Coronal Restoration Research Articles

Coronal restoration of endodontically treated posterior teeth

There is still no consensus on the restoration of endodontically treated posterior teeth in the most appropriate way. With the development of adhesive materials with improved properties and a shift in approach towards minimally invasive dentistry, there is a paradigm change in the restorative modalities of root-filled teeth. Conventionally endodontically treated teeth were restored with post and core followed by a crown, but conservative restorative options have gained popularity with the advancements in adhesive techniques. Many studies have been done, but there is a need to re-explore the scholarly literature with the changing trend. This review article provides a brief overview of the literature on the survival of endodontically treated posterior teeth in relation to the type of post endodontic restoration. A literature search of papers related to the survival of endodontically treated teeth and type of post endodontic restorations published till July 2021 was undertaken in PubMed, MEDLINE, SCOPUS, Web of Science and Science direct. A few of the keywords searched were: post endodontic restorations, survival, clinical performance, root canal treated teeth, endodontically treated teeth, success, resin composite, crown, cuspal coverage restoration.

Comparative Evaluation of Cotton PTFE Tape and Foam Pellets as Endodontic Spacer in Primary Teeth: An In Vivo Study.

Aim and objectiveThis study was conducted to microbiologically evaluate cotton, PTFE tape, and foam pellets as endodontic spacer in primary teeth.Materials and methodsThirty primary second molars indicated for pulpectomy were included in this study. Followed by the completion of pulpectomy in each teeth cotton, PTFE tape, and foam pellets were placed as endodontic spacers randomly in 10 teeth each. The samples were collected from the pulp chamber at baseline and after 7 days to evaluate for microbial contamination of the same. The data obtained was tabulated and subjected to appropriate statistical analysis.ResultsThere was a statistically significant increase in the colony forming unit after 7 days in cotton and foam pellet group. But PTFE tape group showed very minimal contamination of the pulp chamber after 7 days.ConclusionWithin the limitations of this study, it can be concluded that PTFE tape found to be the best alternative to cotton as an endodontic spacer.Clinical significanceIn case of multiple visit pulpectomy procedure, the state of sterility must be maintained in between the appointments until a definitive coronal restoration is placed following root-canal obturation. So it is mandatory to place an endodontic spacer under a provisional restoration to maintain the patency of the root canals and prevention of the microbial growth. The PTFE tape is inorganic, nonfibrous material which can be tightly packed without any voids under the provisional restoration. So PTFE tape is the best material to maintain the root canal patency and to provide a sterile environment by preventing the microbial growth under the provisional restoration as an endodontic spacer material in between the appointments.How to cite this articleSomani R, Arya MV, Singh DJ, et al. Comparative Evaluation of Cotton PTFE Tape and Foam Pellets as Endodontic Spacer in Primary Teeth: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(1):74-78.

Clinical Evaluation of Pediatric Posterior Zirconia and Stainless Steel Crowns: A Comparative Study.

ObjectiveTo clinically evaluate and compare the performance of posterior pediatric zirconia crowns with stainless steel crowns.Materials and methodsTwenty nine children [3-9 years] were selected and given 70 preformed crowns [35: preformed zirconia crowns, Kinderkrown; 35: stainless steel crowns, KIDZ CROWN]. Crowns were evaluated for retention, marginal integrity, opposing tooth wear, plaque accumulation, gingival inflammation, and proximal contact at 3, 6, 9, and 12th month.ResultsAt the end of follow-up period overall success rate with zirconia crown was 93.5% and that of stainless steel crown was 96.7%. Statistical analysis showed no difference between the groups.ConclusionPosterior preformed zirconia and stainless steel crowns showed good clinical performance. Preformed zirconia crowns can be an option for posterior full coronal restoration when esthetics is of prime concern for the parent and child.How to cite this articleMurali G, Mungara J, Vijayakumar P, et al. Clinical Evaluation of Pediatric Posterior Zirconia and Stainless Steel Crowns: A Comparative Study. Int J Clin Pediatr Dent 2022;15(1):9-14.

Compressive strength, surface roughness, and surface microhardness of principle tricalcium silicate-based endodontic cements after universal adhesive application.

It was aimed to evaluate compressive strength (CS), surface roughness, and microhardness of mineral trioxide aggregate (ProRoot MTA) and Biodentine (BD) after adhesive application. Tests was carried out according to international ISO standard. ProRoot MTA and BD were prepared in Teflon molds according to manufacturer's instructions: n = 210 for CS; n = 210 for microhardness. Samples were incubated for 7 days at 37°C in 100% humidity. Surfaces were smoothed with up to 2000 grits of silicon-carbide sandpaper on abrasive device at 150 rpm, randomly divided into seven groups (n = 15). Clearfil Universal Bond, All Bond Universal, and Single Bond Universal (SBU) were applied in both total-etch and self-etch (SE) modes. Adhesives were applied according to manufacturers' recommendations (no adhesive used in control). CS was performed at speed of 1 mm/min, microhardness at 100 gr for 15 s. The surface roughness of the samples was analyzed with atomic force microscopy. Two-way analysis of variance and post hoc Tukey tests were used for the evaluation of the data. Man CS and microhardness values between ProRoot MTA and BD were as follows: 24.9 N, 72.6 HV; 59.8 N, 59.0 HV, respectively. In CS, BD was higher than ProRoot MTA (P < 0.05). In other comparisons except for SBU SE group (P < 0.05), BD and ProRoot MTA showed similar results (P > 0.05). However, ProRoot MTA was found higher than BD regarding microhardness (P < 0.05). As a result of the adhesive application in both BD and ProRoot MTA groups, a decrease in surface roughness was observed compared to the control group. BD exhibited better results than ProRoot MTA regarding CS. However, ProRoot MTA was found to be more successful than BD in terms of microhardness. BD and ProRoot MTA showed similar physical properties in terms of surface roughness. To improve regenerative procedures, besides the selection of bioceramic cements, the interaction between cements and materials applied during coronal restoration should be considered.

Patient record assessment of results and related resources spent during 1year after initiation of root canal treatment in a Swedish public dental organization.

AimTo document treatment outcomes and related resources, in patients undergoing root canal treatment (RCT) in county public dental clinics, by monitoring patient records for 12 months from treatment start.MethodologyThe subjects comprised 243 patients starting RCT at 20 public dental clinics in Västra Götaland county, Sweden. Their computerized dental records were monitored prospectively for a year after starting their endodontic treatment. Treatment was completed with either a root filling or extraction. The following treatment‐specific variables were registered: number of appointments and days until treatment was completed, possible complications and prescriptions for antibiotics, and for the root filled teeth: type of coronal restoration and further procedures undertaken within the year. The treatment outcomes were compared with the preoperative variables and in a logistic regression analysis.ResultsComplete data were available for 240 patients (98.8%): 128 women and 112 men, with a mean age of 48.5 years (SD = 16.3). Molar teeth predominated (n = 113, 47.1%). Most cases were completed with a root filling (n = 169, 70.4%). The remainder were extracted (n = 32, 13.3%) or were still uncompleted (n = 39, 16.3%). On average, a root filling was completed in 2.4 (SD = 0.9) appointments, or extraction at the third appointment (SD = 1.6). The molars were less often completed and often predominant among the extracted teeth. The indication for extraction was often for endodontic or RCT‐related reasons. Most complications were registered in the molars and antibiotics were prescribed in 20 cases. Most root filled teeth were restored with a direct restoration. Four root filled teeth (2.4%) were extracted within the time period.ConclusionsPatient records, followed from the start of treatment, show that 12 months on, the root filling had not been completed in just under 30% of the teeth. Of these, about half were extracted. Of particular concern is the outcome for endodontic treatment of molar teeth. In the general practice setting, molar endodontics are not only technically challenging but also very demanding in terms of chairside resources. In the present study, a successful outcome was achieved in just over half the cases.

Periodontal Manifestations in Vertical Root Fractured Teeth

AbstractVertical root fractures are more commonly encountered following endodontic treatment and in teeth without endodontic treatment, with habits like bruxism and eating coarse, hard food. The teeth most predisposed to fracture are the premolars of the maxilla and mandible, the mesial roots and mesiobuccal roots of the mandibular molars, maxillary molars and the mandibular incisors. Timely identification of cracked teeth and fractures is the key since it permits a conservative and preventive approach. Delay in diagnosis and treatment will result in the involvement of the underlying periodontium, causing periodontal pockets, abscess formation, and bone loss, thereby further complicating the outcome. Appropriate diagnosis, education, and counseling of the patient by the dentist and coronal restoration following root canal treatment are mandatory to prevent the loss of teeth in patients. The prognosis of multirooted teeth is more favorable. Affected single-rooted teeth may, however, require immediate extraction. MEDLINE database and Scopus search (www.scopus.com) were performed using the key words “vertical root fracture” or “longitudinal root fracture.” Text book chapters were manually checked.

Prevalence of periapical lesions in non-endodontically and endodontically treated teeth in an urban Iraqi adult subpopulation: A retrospective CBCT analysis

This study aimed to assess the prevalence of apical periodontitis (AP) and its association with the presence/quality of root canal filling (RCF) and coronal restoration (CR) in Iraqi population. A total of 385 CBCT scans of patients (18-45) yrs. old with 9250 teeth were examined. The teeth were grouped according to the presence/absence of apical radiolucency, presence/radiographic quality of RCF, and CR. Chi-square and Kappa were used to assess associations and intra-consensus reliability. Logistic regression was used to predict risk factors associated with AP. The significant level was set at p<0.05. AP was prevalent in 17.7 and 80.2% of teeth without RCT and with RCT (p<0.05), respectively. AP in root canal-treated teeth with missed canals (93.2%) was higher than that in root canal-treated teeth with no missing canal (78.3%) (p<0.05). AP in teeth with inadequate RCF (87%) was higher than that in teeth with adequate RCF (63%) (P<0.05). No difference in the prevalence of AP in teeth with adequate vs inadequate CR ((79.7%) vs (81%), respectively) (p>0.05). The presence of AP was significantly associated with inadequate RCF (vs adequate RCF) (OR=4.16, CI 95% 2.29-7.56, P<0.05), and was not associated with inadequate CR (vs adequate CR) (OR=-0.71, CI 95% 0.35-1.42, P>0.05). Intra-consensus reliability was (0.9) for AP and (0.82) for RCF and CR quality. AP was highly prevalent in teeth with previous root canal filling compared to non-treated teeth. AP was significantly associated with inadequacy of root canal filling but not with the inadequacy of coronal restoration. Key words:Apical periodontitis, cone beam computed tomography, root canal treatment, endodontics.

Successful regenerative endodontic treatment in a tooth with incomplete root apex and posttreatment apical periodontitis: A case report

This case report describes the procedure and outcome of regenerative endodontic treatment (RET) in a tooth with incomplete root apex and posttreatment apical periodontitis. A 44-year-old patient was referred to the endodontist because of a periapical lesion on tooth #21 and a recent episode of acute periapical abscess. On clinical and radiographic examination, this tooth presented with tenderness to percussion and palpation, periapical radiolucent lesion, external apical resorption, and incomplete apex formation. After coronal access, the filling material was removed, and the canal was gently prepared with hand files, using 1% NaOCl as the main irrigant followed by final irrigation with 17% EDTA, activated with XP-endo Finisher (FKG Dentaire, La Chaux-de-Fonds, Switzerland). The root canal was filled with a double antibiotic paste with ciprofloxacin and metronidazole (1:1). After three weeks, RET was performed by stimulating bleeding into the canal, and when a clot was formed, a bioceramic (EndoSequence BC Sealer, Brasseler USA, Savannah, GA) plug was placed on it, followed by coronal restoration. The tooth remained asymptomatic since RET was concluded. Clinical and radiographic follow-ups showed complete repair of the apical periodontitis lesion and the absence of symptoms after eight months. This satisfactory outcome was confirmed after 34 months. Key words:Bioceramic material; ciprofloxacin; metronidazole; persistent apical periodontitis; regenerative endodontic treatment.

Cusp deflection and fracture strength of root canal filled premolars with two access cavities designs (Conservative vs Traditional).

BackgroundThis study evaluated two endodontic access designs (Conservative (Cons) vs Traditional (Trad)) of class I and class II cavities on cusp deflection (CD) and fracture strength (FS) of root canal filled maxillary premolars. Material and MethodsSeventy-two sound maxillary first premolars were included in this study; Teeth were randomly assigned into nine groups (n=8), a positive control group where teeth left sound and the other eight according to the access cavity designs (Cons class I, Trad class I, Cons class II and Trad class II). After access preparation, teeth were endodontically-treated. Four groups were restored with FiltekTM Bulk-Fill composite. While the other four groups were left without coronal restoration as negative controls for fracture strength. Following thermocycling (500 cycles), CD values were recorded for the restored teeth at the following intervals, after cavity preparation, 15 min after restoration and after thermocycling. The samples were then subjected to fracture using a universal testing machine. The data were analyzed using one-way ANOVA and Tukey Post-Hoc. Statistical significance was set at p<0.05. ResultsThere was a significant difference between groups at 15 min after restoration (p<0.000) and there were no differences after cavity preparation and after thermocycling (p>0.05). At 15 min after restoration, the CD value was significantly higher in Trad class II than in other types of cavities (p<0.05) and there was no difference between Cons and Trad class I (p>0.05). In each group, the CD value was significantly higher 15 min after restoration compared to that after cavity preparation and after thermocycling in all groups. The highest FS was recorded for the control group (1240 N), while the lowest was for the Trad class II not restored group (472.8 N). One-way ANOVA test showed a highly significant difference between groups (p<0.000) and there were no significant differences in FS between the Cons vs Trad access cavity designs in class I and class II cavities, respectively. ConclusionsCusp deflection increased by the increase in the size of cavity preparation and stress relaxation tends to occur after thermocycling. Moreover, the conservation of the endodontic access cavity could improve the resistance of the tooth to fracture compared to its traditional counterpart but not to a statistically significant point. Key words:Conservative, traditional, endodontic access cavity, cusp deflection, fracture strength.

Impact of Endodontic Treatment and Coronal Restoration on Endodontically Treated Teeth&amp;rsquo;s Periapical State; A Systematic Review

Periapical lesions brought on by pulpal infections are one of the most specialised conditions in dentistry. The main objective of endodontic therapy is to use chemo-mechanical debridement and root canal filling to significantly reduce or eliminate the microbial load within the root canal system. The objectives of root canal therapy are to eliminate microorganisms from the canal system, remove inflammatory and necrotic pulp tissue, and stop the infection from returning. The teeth&#39;s function a

Evaluation of the efficacy of Myristica Fragrans as a pulpotomy medicament in primary molars: A Clinical Trial

Background An extensive literature review indicates that Myristica fragrans Nutmeg is a natural wonder drug with a broad range of pharmacological effects. A single spice has the potential to treat a wide range of diseases. This is a preliminary investigation to assess Myristica fragrans Nutmeg efficacy as a pulpotomy medicament.Objective To assess the clinical and radiographic efficacy of Myristica fragrans as pulpotomy medicament and compare it with white mineral trioxide aggregate MTAmdash an excellent biomaterial used for pulpotomy in primary teeth. Materials and methods This is a triple-blinded randomized controlled clinical trial performed on children aged between 4ndash8 years with primary molars requiring pulpotomy. A total of 50 teeth were randomly assigned into two groups after pulp amputation and hemostasis group A received Myristica fragrans with zinc oxide eugenol and group B received MTA over the pulp stumps. Teeth were then filled with glass ionomer cement and then complete coronal restorations with stainless steel crowns were given. The evaluation was done both clinically and radiographically by a blinded calibrated evaluator based on Zurn and Seale criteria at 3 6 and 12 months. The data obtained were subjected to statistical analysis.Results Both groups showed 100 success clinically and radiographically throughout the follow-up period. The results indicated that Myristica fragrans showed similar performance as MTA when used as a pulpotomy medicament.Conclusions Myristica fragrans can be suggested as a pulpotomy agent for primary teeth. However further clinical studies with long-term follow-ups are needed to give more affirmative results.

Outcome of endodontic treatments performed by Brazilian undergraduate students: 3- to 8-year follow up.

ObjectivesThis study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome.Materials and MethodsA follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level.ResultsThe success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17–9.54).ConclusionsThe success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.

Choice of Restorative Materials by Dental Practitioners and Students in Saudi Arabia for Endodontically Treated Teeth: A Systematic Review

Background: There are several elements to consider when determining the optimal procedure for restoring teeth that have undergone endodontic treatment, including the choice and requirement of a post, the kind of coronal restoration, how much coronal structure is still there, and the kind of cementing agent. The ideal restoration procedure for teeth that have undergone endodontic treatment is yet unknown. The goal of this systematic review was to evaluate the restorative material choices and factors that affect the decision-making on endodontically treated teeth (ETT) among dental professionals and students in the Kingdom of Saudi Arabia. Methods: Studies that evaluated the choice or preference of dental professionals for restorative materials for teeth that had undergone endodontic treatment were chosen from surveys that were published between 2012 and 2022 in English. Selected keyword searches were conducted in the Science Direct, PubMed, and Google Scholar databases. The data (theme-related questions and response rates for each survey question) were extracted using a standardized outline, and the likelihood of bias was evaluated. The information gathered was subjected to descriptive analysis. Results: There were 11 articles in total, encompassing 2192 respondents. The response rates ranged from 30% to 98%. The study population consisted of general dental practitioners (n = 1018), followed by dental students (n = 598), specialists (n = 475), and 101 dental surgeons. The years of experience range from 1 to &gt; 30 years, with the majority claiming to have fewer than 10 years. Moreover, 55% of the studies preferred prefabricated posts, such as fiber posts following metal posts. Most of the respondents preferred resin-based cementing agents (22% to 82%). Over 60% of respondents chose composite resin over amalgam as the material for the core foundation Conclusion: The study results from Saudi Arabian data showed that dentists favored using prefabricated posts, such as fiber and metal-based posts, to restore ETTs and resin-based cementing agents. The preferred material for the core foundation built for ETT by regular dentists, specialists, and students is regarded as composite. The amount of coronal tooth structure that is still present is crucial when choosing the post type and restorative material.

The effect of the quality of coronal restoration versus the quality of root canal filling on periapical health: systematic review and meta-analysis

Amaç: Bu çalışmanın amacı, periapikal sağlık üzerine kök kanal dolgusunun kalitesine karşı koronal restorasyonun kalitesinin etkilerini karşılaştırmaktır. Gereç ve Yöntem: Literatür taraması “endodontics”, “periapical index”, “periapical status”, “quality of root canal treatment”, “root treatment”, “root canal treatment”, “coronal restoration”, “quality of root canal treatment”, “cone beam computed tomography” ve “restoration” arama terimleri kullanılarak yapıldı. Kök kanal dolgusunun ve koronal restorasyonun kalitesinin periapikal dokulara etkisini değerlendiren çalışmalar seçildi. Veriler, dâhil edilme ve hariç tutulma kriterlerine göre iki araştırmacı tarafından toplandı. Apikal periodontitisli dişlerin oranı her kategori için kaydedildi: iyi yapılmış kök kanal dolgusu (İE), kötü yapılmış kök kanal dolgusu (KE), iyi yapılmış koronal restorasyon (İR), kötü yapılmış koronal restorasyon (KR). Veriler, olasılık oranları için meta-analiz kullanılarak analiz edildi. Önem seviyesi α=0.05 olarak belirlendi. Bulgular: İE-KR ile İE-İR arasında [p=0.02 ve odds ratio (OR)=1.88, %95 güven aralığı (GA; 1.13-3.13)], KE-İR ile İE-İR arasında [p=0.006 ve OR=3.23 (1.41-7.39)], KE-KR ile İE-İR arasında [p&amp;lt;0.00001 ve OR=5.18 (2.62-10.23)], KE-İR ile İE- KR arasında [p=0.02 ve OR=1.48 (1.07-2.03)], KE-KR ile İE-KR arasında [p&amp;lt;0.0001 ve OR=2.44 (1.69-3.51)] ve KE-KR ile KE-İR arasında [p&amp;lt;0.00001 ve OR=1.80 (1.38-2.34)] istatistiksel olarak anlamlı bir fark vardı. Sonuç: Mevcut en iyi kanıtlara dayanarak, apikal periodontitisin iyileşme olasılığı hem yeterli kök kanal tedavisi hem de yeterli restoratif tedavi ile artar. İE-KR’ye karşı KE-İR değerlendirildiğinde kök kanal dolgusunun koronal restorasyona göre daha önemli olduğu ortaya çıkmıştır.

Esthetic and Functional Rehabilitation of a Patient with Amelogenesis Imperfecta Using Adhesive and Non-Invasive Techniques: A Case Report

Introduction: Limited evidence is available on adhesive dentistry in the management of amelogenesis imperfecta (AI). The presentation, the conservative management with adhesive techniques, and the outcome of hypoplastic AI are discussed. Case Report: Autosomal dominant, hypoplastic AI was diagnosed, on a 36-year-old woman, presented with unesthetic teeth and a history of frequent decay with subsequent complications. Following the hygienic phase, stabilization of caries and root canal treatment (RCT) were done. Coronal restoration of endodontically treated teeth and light-cured direct composite veneering were done in the restorative phase. Surveyed crowns, mucosa-borne partial denture, and a resin-bonded bridge were prescribed in the prosthetic phase. The patient was pleased with the improved masticatory ability and esthetics. Discussion: A stepwise least invasive, yet esthetically acceptable treatment options based on adhesive techniques are successful in hypoplastic AI.

A Prospective Study of Long-Term Regenerative Endodontics Outcomes of Necrotic Immature Permanent Teeth: An 8-Year Follow-Up.

For the management of necrotic immature teeth, regenerative endodontics offers the advantage of further root lengthening, thickening of dentin wall, and apical closure. This prospective study aimed to evaluate the long-term outcome of regenerative endodontics in immature necrotic permanent teeth. A total of 23 immature roots were medicated by triple antibiotic paste. After 21 days, bleeding was induced by over-instrumentation, and then mineral trioxide aggregate and coronal restoration were applied. Patients were scheduled for clinical and radiographic follow-up for 8 years. The radiographic changes of root dimensions were assessed using the ImageJ Plugin and statistically analyzed by Kruskal–Wallis test at a 95% confidence level. For qualitative evaluation, images were overlapped and analyzed using Photoshop software. All teeth were asymptomatic one month after the treatment. All teeth (n = 18) with preoperative periapical radiolucency showed complete resolution within 6–9 months. Recall rate at two, three, and eight years was 69.6%, 56.5%, and 34.8%, respectively. Continuous root development with a significant increase in root length and thickening of dentin wall accompanied by a significant decrease in apical canal diameter was seen at the end of the observation period (p < 0.001). In conclusion, the long-term outcome of regenerative endodontics revealed successful clinical and radiographic results with appropriate case selection.

Evaluation of Microleakage in Resin Composites Bonded to an Er:YAG Laser and Bur-Prepared Root and Coronal Dentin Using Different Bonding Agents.

Introduction: This study was conducted to assess the microleakage in Er:YAG laser-ablated and bur-prepared root and coronal dentin cavities using self-etch and total-etch adhesive systems. Methods: Sixty extracted caries-free human third molars were sectioned for dentin exposure. Then, two standard class V cavities were prepared in the root and coronal dentin of each tooth and allocated to one of the following conditioning groups randomly (n=12/Group): G1: Diamond bur for cavity preparation and single bond (BESB) etch-and-rinse adhesive for bonding, G2: Er:YAG laser (160 mJ, 20 Hz, 29.88 J/cm2) and SB (LESB), G3: Er:YAG laser and SB without acid etching (LSB), G4: Diamond bur and Clearfil SE Bond (BCSE) self-etch system, and G5: Er:YAG laser and Clearfil SE Bond (LCSE). The cavities were filled with Z100 composite resin. Dye penetration was assessed after thermocycling. Data analysis was done by Kruskal-Wallis and Mann-Whitney U tests. Statistical significance was set at P<0.05. Results: The results showed there were no statistically significant differences in microleakage between the two preparation methods (bur and laser) or the bonding agents applied (P>0.05). Regardless of the cavity preparation method, dye penetration was significantly higher in coronal dentin than in root dentin (P<0.05). Conclusion: The Er:YAG laser had the same efficacy as the conventional method for cavity preparation, and microleakage did not depend on the bonding agent. Microleakage was significantly higher in coronal restorations than in root restorations.

Is Coronal Restoration a Predictor of Posttreatment Apical Periodontitis?

Objectives To investigate the posttreatment apical periodontitis (AP) in endodontically treated teeth through a multivariate approach and to analyze the relative importance of quality and type of coronal restoration as predictors of periapical disease. Materials and Methods The present study sample was drawn within 2-year period from the 1,072 consecutive patients older than 18 years, first time attending the Dental Clinic of the Clinical Hospital Center Rijeka, Croatia. A total of 1,350 endodontically treated teeth were included in the study. For each tooth, the periapical status, root filling quality, intracanal post, separated file presence, marginal bone loss, and quality and type of coronal restoration were recorded. Statistical Analysis Chi-square tests were used to analyze the variations in the periapical status, quality of root canal filling, and quality of coronal restoration in different tooth types. The effect of explanatory variables on periapical status was explored using univariate and multivariate logistic regression models. The outcome variable was set as the presence versus absence of AP in the tooth. Results Multivariate logistic regression analysis revealed statistically significant associations and increased risk for AP presence in molars (odds ratio [OR] = 2.15; p < 0.001), teeth positioned in mandible (OR = 1.49; p = 0.007), teeth with short length of root filling (OR = 4.08; p < 0.001), overfilled teeth (OR = 2.99; p = 0.001), and teeth with inadequate density of root filling (OR = 4.14; p < 0.001). Considering variables related to coronal restoration, neither coronal restoration type nor quality was found to be predictive for posttreatment AP. Merely, the presence of intracanal post significantly increased the odds of AP presence (OR = 1.57; p = 0.009). Conclusion The results of the present study did not indicate that type or quality of coronal restoration may be predictors of posttreatment AP. Periapical disease was significantly associated with molars, mandibular teeth, substandard quality of root fillings, and intracanal post presence.

Prevalence of periapical lesions, root canal treatments and restorations in teeth adjacent to implant- or tooth-supported crowns: A multi-centre cross-sectional study.

To describe the prevalence of periapical lesions, root canal treatments and coronal restorations on teeth adjacent to either implant- or natural tooth-supported crowns using cone-beam computed tomography (CBCT) assessment compared to nonadjacent teeth. A total of 1249 CBCT volumes were screened by five pre-calibrated observers in 11 health centres. A step-by-step screening protocol was implemented and reviewed every 3months, and mandatory setting characteristics were established for all CBCT scans using dedicated visualization software. Intra- and inter-rater reliability tests were conducted. The prevalence of periapical lesions, root canal treatments and coronal restorations was recorded on both teeth adjacent and nonadjacent to implant- (predictor 1) or natural tooth-supported crowns (predictor 2). A binary logistic model (Generalizing Estimating Equations test) was used to verify whether the prevalence of periapical lesion, root canal filling and the tooth restorative status are altered when the assessed tooth is adjacent or not to an implant-supported crown (predictor 1); or to a natural tooth-supported crown (predictor 2). Odds ratio and confidence intervals for the dependent variables at both predictors were obtained. The significance level was set at .05. A global sample of 22899 teeth was included. Compared to nonadjacent teeth, the prevalence of periapical lesion, root canals treatments and restorative procedures when adjacent to implant-supported crowns was 10.7%, 19.6% and 22.9% higher, respectively, and when adjacent to tooth-supported crowns was 19.3%, 35.6% and 37.4% higher respectively. These results were significant only for variables root canal filling and coronal restoration (p<.0001). Odds ratio to present root canal treatment is 2.57 times higher (CI 1.95-3.39, p=.0001) when the tooth is adjacent to implant-supported crown and 4.39 times (CI 3.49-5.53, p=.0001) when adjacent to tooth-supported crown, whilst for restorative procedure, the odds are, respectively, 1.63 (CI 1.29-2.06, p=.0001) and 2.30 (CI 1.92-2.76, p=.0001). Teeth adjacent to both implant- and natural tooth-supported crowns were associated with a higher frequency of root canal filling and coronal restorations.

Factors associated with decision-making of replacing the temporary coronal restoration after endodontic treatment

Aim: This study aimed to evaluate the decision-making by patients to replace temporary restorations with permanent restorations after endodontic treatment and to verify the associated factors and evaluate the quality/integrity of the temporary restorative material within one month. Methods: This is a cross-sectional study using non-probabilistic sampling which analyzed patients after one month of endodontic treatment. The self-administered questionnaire contained sociodemographic, treatment decision-making and endodontic treatment questions. The restoration present in the mouth was evaluated in the clinical oral examination. The Poisson Regression test was used to verify the prevalence ratio. Results: The prevalence failure to perform permanent restorations was 61.1% of patients, and 42.7% reported not having adhered. The reasons are lack of time and not knowing the importance of replacing the restoration with a definitive one. The glass ionomer temporary restorative frequency was higher among those who chose not to replace the temporary restoration with a permanent one (PR=5.19; 95%CI 2.10-12.33). In addition, there was an association between the quality of the restorative material and the type of material, and the best clinical quality of the restoration was statistically associated with glass ionomer and composite resin. Conclusions: The findings show the importance of guidance by the dental surgeon in helping patients decide to replace their temporary restoration.