Investigating acute management of irreversible pulpitis: a survey of general dental practitioners in North East England

Gemmell, Andrew; Stone, Simon; Edwards, D. G.

doi:10.1038/s41415-020-1419-8

Cited by 26 publications

(32 citation statements)

References 39 publications

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“…The dental pulp, when subjected to various external stimuli, such as bacterial invasion, causes an inflammatory reaction in the tissues, resulting in clinical signs and symptoms of reversible and irreversible pulpitis, which can be “reversed” if the harmful stimulus is removed. However, if the stimulus exceeds the innate mechanisms of pulp defense and repair, it becomes painful (acute pain) and irreversible, resulting in pulp necrosis and requiring pulpectomy ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

Etiological factors commonly related to the need of endodontic treatment in individuals with orofacial clefts

Siqueira¹,

Mateo-Castillo²,

Pinto³

et al. 2021

J Clin Exp Dent

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Background Dental treatment is fundamental in the rehabilitation of individuals with orofacial clefts, due to their oral condition; when indicated, endodontic therapy allows elimination of infection of the root canal system. Aim: To analyze, by a retrospective study, the most prevalent type of orofacial cleft, the etiological factors most commonly related to the endodontic treatment need, as well as their success and failure rates. Material and Methods This study analyzed data from 136 records (76 females and 60 males) with mean age of 19 years and 7 months, who met the inclusion criteria. Data were collected including the type of cleft, etiological factors that led to the need of endodontic treatment, as well as their success and failure rates. The statistical analysis was performed by the chi-square, Kruskal-Wallis, Fisher’s Exact and Batista Pike tests. Results Among the etiological factors, were pulp involvement due to caries, endodontic treatment for prosthetic rehabilitation, tooth resorptions, for orthodontic movement, dental trauma and indication of internal tooth bleaching; the most prevalent factor was pulp involvement due to caries. Among all data analyzed, cleft lip and palate presented the highest percentage, and there was predominance of treatment success compared to failure. Conclusions The well-conducted root canal treatment is necessary for dental rehabilitation, maintaining the masticatory function and esthetic harmony of these individuals. Key words: Cleft lip, Cleft palate, Endodontics.

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Section: Discussionmentioning

confidence: 99%

Etiological factors commonly related to the need of endodontic treatment in individuals with orofacial clefts

Siqueira¹,

Mateo-Castillo²,

Pinto³

et al. 2021

J Clin Exp Dent

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“…Si estas maniobras pueden realizarse sólo con instrumentos manuales, será de elección su empleo. (28) En estas intervenciones se procurará la exposición de la pulpa cameral, si es posible la pulpotomía, y su posterior sedación (29) .…”

Section: A) Pulpitis Irreversible Sintomáticaunclassified

Tratamientos endodónticos en el contexto de la pandemia por COVID-19 Tratamientos endodónticos en el contexto de la pandemia por COVID-19

Navós¹

2020

Odonto

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Dado que el coronavirus 2 (SARS-CoV-2) se encuentra predominantemente en las secreciones nasofaríngeas y salivales de pacientes afectados (1,2) , los tratamientos odontológicos deben orientarse hacia la prevención y el control de la propagación de la infección. El alto riesgo de infección se debe a las características implícitas en la consulta odontológica (3) , como la generación de aerosoles y la corta distancia de trabajo a la zona orofaríngea del paciente. (4) Las circunstancias sanitarias a las que nos enfrenta el COVID-19, han demandado nuevas estrategias en la atención odontológica. Existen lineamientos generales (5,6) , a partir de los cuales cada especialidad debió construir su especificidad dentro de los protocolos de atención. En lo que respecta a Endodoncia, aún no existe un número abundante de reportes. Al dia 19/4/2020 la búsqueda en PubMed exhibe los siguientes hallazgos: "Coronavirus COVID 19": 2955 resultados, asociado a "Endodontics": 3 resultados. En la estrategia de la presente revisión se empleó las siguientes palabras clave: COVID-19, SARS-CoV-2, Coronavirus, Aerosol, Dentistry, Endodontics, Infection control y Rubber dam. Los criterios de inclusión en la búsqueda abarcaron artículos completos, informes técnicos y comunicados institucionales y/o gubernamentales, publicados hasta el mes de abril de 2020. Las siguientes sugerencias en el área endodóntica, son las que las evidencias actuales nos permiten realizar hasta la fecha. La Asociación Dental Americana (7) y la Facultad de Odontología Udelar (6) han recomendado posponer los tratamientos odontológicos electivos, realizando sólo aquellos que constituyan una urgencia. La causa más frecuente de consulta de urgencia odontológica, es de origen endodóntico. (8) El primer paso es la evaluación inicial del paciente vía telefónica en el consultorio o en el servicio de salud, de acuerdo a la Fig 1.

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“…Despite this, a recent UK‐based study demonstrated that an antibiotic/corticosteroid dressing (e.g. Ledermix ® Aspen, St Leonards, Australia, or Odontopaste ® ADM, Brisbane, Australia) is most commonly placed following an emergency pulpotomy rather than CH (Gemmell et al, 2020). During the COVID‐19 pandemic, pulpotomy followed by placement of an antibiotic/corticosteroid dressing was recommended to manage symptomatic irreversible pulpitis by the British Endodontic Society in order to reduce intervention (BES, 2020).…”

Section: Introductionmentioning

confidence: 99%

How is carious pulp exposure and symptomatic irreversible pulpitis managed in UK primary dental care?

et al. 2021

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Aim To investigate attitudes and approaches of UK primary care dentists to carrying out vital pulp treatment (VPT) after carious exposure and with additional signs and symptoms indicative of irreversible pulpitis. Methodology An electronic questionnaire was openly distributed via publicly funded (NHS) local dental committees, corporate dental service‐providers, professional societies and social media. Principally NHS practitioners and those from mixed and private practice were targeted, in addition to community and military dental officers, and dental therapists. Participants were asked questions relating to several clinical scenarios, with responses analysed using descriptive statistics. χ2 tests with sequential Bonferroni correction were used to explore variables including the method of remuneration, practitioner type (dentist/therapist), postgraduate qualification(s), place of graduation and years since qualification. Variables with a relationship p ≤ .2 were selected for backwards likelihood ratio logistic modelling. Results In total, 648 primary care practitioners were included for analysis. Calcium hydroxide (CH) was most frequently used for direct pulp caps (DPCs) (398/600; 66.3%) with calcium silicate cements (CSCs) less frequently used (119/600; 19.8%). Rubber dam was used by 222/599 (37.1%) practitioners. A definitive pulpotomy for the management of teeth with signs and symptoms indicative of irreversible pulpitis was selected by 65/613 (10.6%) dentists. The principal barrier for the provision of definitive pulpotomies was a lack of training (602/612; 98.4%). Regression analysis identified NHS practitioners as a good predictor for using CH for DPCs, having shorter emergency appointments, limited access to magnification and not using rubber dam. Non‐UK graduates were more likely to select CSCs, appropriately control pulpal haemorrhage, undertake appropriate postoperative evaluation and use rubber dam. Conclusions Practitioners deviated from evidence‐based guidelines in a number of aspects including material selection, asepsis and case selection. A number of other challenges exist in primary care in providing predictable VPTs, including lack of time and access to magnification. These were most evident in NHS practice, potentially exacerbating existing social health inequalities. Possible inconsistencies in the UK undergraduate curriculum were supported by a lack of association between years since qualification and technique employed as well as the fact that non‐UK graduates and dentists with postgraduate qualifications adhered more to evidence‐based VPT guidelines.

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Investigating acute management of irreversible pulpitis: a survey of general dental practitioners in North East England

Cited by 26 publications

References 39 publications

Etiological factors commonly related to the need of endodontic treatment in individuals with orofacial clefts

Etiological factors commonly related to the need of endodontic treatment in individuals with orofacial clefts

Tratamientos endodónticos en el contexto de la pandemia por COVID-19 Tratamientos endodónticos en el contexto de la pandemia por COVID-19

How is carious pulp exposure and symptomatic irreversible pulpitis managed in UK primary dental care?

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