The Impact of Apical Patency in the Success of Endodontic Treatment of Necrotic Teeth with Apical Periodontitis: A Brief Review (original) (raw)
Related papers
Journal of IMAB - Annual Proceeding (Scientific Papers), 2014
Introduction: The pathogenesis of internal and external resorptive processes in the dental tissues and those of the periapical zone is not fully understood, but the main purpose, either in teeth with internal resorption or in teeth with periapical lesions, is decontamination of the endodontic space and subsequent three-dimensional obturation in order to isolate periapical and oral tissues and prevent reinfection. Purpose: The aim of this article is to analyze in vivo some key characteristics of the apical zone in teeth with chronic apical periodontitis. Material and Methods: To facilitate the clinical protocol after the radiographic analysis and assessment of patency, the working lengths of 153 root canals (n = 153) in 106 teeth were determined. The clinical widths of the apical narrowing were measured by using the last instrument (ISO 0.02 tapered file), which can move freely through the apical narrowing after electrometric determination of the working length (Raypex 5 /VDW, Germany/). Results and Discussion: Determination of working width and working length is important for realizing the first stage of decontamination-maximum instrumentation of the endodontic space and choice of a clinical protocol. The classification of root canals in a particular group according to the relative patency or lysed apical opening is important for the selection of obturation technique, which is essential for reducing the microleakage in the zone. Conclusion: Since the target of this work were teeth with CAP, in the majority of the cases with clinical findings of root canals with preexisting filling, radicular pins, obliteration, separated canal instruments, perforations at different levels, via falsa or thresholds, the access to the apical zone was not subjected to a closely observed instrumental clinical protocol. In the treatment of each case, however, the clinical principles of modern endodontic treatment were closely observed.
Assessment of incidence of apical periodontitis in root canal treated teeth: An observational study
International Journal of Applied Dental Sciences, 2019
Background: Apical periodontitis (AP) is a multifactorial condition resulting from the interaction of many factors, predominantly bacteria. Fewer extractions are being performed, and the prevalence of denture use is decreasing. Hence; the present study was planned for assessing the incidence of apical periodontitis in root canal treated teeth. Materials & methods: A total of 100 patients who underwent root canal therapy in the past one year were analyzed. Only those patients were included who underwent root canal therapy for maxillary first molars and in which follow-up radiographic records were available, were enrolled. Complete demographic details and clinical profile of all the patients was recorded separately. Follow-up radiographs were analyzed and evaluated for assessing the presence of apical periodontitis. All the results were recorded in Microsoft excel sheet and were analyzed by SPSS software. Results: Apical periodontitis were found to be present in 23 percent of the pati...
Apical Periodontitis in Canal Treated Teeth: A Literature Review
2019
Citation: Hatem Faisal Bajnaid., et al. “Apical Periodontitis in Canal Treated Teeth: A Literature Review”. EC Dental Science 18.12 (2019): 01-07. Abstract The success rate of root canal treatment (RCT) is relatively high and may reach up to 95%. However, it has been associated with a high prevalence of apical periodontitis (AP). We performed an extensive literature search of the Medline, Cochrane, and EMBASE databases on 20 September 2019. Papers discussing RCT and its association with AP were screened for relevant information. There are many limitations to RCT including; the proper visualization and the ability to adequately disinfect the canal system. The prevalence of AP following RCT is highly variable and depends on multiple factors. These factors may be related to the procedure itself including; the quality of RCT, the status of CR, and the cast restoration performed. They can be also related subjective factors of the studied population like the presence of uncontrolled diabe...
Journal of Endodontics, 2020
Introduction: This study evaluated the microbiological conditions of the apical root canal system of teeth with posttreatment apical periodontitis and correlated them with observations from cone-beam computed tomography (CBCT), micro-computed tomography (micro-CT) and histopathology. Methods: Root apices were obtained from 36 root canal-treated teeth subjected to perirradicular surgery. CBCT exam was available before surgery. The apical root specimens were scanned in a micro-CT device and then cryopulverized. The powder was subjected to DNA extraction for real-time polymerase chain reaction quantification of total bacteria, Streptococcus species, members of the phylum Actinobacteria, and Enterococcus faecalis. Microbiological findings were evaluated for associations with CBCT, micro-CT and histopathologic data. An association between lesion size and the proportion of unfilled apical canal system volume was also assessed. Results: All cryopulverized specimens were positive for total bacteria. Actinobacteria and streptococci occurred in 35 and 33 specimens, respectively, and were usually dominant in the community. Actinobacteria counts were 2.23 times higher in granulomas than in cysts. Streptococcus were significantly more present in small lesion cases. E. faecalis was detected in only 7 samples, always as a dominant community member. Association of total bacteria, streptococci and Actinobacteria counts with the unfilled canal volume was significant in the univariate analyses, but not confirmed in the adjusted analyses. Large lesions were significantly associated with a higher volume of unfilled apical canal. Conclusions: Bacterial infection occurred in all root apices, with high prevalence and dominance of Actinobacteria and streptococci. The volume of unfilled apical canal system was significantly associated with the lesion size and possibly with bacterial counts. Findings illustrate the need to thoroughly disinfect and fill the apical root canal of infected teeth during endodontic therapy.
Root canal treatment and apical periodontitis: What can be learned from observational studies?
Endodontic Topics, 2008
To assess the disease burden in the general population, observational studies and epidemiological methods must be employed. Epidemiological studies describe the distribution of diseases, prevalence, and incidence; they can be used to identify causative relationships or pathways and may form the basis for an intervention strategy. The aim of the present paper is to review previously conducted observational studies on root canal treatment and apical periodontitis (AP). Clinical studies focus on the treatment of a diseased tooth and estimate success rates of a specific treatment. Longitudinal observational studies focus on all teeth, treated/untreated as well as healthy/unhealthy, and may provide knowledge of disease incidence and/or persistence. Findings from the two types of studies reveal that the factors found to be associated with successful outcomes of root canal treatment in clinical studies are similar to the factors found to be related to persistence of AP in observational studies: pre-operative diagnosis, quality of root filling, and coronal restoration. When initially healthy teeth are followed, the observational study provides information that is not obtainable in clinical studies. It has been demonstrated that factors related to the incidence of AP differ slightly from factors related to persistence. It is obvious that besides the quality of the root filling, other factors play a role in relation to AP, in particular the presence of bacteria. Therefore, to estimate the need for root canal treatment and re-treatment in the general population, well-conducted studies, both randomized controlled trials and observational longitudinal studies, are needed.
Influence of apical patency on root canal treatment outcome: a contemporary overview
Journal of Stomatology, 2021
Determining the apical limit of root canal preparation has proved to be a matter of continuous debate. During root canal instrumentation, soft tissue or debris get impacted in the apical region causing canal blockage. This can be avoided if apical patency is maintained. A major concern over apical patency is extrusion causing periapical tissue irritation and delaying or hindering periapical healing. The aim of this review was to evaluate the literature regarding the influence of apical patency on success of root canal treatment. A search of the literature was conducted via PubMed using the terms "apical patency" OR "patency file". Inclusion criteria were: articles published in English, between the years 2000 and 2020, and were neither case reports nor reviews. A total of 32 articles were selected. Clinical studies directly investigating the influence of apical patency on root canal treatment outcome are limited. In-vitro and in-vivo studies were found evaluating amount of extrusion, canal cleanliness, and shaping associated with apical patency examined this influence indirectly. According to the available literature, there is little evidence to contraindicate the use of apical patency or suggest it has a negative effect on root canal treatment outcome. However, more evidence of high quality is required to confirm this.
Apical Periodontitis in Root-Filled Teeth
International Endodontic Journal, 2019
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One versus two visits of endodontic treatment on teeth with apical periodontitis
Journal of Dentomaxillofacial Science, 2016
The microbiological purpose of teeth endodontic treatment with apical periodontitis is to reduce microbes in order to achieve periradicular tissue healing and to prevent microbes recolonized. These are obtained by antimicrobial measures, including chemo-mechanical procedures and intra-canal medication, with root canal obturation steps. One of the problems in endodontic is the planning consideration to give treatment with one or two visits. Performing intra-appointment medication is an absolute measure to promote disinfection and successful treatment. Another purpose of this paper is to provide a reference about one or two visit of endodontic treatment decision making for dental professionals. Root canal system on teeth with apical periodontitis treated in two visits endodontic and calcium hydroxide as the intra-appointment medication achieved better microbiological status than the one treated in one visit endodontic.
International Journal of Dentistry, 2021
Introduction. Apical periodontitis is among the most common pathologies in endodontics. The treatment of apical periodontitis has always been an important occupation in the modern practice of endodontics, and the failure has been associated with nonhermetic root canal filling. With that in mind, bioceramic-based sealers have been incorporated into endodontic practice. The purpose of this study was to evaluate the outcome of nonsurgical root canal treatment (RCT), using a single-cone and Bioroot RCS filling of necrotic teeth with apical periodontitis. Materials and Methods. This follow-up study included patients treated in the department of Restorative Dentistry and Endodontics in the Dental Clinic of Monastir, from January 2018 to December 2019. The study intended to include all adult patients presenting a symptomatic or asymptomatic apical periodontitis. Once the diagnosis was performed, the patients were divided into two groups: a one-session treatment group and a two-session trea...