Radiographic outcome of endodontic treatment and retreatment of teeth with apical periodontitis using two different root canal irrigants. A prospective cohort study

Abstract

AimThe aim of this prospective cohort study was to compare the radiographic outcome of endodontic treatment and retreatment of teeth with apical periodontitis using either 1% sodium hypochlorite (NaOCl) or 2% chlorhexidine digluconate (CHX) for root canal irrigation.Materials and MethodsIn the years from 2013 to 2015 standard irrigation varied by semester between NaOCl and CHX at the Department of Endodontics at the Faculty of Dentistry. During that time, 912 teeth received treatment for apical periodontitis in 744 patients, of whom 532 responded to the request for a 1‐year follow‐up. Only one tooth per person (the most distally located) were included; 285 teeth treated with NaOCl and 247 with CHX. One hundred cases were then randomly sampled from each irrigation group and analysed for outcome by periapical index (PAI) scoring using criteria for success, uncertain and failure. Clinical and other radiographic parameters were scored or recorded and analysed for associations with radiographic outcome using chi‐square, ANOVA and regression analyses.ResultsSuccess rates (PAI score 1 or 2 at control) were nearly identical for the two irrigation liquids. The use of irrigating solution also did not significantly influence the outcome in chi‐square analyses of subgroups of teeth or regression analyses with other variables included. Ordinal regression analysis established that preoperative lesion size or preoperative PAI score were significantly associated with outcome, and teeth in the mandible had significantly better outcomes than in the maxilla.ConclusionsNo significant differences in the radiographic outcome using either 1% NaOCl or 2% CHX as irrigants were found. The outcome was better for teeth with small lesions or lower PAI scores at completion of treatment and for mandibular teeth.

Effects of apical periodontitis treatment on hyperglycaemia in diabetes: A prospective cohort study

“…The standardized RCT protocol was performed by one experienced endodontist, who was blinded to patient allocation regarding the glycaemic level. In this study, as in recent studies (Katle et al, 2024;Zandi et al, 2019), 1% of NaOCl was used as canal disinfectant. Although increased antibacterial effect was observed with higher concentrations of NaOCl, it comes together with higher toxicity.…”