Endodontic Considerations Research Articles

Pediatric endodontic considerations in the application of regenerative therapy for immature permanent teeth: a review article

For adult teeth with necrosis or apical periodontitis, regenerative endodontics provides a useful alternative to standard endodontic treatment. This review focuses on the pediatric endodontic considerations in the application of regenerative therapy for immature permanent teeth. A thorough literature search was conducted in the MEDLINE database using the keywords "pediatric, regenerative, therapy, endodontics, immature, permanent, and teeth" to find relevant publications published between 2017 and 2024. Additionally, Google Scholar was used to find and access pertinent scientific publications using the appropriate search terms. Various inclusion criteria were applied to select the articles for review. The selected articles were published between 2020 and 2024 and included discussions on several specific elements. Topics covered include the criteria for case selection for regenerative endodontics. Overall, the existing evidence indicates that using regenerative endodontic techniques to treat adult permanent teeth with apical periodontitis or necrosis may successfully lead to the resolution of apical translucencies and the absence of clinical signs and symptoms. With slight modifications to the clinical procedure, regenerative dentistry methods can be effectively applied to specific cases, such as those involving a small apical foramen, decreased blood supply, and a lack of growth factors. However, additional research is required to determine the optimal conditions for achieving successful treatment outcomes.

Endodontic Considerations in Contemporary Orthodontic Practice- A Review

Introduction: With increase in number of adult orthodontic patients, the orthodontic- endodontic related patients are also expected to rise. There are number of clinical dilemma where both the specialties need robust guideline for clinical decision making. The effect of orthodontic force is expressed in different way in different patients and teeth which need to be understood by clinicians. On the contrary, the tooth movement of endodontically involved teeth demands careful evaluation of the tooth and its surrounding tissue, quality of root treatment, presence or absence of peri-apical pathologies, previous history of trauma etc. Management of external apical root resorption following orthodontic therapy might be challenging some time. Orthodontic extrusion of fractured teeth is one of the viable prosthetic rehabilitation options where orthodontic, endodontic and prosthodontics specialties are involved. So this review article will focus on reviewing current level of evidence on orthodontic- endodontic interface.

Endodontic considerations of survival rate for autotransplanted third molars: a nationwide population-based study.

To investigate whether the timing of root canal treatment (primary aim) or other endodontic parameters (secondary aim) is associated with the survival probability of autotransplanted third molars, using a nationwide population-based database. A total of 1811 third molars autotransplanted between 2000 and 2013 met the inclusion criteria and were followed until the end of 2016. The teeth were classified into three groups on the basis of timing between root canal treatment and the autotransplantation: preoperative, extraoral and postoperative treatment groups. Univariate and multivariate Cox proportional hazards models were used to estimate the association between the timing of root canal treatment and the risk of tooth extraction after autotransplantation. Of the 1811 autotransplanted third molars, 462 were extracted, yielding a 17-year survival probability of 0.578. The survival probability of autotransplanted teeth that received postoperative root fillings after 17years was 0.583, which was significantly higher than the 0.434 and 0.566 for teeth that received preoperative and extraoral root fillings, respectively (P=0.0013). After adjustment for potential confounding factors, teeth that received postoperative root fillings were associated with a significantly lower tooth extraction hazard ratio (HR) compared with those that received extraoral root fillings (adjusted HR, 1.43; 95% confidence interval [CI], 1.14-1.78) and those that received preoperative root fillings (adjusted HR, 2.13; 95% CI, 1.19-3.82). Furthermore, the use of a rubber dam during postoperative root filling was associated with a significantly lower extraction rate after autotransplantation (adjusted HR, 0.54; 95% CI, 0.43-0.69). Postoperative root canal treatment resulted in a significantly lower extraction rate than did preoperative or extraoral root canal treatment amongst autotransplanted third molars during a mean follow-up period of 8.33years. Rubber dam use is recommended during postoperative root canal treatment to improve the outcomes of autotransplantation.

Endodontic Considerations in Pulmonary Disorder Patients

Endodontic Considerations in Pulmonary Disorder Patients

Dental care during the coronavirus disease 2019 (COVID-19) outbreak: operatory considerations and clinical aspects.

This paper is aimed at addressing the urgent need to develop a protocol that will address the operatory and clinical aspects of dental care during the Coronavirus disease 2019 (COVID-19) outbreak. The epidemiology, clinical signs and symptoms, and modes of transmission of COVID-19 are presented. This protocol was established as an international collaboration of three dental universities: Hadassah School of Dental Medicine, Israel; University of Rochester Medical Center, USA; and the University of Pennsylvania, USA. This protocol is based on a detailed review of the existing English language literature as well on the logistic and clinical experience of each facility and the opinion of the authors. The protocol is designed for a hospital setting and includes considerations related to dental treatment in both healthy subjects and those suspected or diagnosed with COVID-19. The first part of this review discusses operatory considerations; the second part discusses general dental clinical aspects; the third part discusses endodontic considerations; and the fourth part discusses surgical aspects. This protocol may be applicable to other future similar pandemics. Logistic and clinical steps are required to provide dental care during the COVID-19 outbreak while preventing cross-contamination and protecting the dental team during the provision of care.

Endodontic Considerations in Three-canalled Premolars: A Practical Update.

The most difficult clinical considertions in orthograde root canal treatment are generally related to the anatomy of the teeth. Three-canalled maxillary and mandibular premolars (mini-molars) have been reported in several studies. The purpose of this paper was to review various aspects of three-canalled premolars including incidence, clinical and radiographic diagnosis, racial predisposition, access cavity preparation, instrumentation and obturation.

Implant Treatment Planning: Endodontic Considerations

Implants are a predictable and effective method for replacing missing teeth. Some clinicians have advocated extraction and replacement of compromised but treatable teeth on the assumption that implants will outperform endodontically and/or periodontally treated teeth. However, evidence shows that conventional therapy is as effective as implant treatment. With data on implants developing complications long term and a lack of predictable treatment for peri-implantitis, retaining and restoring the natural dentition should be the first choice when possible.

Inquiries of the body: Novice questions and the instructable observability of endodontic scenes

This study explores questions posed by students in response to live video broadcasts of dental treatments. The aim of the study is to show and discuss the reflexive relationship between the questions, what they were occasioned by and how they are responded to. Procedures and anatomical features, that for the seminar leader are unproblematically seen in endodontic terms, repeatedly present problems for the students. Visible but unrecognized shifts in the dentist’s work, for instance, provide occasions for questions of the form ‘What is he doing now?’. In the midst of an ongoing procedure, questions tend to be formulated as noticings that elicit instruction either about some detail of the dentist’s actions or about what a generic ‘one should’ or ‘should not do’, what ‘frequently’ happens and so on. It is shown, however, that the movement between specific here-and-now features on the one hand and more general issues on the other characterizes the entire scope of the relevant material, particularly because the seminar leaders’ answers tend to place even minute details within more general endodontic considerations.

Endodontic and clinical considerations in the management of variable anatomy in mandibular premolars: a literature review.

Mandibular premolars are known to have numerous anatomic variations of their roots and root canals, which are a challenge to treat endodontically. The paper reviews literature to detail the various clinically relevant anatomic considerations with detailed techniques and methods to successfully manage these anomalies. An emphasis and detailed description of every step of treatment including preoperative diagnosis, intraoperative identification and management, and surgical endodontic considerations for the successful management of these complex cases have been included.

Endodontic considerations in the elderly - case series

Tooth retention has increased significantly in older individuals, and dentists are now challenged to preserve the strategic teeth. There will be a need to consider the endodontic therapy, and this paper describes how successful endodontics can be provided for elderly patients. Strategic treatment planning is essential, and preservation of key teeth will facilitate the satisfactory oral function for elderly patients. These teeth may be important in achieving and maintaining an intact anterior dental arch, for removable partial denture retention or preservation of alveolar bone. Elimination of infection can be challenging in narrow canals, and a systematic approach in improving access into and negotiating these canals is outlined.

Endodontic and restorative considerations of traumatically injured teeth

Traumatic injuries cause different kinds of damage to dental and periodontal tissues. The treatment approach varies according to the type and degree of injury. Periodontal injuries in which loosening or loss of attachment is present require immediate fixation of the tooth. In this kind of injury, root canal treatment is indicated when the signs of pulp necrosis such as spontaneous pain, pain to percussion, periradicular pathosis, inflammatory root resorptions and discoloration are present. In cases of coronal fractures, the treatment strategy differs according to the status of pulp tissue. If the fracture line is limited in enamel or dentin, restoration of the missing tissues can be achieved with composite resin. However, involvement of pulp may require direct pulp capping, pulpotomy or pulpectomy. The treatment process for three subluxated and four crown fractured teeth requiring a follow up over 8 months is presented in this case report.

Endodontic considerations on the variations of the anatomy of the mandibular premolars

Objectives: This article investigates the internal and external morphological variability of mandibular premolars along with clinical and radiographical signs that leads to early identification of these cases. Materials and Methods: The authors identified articles by searching the PubMed, Medline and Scopus databases. Inclusion criteria were case reports of mandibular premolars with aberrant internal and external anatomy, articles that describe the origin of anatomy of mandibular premolars, the traits that may influence their external and internal variability through species revolution and articles of new technologies like cone beam computed tomography that help the diagnosis of difficult cases. Results: In the majority of the cases, mandibular premolars are reported to have one root canal running a single root. On the other hand, anatomic irregularities in this group of teeth, such as the existence of more than one root or more than one root canals or even a more complicated root canal system cannot be considered infrequent as it appears in 10-25% of the cases. Conclusion: Successful endodontic treatment of mandibular premolars is a challenge for the clinician as they often present morphological and anatomical abnormalities.

Continuing professional development self‐assessment quiz: Accessory roots in maxillary molar teeth: a review and endodontic considerations

Continuing professional development self‐assessment quiz: Accessory roots in maxillary molar teeth: a review and endodontic considerations

Accessory roots in maxillary molar teeth: a review and endodontic considerations

Maxillary molar teeth may have accessory roots. The aim of this paper is to review and discuss the endodontic implications of this anatomical variation. A review of the literature was undertaken to identify studies and reported cases where accessory roots have been recorded in maxillary molar teeth. The results show that although the prevalence of accessory roots in maxillary molar teeth is low, they can exist in all three types of maxillary molar teeth, and they may be located palatally, buccally, mesially or distally. Hence, it is essential that dentists undertaking root canal treatment thoroughly assess all teeth to determine how many roots are present in order to provide the best possible outcome of treatment for the patient.

Endodontic Considerations in Dental Trauma and Tooth Autotransplantation

Endodontic Considerations in Dental Trauma and Tooth Autotransplantation

Results after replantation of avulsed permanent teeth. I. Endodontic considerations

Following avulsion and replantation, teeth are at risk for infection and infection related resorption (IRR). Severe discolorations of tooth crowns and cervical root fractures are common. This study presents data on endodontic related complications of avulsed teeth replanted following an extraoral endodontic treatment. Periodontal aspects will be discussed in the second part of the present publication. Twenty-eight permanent teeth in 24 patients aged seven to 17 years were replanted after avulsion. All teeth could be evaluated. In all teeth extraoral endodontic treatment by retrograde insertion of ceramic or titanium posts was performed. Mean observation period was 31.2 months (median: 24.1 months). Nine teeth healed with a functional periodontal ligament (PDL) (functional healing, FH), 19 teeth exhibited replacement resorption (RR), which was succeeded by IRR in three teeth after observation periods of more than 14 months. Diagnosis was set to tunneling resorption (one case) and to cervical resorption preceded by complete RR (two cases). No early IRR was observed. All six teeth rescued in physiologic conditions (cell culture medium of tooth rescue box) exhibited FH. Discolorations of tooth crowns or other complications (cervical root fractures, fractures of posts) were not observed. No differences in the healing results of immature and mature teeth were observed which is in contrast to previous studies. This finding is explained with the different endodontic treatment protocols. Extraoral endodontic treatment by retrograde insertion of posts prevents early IRR and minimizes the overall incidence of IRR. The method does not negatively influence periodontal healing. As there are further advantages (no discoloration, no root fractures, patient not involved, less radiographs, less time consumption, less costs) the method is recommended in isolated teeth before replantation. Especially immature teeth profit from the prevention of complications.

Endodontic considerations for autotransplanted teeth

Endodontic considerations for autotransplanted teeth

Endodontic considerations in the elderly

Tooth retention has increased significantly in older adults, and dentists are now challenged by the need to preserve critical teeth. There will be a need to consider endodontic therapy, and this paper describes how successful endodontics can be provided for elderly patients. Strategic treatment planning is essential, and preservation of key teeth will facilitate satisfactory oral function for elderly patients. These teeth may be important in achieving and maintaining an intact anterior dental arch, for removable partial denture retention or preservation of alveolar bone. In some cases, this can only be achieved if endodontic procedures are undertaken. When infection of a root canal is present, there is no reason why good quality endodontic therapy should not work in a healthy elderly patient. Elimination of infection can be challenging in narrow root canals, and a systematic approach for improving access into and negotiating these canals is outlined.

Crowns and extra-coronal restorations: Endodontic considerations: the pulp, the root-treated tooth and the crown

Crowns and extra-coronal restorations: Endodontic considerations is the fourth in the series on crowns and other extra-coronal restorations. This article focuses strongly on contemporary biological principles, and is not intended to provide a comprehensive review of commercially available materials and techniques. Principles are illustrated in a variety of clinical case scenarios.

Crowns and extra-coronal restorations: Endodontic considerations: the pulp, the root-treated tooth and the crown

Endodontic considerations is the fourth in the series on crowns and other extra-coronal restorations. This article focuses strongly on contemporary biological principles, and is not intended to provide a comprehensive review of commercially available materials and techniques. Principles are illustrated in a variety of clinical case scenarios.