129 research outputs found
Endodontics / edited by Kishor Gulabivala, BDS, MSc, FDS RCS (Edin), PhD, FHEA, Yuan-Ling Ng, BDS, MSc, MRD RCS (Eng), PhD, FHEA.
No full textIncludes bibliographical references and index.388 pages :Suitable for graduates who wish to consolidate their knowledge, GDPs who need to enhance their skills and any reader about to launch a career through specialist training, this book provides a guide to the practice of clinical endodontics
Species richness of gram-positive coccoid morphotypes isolated from untreated and treated root canals of teeth associated with periapical disease
No full textEThOS - Electronic Theses Online ServiceGBUnited Kingdo
Factors that affect the outcomes of root canal treatment and retreatment – a reframing of the principles
No full textThis paper undertakes a broad and comprehensive synthesis of relevant clinical,
biological, biomechanical, technical and healthcare services data to understand the
factors affecting outcomes of periapical healing after root canal (re)treatment. The
medical and dental evidence-based
era (1980–present)
is contextualized with the earlier
evidence drive in endodontics (1911–1940)
triggered by the focal infection era.
The current evidence-based
approach has a sharper focus on evidence quality and
derivation of practice guidelines. Contrary views question whether guideline-driven,
or expertise-development-
driven
endeavours would best serve outcome improvement
in society. The endodontic discipline functions in a broad healthcare framework
and sustains industrial, economic and trend pressures that may be deemed to
influence outcomes. The nature of root canal treatment and the challenges in determining
the factors that affect its outcomes is discussed. The factors potentially affecting
periapical healing after root canal treatment are classified into pre-operative,
intra-operative
and postoperative groups. These categories subsume multiple elements
with interactive influences, creating a complex picture, further confounded
by some apparently surprising, counter-intuitive
and contradictory findings. The
technical versus biological conundrum in root canal treatment continues to cause
cognitive dissonance. However, due reflection and cross-discipline-
synthesis
resolve
the apparent data conflicts into a very simple, consistent and plausible picture of how
root canal treatment works and the key factors that affect periapical healing. Root
canal retreatment is considered mainly in the context of its differences from primary
treatment as the majority of factors influencing outcomes are common to both. The
exceptional difference is that retreatments have a proportionately reduced probability
of healing by virtue of compromised apical root canal ramification access or modified
host/infection interactions. Root canal (re)treatment outcomes are dominantly
influenced by the nature of prior dynamic host/infection interaction (pre-operative
patient factors) and how the direction of this dynamic is influenced by two factors:
(1) the active efficacy of the operators' root canal treatment protocol to sustain a microbial
ecological shift (intra-operative
treatment factors) and dampen periapical inflammation;
and (2) the passive ability of the functional tooth (and its restoration margin) to maintain its integrity to resist infection reversal (postoperative restorative
factors)
Survival against the odds: microbiology of root canals associated with post-treatment disease
No full textFactors that influence the outcomes of surgical endodontic treatment
No full textSurgical endodontic treatment encompasses a broad spectrum of procedures, amongst which root-end cavity preparation and filling, retrograde root canal treatment and through-and-through endodontic surgery, may be classified under the umbrella term ‘Root-end surgery’. This narrative review considers the available data on periapical healing, soft tissue healing, tooth survival and oral health-related quality of life (OHRQoL), following root-end surgery and the factors that affect its outcomes. The pooled periapical healed rate for the studies published up to 2021 was 69% (95% CI: 65%, 73%) but increased to 76% (95% CI: 66%, 86%) when only data from the 2020's studies were analysed. The prognostic factors consistently reported for periapical healing have included: pre-operative periapical lesion with complete loss of buccal plate, quality of root-end preparation, remaining thickness of apical root dentine and restorative status. Soft tissue healing of the reflected flap was found to have a positive association with periapical healing. The survival rates following root-end surgery range from 48% to 93%, with failure of periapical healing associated with root and crown fracture, being the predominant reasons for tooth extraction. The factors influencing impact of root-end surgery on patients' quality of life could not be adequately evaluated due to design flaws in the available studies. In conclusion, if root canal treatment failure due to leakage through cracks, fractures or restoration margin are excluded, the remaining cases may represent localized residual infection and inflammation at the periapex that should be amenable to predictable management with the aid of modern root-end surgery
Outcome of non-surgical re-treatment
No full textThe purpose of this review was to critically analyze the relevant literature in order to synthesize an overview on the clinical outcomes (radiographically judged periapical healing and tooth survival) following root canal re‐treatment and the factors influencing them. A further aim was to explain the findings on the basis of current knowledge and understanding. The relevant literature was captured and critiqued using the principles of a systematic review. The data were classified into a coherent structure for analyses and presentation but are not presented as a systematic review; rather, the authors have chosen a narrative style to enable integration of the clinical outcomes with relevant findings from laboratory and animal studies. Overall, the outcomes were similar to those for teeth undergoing primary treatment with common factors influencing the outcomes. The major differences between the outcomes of primary and secondary root canal (re‐)treatment reside only in the ability to predictably access and negotiate the root canal system to the (residual) apical infection. The data offer a very favorable prognosis for non‐surgical root canal re‐treatment performed to guideline standards
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