was no significant difference between contaminated files that were not cleaned before sterilization and contaminated files that were cleaned before sterilization. Bioburden present on endodontic files does not appear to affect the sterilization process.

Animals↗

Effect of endodontic procedures on enterococci, enteric bacteria and yeasts in primary endodontic infections.

AIM: To detect enterococci, enteric bacteria and yeast species from the canals of teeth with primary endodontic infections before and after canal preparation and to test the antibiotic susceptibility of enterococcal strains isolated from infected root canals. METHODOLOGY: Twenty-five single-rooted teeth with pulp necrosis, intact pulp chambers and periradicular lesions were selected for study. Samples were collected from canals before and after instrumentation. Amongst isolated microorganisms from infected root canals only enterococci, enteric bacteria and yeasts were identified by biochemical tests. The in vitro antimicrobial susceptibility of isolated enterococci strains was evaluated by the Etest system. RESULTS: Microorganisms were isolated from 92% of the samples following intracoronal access, 22% were enterococci, enteric bacteria or yeast species. After biomechanical preparation, these species were no longer detected. After 7 days without intracanal dressing, 100% of the canals contained microorganisms, 52% of which were target species. However, after using paramonochlorophenol [PRP (2.0 g), Rinosoro and polyethylene glycol (400 equal parts up to 100 mL)] as an intracanal dressing for 7 days, enteric bacteria and yeasts were not detected; only enterococci were still present. All strains of enterococci were susceptible to ampicillin, but exhibited variable susceptibility to rifampin and ciprofloxacin. CONCLUSIONS: Enterococci, enteric bacteria and yeasts were present in primary endodontic infections. Enterococci, particularly Enterococcus faecalis and E. faecium were resistant to removal by root canal preparation followed by intracanal dressing.

Adult↗

Diagnosis and treatment planning are essential prior to commencing endodontic treatment: discuss this statement as it relates to clinical endodontic management.

Diagnosis and treatment planning are essential to the practice of endodontics. Diagnosis aims to determine whether pathological involvement of the dental pulp has or is occurring. Treatment planning meanwhile, involves appropriately selecting cases, determining how difficult the treatment may be to perform on a specific individual and sequencing treatment procedures to achieve a healthy and functional dentition. In endodontic management, this may involve establishing whether the tooth is restorable and periodontally sound, the patient is able to tolerate the treatments and the clinician has the skills to perform the required treatment procedures. Careful consideration of these issues must be given prior to commencing treatment.

Decision Making↗

The use of guided tissue regeneration principles in endodontic surgery for induced chronic periodontic-endodontic lesions: a clinical, radiographic, and histologic evaluation.

BACKGROUND: Chronic periodontic-endodontic lesions are not uncommon in clinical practice and their regenerative capacity has long been questioned. However, there are no published studies investigating the application of guided tissue regeneration techniques in combination with endodontic surgery using an induced perio-endo defect model. This study evaluated the clinical, radiographic, and histologic outcomes of three surgical procedures used to treat induced perio-endo lesions. METHODS: Pulpal necrosis was induced in foxhounds along with surgical removal of radicular buccal bone. After 4 weeks, chronic lesions were clinically and radiographically assessed. Treatment surgery consisted of apicoectomy, root canal instrumentation, and retrofilling with mineral trioxide aggregate. Teeth were then assigned to one of the following treatment groups: open flap debridement only (OFD), OFD with bioabsorbable porcine-derived collagen membrane (BG), or OFD with BG and anorganic bovine bone matrix (BO/BG). Clinical parameters and standardized radiographs were assessed at defect creation; treatment surgery; and at 1, 2, 4, and 6 months. Animals were sacrificed at 6 months and specimens prepared for histometric analysis. RESULTS: Clinical and radiographic conditions improved during the study period. Mean epithelial attachment was similar between all groups. Mean connective tissue attachment for groups OFD, BG, and BO/BG was 3.79 mm, 2.63 mm, and 1.75 mm, respectively, and mean radicular bone height was 2.16 mm, 3.24 mm, and 3.45 mm, respectively. Statistically significant increases in the amount of new cementum were observed in groups BG and BO/BG when compared with OFD (P <0.05). CONCLUSIONS: Treatment of combined induced perio-endo lesions using bioabsorbable collagen membranes alone or in combination with anorganic bovine bone matrix resulted in increased amounts of bone, periodontal ligament, and significant increases in the amount of new cementum when compared to open flap debridement in a canine model.

Absorbable Implants↗

An update on endodontics: 1. Endodontic diagnosis and preparation.

In recent years manufacturers have responded to an increase in endodontic treatments by developing a number of new products. New techniques have also been introduced. In this two-part article the author critically reviews these developments. In Part 1 he looks at diagnosis of endodontic problems and outlines root canal preparation techniques. In Part 2 he will examine file designs and techniques for root canal obturation.

Dental Pulp Diseases↗