1,721,282 research outputs found
Teeth treated with apicOectomies had acceptable 3-year survival rates, based on insurance claims data
No full textSubjects
This retrospective data analysis was based on the claims data of a major German
national health insurance company (BARMER GEK) that represent about 8.6
million persons. The study data included about 93,797 apicoectomies performed
in 77,636 patients (26,640 men), with a mean age of 50.58 years (standard deviation
of 15.59; range, 8-99 years).
Key Exposure/Study factor
The intervention analyzed was apicoectomy. Diagnosis and tooth condition were
unknown. The observation period was up to 3 years. Most of the apicoectomies
were delivered in anterior teeth (n 5 32,353) and premolars (n 5 32,340) as
compared to molar teeth (n 5 29,104).
Main Outcome Measure
The main outcome measure was tooth survival as evaluated 1, 2, and 3 years after
surgery.
Main Results
The principal finding was that cumulative survival rates for all teeth were 91.4% at
1 year, 85.7% at 2 years, and 81.6% at 3 years. The 3-year survival rate was
highest in anterior teeth (84.0%) and similar in premolars (80.4%) and molars
(80.2%). The difference between anterior teeth and posterior teeth was highly
significant (P ,.0001). The survival rate was higher in men than in women (83.5%
vs 80.6%). This difference was highly significant (P ,.0001). Analyzing survival by
age, significant differences among the age groups were found (P , .0001).
Analysis of survival by age revealed continuously declining survival rates with age
(93.3% for subjects under age 18 years to 75.6% for subjects over age 84 years).
Conclusions
The authors concluded that the survival rates for teeth treated with apicoectomies
are acceptable for an intervention that is primarily conducted as a retreatment after failure of root canal treatment. The study
underlined that the rate of failures as evaluated each year
potentially indicates a minor tendency toward more early
failures
A systematic review on the outcome of surgical vs non-surgical procedure for the retreatment of periapical lesions
No full textThe most common therapeutical options for the retreatment of teeth with periapical pathosis are orthograde treatment and periapical surgery. The aim of this review was to evaluate the outcomes of surgical versus non-surgical retreatment, in order to provide clinicians with evidence-based information for decision making process. Articles were retrieved by electronic search strategy and traditional searching. Articles were selected based on strict inclusion criteria. The first criterion was the success of retreatment, as determined by clinical and radiographic criteria. The outcomes were further dichotomized according to functionality criteria.Two randomized trials (RCTs) were found. One hundred and twenty-six teeth were followed up after one year, and 82 after 4 years. The success rate for surgical treatment after one year was slightly better than non-surgical: 90.7% vs 80.6%, respectively, according to functional criteria. At the four-year evaluation (40 surgically treated and 42 non-surgically treated cases from 1 RCT) the outcomes were similar. A higher early post-operative discomfort was reported for surgically treated cases. There is no apparent advantage of using a surgical or non-surgical approach for the retreatment of periapical lesions in terms of long-term outcome. The choice between the two procedures should rely upon factors other than the mere treatment outcome, such as patient’s initial clinical situation, patient’s preference, operator’s experience and skill, complication risk, technical feasibility, and overall treatment cost. More well-designed RCTs should be performed with a large sample size and at least 4 years follow-up, using modern instrumentation and materials, to detect a true difference in the long term between the outcomes of the two alternative treatments, if any exists
Revisione sistematica della letteratura
No full textObjectives: To present an international literature revision on etiology, epidemiology, diagnosis and therapeutic options of teeth transpositions. Materials and methods: A systematic revision of the literature has been done on Medline database (www.ncbi.nim.nih.gov/pubmed). Keywords chosen were "teeth transposition, canine transposition, mandibular teeth transposition, tooth eruption (ectopic), premolar transposition, incisor transposition, molar transposition" and articles about dental maxillary and mandibular transposition developing with etiology, etiopathology, therapeutic options, results obtained were considered. Among articles, that ones published among 1977 and 2008 were considered. Using limits, only articles referred to humans were considered. Results: In literature different definitions about transposition are present. Etiology is variable, with genetic and extrinsic causes. Besides, variables are also prevalence and incidence, largely influenceable by geography and population. Therapeutic possibilities are different on the basis of the age of the patients, on the type of transposition, on the aesthetic advantage, on the compliance of the patients and on the teeth interested. Conclusions: On the scientific evidences present in literature it is possible to conclude that orthodontic correction of dental transposition is one of the therapeutic possibilities and it is largely influenced by the age of the patient, the eruptive stadium and bone structure. Early diagnosis and treatment are important conditions for reaching a good clinical result
I concentrati piastrinici quale approccio biomimetico capace di innescare e potenziare il processo rigenerativo [Platelet concentrates as biomimetic approach that can trigger and enhance the regeneration process]
No full textDecision-making in endodontics : a systematic review on the success of surgical vs non-surgical procedure for the re-treatment of periapical lesions
No full textThe most common therapeutical options for the retreatment of teeth with periapical pathosis are orthograde treatment and periapical surgery. The aim of this review was to evaluate the outcomes of surgical versus non-surgical retreatment, in order to provide clinicians with evidence-based information for decision making process. Articles were retrieved by electronic search strategy and traditional searching. Articles were selected based on strict inclusion criteria. The first criterion was the success of retreatment, as determined by clinical and radiographic criteria. The outcomes were further dichotomized according to functionality criteria.Two randomized trials (RCTs) were found. One hundred and twenty-six teeth were followed up after one year, and 82 after 4 years. The success rate for surgical treatment after one year was slightly better than non-surgical: 90.7% vs 80.6%, respectively, according to functional criteria. At the four-year evaluation (40 surgically treated and 42 non-surgically treated cases from 1 RCT) the outcomes were similar. A higher early post-operative discomfort was reported for surgically treated cases. There is no apparent advantage of using a surgical or non-surgical approach for the retreatment of periapical lesions in terms of long-term outcome. The choice between the two procedures should rely upon factors other than the mere treatment outcome, such as patient's initial clinical situation, patient's preference, operator's experience and skill, complication risk, technical feasibility, and overall treatment cost. More well-designed RCTs should be performed with a large sample size and at least 4 years follow-up, using modern instrumentation and materials, to detect a true difference in the long term between the outcomes of the two alternative treatments, if any exists
Revisione sistematica della letteratura sull’effetto dei concentrati piastrinici nel trattamento chirurgico dei difetti parodontali
No full textObiettivi
Scopo di questa revisione della letteratura è valutare in modo sistematico gli effetti dei concentrati piastrinici autogeni (CP) in aggiunta al trattamento chirurgico dei difetti parodontali.
Materiali e metodi
È stata effettuata una ricerca elettronica in MedLine, Em-Base e Cochrane Central Register of Controlled Trials utilizzando specifiche parole chiave. È stata eseguita anche una ricerca manuale nell’ambito delle principali riviste nel campo della parodontologia. Sono stati inclusi solo gli studi randomizzati. Il livello di attaccamento clinico era la principale variabile di successo per i difetti intraossei parodontali. L’aumento della copertura radicolare e l’aumento della cheratinizzazione tissutale erano le principali variabili della recessione gengivale. Per l’analisi statistica tutti i dati sono stati normalizzati rispetto ai valori basali. È stato valutato anche il rischio di bias degli studi inclusi. Per i difetti intraossei sono state analizzate anche le influenze della rigenerazione tissutale guidata (Guided Tissue Regeneration, GTR), del tipo di studio (split-mouth vs studi paralleli) e del tipo di CP (Platelet Rich Plasma, PRP, vs Platelet Rich Fibrin, PRF).
Risultati
Dei 456 articoli inizialmente esaminati, 48 erano idonei e ne è stato analizzato il testo completo. Infine, 34 studi sono stati inclusi: 24 studi sui difetti parodontali intraossei, 7 studi sulla recessione gengivale e 3 studi sui difetti di forcazione. È stato rilevato un significativo effetto positivo dell’aggiunta del CP nel trattamento dei difetti intraossei. Tale effetto era amplificato negli studi in cui non si utilizzava la GTR, mentre negli studi con GTR l’uso del CP non aveva un effetto adiuvante. Non è stato trovato alcun effetto del tipo di studio, della durata del follow-up o del tipo di CP. Tutti gli studi split-mouth (eccetto uno in cui è stata utilizzata la GTR) hanno mostrato un significativo effetto positivo del CP. Per il trattamento della recessione gengivale non è stato trovato alcun beneficio significativo del CP. Per il trattamento dei difetti di forcazione sono stati riportati vantaggi positivi del CP, ma non si è potuta eseguire alcuna metanalisi a causa dell’eterogeneità degli studi.Objectives The aim of this review was to systematically evaluate the effects of autogenous platelet concentrates (PC) as an adjunct to the surgical treatment of periodontal defects.
Materials and methods
An electronic search was performed on MedLine, EmBase, and the Cochrane Central Register of Controlled Trials using specific search terms. A manual search of the main journals in the field of periodontology was also performed. Only randomized trials were included. The clinical attachment level was the primary outcome variable for periodontal intrabony defects. Root coverage and keratinized tissue increase was the main variable for gingival recession. For the statistical analysis all data were normalized to baseline values. The risk of bias of the included studies was also assessed. For intrabony defects, the influences of Guided Tissue Regeneration (GTR), of the study type (split-mouth vs parallel studies), and of the type of PC (Platelet Rich Plasma, PRP, vs Platelet Rich Fibrin, PRF) were also evaluated.
Results
Of the 456 studies initially retrieved, 48 were eligible and their full text was examined. Finally, 34 studies were included: 24 studies on periodontal intrabony defects, 7 studies on gingival recession, and 3 studies on furcation defects. A significant positive effect of the adjunct of PC was found for intrabony defects. Such an effect was magnified in studies in which GTR was not used, whereas in studies that used GTR, the use of PC had no adjunctive effect. No effect of the study type, of the follow-up duration or of the type of PC was observed. All split-mouth studies (except one in which GTR was used) displayed a significant positive effect of PC. No significant effect of PC was found for gingival recession treatment. Significant benefits of PC were reported for furcation treatment but, due to heterogeneity of the studies, no meta-analysis could be done.
Conclusions
The use of PC may exert a positive adjunctive effect for the treatment of intrabony defects when used in combination with graft materials, but not with GTR. No significant adjunctive benefit of PC could be demonstrated for the treatment of gingival recession and furcation defects. A standardization of study design and clinical protocols is needed in future studies in order to gain more insight into the true effect of PC in periodontal regeneration
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