Radiographic Study of the Problems and Failures of Endodontic Treatment

Akbar, Iftikhar

doi:10.12816/0024104

Cited by 31 publications

(37 citation statements)

References 29 publications

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“…Perforation was the reason for extraction in 2.9% of cases; prosthetic reasons dominated (40.8%). Reports from some Middle East countries present perforations in 1% of endodontic failures in Iran [8,9] or from 3 [10] to 5.5% [11] of those in Saudi Arabia. These reports evaluated 90-150 failure cases, except for the first mentioned study, which assessed 1335 cases.…”

Section: Introductionmentioning

confidence: 99%

Accidental perforations during root canal treatment: an 8-year nationwide perspective on healthcare malpractice claims

Vehkalahti

Swanljung

2020

Clin Oral Invest

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Objectives To assess occurrence and its variation over time of serious accidental perforations during endodontic treatment and the fate of perforated teeth by tooth type and characteristics of patients and dentists. Materials and methods Data, based on patient documents on healthcare malpractice claims, comprised all endodontic injuries (n = 970) verified by the Patient Insurance Centre in Finland in 2002-2006 and 2011-2013. Two specialists in endodontics scrutinized the documents. Accidental perforations were recorded by location (tooth type, chamber/canals) and dichotomized as avoidable (could have been avoided by following good clinical practice) or unavoidable (normal treatment-related risks). Fate of perforation cases was recorded as treatment discontinued, root canal(s) filled, or tooth extracted. Background information included patients' and dentists' sex and age and the service sector. Statistical evaluation used Chi-square tests. Results Serious accidental perforations comprised 29% of all verified injuries. Most perforations were judged as avoidable: 93% in patients aged below 35 years, 87% when located in the pulp chamber or in molars (84%); 70% of all perforations and 75% of those in molars resulted in tooth extraction. The overall rate of serious accidental perforations was 17.6 cases per 100,000 endodontic patients per year. Conclusions The rate of serious accidental perforations increased over time. The majority was in molars and resulted in tooth extraction. Clinical relevance Accidental perforations comprise almost a third of serious injuries during root canal treatment. However, four of five perforations could be avoided by following good clinical practice. Therefore, training is needed before adopting new working equipment and methods.

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Section: Introductionmentioning

confidence: 99%

Accidental perforations during root canal treatment: an 8-year nationwide perspective on healthcare malpractice claims

Vehkalahti

Swanljung

2020

Clin Oral Invest

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“…However, to our knowledge, there is no specific mention regarding the evaluation of the danger zone at the furcation area, neither any study validating the use of CBCT for this purpose. The need of this investigation is justified by the high prevalence of strip perforation accidents at the furcation area, reported by several articles [3][4][5][6] , suggesting that the understanding of the danger zone may be an important step during endodontic treatment planning. Preparation of the cervical and middle thirds provides countless advantages for endodontic treatment, enabling free and direct access for the entire actual working length.…”

Section: Introductionmentioning

confidence: 99%

Validation of cone beam computed tomography as a clinical imaging method for dentin thickness measurement in the danger zone of mandibular molars

Corrêa

Flores

Marquezan

et al. 2018

Rev. da Fac. de Odontologia, UPF

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Objective: to verify the accuracy of cone beam computedtomography (CBCT) for measuring dentin thicknessin the danger zone of mandibular molars in order to validatethis method to be used as a clinical auxiliary. Materialsand method: dentin thickness of the distal wall ofmesial canals was measured at 2 mm of furcation areain ten mandibular molars before and after preparation ofcervical and middle thirds. CBCT (0.25 mm voxel size)and stereomicroscopy images were acquired twice foreach sample. CBCT axial images and stereomicroscopeimages were evaluated by a calibrated examiner. Statisticalanalysis was performed using Mann-Whitney testin order to investigate whether CBCT images providedtrusted values. Results: mean values of initial (1.23 versus1.24 mm) and final measurements (0.88 versus 0.87mm) obtained with, respectively, CBCT and stereomicroscopemethods did not show statistical differences(P > 0.5). Conclusion: CBCT images provide high accuracyfor measuring dentin thickness in the danger zoneof mandibular molars.Keywords: Cone beam computed tomography. Endodontics.Root canal preparation.

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“…1 The main cause could be a result of inadequate root canal illing, extravasation of illing materials into the periapical region, poor coronal sealing, or non-instrumented root canals (primary and accessory). 1 The main cause could be a result of inadequate root canal illing, extravasation of illing materials into the periapical region, poor coronal sealing, or non-instrumented root canals (primary and accessory).…”

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confidence: 99%

“…O ne of the main causes of endodontic failure is the presence of pathogenic agents in the root canal system, resulting in persistent periapical lesions. 1 The main cause could be a result of inadequate root canal illing, extravasation of illing materials into the periapical region, poor coronal sealing, or non-instrumented root canals (primary and accessory). Adequate cleaning and shaping are essential to eliminate microorganisms and ensure successful treatment.…”

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confidence: 99%

“…Adequate cleaning and shaping are essential to eliminate microorganisms and ensure successful treatment. 1,2 Non-microbial factors leading to failure of endodontic treatment include iatrogenic errors such as over-instrumentation, root canal perforation, and instrument fracture, 2 root fracture, 3 internal and external root resorption, [4][5][6] and post deviation. 7 Endodontic complications represent a challenge to the dental practitioner, making early diagnosis crucial.…”

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confidence: 99%

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Effectiveness of Using a Mobile App to Improve Dental Students’ Ability to Identify Endodontic Complications from Periapical Radiographs

Oliveira

Verner

Kamburoğlu

et al. 2019

Journal of Dental Education

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The aim of this study was to evaluate the feasibility and efectiveness of a mobile application as a supplementary tool in the radiographic diagnosis of endodontic complications by dental students. Radiographic images of the following endodontic conditions were selected: 1) absence of endodontic treatment (ET) without periapical lesion (PL); 2) absence of ET with PL; 3) satisfactory ET without PL; 4) satisfactory ET with PL; 5) unsatisfactory ET without PL; 6) unsatisfactory ET with PL; 7) fractured instrument; 8) deviated cast post; 9) root fracture; and 10) root resorption. In 2018, images were evaluated by 20 students at a dental school in Brazil who had been divided into experimental and control groups. The experimental group was permitted to use the Kahoot! mobile application (app) to access reference images of endodontic conditions. Reference standards were established through consensus by two endodontists and three oral radiologists. The results showed that intraobserver agreement ranged from moderate to substantial for both groups. Signiicant diferences from the specialists' reference standards were found in the evaluation of conditions 4 and 10 for the experimental group, which used the app (p<0.001), and conditions 1, 4, 6, 7, 8, and 10 for the control group, which did not use the app (p<0.05). No statistically signiicant diferences were found in accuracy, sensitivity, or speciicity values between the groups for any of the endodontic conditions evaluated (p>0.05). This study found that the use of a mobile app containing reference images improved the students' ability to diagnose endodontic complications, suggesting it would be a valuable supplementary tool in dental education.

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Radiographic Study of the Problems and Failures of Endodontic Treatment

Cited by 31 publications

References 29 publications

Accidental perforations during root canal treatment: an 8-year nationwide perspective on healthcare malpractice claims

Accidental perforations during root canal treatment: an 8-year nationwide perspective on healthcare malpractice claims

Validation of cone beam computed tomography as a clinical imaging method for dentin thickness measurement in the danger zone of mandibular molars

Effectiveness of Using a Mobile App to Improve Dental Students’ Ability to Identify Endodontic Complications from Periapical Radiographs

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