Completion Of Endodontic Treatment Research Articles

Root-filling materials for endodontic surgery: biological and clinical aspects

The placement of root filling materials aims to prevent the occurrence of post-treatment apical periodontitis following completion of endodontic treatment. Materials should possess properties that will not permit bacterial invasion and infection, namely excellent sealing ability and/or antibacterial properties. In root-end filling procedures or repair of root perforations, the root filling materials are placed in a particularly challenging clinical environment, as they interface with a relatively large area with the periradicular tissues. The biological properties of these materials are therefore of significant importance. The current review discusses the most widely used materials for endodontic surgery (i.e., root-end filling and perforation repair), with particular focus on their biological characteristics, namely antibacterial properties and interactions with host tissue cells, together with clinical studies. Properties of amalgam, glass ionomer cements (GICs), resin systems, zinc oxide eugenol-based cements and hydraulic calcium silicate cements (HCSCs), together with representative and well-researched commercial materials in the context of their use in endodontic surgery are presented. While the use of HCSCs seems to offer several biological advantages, together with addressing issues with the initial formulation in the most recent versions, materials with different chemical compositions, such as zinc oxide eugenol-based cements, are still in use and appear to provide similar clinical success rates to HCSCs. Thus, the significance of the currently available materials on clinical outcomes remains unclear.

Tooth avulsion and its consequences: Case series

On an average about 30% of all school children suffer traumatic dental injury in primary dentition, whereas 22% suffer in permanent dentition. Avulsion is a serious injury which causes damage to dental and supportive tissues, ranging from 0.5-16 % among dental injuries and it mostly occurs in maxillary incisors. Tooth avulsion can be described as the complete displacement of the entire tooth out of its alveolar socket as a result of force generated due to external injury. The accepted management of choice is immediate replantation of the tooth into its socket provided dental facilities are nearby available and if it is delayed, placement of the tooth in an appropriate storage media until dental treatment can be initiated. Replantation of avulsed incisors in children has shown successful prognosis. The replanted teeth with time may lead to ankylosis followed by inflammatory or replacement resorption, as immediate replantation is practically rare. This case series showcases management of an avulsed maxillary left central incisor which was kept in patient oral cavity from the moment of trauma until its replantation in a eight year old boy. The avulsed tooth was replanted back into the alveolar socket after completion of endodontic treatment extra orally in same visit and splinted with composite resin. The other 2 case reports are 01 & 1.5 years follow up of replantated avulsed central incisors. During the follow up of these cases it was found that the teeth reported in these cases have remained in a stable, functional position but revealed external root resorption & replacement resorption even after completion of endodontic treatment. The amount of damage to tooth and supporting structures like bone, gingiva, emergency management and follow up period play a vital role in the prognosis of the avulsed tooth. It can be recommended to keep the avulsed tooth in saline solution as it is easily available when more appropriate storage media like HBSS are not available immediately.

Real-world effectiveness of national pit and fissure sealants program in Taiwan

ObjectivesThis study investigated the effectiveness of a national population-based pit and fissure sealants (PFS) program in Taiwan. MethodsPart 1 (effectiveness of national PFS program) involved children who had participated in the PFS program from 2015 to 2019. After propensity score matching, 670,840 children were selected for analysis until the end of 2019. During follow-up, the permanent first molars of the participants were assessed for caries-related treatments by employing multilevel Cox proportional hazards models. In Part 2 (effectiveness of retained sealants), which involved 1,561 children, sealant retention was evaluated 3 years after placement. A structured questionnaire was employed to collect information on family and individual factors. The endpoints were the same as in Part 1. ResultsIn Part 1, the adjusted hazard ratios (HRs) for caries-related treatments among participants in the PFS program were 0.90 (95% confidence interval [CI] = 0.89, 0.91) for dental restoration, 0.42 (95% CI = 0.38, 0.46) for initiation of endodontic treatment, 0.46 (95% CI = 0.41, 0.52) for completion of endodontic treatment, and 0.25 (95% CI = 0.18, 0.34, all Ps < 0.0001) for extraction. In Part 2, the adjusted HR for dental restoration of teeth with retained sealants was 0.70 (95% CI = 0.58, 0.85), significantly lower than that for teeth without retained sealants (P = 0.0002). ConclusionsParticipation in the national PFS program was associated with a significant reduction of at least 10% in the risk of caries-related treatments, and an additional 30% risk reduction may have been attributed to sealant retention. Clinical SignificanceIn a real-world setting, schoolchildren in the national PFS program were associated with a significant reduction of at least 10% in the likelihood of caries-related treatments. The program provided moderate protection against caries for the study population and could be improved by increasing the sealant retention rate.

Comparative evaluation of postoperative pain after single-visit endodontic treatment using protaper gold and hyflex electrical discharge machining rotary file system

Background: Endodontics has a widened range due to its increase in success rate and increase in lifespan of individuals. As of today, extracting the tooth has become a rare situation, and endodontic intrusion has become a custom. Although after having detailed knowledge about the internal anatomy of tooth, it is a must to know about the upcoming evolution of instruments as well as materials and complete knowledge regarding techniques of treatment modalities. Postoperative pain could leave a significant control on the quality of life, which will begin after completion of endodontic treatment having a range of 3%–58% cases. Materials and Methods: Twenty-six patients with irreversible pulpitis were selected for single-visit endodontics. The teeth were blindly assigned to two groups based on the instrumentation systems used: Group A (Protaper Gold) and Group B (Electrical Discharge Machining [EDM] Hyflex). Participants were asked to note the incidence of preand postoperative pain on the Visual Analog Scale at different time intervals. Results: The greatest mean pain in both Group A and B was found to be maximum in the first 24 h, with a significant reduction in pain at the subsequent observation time points of 48 h, 72 h, and 7 days. The least painful group was Group A, followed by Group B. Conclusion: In single-visit endodontics, both Protaper Gold and EDM Hyflex both may prove to be a better system, but according to statistics Protaper gold being slightly superior as it produces minimal postoperative pain, thus improving the overall acceptance of endodontic treatment.

Development of a predictive model for identifying previously undetected vertical root fractures.

This study aimed to develop a predictive model to screen for undetected vertical root fractures (VRFs) in root canal treated teeth. We included 95 root canal treated teeth with suspected VRFs; 77 for training and 18 for validation. Following clinical and cone-beam CT parameters were recorded: sex, tooth type, coronal restoration, time interval from completion of endodontic treatment to definitive diagnosis (TI), type of bone loss (BL), apical extent of root filling (AR) and the ratio of root filling diameter to the actual diameter in the coronal (1/3TA) and middle (2/3TA) root thirds. A predictive model p=1/(1-e-x ) was generated, where x=-7.433 + 1.977BL + 1.479 (2/3TA) + 1.102 AR; the sensitivity and specificity were 0.852 and 0.875 for training and 0.917 and 0.833 for validation. VRF teeth were more likely to have vertical bone loss and overfilled root canals. This model had a high diagnostic efficacy for VRFs.

MANAGEMENT OF ANTERIOR TOOTH TRAUMA, WITH 1 YEAR FOLLOW-UP, – TWO CASE REPORTS.

Trauma of the Oral &amp; Maxillofacial region occurs frequently and comprises 5% of all injuries. Among all facial injuries, dental injuries are the most common, of which crown fracture &amp; luxation occurs more frequently. This article highlighted two cases of anterior teeth trauma of which the first case is about a crown fracture of upper right lateral incisor, wherein a single visit RCT was performed and the fractured fragment was reattached directly to the tooth and the second case is about a luxation injury of both the upper central incisors, in which the luxated teeth were digitally reduced &amp; stabilized by splinting followed by completion of endodontic treatment. Both these case reports contain a successful follow-up of 1 year clinically &amp; radiographically. The second case (i.e., the luxation injury), was further evaluated with Cone Beam Computed Tomography after 1year to assess healing &amp; resorption.

Coronal Bacterial Penetration after 7 days in class II endodontic access cavities restored with two temporary restorations: A Randomised Clinical Trial.

The aim of this in vivo randomised clinical trial was to assess coronal bacterial penetration after placement of Cavit G and IRM temporary restorations in Class II endodontic access cavities. After completion of endodontic treatment, placement of an orifice seal and disinfection of the operating field, sterile cotton pellets were placed in the pulp chamber and the cavities were restored with Cavit G or IRM. After 7days, coronal and proximal restoration thickness was measured by digital radiographs. Cotton pellet was evaluated by culture methods and polymerase chain reaction assay and bacterial species identified. Bacterial growth was observed in 5 of the 27 (18%) Cavit G samples and in 11 of the 27 (40%) IRM samples which was not significant. Coronal restoration thickness of 4-5mm and proximal restoration thickness of more than 2.15mm for Cavit G and 2.35mm for IRM are recommended to prevent bacterial penetration over 7days. Adequate restoration thickness is critical to prevent bacterial penetration.

Features of clinical course and treatment principles of endodontic-periodontal lesions

Aim. To study the characteristic differences in the clinical course of chronic generalized periodontitis in the presence of periapical infection focus and the principles of combined treatment of endodontium and periodontium. Methods. A clinical and X-ray examination of 1525 patients of different age groups was performed. As a result, a clinical group of 68 patients with chronic generalized moderate and severe periodontitis was formed, who were divided into two groups depending on the presence or absence of periapical destruction. In group 1, 32 patients with the presence of chronic generalized periodontitis and signs of chronic apical periodontitis were united. Group 2 included 36 patients with chronic generalized periodontitis and no periapical infection and damage. The index estimation of the periodontal tissues state in the dynamics of combined endodontic and periodontal treatment was performed. Results. The initial task of treating endodontic periodontal lesions, regardless of the localization of the primary lesion focus, is the elimination or reversal of chronic periapical inflammatory processes of the teeth. The proposed monitoring system in the course of treatment and dynamic follow-up for 18 months for patients suffering from endodontic periodontal lesions using clinical and radiological methods of examination involves: (1) interim epicrisis or conclusion about negative or positive compliance 1-2 months after the completion of endodontic treatment and hygiene procedures; (2) periodontal treatment (according to indications) with the assessment of clinical efficacy 6 and 12 months after the start of treatment; (3) epicrisis after 18 months. Conclusion. The use of proposed concept of complex treatment of endodontic-periodontal lesions, monitoring system in the course of dental therapeutic and preventive measures and dynamic follow-up for 18 months allows achieving positive compliance in 85% of patients according to the clinical examination and in 80% of patients according to radiologic examination.

A Novel Treatment Decision Tree and Literature Review of Retrograde Peri-Implantitis.

Although retrograde peri-implantitis (RPI) is not a common sequela of dental implant surgery, its prevalence has been reported in the literature to be 0.26%. Incidence of RPI is reported to increase to 7.8% when teeth adjacent to the implant site have a previous history of root canal therapy, and it is correlated with distance between implant and adjacent tooth and/or with time from endodontic treatment of adjacent tooth to implant placement. Minimum 2 mm space between implant and adjacent tooth is needed to decrease incidence of apical RPI, with minimum 4 weeks between completion of endodontic treatment and actual implant placement. The purpose of this study is to compile all available treatment modalities and to provide a decision tree as a general guide for clinicians to aid in diagnosis and treatment of RPI. Literature search was performed for articles published in English on the topic of RPI. Articles selected were case reports with study populations ranging from 1 to 32 patients. Any case report or clinical trial that attempted to treat or rescue an implant diagnosed with RPI was included. Predominant diagnostic presentation of a lesion was presence of sinus tract at buccal or facial abscess of apical portion of implant, and subsequent periapical radiographs taken demonstrated a radiolucent lesion. On the basis of case reports analyzed, RPI was diagnosed between 1 week and 4 years after implant placement. Twelve of 20 studies reported that RPI lesions were diagnosed within 6 months after implant placement. A step-by-step decision tree is provided to allow clinicians to triage and properly manage cases of RPI on the basis of recommendations and successful treatments provided in analyzed case reports. It is divided between symptomatic and asymptomatic implants and adjacent teeth with vital and necrotic pulps. Most common etiology of apical RPI is endodontic infection from neighboring teeth, which was diagnosed within 6 months after implant placement. Most common findings, radiographically and clinically, are lesions around implant apex and sinus tract. A small number of implants did not improve with treatment. Decision tree provides a path to diagnose and treat lesions to facilitate their management. Further studies are needed to focus on histologic data around periapical microbiota to establish specific etiology and differential diagnoses compared with marginal peri-implantitis and other implant-related conditions.

Restoration of the root canal treated tooth.

When considering endodontically treated teeth, the quality of the restoration is important from the outset. It sheds light into possible causes of pulp necrosis or failure of endodontic treatment and influences the outcome of future endodontic treatment. A tooth undergoing endodontic treatment requires an effective coronal seal during and following completion of endodontic treatment. This paper discusses, using the available literature, the maintenance of optimal coronal seal and coronal integrity during and after root canal treatment.

Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain.

To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. Peak postoperative pain occurred at 16 hours post-treatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402). Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients.

Maxillary First Molar with Two Palatal Roots Located Under Dental Operating Microscope

An awareness and understanding of the presence of an additional root and unusual root canal morphology is essential as it determines the successful outcome of endodontic treatment. A thorough knowledge of basic root canal anatomy and its variation is necessary for successful completion of endodontic treatment. This report points to the importance of looking for additional roots and canals with the help of operating microscope. Finding additional roots and canals would enable clinician to successfully treat a case that would otherwise not be successful.

Pain Reduction Using Low Level Laser Irradiation in Single-Visit Endodontic Treatment

INTRODUCTION: Post-endodontic treatment pain is a relatively common condition which needs analgesics for patient’s pain relief. Low-level laser therapy (LLLT) is suggested as a non-pharmacological and non-invasive treatment for dealing with painful conditions. The purpose of this study was to evaluate the pain relief effect of LLLT after endodontic treatment.METHODS: Eighty patients randomly received either LLLT (n=40), or placebo laser (n=40) after the completion of endodontic treatment for their first permanent upper or lower molars. In the laser group, the patients received a single course of low level laser therapy (Whitening Lase II- Laser DMC, Samsung, Korea) for 80 second (a dose = 70 j/cm²) per tooth. Intensity of post treatment pain was recorded using a questionnaire (The McGill Pain Questionnaire) and a numeric rating scale (Visual Analogue Scale {VAS}) at 4, 8, 12, 24, and 48 hours. VAS is a 10 cm line with “no pain” at one end, and “worst pain imaginable” at the other end. This method makes it possible to quantify pain levels. T-test and Chi-square test were used for data statistical analyses.RESULTS: Compared to the placebo group, post-endodontic pain was significantly reduced in LLLT group at 4, 8, 12, and 48 hours (P 0.05).CONCLUSION: Regarding the significant pain reduction in LLLT group at 4, 8, 12, and 48 hours after endodontic treatment, LLLT seems to be an effective and nonpharmacological approach for the reduction of post-endodontic treatment pain.

Is endodontic re-treatment mandatory for every relatively old temporary restoration?: A narrative review

In this review, the authors examine whether there is any decisive evidence to support the revision of root fillings that have been exposed to the oral environment for more than three months, undertaken solely because of suspicions of microleakage. Researchers in numerous endodontic studies have addressed the evaluation of coronal microleakage by using different tracers and techniques. The need to achieve a tight, permanent coronal seal as soon as possible after the completion of endodontic treatment is obvious. However, the clinical importance of microleakage studies recently has been questioned because of their wide range and even contradictory results, and findings from only a few clinical investigations have demonstrated a clear relationship between the endodontic success rate and failure rate owed to coronal microleakage in cases involving high-quality endodontic therapy. The authors analyzed commonly cited articles regarding the clinical relevance of microleakage studies and the success rate of teeth with compromised restorations. In a review of the literature, the authors found no clear evidence to support immediate replacement of well-obturated endodontic treatment that has lasted more than three months solely because of suspicions of microleakage. It may be prudent in such cases to make a new coronal restoration immediately and to observe the tooth for at least three months before placing the permanent crown.

Sniffing out Endodontic Pain: Use of an Intranasal Analgesic in a Randomized Clinical Trial

Introduction Orofacial pain is a common encounter in dentistry (affecting 12% of the population) and is a primary reason for patients seeking emergency care. Dentists often prescribe oral analgesics, which have disadvantages of decreased absorption rates and delayed onset. Intranasal (IN) delivery takes advantage of a large surface area of mucosal tissue for rapid absorption. The purpose of this study was to evaluate the efficacy of IN ketorolac for endodontic pain using a randomized, double-blind, placebo-controlled parallel design study. Methods Twenty-two patients presenting with moderate to severe endodontic pain were selected to receive IN treatment with placebo (n = 11) or ketorolac (n = 11) 30 minutes before endodontic treatment was started and immediately after the completion of endodontic treatment. Baseline pain levels were recorded before IN treatment. Pain levels were also recorded at 15 and 30 minutes after the initial IN dosing (before endodontic treatment); 30 minutes after completion of endodontic treatment; and 4, 8, and 12 hours after the initial IN spray. Primary analysis was a repeated-measures analysis of variance. Results IN ketorolac alone or with endodontic treatment showed significantly better pain relief compared with IN placebo spray alone or with endodontic treatment at 30 minutes after the first or second intranasal dose and at 4 hours after the first intranasal dose ( P = .03). Conclusions These results suggest that IN ketorolac may provide a novel and efficacious method for pain relief in endodontic pain patients.

Endodontic treatment completion following emergency pulpectomy

Emergency pulpectomy is frequently performed to relieve pain experienced by patients following acute episodes of endodontic pain, or to limit the risks of infection or possible root resorption following traumatic pulpal exposures. The aim of this study was to examine subsequent patient attendance for completion of root canal treatment following pulpectomy procedures in a dental emergency unit. The treatment records of 574 patients who had each received an emergency pulpectomy at the Casualty Clinic of the University Dental School and Hospital, Cork, Ireland were reviewed. The influence of age, gender, etiology, tooth type, and month in which the pulpectomy was performed on subsequent completion of endodontic treatment was examined. Of 574 patients, 39% (n = 224) returned to have endodontic treatment completed, 11% (n = 63) returned to have the tooth extracted, and 50% (n = 287) did not return for completion of the endodontic treatment. Cases were monitored up to five years following pulpectomy. Using a multinomial regression model, tooth type, etiology, and month in which the treatment was performed were found to be statistically significant predictors (p < 0.05) of endodontic treatment completion in the Cork University Dental School and Hospital. Proper patient selection and pre-treatment counseling are important considerations when planning emergency pulpectomies to avoid inappropriate use of resources and manpower.

Non‐surgical management of paraesthesia and pain associated with endodontic sealer extrusion into the mandibular canal

The aim of this report was to present a case of endodontic sealer extrusion into the mandibular canal in a 42-year-old woman. The patient was referred to the Endodontology and Stomatology Clinics, School of Dentistry, Estácio de Sá University, complaining of 5-day duration intense spontaneous pain and paraesthesia, both arising after an endodontic intervention. Conventional radiographs and computed tomography of the mandible showed the presence of radiopacities inside the right mandibular canal. History and these radiographs confirmed extrusion of endodontic sealer. Treatment included an anti-inflammatory drug, completion of endodontic treatment and follow up. The patient reported gradual improvement, becoming asymptomatic after 2 months. Radiographs 30 months after initial examination revealed partial resorption of the foreign material. In conclusion, iatrogenic extrusion of endodontic materials should be included in differential diagnosis of endodontic pain and can sometimes be managed through non-surgical interventions in some cases.

Effect of calcium hydroxide‐based materials on periapical tissue healing and orthodontic root resorption of endodontically treated teeth in dogs

This study evaluated periapical tissue healing and orthodontic root resorption of endodontically treated teeth sealed with calcium hydroxide in dogs. The sample consisted of three contralateral pairs of maxillary incisors and two contralateral pairs of mandibular incisors in each of two dogs using a split mouth design. After biomechanical preparation of the teeth in the first group (n = 10), a Ca(OH)(2) dressing was placed for 14 days before root canal filling with Ca(OH)(2)-based sealer (Sealapex) and gutta-percha points. In the second group (n = 10), root canals were obturated immediately after the mechanical preparation with gutta-percha points and zinc oxide and eugenol (ZOE)-based sealer (Endofill). After completion of endodontic treatment, the teeth were moved with an orthodontic appliance with a calibrated force of 200 g, reactivated every 21 days. After 105 days, the animals were killed and the teeth were removed upon completion of active treatment, without a period of recovery, and prepared for histomorphological analysis. All sections of each tooth were graded subjectively on a scale from one to four to obtain the average of the 16 histomorphological parameters analysed. Evaluation of the differences between the two treatment protocols was made with Mann-Whitney U-test. It was observed that the teeth treated with Ca(OH)(2)-based materials provided better outcomes (P = 5%), with complete repair of all root resorption areas, high rate of biological closure of the main canal and apical accessory canals by newly formed cementum, less intense and extensive chronic inflammatory infiltrate, and better organization of the periodontal ligament. Under the tested conditions, Ca(OH)(2)-based materials had a favourable action on periapical tissue healing and repair of orthodontic root resorption in endodontically treated dogs' teeth.

Endodontic treatment outcome: effect of the permanent restoration

To investigate the relationship between the presence of the coronal restoration and endodontic treatment success or failure. This study comprised 200 endodontically treated teeth with 441 roots. Follow-up examination was conducted 4 +/- 0.5 years after completion of endodontic treatment. Outcome criteria were modified from Strindberg. Teeth/roots restored with permanent coronal restoration (casting or filling) had a higher success rate (80%) than teeth/roots not restored (60%; P < .01) in the analysis of aggregate data. However, the results of stratified analysis on key confounding factor (preoperative periapical diagnosis) showed that there is no significant association between the presence of permanent restoration and endodontic outcome. Teeth with preoperative apical periodontitis were less likely to be restored with a crown (23.9%) than teeth without apical periodontitis (76.1%; P < .01). Anterior teeth were more likely to be restored with a filling and sooner than the posterior teeth. These associations suggest a treatment selection bias. Stratified analysis on the key confounding factor reveals that endodontic outcome is driven by the presence of preoperative root canal infection (apical periodontitis). Lack of stratification on key confounding factors inaccurately suggests that presence of permanent restoration contributes to the success of endodontic treatment in the aggregate analysis of grouped data. The choice to restore the tooth as well as the choice and timing of permanent restoration may be the result of a bias in treatment selection. Stratified analysis on key confounding factors is the key to valid analysis and accurate results.

Endodontic Treatment Outcome: Survey of Oral Health Care Professionals

This study assessed the opinion of oral health care professionals regarding the predictability of initial endodontic treatment, expected long-term outcome and the importance of placing a coronal coverage after completion of treatment. An eight-item questionnaire was distributed among oral health care professionals. There were 49% of participants who responded that the expected retention rate of teeth 5 to 10 yr after endodontic treatment was more than 90%, whereas 44% responded that such retention rate was between 70 to 80%. The majority of the participants also responded that the need for additional treatment, such as retreatment, apical surgery or extraction, was expected to occur within the first 3 yr after endodontic treatment if initial treatment has failed. About 87% of participants responded that placing coronal coverage after completion of endodontic treatment in premolars and molars was very important for long-term tooth retention and 92% responded that overall, endodontic treatment was a predictable procedure with long-term tooth retention rate. Statistically significant associations were found between years of experience and expected rate of retention for both the total group of respondents (p < 0.001) and for general practitioners when examined separately (p < 0.002). Statistically significant associations were only found for general practitioners between years of experience and their responses regarding the need for additional treatment (p < 0.05) and overall predictability of endodontic treatment (p < 0.02). A trend was found between the professionals’ years of experience and their opinion regarding the importance of coronal coverage. Of the group who had more than 20 yr of experience, about 87% considered coronal coverage to be very important for long-term tooth retention. In conclusion, it appears that most clinicians participating in this study consider endodontic therapy to be a predictable procedure with long-term tooth retention rate. Their opinions also reflect the variations that currently exist in the literature regarding the reported outcome of endodontic treatment.