Incidence and Impact of Painful Exacerbations in a Cohort with Post-treatment Persistent Endodontic Lesions

Yu, Victoria Soo Hoon; Messer, Harold H.; Yee, Robert; Shen, Leyi

doi:10.1016/j.joen.2011.10.006

Cited by 59 publications

(57 citation statements)

References 19 publications

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“…In a study from Singapore, Yu et al . () reported that only 5.8% of the cases with persistent apical lesions developed flare‐ups over a period of 20 years. Less severe pain was more frequent, although, resulting in a combined incidence of 45% painful teeth over the same period.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of teeth referred to a public dental specialist clinic in endodontics

et al. 2016

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Root filled teeth constituted the majority of cases referred to this specialist clinic in endodontics. The majority of these teeth were associated with symptomatic conditions, and antibiotics were prescribed to approximately 20% of the patients referred for a root filled tooth. The findings suggest that symptomatic root filled teeth may be a substantial clinical problem in general dentistry and contribute to avoidable prescription of antibiotics.

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Section: Introductionmentioning

confidence: 99%

Characteristics of teeth referred to a public dental specialist clinic in endodontics

et al. 2016

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“…Ethical approval was obtained from the Institutional Review Board (NUS-IRB 10-171), and written informed consent was obtained from all patients taking part in the study. The selection of cases, data collection, and scoring of lesion progression included in the final cohort have been described in detail (Yu et al, 2012a(Yu et al, , 2012b. In brief, patients who received root canal treatment for AP from general dentists, endodontic specialists, undergraduate dental students, and endodontic residents at a university-based dental center from 2003 to 2008 whose AP had not resolved at shortterm recall were screened for AP at least 4 yr later.…”

Section: Materials and Methods Selection Of Casesmentioning

confidence: 99%

“…The calibration process was previously reported; weighted Cohen kappa score for interexaminer reliability was 0.716, and weighted Cohen kappa scores for intraexaminer reliability were 0.638 and 0.821 (Yu et al, 2012a). Any disagreements were resolved by discussion and consensus before reporting the final score.…”

Section: Scoring Of Lesion Progressionmentioning

confidence: 99%

“…It can remain asymptomatic or progress to symptomatic AP, which affects daily living and prompts patients to seek treatment (Iqbal et al, 2009;Yu et al, 2012a;Grönholm et al, 2013). Although accepted quality guidelines (European Society of Endodontology, 2006) recommend intervention (retreatment or apical surgery) for AP persisting for 4 yr or more, asymptomatic persistent AP may be compatible with health if the tooth remains functional (Friedman and Mor, 2004) and may even be capable of further healing over prolonged periods beyond 4 yr (Molven et al, 2002;Fristad et al, 2004;Yu et al, 2012b).…”

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confidence: 99%

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Risk Score Algorithm for Treatment of Persistent Apical Periodontitis

Khin

Hsu

et al. 2014

J Dent Res

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Persistent apical periodontitis related to a nonvital tooth that does not resolve following root canal treatment may be compatible with health and may not require further intervention. This research aimed to develop a Deterioration Risk Score (DRS) to differentiate lesions requiring further intervention from lesions likely to be compatible with health. In this cross-sectional study, patient records (2003-2008) were screened for root-filled teeth with periapical radiolucency visible on periapical radiographs taken at treatment and at recruitment at least 4 yr later. The final sample consisted of 228 lesions in 182 patients. Potential demographic and treatment risk factors were screened against 3 categorical outcomes (improved/unchanged/deteriorated), and a multivariate independent multinomial probit regression model was built. A 5-level DRS was constructed by summing values of adjusted regression coefficients in the model, based on predicted probabilities of deterioration. Most lesions (127, 55.7%) had improved over time, while 32 (14.0%) remained unchanged, and 69 (30.3%) had deteriorated. Significant predictors of deterioration were as follows: time since treatment (relative risk [RR]: 1.11, 95% confidence interval [CI]: 1.01-1.22, p = .030, rounded beta value = 1, for every year increase after 4 yr), current pain (RR: 3.79, 95% CI: 1.48-9.70, p = .005, rounded beta value = 13), sinus tract present (RR: 4.13, 95% CI: 1.11-15.29, p = .034, rounded beta value = 14), and lesion size (RR: 7.20, 95% CI: 3.70-14.02, p < .001, rounded beta value = 20). Persistent apical periodontitis with DRS <15 represented very low risk; 15-20, low risk; 21-30, moderate risk; 31-40, high risk; and >40, very high risk. DRS could help the clinician identify persistent apical periodontitis at low risk for deterioration, and it would not require intervention. When validated, this tool could reduce the risk of overtreatment and contribute toward targeted care and better efficiency in the timely management of disease.

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“…Most persistent lesions remain asymptomatic [22][23][24], Friedman's study [25] introduce the concept of asymptomatic function. In addition to the groups ''healed,'' ''healing,'' and ''non-healed,'' the American Association of Endodontists has added the group ''functional'' to endodontic treatment outcomes [26].…”

Section: Introductionmentioning

confidence: 99%

Relationship between Clinical and Histopathologic Findings of 40 Periapical Lesions

Enríquez¹

2015

Dentistry

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Purpose: To relate the clinical and histopathological findings of periapical inflammatory lesions treated by endodontic surgery with the results of histopathological investigation of the same lesions. Materials and methods:Forty biopsies obtained during periapical surgery were histologically analyzed following curettage of the tissue, establishing the diagnosis as either periapical granuloma, radicular cyst, or abscess. The radiographic size of the lesion (area in cm 2 ) before surgery and after 2 years of follow-up was measured. The evolution at 48 months after surgery was evaluated according to the criteria of von Arx and Kurt. A statistical study was made, the inter-variable relationships were studied using analysis of variance with subsequent Tukey testing and calculation of Pearson's correlation coefficient. The hypothesis tests were conducted at the 0.05 level of significance. Results:Results indicated that 26 (65%) were women and 14 (35%) men at a mean age of 43.54 years (range, 18 to 69 years) with 40 biopsy samples. 65.5% of lesions were granulomas, 20% cysts, and 17.5% abscess. The results showed that tooth lower second molar had a high percentage of periapical lesion corresponding to periapical granuloma associated with overfilled canals. Conclusions:The outcomes of the present study show a high number of periapical granulomas among periapical cysts and confirms that periapical granulomas are the most common periapical lesions of endodontic origin associated with persistent apical periodontitis.

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Incidence and Impact of Painful Exacerbations in a Cohort with Post-treatment Persistent Endodontic Lesions

Cited by 59 publications

References 19 publications

Characteristics of teeth referred to a public dental specialist clinic in endodontics

Characteristics of teeth referred to a public dental specialist clinic in endodontics

Risk Score Algorithm for Treatment of Persistent Apical Periodontitis

Relationship between Clinical and Histopathologic Findings of 40 Periapical Lesions

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