Long-term results of endodontic treatment performed with a standardized technique

Kerekes, Kasmer; Tronstad, Leif

doi:10.1016/s0099-2399(79)80154-5

Cited by 461 publications

(387 citation statements)

References 9 publications

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“…A tooth without periapical radiolucency has a higher endodontic success rate upon treatment than a tooth with a radiolucency (5)(6)(7)(8). Likewise, teeth that are obturated after a negative culture have a better prognosis than those obturated following a positive culture (9 -11).…”

mentioning

confidence: 99%

Reduction of Intracanal Bacteria Using GT Rotary Instrumentation, 5.25% NaOCl, EDTA, and Ca(OH)2

McGurkin-Smith

Trope

Caplan

et al. 2005

Journal of Endodontics

158

125

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This study was conducted to determine the bacterial reduction using Profile GT® files and a strict irrigation protocol utilizing 5.25% NaOCl and EDTA. The additive antibacterial effect of Ca(OH) 2 was also evaluated. In addition, the study compared the bacterial reduction with the GT protocol versus larger instrumentation. Thirty-one subjects with apical periodontitis were recruited. Bacterial samples were taken upon access (S1), after instrumentation and a strict irrigation protocol (S2), and following Ͼ1 wk of Ca(OH) 2 (SC). A log 10 transformation of colony forming units was done since sample bacterial counts are not normally distributed. At S1, 93.55% of canals sampled bacteria. At S2, 52.72% of the cases sampled bacteria. At SC, 14% of the cases cultured bacteria. The McNemar test showed a significant reduction (p Ͻ 0.0009) in bacteria between S1 and S2. This was also true between S2 and SC (p Ͻ 0.0019). It was concluded the GT protocol significantly reduced the number of bacteria in the canal but failed to render the canal bacteria free in more than half of the cases Ca(OH) 2 application significantly further reduced bacteria. Lastly, large apical instrumentation removed more bacteria than small apical instrumentation.This study was funded in part by a grant from The Amer- (1-4).Because bacteria are the cause of apical periodontitis, it is logical that the elimination of bacteria would cure apical periodontitis. A tooth without periapical radiolucency has a higher endodontic success rate upon treatment than a tooth with a radiolucency (5-8). Likewise, teeth that are obturated after a negative culture have a better prognosis than those obturated following a positive culture (9 -11). Although there is substantial evidence that a negative culture does not equate to bacteria free (12-14), there is a threshold level of bacteria below that gives a negative sample and a success rate similar to teeth treated without apical periodontitis (11).The current technique for bacterial reduction includes instrumentation, irrigation with NaOCl and an intracanal antimicrobial medication. showed that each step leads to less bacteria and eventually a canal that does not sample bacteria. In a 5 yr follow-up study, root canal samples that gave a negative culture following these steps were recalled to evaluate healing. Ninety-five percent of these cases showed complete radiographic healing or a decrease in the radiolucency size (10).A recent series of studies have been carried out where NiTi instruments were used in place of stainless steel files (19 -21). Similar to the Bystrom and Sunqvist (15) findings, Dalton et al. (19) found that while instrumentation decreased the number of canals that cultured bacteria, instrumentation alone does not predictable result in canals that did not culture bacteria. Shuping at al (20). evaluated the bacterial reduction following the addition of 1.25% NaOCl irrigation and Ca(OH)2 to NiTi instrumentation. Similar to previous studies, Shuping et al. (20) found that instrumentation and i...

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confidence: 99%

Reduction of Intracanal Bacteria Using GT Rotary Instrumentation, 5.25% NaOCl, EDTA, and Ca(OH)2

McGurkin-Smith

Trope

Caplan

et al. 2005

Journal of Endodontics

158

125

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“…8,9 Nonsurgical remedies for file fracture consist of three strategies: removal of fractured instrument from canal space, to bypass the fractured file and instrument in the apical third and if above two are not possible then prepare and obturate the accessible part of the canal. 2 Presence of separated instrument in the canal hinders accessibility to the apical terminus thus compromising cleaning and shaping procedure. Hence, attempt to retrieve the separated instrument is considered as a more favorable removal include excessive loss of dentin, perforation, extrusion of the fragment beyond the root and temperature rise on external root surface.…”

Section: Jcdmentioning

confidence: 99%

“…1 It has been reported that the prevalence of separated instrument ranges from 2 to 6% by Tronstad et al 2 and 0.5 to 5% by Iqbal et al 3 Unfortunately, even with the advent of nickel-titanium (NiTi) alloy which are more resistant to fracture there has not been any significant decline in the incidence of instrument separation. Whereas separation rates of stainless steel instruments have been reported to range between 0.25 and 6%, the separation rate of NiTi rotary instruments has been reported to range between 1.3 and 10.0%.…”

Section: Introductionmentioning

confidence: 99%

Retrieval of Separated Instrument using Ultrasonics in a Permanent Mandibular Second Molar: A Case Report

Shenoy¹,

Sokhi²

2014

Journal of Contemporary Dentistry

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Clinicians are frequently challenged by endodontically treated teeth that have obstructions, such as hard impenetrable pastes, separated instruments, silver points or posts in their root canals. Intracanal separation of endodontic instruments may hinder cleaning and shaping procedures within the root canal system, with a potential impact on the outcome of treatment. Broken instruments usually prevent access to the apex and the prognosis of teeth with broken instruments in the canals may be lower than for normal ones. The prognosis of these cases mainly depends on the preoperative condition of the periapical tissues. For these reasons, an attempt to remove broken instruments should be undertaken in every case.Ultrasonics have often been advocated for the removal of broken instruments because the ultrasonic tips or endosonic files may be used deep in the root canal system. Furthermore, the use of an ultrasonic endodontic device is not restricted by the position of the fragment in the root canal or the tooth involved. This case report elaborates on retrieval of broken instrument lodged in the coronal third of the root canal using ultrasonics and dental operating microscope.

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“…There is substantial evidence that the technical quality of root canal fillings has a significant impact on the outcome of the treatment and long-term retention of endodontically treated teeth 1 . Many studies reported that root canal fillings placed within 0-2 mm of the radiographic apex are associated with lesser chances of radiographic and clinical failures than those that are under-filled or over-filled [2][3][4][5][6] . Clinical audit is defined as a quality improvement process that seeks to improve patient care and outcomes by systematic review of care against explicit criteria and the implementation of change.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with the technical quality of root canal fillings performed by undergraduate dental students in a Malaysian Dental School

et al. 2016

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Aim: A retrospective clinical audit was carried out on records of endodontic treatment performed by dental undergraduates. The audit was performed to evaluate the technical quality of root canal fillings performed by dental undergraduates and determine the associated factors. Methods: 140 records of patients who had received root canal treatment by dental undergraduates were evaluated through periapical radiographs by two examiners (κ =0.74). The root canal fillings had their quality evaluated according to extent, condensation and presence of procedural mishap. Possible factors associated with technical quality such as tooth type, canal curvature, student level and quality of record keeping were evaluated. Data were statistically analyzed using chi-square test (p<0.05). Results: Among the 140 root-filled teeth, acceptable extent, condensation and no-mishap were observed in 72.1%, 66.4% and 77.9% cases respectively. Overall, the technical quality of 68 (48.6%) root-filled teeth was considered acceptable. Overall, non-acceptable root canal fillings were significantly more likely to be observed in molars (69.2%), moderately and severely curved canals (71.4%) and junior students (61.5%). There was no association between acceptable root canal fillings and quality of record keeping. Conclusions: The technical quality of root canal fillings was acceptable in 48.6% cases and it was associated with tooth type, degree of canal curvature and student seniority.

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Long-term results of endodontic treatment performed with a standardized technique

Cited by 461 publications

References 9 publications

Reduction of Intracanal Bacteria Using GT Rotary Instrumentation, 5.25% NaOCl, EDTA, and Ca(OH)2

Reduction of Intracanal Bacteria Using GT Rotary Instrumentation, 5.25% NaOCl, EDTA, and Ca(OH)2

Retrieval of Separated Instrument using Ultrasonics in a Permanent Mandibular Second Molar: A Case Report

Factors associated with the technical quality of root canal fillings performed by undergraduate dental students in a Malaysian Dental School

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