Endodontic retreatment decisions: no consensus

Aryanpour, S; Nieuwenhuysen, John; D’Hoore, William

doi:10.1046/j.1365-2591.1999.00297.x

Cited by 41 publications

(44 citation statements)

References 25 publications

(53 reference statements)

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“…Furthermore, in this study, 42.7% of the teeth were from male subjects, but there was no difference in the final outcome between the male and female groups. This lower rate has been confirmed in other studies as well [5,[18][19][20].…”

Section: Resultssupporting

confidence: 82%

Retrospective study of the healing processes of endodontically treated teeth characterized by osteolytic defects of the periapical area: four-year follow-up

Gusiyska

Gateva

Kabaktchieva

et al. 2016

Biotechnology & Biotechnological Equipment

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One of the main objectives of primary endodontic treatment is the prevention of periapical tissue changes which, in the majority of clinical cases in general practice, does not take place because of the availability of a wide range of precise endodontic instruments. The healing process of the periapical area in teeth with inflammatory bone destruction is still a challenge in contemporary endodontic practice. The aim of this retrospective study was to assess the postoperative healing process of teeth with osteolytic defects in the periapical area. Eightynine endodontically treated teeth (n D 89) were included in the study. The teeth with necrotic pulp and without detectable periapical lesions were successfully treated in 92.9% of the cases. All of the incisors, canines and premolars showed significantly higher probabilities of success (97.8%) than molars (90.9%; P D 0.036). In all monitored teeth, the maxillary first molars with periapical index (PAI) 1 (80.2%), mandibular premolars with PAI3 (75%) and mandibular molars with PAI5 (75%) had the lowest rates of treatment success. In this study, the success rate of teeth with pulp necrosis complicated with a periapical lesion was 89.75% (P > 0.05). The analysis of the results from this study confirmed that the exact orthograde retreatment of the cases with osteolytic defects of the periapical area led to satisfactory healing and regeneration in the periapical area.

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Section: Resultssupporting

confidence: 82%

Retrospective study of the healing processes of endodontically treated teeth characterized by osteolytic defects of the periapical area: four-year follow-up

Gusiyska

Gateva

Kabaktchieva

et al. 2016

Biotechnology & Biotechnological Equipment

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“…Patients usually tend to choose treatment procedures consistent with the clinician's recommendation (18). However, it appears that the recommendations are often subjective and inconsistent, and there is a lack of consensus among dental professionals when making decisions related to retreatment or endodontic surgery (19)(20)(21)(22).…”

mentioning

confidence: 99%

Outcomes of Nonsurgical Retreatment and Endodontic Surgery: A Systematic Review

Torabinejad

Corr

Handysides

et al. 2009

Journal of Endodontics

362

210

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Introduction: The purpose of this systematic review was to compare the clinical and radiographic outcomes of nonsurgical retreatment with those of endodontic surgery to determine which modality offers more favorable outcomes. Methods: The study began with targeted electronic searches of MEDLINE, PubMed, and Cochrane databases, followed with exhaustive hand searching and citation mining for all articles reporting clinical and/or radiographic outcomes for at least a mean follow-up of 2 years for these procedures. Pooled and weighted success rates were determined from a meta-analysis of the data abstracted from the articles. Results: A significantly higher success rate was found for endodontic surgery at 2-4 years (77.8%) compared with nonsurgical retreatment for the same follow-up period (70.9%; P < .05). At 4-6 years, however, this relationship was reversed, with nonsurgical retreatment showing a higher success rate of 83.0% compared with 71.8% for endodontic surgery (P < .05). Insufficient numbers of articles were available to make comparisons after 6 years of follow-up period. Endodontic surgery studies showed a statistically significant decrease in success with each increasing follow-up interval (P < .05). The weighted success for 2-4 years was 77.8%, which declined at 4-6 years to 71.8% and further declined at 6+ years to 62.9% (P < .05). Conversely, the nonsurgical retreatment success rates demonstrated a statistically significant increase in weighted success from 2-4 years (70.9%) to 4-6 years (83.0%; P < .05). Conclusions: On the basis of these results it appears that endodontic surgery offers more favorable initial success, but nonsurgical retreatment offers a more favorable long-term outcome. (J Endod 2009;35:930-937)

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“…In a study on endodontic retreatment decisions, Aryanpour et al [27] reported that the main source of variation among dental students, endodontic staff members and instructors in 10 European dental schools was what they called the 'school effect'. In our study, the school effect became manifest as participants who had had their undergraduate dental education in Eastern Europe or in the Middle East showed the highest CRT when it was associated with recurrent caries, whereas participants who had had their undergraduate training in North America or Asia had the lowest CRT.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Caries at Crown Margins: Making a Decision on Treatment

Alomari

Al-Saiegh²,

Qudeimat³

et al. 2009

Med Princ Pract

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Objective: To evaluate dentists’ treatment choices for a crowned tooth with varying degrees of recurrent caries. Materials and Methods: A total of 158 dentists participated in the study. A paper patient case (PPC) depicting a radiograph showing varying degrees of recurrent caries at the crown margin was used: PPC1 = small carious lesion away from crown margin; PPC2 = small carious lesion at crown margin; PPC3 = small carious lesion at crown margin extending onto the root, and PPC4 = large carious lesion at the margin; PPC5–PPC8 had the same carious conditions as PPC1–PPC4, respectively, but the teeth were non-vital. Participants were asked to indicate their choice of treatment from a list of options for each PPC. Crown removal tendency was computed after dichotomization of the responses for the different cases for each participant. Demographic information, educational background and practice characteristics were collected. Descriptive statistics, logistic regression analysis and paired-sample t test were used to analyse the data at a statistically significant level of p < 0.05. Results: For PPC1 and PPC5, most of the participants recommended management without crown removal (p < 0.05). For PPC6, there was wide disagreement about management (p = 0.81). For all other PPCs, the majority of participants chose to remove the crown before making a treatment decision (p < 0.05). Logistic regression analysis showed that the size of the lesion, vitality of the tooth, participants’ age as well as the undergraduate training background of dentists were factors that affected treatment decisions. Conclusion: The data showed a lack of agreement among dentists regarding the management of recurrent caries around crown margins. Size of the lesion, vitality of the tooth, educational training and experience appeared to be the main factors that affected their decisions.

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Endodontic retreatment decisions: no consensus

Abstract: No clear consensus occurred amongst and within dental schools concerning the clinical management of the 14 cases. The lack of consensus amongst schools seems to be due mainly to chance or uncertainty, but can be partly explained by the 'school effect'.

Cited by 41 publications

References 25 publications

Retrospective study of the healing processes of endodontically treated teeth characterized by osteolytic defects of the periapical area: four-year follow-up

Retrospective study of the healing processes of endodontically treated teeth characterized by osteolytic defects of the periapical area: four-year follow-up

Outcomes of Nonsurgical Retreatment and Endodontic Surgery: A Systematic Review

Recurrent Caries at Crown Margins: Making a Decision on Treatment

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