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Sinsareekul C, Saengthong-Aram P, Limpuangthip N. Survival, complications, and patient-reported outcomes of endodontically treated teeth versus dental implant-supported prostheses: A systematic review. J Prosthet Dent 2025; 133:669-676. [PMID: 38443242 DOI: 10.1016/j.prosdent.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
STATEMENT OF PROBLEM Decision making for compromised teeth involving the choice between endodontic treatment and tooth extraction followed by an implant-supported prosthesis is challenging. However, systematic reviews examining studies using the same patients or clinical settings to provide conclusive evidence regarding the best approach are lacking. PURPOSE The purpose of this systematic review was to compare the survival rate, complications, failure, and patient-reported outcomes of endodontically treated teeth and implant-supported prostheses. MATERIAL AND METHODS After the protocol had been registered at the International Prospective Register of Systematic Reviews (PROSPERO), PubMed, Scopus, and the Cochrane Database of Systematic Reviews were searched from database inception to July 2023 with no language restriction. A manual literature search was performed. The review protocol was based on the population, intervention, comparator, outcome, and study design (PICOS) criteria and included all observational and experimental human studies that directly compared the survival, complications, and patient-reported outcomes of teeth with pulpal and periapical disease after all types of endodontic treatment and subsequent restoration and tooth extraction followed by an implant-supported prosthesis. The risk of bias of the included studies was assessed by using the modified Newcastle-Ottawa scale. RESULTS Eight observational studies were included in this systematic review: 3 retrospective cohort and 5 case-control studies. Three included studies revealed no difference in survival rate between endodontically treated teeth and implant-supported prostheses during the first 3 years, but the survival of endodontically treated teeth declined over time with a higher failure rate than implant-supported prostheses. In contrast, the other 3 included studies reported lower survival rate for implant-supported prostheses and more complications. In terms of patient-reported outcomes, patients were generally satisfied with both treatment modalities, with notable improvements in oral health-related quality of life in those receiving endodontic treatment. CONCLUSIONS Whether implant-supported prostheses or endodontically treated teeth are better in terms of survival outcome is unclear. Improved oral health-related quality of life was found after endodontic treatment.
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Affiliation(s)
- Chanakarn Sinsareekul
- Lecturer, Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | - Nareudee Limpuangthip
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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Ul Haq I, Khan TA, Krukiewicz K. Etiology, pathology, and host-impaired immunity in medical implant-associated infections. J Infect Public Health 2024; 17:189-203. [PMID: 38113816 DOI: 10.1016/j.jiph.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/20/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023] Open
Abstract
Host impaired immunity and pathogens adhesion factors are the key elements in analyzing medical implant-associated infections (MIAI). The infection chances are further influenced by surface properties of implants. This review addresses the medical implant-associated pathogens and summarizes the etiology, pathology, and host-impaired immunity in MIAI. Several bacterial and fungal pathogens have been isolated from MIAI; together, they form cross-kingdom species biofilms and support each other in different ways. The adhesion factors initiate the pathogen's adherence on the implant's surface; however, implant-induced impaired immunity promotes the pathogen's colonization and biofilm formation. Depending on the implant's surface properties, immune cell functions get slow or get exaggerated and cause immunity-induced secondary complications resulting in resistant depression and immuno-incompetent fibro-inflammatory zone that compromise implant's performance. Such consequences lead to the unavoidable and straightforward conclusion for the downstream transformation of new ideas, such as the development of multifunctional implant coatings.
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Affiliation(s)
- Ihtisham Ul Haq
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland; Joint Doctoral School, Silesian University of Technology, Akademicka 2A, 44-100 Gliwice, Poland; Programa de Pós-graduação em Inovação Tecnológica, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil.
| | - Taj Ali Khan
- Division of Infectious Diseases & Global Medicine, Department of Medicine, University of Florida, Gainesville, FL, United States; Institute of Pathology and Diagnostic Medicine, Khyber Medical University, Peshawar, Pakistan.
| | - Katarzyna Krukiewicz
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland; Centre for Organic and Nanohybrid Electronics, Silesian University of Technology, Konarskiego 22B, 44-100 Gliwice, Poland.
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Sequeira DB, Diogo P, Gomes BPFA, Peça J, Santos JMM. Scaffolds for Dentin-Pulp Complex Regeneration. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:7. [PMID: 38276040 PMCID: PMC10821321 DOI: 10.3390/medicina60010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/24/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024]
Abstract
Background and Objectives: Regenerative dentistry aims to regenerate the pulp-dentin complex and restore those of its functions that have become compromised by pulp injury and/or inflammation. Scaffold-based techniques are a regeneration strategy that replicate a biological environment by utilizing a suitable scaffold, which is considered crucial for the successful regeneration of dental pulp. The aim of the present review is to address the main characteristics of the different scaffolds, as well as their application in dentin-pulp complex regeneration. Materials and Methods: A narrative review was conducted by two independent reviewers to answer the research question: What type of scaffolds can be used in dentin-pulp complex regeneration? An electronic search of PubMed, EMBASE and Cochrane library databases was undertaken. Keywords including "pulp-dentin regeneration scaffold" and "pulp-dentin complex regeneration" were used. To locate additional reports, reference mining of the identified papers was undertaken. Results: A wide variety of biomaterials is already available for tissue engineering and can be broadly categorized into two groups: (i) natural, and (ii) synthetic, scaffolds. Natural scaffolds often contain bioactive molecules, growth factors, and signaling cues that can positively influence cell behavior. These signaling molecules can promote specific cellular responses, such as cell proliferation and differentiation, crucial for effective tissue regeneration. Synthetic scaffolds offer flexibility in design and can be tailored to meet specific requirements, such as size, shape, and mechanical properties. Moreover, they can be functionalized with bioactive molecules, growth factors, or signaling cues to enhance their biological properties and the manufacturing process can be standardized, ensuring consistent quality for widespread clinical use. Conclusions: There is still a lack of evidence to determine the optimal scaffold composition that meets the specific requirements and complexities needed for effectively promoting dental pulp tissue engineering and achieving successful clinical outcomes.
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Affiliation(s)
- Diana B. Sequeira
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal (P.D.)
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal;
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Patrícia Diogo
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal (P.D.)
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Brenda P. F. A. Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas—UNICAMP, Piracicaba 13083-970, Brazil;
| | - João Peça
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal;
- Department of Life Sciences, Faculty of Science and Technology, University of Coimbra, 3000-456 Coimbra, Portugal
| | - João Miguel Marques Santos
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal (P.D.)
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
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Zang HL, Zhang Y, Hao XW, Yang L, Liang YH. Cost-effectiveness analysis: nonsurgical root canal treatment versus single-tooth implant. BMC Oral Health 2023; 23:489. [PMID: 37454076 PMCID: PMC10349452 DOI: 10.1186/s12903-023-03173-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Economic evaluation of nonsurgical root canal treatment (NSRCT) and single-tooth implant (STI) provides useful information for medical decision. This retrospective study aimed to evaluate the cost-effectiveness of NSRCT versus single-tooth implant (STI) after 5-year treatment in a university affiliated hospital in Beijing, China. METHODS 211 patients who underwent NSRCT and 142 patients who had STI were included and recalled after 5-year treatment. The propensity scores were used to match the cases of two treatment modalities. At recall, outcomes were determined based on clinical and radiographical examinations. For endodontically treated cases, absence or reduction of radiolucency were defined as success. Marginal bone loss (MBL) ≤ 4 mm were determined as success for implant cases. Direct and indirect costs were calculated in China Yuan (CNY). Patients' willingness to pay (WTP) for each treatment modality was evaluated by questionnaires. A cost-effectiveness analysis was performed from the societal perspective. RESULTS 170 patients with 120 NSRCT teeth and 96 STI were available at recall. Based on propensity score matching, 76 endodontically treated teeth were matched to 76 implants. Absence of the radiolucency was observed in 58 of 76 endodontically treated teeth (76%) and reduction of the radiolucency in 9 of 76 teeth (12%) and altogether the success rate was 88%. 100% implants were detected with marginal bone loss (MBL) ≤ 4 mm. The cost advantage of NSRCT (4,751 CNY) over STI (20,298 CNY) was more pronounced. Incremental cost effectiveness ratio (ICER) was 129,563 CNY (STI-NSRCT) per success rate gained. It exceeded the patients' willingness to pay value 7,533 CNY. CONCLUSIONS Clinical outcomes of NSRCT and STI could be predictable after 5-year treatment. NSRCT may be more cost-effective than STI for managing endodontically diseased teeth.
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Affiliation(s)
- Hai-Ling Zang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Department of Stomatology, Peking University International Hospital, Beijing, China
| | - Yu Zhang
- Department of Implantology, Peking University School and Hospital of Stomatology & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Xiao-Wen Hao
- Department of Implantology, Peking University School and Hospital of Stomatology & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Li Yang
- Department of Health Policy and Management, School of Public Health, Peking University, NO.38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Yu-Hong Liang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China.
- Department of Stomatology, Peking University International Hospital, Beijing, China.
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Sanz E, Azabal M, Arias A. Quality of life and satisfaction of patients two years after endodontic and dental implant treatments performed by experienced practitioners. J Dent 2022; 125:104280. [PMID: 36075535 DOI: 10.1016/j.jdent.2022.104280] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVES To compare oral health related quality of life (OHRQoL) and patients´ satisfaction with root canal treatment (RCT) and dental implant (DI) therapy performed by experienced practitioners. METHODS Patients with both an RCT and a DI performed respectively by an endodontist and an oral surgeon with more than 15 years of experience two years prior to the study were included. The survival and satisfactory outcome of both treatments were verified with clinical and radiographic data. Participants completed two constructed questionnaire (one for each treatment). OHRQoL assessment included 24 items (OHIP-14 plus other relevant 10 items from the original OHIP-49 questionnaire). Satisfaction regarding duration, cost and pain (both during and after treatment) of treatment was assessed with a 0-10 scale and perceptions with true/false questions. Weighted sums for each dimension, total OHIP scores, prevalence of impact and general satisfaction of patients were then calculated for DI and RCT and compared using the Wilcoxon test for related samples. Patients´ perceptions were compared with Chi-square test. RESULTS Total OHIP scores were low for both treatments (8.82 and 7.87, respectively for RCT and DI). No significant differences were detected in OHIP total score or any dimension, except for physical pain (significantly higher for RCT than DI (p=0.044)). All patients were satisfied with both treatments; however, patients recalled that pain during treatment was significantly worse for RCT than DI (p=0.003). CONCLUSIONS High long-term OHRQoL and satisfaction is expected with either DI or RCT performed by experienced practitioners; however, physical pain dimension is higher for RCT. CLINICAL SIGNIFICANCE This study demonstrated a high satisfaction and long-term quality of life of patients undergoing both DI and RCT if treatments provide a functional balance and are performed by experienced practitioners. Very importantly, all participants had received both treatment modalities and being their own control eliminates individual variability.
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Affiliation(s)
- Elena Sanz
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Plaza Ramon y Cajal s/n. Ciudad Universitaria., Madrid 28040, Spain
| | - Magdalena Azabal
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Plaza Ramon y Cajal s/n. Ciudad Universitaria., Madrid 28040, Spain
| | - Ana Arias
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Plaza Ramon y Cajal s/n. Ciudad Universitaria., Madrid 28040, Spain.
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Lee C, Preston A, Tran D, James J, Makins SR, Gajjar D, Weltman R. A long‐term retrospective analysis of single tooth implants and endodontic therapies in a university setting. J Periodontol 2022; 93:1510-1524. [DOI: 10.1002/jper.21-0390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/21/2021] [Accepted: 10/12/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Chun‐Teh Lee
- The University of Texas Health Science Center at Houston School of Dentistry Department of Periodontics and Dental Hygiene Houston Texas United States
| | - Alfred Preston
- The University of Texas Health Science Center at Houston School of Dentistry Department of Periodontics and Dental Hygiene Houston Texas United States
- Private practice McKinney Texas United States
| | - Duong Tran
- Tufts University School of Dental Medicine Department of Public Health & Community Service Boston MA United States
| | - Jennifer James
- The University of Texas Health Science Center at Houston School of Dentistry Department of Periodontics and Dental Hygiene Houston Texas United States
- Private practice Pearland Texas United States
| | - Scott R. Makins
- The University of Texas Health Science Center at Houston School of Dentistry Department of Endodontics Houston Texas United States
| | - Devanshi Gajjar
- Richard L. Roudebush Veterans Affairs Hospital Indianapolis Indiana United States
| | - Robin Weltman
- The University of Texas Health Science Center at Houston School of Dentistry Department of Periodontics and Dental Hygiene Houston Texas United States
- University of Nevada School of Dental Medicine Department of Clinical Sciences Las Vegas Nevada United States
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Azarpazhooh A, Sgro A, Cardoso E, Elbarbary M, Laghapour Lighvan N, Badewy R, Malkhassian G, Jafarzadeh H, Bakhtiar H, Khazaei S, Oren A, Gerbig M, He H, Kishen A, Shah PS. A Scoping Review of 4 Decades of Outcomes in Nonsurgical Root Canal Treatment, Nonsurgical Retreatment, and Apexification Studies-Part 2: Outcome Measures. J Endod 2022; 48:29-39. [PMID: 34688793 DOI: 10.1016/j.joen.2021.09.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Inconsistencies in the definitions of endodontic outcome terminology jeopardize evaluations of proposed interventions and patient care quality. This scoping review aimed to provide groundwork to develop a set of basic outcomes in endodontics. METHODS We performed a comprehensive literature search for randomized controlled trials, cohort studies, case-control studies, and case series (≥10 patients) published after 1980 with patients ≥10 years of age with any preoperative pulpal and periapical diagnosis in permanent teeth requiring nonsurgical root canal treatment, retreatment, or apexification. Abstracted data on outcome assessment methods, assessors, and domains were reported after univariate and bivariate analyses. RESULTS Treatment outcomes were evaluated radiographically (88%) or clinically (73%). Although 2-dimensional radiography exceeded 3-dimensional radiography, the use of the latter has increased since 2010, mostly for nonsurgical retreatments. Of 19 identified outcomes, 5 were most frequent: success (168 studies, 40%), radiographic healing (128 studies, 30%), survival (of an asymptomatic tooth [48 studies, 12%] or of a procedure code in administrative databases [31 studies, 7%]), pain assessment (14 studies, 3%), and quality of life (11 studies, 3%). Clinician-centered outcomes have been most frequently studied since the 1980s (71%), in academic settings (76%), and using a prospective design (45%). Patient-centered outcomes were reported in 19% of studies before 2010 and 30% since 2010. They were more common among retrospective studies (49%). CONCLUSIONS Patient-centered outcome measures are lacking in endodontic studies. The state of available research can provide a baseline for the development of a core outcome set in endodontics, which should represent the important patient-centered outcomes in conjunction with well-validated clinician-centered outcomes.
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Affiliation(s)
- Amir Azarpazhooh
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada.
| | - Adam Sgro
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Elaine Cardoso
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Mohamed Elbarbary
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | | | - Rana Badewy
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Gevik Malkhassian
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Hamid Jafarzadeh
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Hengameh Bakhtiar
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Saber Khazaei
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Ariel Oren
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Madeline Gerbig
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Helen He
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Anil Kishen
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Prakesh S Shah
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada
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Vahdati SA, Torabinejad M, Handysides R, Lozada J. A Retrospective Comparison of Outcome in Patients Who Received Both Nonsurgical Root Canal Treatment and Single-tooth Implants. J Endod 2019; 45:99-103. [DOI: 10.1016/j.joen.2018.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/11/2018] [Accepted: 10/29/2018] [Indexed: 12/18/2022]
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Murray PE. Platelet-Rich Plasma and Platelet-Rich Fibrin Can Induce Apical Closure More Frequently Than Blood-Clot Revascularization for the Regeneration of Immature Permanent Teeth: A Meta-Analysis of Clinical Efficacy. Front Bioeng Biotechnol 2018; 6:139. [PMID: 30364277 PMCID: PMC6193104 DOI: 10.3389/fbioe.2018.00139] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/17/2018] [Indexed: 12/21/2022] Open
Abstract
The purpose of this review was to compare the clinical efficacy of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), vs. blood clot revascularization (BCR) for the regeneration of immature permanent teeth. A survey of the literature identified 222 cases of immature permanent teeth which had been given PRP, PRF or BCR regeneration treatment with at least a year-long follow-up in 12 different articles. A meta-analysis of the 222 immature permanent teeth after 1 year, were compared to assess the ability of PRP, PRF, and BCR to accomplish apical closure, a periapical lesion healing response, root lengthening, and dentinal wall thickening. The mean success rate for apical closure or reduction after 1 year was: PRP (85.1%) PRF (85.2%), and BCR (58.8%). The mean success rate for root lengthening after 1 year was: BCR (64.1%), PRP (64.2%), and PRF (74.1%). The periapical lesion healing response was 88.9% for BCR, 100% for PRP, and 100% for PRF. Dentinal wall thickening was 100% for BCR, 100% for PRP, and 100% for PRF. Apical closure occurred more frequently following PRP and PRF than with BCR (Fischer test, P < 0.0011), for all the other effects the PRP, PRF, and BCR treatments were similarly effective (Fischer tests, P > 0.05). In conclusion, the fractured or decayed immature permanent teeth of children and young adults aged 6 years to 28 which have a restorable crown, but thin dentinal walls may be regenerated by using a revascularization procedure which draws blood and stem cells into a disinfected root canal space. Although BCR is most common revascularization method, apical closure may occur more frequently if PRF and PRP are used instead of BCR for the regeneration of immature permanent teeth. The proper use of regenerative procedures can be very successful at the disinfection of bacteria from the periapical region of immature permanent teeth, which helps to heal localized lesions, and avoid the need for complex apical surgery, in addition to regenerating tissues to strengthen the structure of immature teeth, to help prevent tooth fracture and tooth loss.
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Affiliation(s)
- Peter E Murray
- Department of Periodontics, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
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Murray PE. Minireview of the clinical efficacy of platelet-rich plasma, platelet-rich fibrin and blood-clot revascularization for the regeneration of immature permanent teeth. World J Stomatol 2018; 6:1-5. [DOI: 10.5321/wjs.v6.i1.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 05/30/2018] [Accepted: 06/15/2018] [Indexed: 02/06/2023] Open
Abstract
The aim of this mini-review was to investigate and compare the clinical efficacy of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), vs blood clot revascularization (BCR) for the regeneration of immature permanent teeth. The clinical efficacy of PRP, PRF, and BCR to regenerate 90 immature permanent teeth after one year, were compared for their ability to accomplish apical closure, a periapical lesion healing response, root lengthening, and dentinal wall thickening. The 90 cases were published in three different articles. The mean success rate for apical closure after one year was: PRP (89.2%) PRF (80%), and BCR (75.6%). The mean success rate for root lengthening after one year was: BCR (88.9%), PRP (68.2%), and PRF (65%). The periapical lesion healing response was 100% for BCR and 100% for PRP. Dentinal wall thickening was 100% for BCR, and 100% for PRP. All the PRP, PRF, and BCR treatments appeared to be effective. The published clinical results for PRP, PRF, and BCR indicate that these treatments are effective for the regeneration of immature permanent teeth.
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Affiliation(s)
- Peter E Murray
- Department of Endodontics, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL 33328, United States
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Influence of Cone-beam Computed Tomography on Endodontic Retreatment Strategies among General Dental Practitioners and Endodontists. J Endod 2017; 43:1433-1437. [DOI: 10.1016/j.joen.2017.04.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 03/27/2017] [Accepted: 04/02/2017] [Indexed: 12/16/2022]
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Chércoles-Ruiz A, Sánchez-Torres A, Gay-Escoda C. Endodontics, Endodontic Retreatment, and Apical Surgery Versus Tooth Extraction and Implant Placement: A Systematic Review. J Endod 2017; 43:679-686. [DOI: 10.1016/j.joen.2017.01.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/01/2017] [Accepted: 01/08/2017] [Indexed: 10/19/2022]
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Rodríguez G, Abella F, Durán-Sindreu F, Patel S, Roig M. Influence of Cone-beam Computed Tomography in Clinical Decision Making among Specialists. J Endod 2017; 43:194-199. [DOI: 10.1016/j.joen.2016.10.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 09/18/2016] [Accepted: 10/09/2016] [Indexed: 01/11/2023]
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Tissue Reaction to a Novel Bone Substitute Material Fabricated With Biodegradable Polymer-Calcium Phosphate Nanoparticle Composite. IMPLANT DENT 2016; 25:567-74. [DOI: 10.1097/id.0000000000000447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Çiçek E, Koçak MM, Koçak S, Sağlam BC. Comparison of the amount of apical debris extrusion associated with different retreatment systems and supplementary file application during retreatment process. J Conserv Dent 2016; 19:351-4. [PMID: 27563185 PMCID: PMC4979283 DOI: 10.4103/0972-0707.186456] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The type of instrument affects the amount of debris extruded. The aim of this study was to compare the effect of retreatment systems and supplementary file application on the amount of apical debris extrusion. MATERIALS AND METHODS Forty-eight extracted mandibular premolars with a single canal and similar length were selected. The root canals were prepared with the ProTaper Universal system with a torque-controlled engine. The root canals were dried and were obturated using Gutta-percha and sealer. The specimens were randomly divided into four equal groups according to the retreatment procedures (Group 1, Mtwo retreatment files; Group 2, Mtwo retreatment files + Mtwo rotary file #30 supplementary file; Group 3, ProTaper Universal retreatment (PTUR) files; and Group 4, PTUR files + ProTaper F3 supplementary file). The extruded debris during instrumentation were collected into preweighed Eppendorf tubes. The amount of apically extruded debris was calculated by subtracting the initial weight of the tube from the final weight. Three consecutive weights were obtained for each tube. RESULTS No statistically significant difference was found in the amount of apically extruded debris between Groups 1 and 3 (P = 0.590). A significant difference was observed between Groups 1 and 2 (P < 0.05), and between Groups 3 and 4 (P < 0.05). CONCLUSIONS The use of supplementary file significantly increased the amount of apically extruded debris.
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Affiliation(s)
- Ersan Çiçek
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - Mustafa Murat Koçak
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - Sibel Koçak
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - Baran Can Sağlam
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
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Angerame D, De Biasi M, Franco V, Bevilacqua L, Castaldo A. Upper central incisors with periapical lesions treated with two integrated endodontic systems: a six-month randomized controlled trial. GIORNALE ITALIANO DI ENDODONZIA 2016. [DOI: 10.1016/j.gien.2016.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Azarpazhooh A, Dao T, Ungar WJ, Da Costa J, Figueiredo R, Krahn M, Friedman S. Patients' Values Related to Treatment Options for Teeth with Apical Periodontitis. J Endod 2016; 42:365-70. [DOI: 10.1016/j.joen.2015.11.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 11/23/2015] [Accepted: 11/29/2015] [Indexed: 10/22/2022]
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Kzhyshkowska J, Gudima A, Riabov V, Dollinger C, Lavalle P, Vrana NE. Macrophage responses to implants: prospects for personalized medicine. J Leukoc Biol 2015; 98:953-62. [PMID: 26168797 DOI: 10.1189/jlb.5vmr0415-166r] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 06/15/2015] [Indexed: 01/08/2023] Open
Abstract
Implants, transplants, and implantable biomedical devices are mainstream solutions for a wide variety of human pathologies. One of the persistent problems around nondegradable metallic and polymeric implants is failure of macrophages to resolve the inflammation and their tendency to stay in a state, named "frustrated phagocytosis." During the initial phase, proinflammatory macrophages induce acute reactions to trauma and foreign materials, whereas tolerogenic anti-inflammatory macrophages control resolution of inflammation and induce the subsequent healing stage. However, implanted materials can induce a mixed pro/anti-inflammatory phenotype, supporting chronic inflammatory reactions accompanied by microbial contamination and resulting in implant failure. Several materials based on natural polymers for improved interaction with host tissue or surfaces that release anti-inflammatory drugs/bioactive agents have been developed for implant coating to reduce implant rejection. However, no definitive, long-term solution to avoid adverse immune responses to the implanted materials is available to date. The prevention of implant-associated infections or chronic inflammation by manipulating the macrophage phenotype is a promising strategy to improve implant acceptance. The immunomodulatory properties of currently available implant coatings need to be improved to develop personalized therapeutic solutions. Human primary macrophages exposed to the implantable materials ex vivo can be used to predict the individual's reactions and allow selection of an optimal coating composition. Our review describes current understanding of the mechanisms of macrophage interactions with implantable materials and outlines the prospects for use of human primary macrophages for diagnostic and therapeutic approaches to personalized implant therapy.
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Affiliation(s)
- Julia Kzhyshkowska
- *Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany; Laboratory for Translational Cellular and Molecular Biomedicine, Tomsk State University, Tomsk, Russia; Protip SAS, Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, Strasbourg, France; and Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Alexandru Gudima
- *Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany; Laboratory for Translational Cellular and Molecular Biomedicine, Tomsk State University, Tomsk, Russia; Protip SAS, Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, Strasbourg, France; and Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Vladimir Riabov
- *Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany; Laboratory for Translational Cellular and Molecular Biomedicine, Tomsk State University, Tomsk, Russia; Protip SAS, Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, Strasbourg, France; and Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Camille Dollinger
- *Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany; Laboratory for Translational Cellular and Molecular Biomedicine, Tomsk State University, Tomsk, Russia; Protip SAS, Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, Strasbourg, France; and Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Philippe Lavalle
- *Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany; Laboratory for Translational Cellular and Molecular Biomedicine, Tomsk State University, Tomsk, Russia; Protip SAS, Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, Strasbourg, France; and Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Nihal Engin Vrana
- *Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany; Laboratory for Translational Cellular and Molecular Biomedicine, Tomsk State University, Tomsk, Russia; Protip SAS, Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, INSERM Unité 1121, Strasbourg, France; and Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
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Parirokh M, Zarifian A, Ghoddusi J. Choice of Treatment Plan Based on Root Canal Therapy versus Extraction and Implant Placement: A Mini Review. IRANIAN ENDODONTIC JOURNAL 2015. [PMID: 26213535 PMCID: PMC4509120 DOI: 10.7508/iej.2015.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Case selection and treatment plan are important aspects of endodontic treatment. Dentists should organize the treatment plan based on their knowledge, abilities, skills and more importantly the patients’ preference and dentition. Indubitably, the treatment plan for each patient is exclusive and “tailor-made” and cannot be used for all patients. Dentists’ selfestimation of their abilities opens up treatment options; however, in difficult or complicated cases it is advisable to refer to a specialist. Currently, one of the most challenging aspects in dentistry is the choice between extraction and placement of implant (EPI) instead of a complicated root canal treatment (RCT). Overemphasis on one treatment plan while neglecting other options, not only mislead the dentist but also impose unnecessary charges to the patients. This mini-review compares RCT to EPI from various aspects to help practitioners in routine decision making.
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Affiliation(s)
- Masoud Parirokh
- Endodontology Research Center, Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmadreza Zarifian
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jamileh Ghoddusi
- Dental Research Center, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
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Influence of Demographics on Patients' Receipt of Endodontic Therapy or Implant Placement. J Endod 2015; 41:470-2. [DOI: 10.1016/j.joen.2014.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/17/2014] [Accepted: 12/28/2014] [Indexed: 12/27/2022]
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Tooth Retention through Endodontic Microsurgery or Tooth Replacement Using Single Implants: A Systematic Review of Treatment Outcomes. J Endod 2015; 41:1-10. [DOI: 10.1016/j.joen.2014.09.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 09/01/2014] [Indexed: 12/20/2022]
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Wenteler GL, Sathorn C, Parashos P. Factors influencing root canal retreatment strategies by general practitioners and specialists in Australia. Int Endod J 2014; 48:417-27. [DOI: 10.1111/iej.12330] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 05/31/2014] [Indexed: 11/30/2022]
Affiliation(s)
- G. L. Wenteler
- Melbourne Dental School; University of Melbourne; Melbourne Vic Australia
| | - C. Sathorn
- Melbourne Dental School; University of Melbourne; Melbourne Vic Australia
| | - P. Parashos
- Melbourne Dental School; University of Melbourne; Melbourne Vic Australia
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Keçeci AD, Ureyen Kaya B, Sener E. Determination of canal orifice co-ordinates and MB2 incidence of maxillary first molars in a Turkish sub-population. Acta Odontol Scand 2014; 72:354-61. [PMID: 24495011 DOI: 10.3109/00016357.2013.837959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To measure the co-ordinates of the root canal orifices and to determine the incidence of mesiobuccal-2 (MB2) in maxillary first molars in a Turkish sub-population. MATERIALS AND METHODS Standard digital photographs were taken under a stereomicroscope from the occlusal aspect of each tooth (n = 176) before and after crown removal. Canal orifices were negotiated under moderate magnification using dental loupes. The coordinates of the orifices and the distances of each from the central fossa were measured by using geographic software. Intensity maps of the orifice locations were created by using the co-ordinates of all canal orifices. A representative map was drawn using the mean values of orifice locations and access projection area. RESULTS In the right maxillary first molars, the mean values for the (X, Y) co-ordinates were (0.67, 2.68) for mesiobuccal-1 (MB1), (0.81, 0.84) for MB2, (-1.12, 1.26) for distobuccal-1 (D1), (-0.89, 0.23) for distobuccal-2 (D2) and (0, -2.50) for palatinal (P); the corresponding mean values in the left maxillary first molars were (-0.78, 2.56), (-0.98, 0.90), (0.99, 1.18), (0.69, 0.78) and (0.00, -2.53), respectively. The average MB1-MB2 distance was 1.97 mm. Distobuccalcanal orifices were localized at the distal side of the center in 98.3% of teeth. The incidence of MB2 was 46.02%. CONCLUSIONS The distobuccal canal orifice is mostly located on the distal side of the central fossa. Thus, it should be considered that the access cavity of the maxillary molars may not be always limited mesially. The incidence of MB2 in this sub-population was 46.02%, which is of great importance clinically.
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Long-term outcome of non-surgical root canal treatment: a retrospective analysis. Odontology 2014; 103:185-93. [PMID: 24908421 DOI: 10.1007/s10266-014-0159-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
Abstract
This study investigated the long-term clinical outcome of root canal treatment. 240 root-treated teeth (n = 61 patients) were initially classified on the basis of radiographic presence/absence of initial apical periodontitis (IAP) and clinical data. The final outcome measure was the periapical healing (healed/disease). The outcome at 6-9 months was correlated with the outcome at 10 years following treatment. Prognostic factors for the periapical healing were assessed. Extraction data were recorded. Univariate and multivariate logistic regression analysis was used to identify risk indicators for apical periodontitis (AP) development. Chi-square analysis was performed to evaluate a possible relationship between the 6-9 months outcome and the final outcome related to IAP. Mean observation time was 14 ± 3.7 years. Survival rate was 84.6% and healing rate was 79% (10-19 years). Predictors of outcome (p < .05) were considered statistically significant. Multivariate logistic regression analysis showed that initial pulpal and periapical status and the quality of root canal filling as assessed two-dimensionally were independent predictors of outcome. The 6-9 months evaluation appears to be an indicator for the final outcome of primary root canal treatment both in the presence and in the absence of IAP. An initial radiolucency associated with an unsatisfactory quality and extent of root canal filling significantly diminishes the possibility of achieving long-term radiographic success. For those with uncertain healing at 6-9 months (91%), clinicians should consider the high healing rate when estimating the prognosis and adjust the decision making accordingly.
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Saunders WP. Treatment planning the endodontic-implant interface. Br Dent J 2014; 216:325-30. [PMID: 24651338 DOI: 10.1038/sj.bdj.2014.202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2013] [Indexed: 11/09/2022]
Abstract
One of the most challenging treatment planning decisions in restorative dentistry is the retention of a root filled tooth or its extraction and replacement with an implant. Making an informed judgement relies upon not only clinical experience and expertise but also interpretation of the published clinical evidence. In the last few years, more robust data and closer scrutiny of the evidence has helped to understand the advantages and disadvantages of each of these treatment modalities. The purpose of this paper is to provide a narrative review of some of the factors that may influence treatment planning for root canal treated teeth and indications for whether these teeth would be better replaced by an implant. From the evidence presented it is clear that both treatments have a place in contemporary restorative dental treatment and that survival for both root filled teeth and implants are similar. Unsurprisingly, both these treatment choices require high standards of clinical expertise and careful planning to ensure the best outcome.
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Affiliation(s)
- W P Saunders
- Emeritus Professor of Endodontology, School of Dentistry, University of Dundee, Park Place, Dundee, DD1 4HN
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26
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Angerame D, De Biasi M, Sossi D, Marigo L, Castagnola R, Somma F, Castaldo A. Periapical healing after simplified endodontic treatments: A digital subtraction radiography study. GIORNALE ITALIANO DI ENDODONZIA 2013. [DOI: 10.1016/j.gien.2013.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Cheung GSP, Lee AHC, Wong MCM. Suitability of time estimates for survival analysis of endodontic treatment. J Endod 2013; 39:593-6. [PMID: 23611374 DOI: 10.1016/j.joen.2012.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 12/03/2012] [Accepted: 12/10/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION This study aimed to determine the most suitable estimates of the event date for Kaplan-Meier (K-M) survival analysis for the assessment of endodontic treatment outcomes. Survival probability computed using the Weibull accelerated failure time (WAFT) models based on interval-censored data was used for comparison. METHODS A sample of root canal-treated teeth was included for survival analysis using the K-M and WAFT models. Treatment outcomes were categorized for the presence or absence of periapical healing and tooth survival. For the K-M analysis, the following time estimates between a visit when failure was diagnosed and the preceding visit were tested: the one-quarter point (T1), the half-way point (T2), the three-quarter point (T3), the date of diagnosis (T4), and the geometric mean (T5). RESULTS The survival curve plotted from T2 consistently showed the least discrepancies in trend when compared against the WAFT curve. Those curves generated from T1 to T5 were significantly different from each other for periapical healing but not for tooth survival. CONCLUSIONS T2 is the most reliable date for K-M analysis for measuring endodontic outcomes, especially when periapical healing is concerned. T4 would be a reasonable estimate for assessing tooth survival. Further research aiming at appropriate statistical exercise with simulations followed by proper goodness of fit tests should be considered.
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Affiliation(s)
- Gary S P Cheung
- Area of Endodontics, Comprehensive Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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Outcomes of endodontic therapy in general practice: a study by the Practitioners Engaged in Applied Research and Learning Network. J Am Dent Assoc 2012; 143:478-87. [PMID: 22547719 DOI: 10.14219/jada.archive.2012.0208] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy. METHODS Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. RESULTS P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. CONCLUSIONS These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. CLINICAL IMPLICATIONS The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for teeth with irreversible pulpitis, necrotic pulp or periapical periodontitis.
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Saini HR, Tewari S, Sangwan P, Duhan J, Gupta A. Effect of Different Apical Preparation Sizes on Outcome of Primary Endodontic Treatment: A Randomized Controlled Trial. J Endod 2012; 38:1309-15. [DOI: 10.1016/j.joen.2012.06.024] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 06/14/2012] [Accepted: 06/20/2012] [Indexed: 11/26/2022]
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MORE ABOUT OUTCOMES: Authors' response. J Am Dent Assoc 2012. [DOI: 10.14219/jada.archive.2012.0313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lang-Hua BH, Lang NP, Lo ECM, McGrath CPJ. Attitudes of general dental practitioners towards implant dentistry in an environment with widespread provision of implant therapy. Clin Oral Implants Res 2012; 24:278-84. [DOI: 10.1111/j.1600-0501.2012.02537.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2012] [Indexed: 11/25/2022]
Affiliation(s)
- Bich Hue Lang-Hua
- Discipline of Periodontology & Public Health, Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - Niklaus P. Lang
- Discipline of Oral Rehabilitation, Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - Edward C. M. Lo
- Discipline of Periodontology & Public Health, Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - Colman P. J. McGrath
- Discipline of Periodontology & Public Health, Faculty of Dentistry; The University of Hong Kong; Hong Kong
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Kim RH, Mehrazarin S, Kang MK. Therapeutic potential of mesenchymal stem cells for oral and systemic diseases. Dent Clin North Am 2012; 56:651-75. [PMID: 22835544 PMCID: PMC3426923 DOI: 10.1016/j.cden.2012.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Mesenchymal stem cells (MSCs) are adult stem cells whose self-renewal, multipotency, and immunosuppressive functions have been investigated for therapeutic applications. MSCs have used for various systemic organ regenerative therapies, allowing rescue of tissue function in damaged or failing organs. This article reviews the regenerative and immunomodulatory functions of MSCs and their applications in dental, orofacial, and systemic tissue regeneration and treatment of inflammatory disorders. It also addresses challenges to MSC-mediated therapeutics arising from tissue and MSC aging and host immune response against allogenic MSC transplantation, and discusses alternative sources of MSCs aimed at overcoming these limitations.
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Affiliation(s)
- Reuben H. Kim
- Phone: (310) 825-7312, , UCLA School of Dentistry, Division of Restorative Dentistry, 10833 Le Conte Ave., Los Angeles, CA 90095
| | - Shebli Mehrazarin
- , Phone: (310) 267-2810, UCLA School of Dentistry, 10833 Le Conte Ave., Los Angeles, CA 90095
| | - Mo K. Kang
- Jack Weichman Endowed Chair, Phone: (310) 825-8048, , UCLA School of Dentistry, Division of Associated Clinical Specialty, Section of Endodontics, 10833 Le Conte Ave., Los Angeles, CA 90095
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Silva JA, Alencar AHGD, Rocha SSD, Lopes LG, Estrela C. Three-dimensional image contribution for evaluation of operative procedural errors in endodontic therapy and dental implants. Braz Dent J 2012; 23:127-34. [DOI: 10.1590/s0103-64402012000200007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 03/03/2012] [Indexed: 11/22/2022] Open
Abstract
Acceptable therapeutic protocol in dentistry depends on the outcomes obtained with follow up. Operative procedural errors (OPE) may occur and they represent risk factors able to compromise a tooth or a dental implant. The aim of this study was to detect the OPE in endodontically treated teeth and dental implants, using cone beam computed tomography (CBCT).Eight hundred and sixteen CBCT exams were performed between January 2009 and October 2010, and only those which presented endodontically treated teeth and/or dental implants were selected. The sample was as follows: 195 CBCT exams (n=200 teeth and 200 dental implants), 72 male, 123 female, with mean age of 51 years.In endodontically treated teeth, OPE included underfilling, overfilling, and root perforation; OPEin dental implants were thread exposures, contact with anatomical structures, and contact with adjacent teeth. Kolmogorov-Smirnov test was used for statistical analysis, with significance level set at α=0.05. Underfilling, overfilling, and root perforations were detected in 33.5%, 8% and 4.5% of the teeth, respectively. Dental implants with thread exposures, contact with important anatomical structures and contact with adjacent teeth were seen in 37.5%, 13% and 6.5% of the cases, respectively. OPE were detected in endodontically treated teeth and dental implants, and underfilling and thread exposures were the most frequent occurrences, respectively.
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Vozza I, Barone A, Quaranta M, De Paolis G, Covani U, Quaranta A. A comparison between endodontics and implantology: an 8-year retrospective study. Clin Implant Dent Relat Res 2011; 15:29-36. [PMID: 22082010 DOI: 10.1111/j.1708-8208.2011.00397.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE The aim of this study was to compare endodontic and implant treatments and to evaluate their predictability over an 8-year period on the basis of an analysis of survival data and a retrospective clinical study. MATERIALS AND METHODS A group of 40 partially edentulous patients were selected for this study. Their teeth had been endodontically treated and rehabilitated using gold alloy and ceramic restorations. In these patients, 65 osseointegrated implants were restored with single gold alloy-ceramic crowns and monitored on a yearly basis for 8 years with standardized periapical radiographs, using a polivynilsiloxane occlusal key as a positioner. A total of nine patients who did not attend the yearly follow-up were excluded from the study. The Melloning and Triplett criteria were used to evaluate the clinical results obtained in the implant sites. The clinical results of the 56 endodontically treated teeth, restored with the fixed prosthesis of 40 patients, were analyzed according to probing depth as well as an assessment of the correct apical and coronal seals. The survival rate was calculated using the Kaplan-Meier method and the statistical significance was calculated using the chi-square test. RESULTS During the follow-up of the endodontically treated elements, seven failures were detected (83.34%) and the success rate of implants inserted in the same patients was equal to 80.8%, with nine implants lost in 8 years. The survival analysis of the elements treated with both therapies was not statistically significant (p = .757) and the confidence interval was between 0.2455 and 2.777. CONCLUSION In view of the superimposable results between the two therapies, it should be noted that the endodontically treated teeth could be interested by different pathologies while the restoration of the atrophic edentulous ridge with an implant support is predictable when patients comply with correct oral hygiene and when the occlusal loads are axially distributed in implant-protected occlusion.
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Affiliation(s)
- Iole Vozza
- School of Dental Medicine, Sapienza University of Rome, Via Cesare Balbo 43, Rome, Italy.
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Meyer G, Fanghänel J, Proff P. Morphofunctional aspects of dental implants. Ann Anat 2011; 194:190-4. [PMID: 22137145 DOI: 10.1016/j.aanat.2011.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 09/12/2011] [Accepted: 09/27/2011] [Indexed: 10/16/2022]
Abstract
Although oral implantology is among the most beneficial developments of modern dentistry, the widely spread opinion that the long-term outcome of implants is superior to that of natural teeth has been refuted. To evade uncritical extractions, the morphofunctional properties of natural teeth and implant-supported restorations are compared from a proprioceptive and occlusal trauma perspective. The periodontal ligament of natural teeth provides the central nerve system with feedback for sensory perception and motor control. Conversely, the lack of such proprioception causes lower tactile sensitivity and less coordinated masticatory muscle activity in implant-borne restorations and makes them more prone to occlusal overload and possible subsequent failure. Moreover, occlusal anomalies may be conducive to parafunctional activity, craniomandibular disorder, tinnitus, and headache. Oral implantology, therefore, has to take appropriate account of occlusal conditions and the biomechanical and neuromuscular aspects of masticatory function.
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Affiliation(s)
- Georg Meyer
- Department of Restorative Dentistry and Periodontology and Endodontology, Ernst Moritz Arndt University of Greifswald, Germany
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Elemam RF, Pretty I. Comparison of the success rate of endodontic treatment and implant treatment. ISRN DENTISTRY 2011; 2011:640509. [PMID: 21991484 PMCID: PMC3168915 DOI: 10.5402/2011/640509] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Accepted: 04/18/2011] [Indexed: 01/10/2023]
Abstract
Dentists and patients are facing a perplexity between saving a compromised tooth through endodontic treatment and restoration or by extraction and replacement with an implant. The purpose of this paper was to compare the success rates of these two treatments. Success was measured as the longevity of the tooth or implant. Studies which met strict inclusion criteria to ensure best evidence were included. Searches were performed in Ovid Medline, Pubmed, Scopus database, and the Cochrane Library. Evidence-based groups were formed following the assessment of inclusion/exclusion criteria. The overall success rates for primary endodontic, nonsurgical retreatment, and surgical treatment were (86.02%), (78.2%), and (63.4%), respectively, implants was 90.9%. In conclusion, choice between implant and endodontic therapy cannot be exclusively based on outcome as both treatments differ in the biological process, diagnostic modalities, failure patterns, and patients preferences. More research is required with improved study designs before long-term success rates can be compared.
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ABBOTT PAULV. Diagnosis and management planning for root-filled teeth with persisting or new apical pathosis. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1601-1546.2010.00252.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kim SG, Solomon C. Cost-effectiveness of Endodontic Molar Retreatment Compared with Fixed Partial Dentures and Single-tooth Implant Alternatives. J Endod 2011; 37:321-5. [PMID: 21329815 DOI: 10.1016/j.joen.2010.11.035] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 11/24/2010] [Accepted: 11/30/2010] [Indexed: 10/18/2022]
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Gómez-Polo M, Llidó B, Rivero A, del Río J, Celemín A. A 10-year retrospective study of the survival rate of teeth restored with metal prefabricated posts versus cast metal posts and cores. J Dent 2010; 38:916-20. [DOI: 10.1016/j.jdent.2010.08.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 08/09/2010] [Accepted: 08/09/2010] [Indexed: 01/21/2023] Open
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Vital pulp therapy-current progress of dental pulp regeneration and revascularization. Int J Dent 2010; 2010:856087. [PMID: 20454445 PMCID: PMC2861196 DOI: 10.1155/2010/856087] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 12/14/2009] [Accepted: 02/10/2010] [Indexed: 12/16/2022] Open
Abstract
Pulp vitality is extremely important for the tooth viability, since it provides nutrition and acts as biosensor to detect pathogenic stimuli. In the dental clinic, most dental pulp infections are irreversible due to its anatomical position and organization. It is difficult for the body to eliminate the infection, which subsequently persists and worsens. The widely used strategy currently in the clinic is to partly or fully remove the contaminated pulp tissue, and fill and seal the void space with synthetic material. Over time, the pulpless tooth, now lacking proper blood supply and nervous system, becomes more vulnerable to injury. Recently, potential for successful pulp regeneration and revascularization therapies is increasing due to accumulated knowledge of stem cells, especially dental pulp stem cells. This paper will review current progress and feasible strategies for dental pulp regeneration and revascularization.
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Abstract
Dental professionals are often faced with challenges when formulating a treatment plan for patients presenting with a compromised tooth. A common dilemma involves the decision between tooth retention using endodontic treatment with crown restoration, and extraction and an implant-borne restoration. In this article the authors evaluate the 2 treatment modes, and observe that because outcomes are similar with both treatments, decisions should be based on the patient's informed decision concerning restorability, costs associated with the procedures, esthetics, potential adverse outcomes, and ethical factors.
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Affiliation(s)
- W R Bowles
- Department of Restorative Sciences, University of Minnesota School of Dentistry, 515 Delaware Street SE, Minneapolis, MN 55455, USA.
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PATEL PM, LYNCH CD, SLOAN AJ, GILMOUR ASM. Treatment planning for replacing missing teeth in UK general dental practice: current trends. J Oral Rehabil 2010; 37:509-17. [DOI: 10.1111/j.1365-2842.2010.02077.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Morris MF, Kirkpatrick TC, Rutledge RE, Schindler WG. Comparison of Nonsurgical Root Canal Treatment and Single-tooth Implants. J Endod 2009; 35:1325-30. [DOI: 10.1016/j.joen.2009.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Revised: 07/06/2009] [Accepted: 07/12/2009] [Indexed: 10/20/2022]
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Wu MK, Shemesh H, Wesselink PR. Limitations of previously published systematic reviews evaluating the outcome of endodontic treatment. Int Endod J 2009; 42:656-66. [DOI: 10.1111/j.1365-2591.2009.01600.x] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Should Endodontists Place Implants? A Survey of U.S. Endodontists. J Endod 2009; 35:966-70. [DOI: 10.1016/j.joen.2009.04.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Revised: 04/16/2009] [Accepted: 04/25/2009] [Indexed: 11/20/2022]
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Rossman LE. Re: Is endodontic treatment passé? ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2009; 107:450-451. [PMID: 19217327 DOI: 10.1016/j.tripleo.2009.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Accepted: 01/06/2009] [Indexed: 05/27/2023]
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