Quality Of Endodontic Treatment Research Articles

Does cervical root canal preparation influence the quality of endodontic treatment? A systematic review

Cervical preparation aims to remove dentin prominences located in the cervical region of the root canal. However, there is no consensus in the literature regarding the importance of this operative maneuver in endodontic treatment. The objective of this systematic review was to answer the question: Does cervical root canal preparation influence the quality of endodontic treatment? Material and methods: Electronic databases (Medline/PubMed, Lilacs, Scopus, Embase, Scientific Electronic Library Online – SciELO, and Central Register of Controlled Trials – Central) were searched until July 2023, without language or year restriction. Grey literature was also searched through Google scholar and OpenGrey repository. Only in vitro studies were included that evaluated the influence of cervical preparation on endodontic treatment. Relevant results were summarized and evaluated. The risk of bias was also assessed in the studies. Results: Initial screening of databases resulted in 235 studies, of which 80 were excluded for being duplicates. Of 155 eligible papers, twenty-nine studies met the inclusion criteria and were selected for full-text reading. Most of studies included in this review were qualified with low risk of bias. Five studies showed moderate risk. Conclusion: Based on the analyzed studies, it is possible to conclude that performing the cervical preparation facilitates the execution of the steps of odontometry and mechanical chemical preparation in clinical practice.

The first experiences of preclinical dentistry students with rotary instruments: A pilot study

Abstract Introduction: Rotary instrumentation has been included in the undergraduate endodontic curriculum to improve the quality of endodontic treatment. The aim of this study was to compare the technical quality of root canal fillings performed by preclinical dentistry students trained with hand instrumentation (THI) or not during their initial trial with rotary instruments. Materials and Methods: Twenty-four 3rd-year students were distributed into two groups: 12 students THI group and 12 students not trained with hand instrumentation (NTHI group). Both the groups received a 50-min theoretical lecture and a demonstration about the ProTaper Universal® system before being asked to complete endodontic treatments on one extracted maxillary central incisor, premolar, and molar using rotary instrumentation and obturation with the single-cone technique. The endodontic treatment technical quality was determined by periapical radiographs. Data were statistically analyzed, and P < 0.05 was considered statistically significant. Results: A total of 144 root canals were performed by preclinical students. Although the difference in the technical quality of the canals was nonsignificant among the groups (P > 0.05), the THI group had more adequately filled root canals (45.8%) than the NTHI group (29.2%). Only maxillary central incisors had underfilled canals, whereas teeth with multirooted canals were subjected to various procedural errors in both the groups (P > 0.05). Conclusions: Intensive hand instrumentation (HI) preclinical training did not significantly improve the technical quality of root canals performed by preclinical dentistry students during their initial trial with rotary instruments. The student’s familiarity with HI did not decrease the incidence of procedural errors when performing root canal treatment with rotary instruments.

Implications of Artificial intelligence in the form of 3D-printing in Endodontics: A Review

Three-dimensional (3D) printing has become an emerging technology in dentistry, and specifically in endodontics. This technology enables the creation of highly accurate and patient-specific 3D models, surgical guides, and custom-made instruments that have revolutionized endodontic treatment. This abstract provides an overview of the applications of 3D printing in endodontics, including preoperative planning, fabrication of surgical guides, production of custom-made instruments, and postoperative evaluation. The accuracy and precision of 3D-printed models have shown to improve the quality of endodontic treatment and reduce the risk of complications. The creation of new dental models is made possible by three-dimensional printing. 3D-printed teeth have been used in a lot of studies, however standards for standardised research are still being created. Although they have significant disadvantages, using real teeth is still the norm in ex vivo investigations and pre-clinical training. All the restrictions of natural teeth may be overcome by printed teeth. Printing technology uses 3D data and post-processing tools to create a 3D model, which is then used by 3D printers to create a prototype. The hardness of the resin and the correctness of the canal anatomy printing are the main issues with 3D-printed teeth. Future research is given direction in order to address the issues with 3D-printed teeth and create defined protocols in order to attain method standardisation. In the future, ex vivo investigations and endodontic training could use 3D-printed teeth as the gold standard. Furthermore, 3D printing has also facilitated communication between the dental team and the patient, leading to a better understanding of the treatment plan and enhancing the patient experience. This review intends to gather information regarding 3D-printed teeth on the following themes: (1) their benefits; (2) their manufacturing processes; (3) their issues; and (4) potential future research topics. In conclusion, 3D printing has the potential to enhance the accuracy and efficiency of endodontic treatment and improve clinical outcomes.

A system for automatic classification of endodontic treatment quality in CBCT.

An evaluation of the effectiveness of a new computational system proposed for automatic classification, developed based on a Siamese network combined with Convolutional Neural Networks (CNNs), is presented. It aims to identify endodontic technical errors using Cone Beam Computed Tomography (CBCT). The study also aims to compare the performance of the automatic classification system with that of dentists. One thousand endodontically treated maxillary molars sagittal and coronal reconstructions were evaluated for the quality of the endodontic treatment and the presence of periapical hypodensities by three board-certified dentists and by an oral and maxillofacial radiologist. The proposed classification system was based on a Siamese network combined with EfficientNet B1 or EfficientNet B7 networks. Accuracy, sensivity, precision, specificity, and F1-score values were calculated for automated artificial systems and dentists. Chi-square tests were performed. The performances were obtained for EfficienteNet B1, EfficientNet B7 and dentists. Regarding accuracy, sensivity and specificity, the best results were obtained with EfficientNet B1. Concerning precision and F1-score, the best results were obtained with EfficientNet B7. The presence of periapical hypodensity lesions was associated with endodontic technical errors. In contrast, the absence of endodontic technical errors was associated with the absence of hypodensity. Quality evaluation of the endodontic treatment performed by dentists and by Siamese Network combined with EfficientNet B7 or EfficientNet B1 networks was comparable with a slight superiority for the Siamese Network. CNNs have the potential to be used as a support and standardization tool in assessing endodontic treatment quality in clinical practice.

Radiographic Criteria for Differential Diagnosis Between Vertical Root Fracture and Apical Periodontitis in Single-Rooted Endodontically Treated Premolars Using Cone-Beam Computed Tomography

IntroductionThis study explores the differences between the patterns of bone defects associated with vertical root fracture (VRF) and apical periodontitis (AP) in single-rooted endodontically treated premolars (SRETPs) based on cone-beam computed tomography (CBCT) data. MethodsEighty-four SRETPs were extracted and categorized into the VRF and AP groups. On preoperative CBCT images, the location of bone defects according to the root thirds in buccolingual and mesiodistal directions across the study groups were compared. ResultsThe majority of bone defects in the VRF group were longitudinal and combined, involving more than one root thirds in buccolingual and mesiodistal directions simultaneously. A uniform approach to comparing bone defects using the sites of periradicular area with bone loss as a comparison unit was developed. In the VRF group, bone loss sites in the middle and coronal thirds were detected more often and were located mainly buccolingually compared with the AP group (P < .001). ConclusionBone defects in the middle or middle and coronal root thirds in the buccolingual direction may be potential radiographic signs useful in differentiating between VRF and AP in SRETPs. The introduction of the uniform approach to assessment of bone loss patterns will give practitioners a single simple tool and improve the quality of endodontic treatment.

Assessment of Periapical Status in Posterior Root Canal-Treated Teeth Using Cone Beam Computed Tomography in the Iranian Population

Background: Periapical radiolucency occurs due to root canal infections. In this respect, effective root canal treatment and appropriate coronal restoration can aid in preventing these lesions. Thus, the present study aimed to assess the periapical status in posterior root canal-treated teeth by cone-beam computed tomography (CBCT) in the Iranian population. Methods: The CBCT images of 210 patients (475 endodontically treated molars and premolars) referred to the Hamadan Dental School (from 2020 to 2022) were evaluated in this observational study. The images were obtained by a NewTom 3G CBCT device (NewTom, Verona, Italy) with an FOV of 6×6 inches at 110 kVp and varying milliampers and exposure times according to the patient’s age and body size. They were observed by two maxillofacial radiologists who recorded the periapical status, coronal seal, and endodontic treatment quality of root canal-treated teeth. The Chi-square test was used for data analysis (P≤0.05). Finally, the periapical lesion was determined, along with its association with gender, type of tooth, endodontic treatment quality, and appropriate restoration. Results: The results revealed no significant association between periapical radiolucency and gender. The prevalence of periapical lesions was higher in males aged 25–50 years, but no significant correlation was found in this regard. There was no significant relationship between tooth type and the presence of periapical lesions, while it had the highest prevalence in maxillary molars. Endodontic treatment quality and coronal restoration showed significant correlations with the presence of periapical radiolucency. Conclusion: There was no significant association between the presence of periapical radiolucency and gender and age. The prevalence of periapical lesions was higher in males. Cases with poor endodontic treatment and poor restoration demonstrated the highest prevalence of periapical lesions.

Relationship between apical periodontitis and missed canals in mesio-buccal roots of maxillary molars: CBCT study

ObjectivesThe objectives of this study were to: (1) assess the frequency of missed canals in the mesiobuccal root (MB) of endodontically treated maxillary molars and its association with apical periodontitis (AP); (2) examine the correlation between the presence of a confluent or separate missed MB2 canal and the prevalence of AP; and (3) examine the correlation between the technical quality of endodontic treatment in the MB1 canal and the prevalence of AP. MethodsWe obtained and examined 800 cone-beam computed tomography (CBCT) scans from 800 patient records over 6 months. The parameters noted for each tooth included the tooth number; presence of missed canals in the MB root; configuration of missed MB2 canals (confluent or separate); technical acceptability of root canal treatment (RCT) of treated MB1 canals; and the CBCT periapical index score. Data were analyzed in SPSS version 24. ResultsA total of 203 maxillary molars from 148 CBCT scans were included. The MB2 canal prevalence was 88.2% in maxillary first molars and 62.7% in maxillary second molars. MB2 was found in 164 endodontically treated maxillary molars. During treatment, MB2 was missed in 150 (91.5%) and treated in 14 (8.5%) teeth. A total of 103 teeth (50.73%) had AP, which was observed in 67.3% of teeth with a missed MB2 canal but only 14.3% of teeth with a treated MB2 canal. The prevalence of AP was 43.7% in teeth with confluent MB2 canals and 80.9% in teeth with separate MB2 canals. ConclusionThe MB2 canal frequency was significantly higher in the examined maxillary first molars than the maxillary second molars. The MB2 canal was missed in most teeth that underwent endodontic treatment. The AP prevalence was relatively higher in endodontically treated maxillary molars with missed MB2 canals.

Përdorimi i diod lazerit në mjekimin endodontik te periodontitet apikale kronike

The complete elimination of microorganisms from the root canal is difficult due to the complex anatomy of the canal, the microbial invasion of the dentinal tubules, and the for- mation of the intracanal biofilm, which gives rise to contin- uous apical periodontitis. The use of lasers in the treatment of caries complications has led to the improvement of various endodontic diagnoses. The aim is to provide clin- ical-radiological data on increasing the effectiveness and quality of endodontic treatment, using a diode laser with a wavelength of 980 nm and a laser power of 0.8–1.0 W in the radicular canals, in the treatment of chronic apical periodontitis. Materials and methods: Eighty-four patients aged between 20 and 70 years were treated, with a total number of teeth of 91; of these, 64 were mono radicular and 27 multi radicular. We divided the patients into two groups; where the first group was the control one, with 40 patients in which 30 single-root teeth and 11 multi- root teeth were selected and treated with the traditional method by performing chemical-mechanical processes. The second group, which was the study one, treated 44 patients from which 36 single-root teeth with chronic peri- odontitis with periapical destruction and 14 multi-root teeth were selected; in this group, in addition to the chemical-mechanical processes, was also applied the diode laser with a wavelength of 980 nm. The cases were observed clinically and radiologically in dynamics for a period of time ranging from 6 to 12 months. Results: We highlighted that the number of complications in chronic apical periodontitis was reduced to a large per- centage in the diode laser group (study group), which achieved 96 % success after 12 months and 4 % failure. As for the control group, there were many complications in the first 6 months and after 12 months, where the final result was 78.1% success, while complications were 21.9%. Conclusions: The quality of root canal treatment with the traditional endodontic treatment protocol has not been sufficient to achieve a clinical effect for a long time. Modification of this protocol by diode laser processing showed high-quality sterilization of canals and rapid reduction of de- structive focus by stimulating osteogenesis.

Cone-Beam Computed Tomography Assessment of Quality of Endodontic Treatment and Prevalence of Procedural Errors in Mandibular Molars.

This study assessed the quality of endodontic treatment and the prevalence of procedural errors in permanent mandibular molars using cone-beam computed tomography (CBCT). This cross-sectional study was conducted on 328 CBCT scans (182 females and 146 males) of endodontically treated mandibular molars retrieved from the archives of two radiology centers in Ardabil city, Iran, in 2019. Mandibular molars were evaluated on sagittal, coronal, and axial sections regarding obturation length, obturation density (voids), missed canals, broken instruments, apical perforation, strip perforation, ledge formation, transportation, root fracture, root resorption, and periapical lesions by a senior dental student under the supervision of an oral and maxillofacial radiologist and an endodontist. Differences between the frequency of procedural errors and tooth type and gender were analyzed by the chi-square test. The frequency of underfilling, missed canals, overfilling, voids, apical perforation, transportation, ledge formation, broken instruments, root fracture, strip perforation, root resorption, and periapical lesions was 34.8%, 17.4%, 16.8%, 14.3%, 7.3%, 6.1%, 4.3%, 3%, 1.2%, 0.6%, 5.5%, and 46%, respectively. The frequency of root fracture was significantly higher in females than in males (P < 0.05). The prevalence of underfilling was the highest in right second molars (47.2%), followed by right first molars, left second molars, and left first molars (P < 0.005). The frequency of transportation was maximum in right first molars (10%), followed by right second molars, left first molars, and left second molars (P < 0.04). Underfilling, missed canals, and overfilling were the most prevalent procedural errors in mandibular molars in our study population.

Laser in endodontics: a scoping review

Objective: To evaluate the effect of LASER (Light Amplification by Stimulated Emission of Radiation) in endodontics and its effectiveness compared to conventional techniques and methods currently used. Material and method: The electronic databases PubMed, Science direct and Cochrane library, were searched from 2010-2022 to identify clinical trials and in vitro/in vivo trials evaluating the clinical application of laser in endodontics. The search terms utilized various combinations as follows: endodontics or root canal therapy or dentin or dental pulp and laser. Articles were selected according to the inclusion criteria, data were extracted and methodological quality was assessed. Results: Twenty articles were deemed eligible and included in the review. Of these twenty studies, eleven were in vitro trials and nine were in vivo trials. An assessment of the risk of bias of the included studies was used to classify the studies into three categories: low, medium, and high risk of bias. To evaluate the results of these articles, we established the following analysis criteria: root canal disinfection, direct pulp capping, post endodontic pain and opening of dentinal tubuli. The results of the studies included in this review showed that laser appears to improve root canal disinfection, removal of debris and smear layer, adaptation of filling materials to dentin by increasing the penetration of root canal sealants into the dentinal tubuli, improved prognosis of direct pulp capping treatment as well as decreased postoperative endodontic pain. Conclusion: Although laser appears to improve the quality of endodontic treatment, the heterogeneity in the methodology among the eligible studies did not allow a meta-analysis to be performed for clinical decisions with greater certainty of evidence. Further in vivo studies with standardization of laser parameters are needed to validate its utility as an innovative technology in modern endodontics.

Prevalence and Quality of Endodontic Treatment in Patients with Cardiovascular Disease and Associated Risk Factors.

This study aimed to determine the prevalence and quality of endodontic treatment, by radiographically assessing the periapical periodontitis and endodontic treatment status in patients with cardiovascular disease (CVD) and cardiovascular risk (CVR) factors. Patients who visited the Out Patient Department of Institute of Dental Sciences and Department of Cardiology, Institute of Medical Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar, from August 2021 to February 2022, for a check-up or dental problem were considered as participants in this study. After obtaining informed consent, the participants were enrolled on the Oral Infections and Vascular Disease Epidemiology Study (INVEST) IDS, BHUBANESWAR. After testing negative for COVID-19, patients’ demographic details, such as age and gender were recorded, followed by a panoramic radiographic examination (OPG). A total sample of 408 patients were divided into three groups: Group 1/control (without any cardiovascular manifestation) consisting of 102 samples, group 2 of 222 CVR patients, and group 3 of 84 CVD cases. The CVR and CVD groups had a preponderance of elderly age groups between 60 to 70 years, with a significantly higher proportion of males. Co-morbidities such as diabetes mellitus, hypertension, and dyslipidemia were significantly associated with the CVR and CVD groups. From OPG interpretation, it was observed that the periapical radiolucency was greater in the CVR and CVD groups than in the control group (p = 0.009). The prevalence of endodontically treated teeth was higher in CVR and CVD than in the control group (p = 0.028). A high prevalence of dental caries, about 70%, was reported in all three groups (p = 0.356). The presence of dental restoration among all the groups was low (p = 0.079). The proportion of periodontal bone loss in the control group was significantly lower than CVR and CVD (p = 0.000). There was a strong association between periapical radiolucency, endodontically treated teeth, and periodontal bone loss in CVR and CVD patients. Notably, the associations reported herein do not reflect a cause-effect relationship; however, individuals with endodontic pathologies may accumulate additional risk factors predisposing them to hypertension or other CVDs. The results emphasize that eliminating local infections may decrease the systemic infection burden.

Radiological assessment of prevalence and quality of endodontic treatments in a Turkish subpopulation

<h3>Objective</h3> The aim of this study was to determine the current prevalence and quality of endodontic treatments and investigate the relationship of various factors with periapical status in a Turkish subpopulation. <h3>Study Design</h3> The CBCT images of 1069 patients (50.9% males, 49.1% females; mean age 45.32 ± 13.50 years) who applied to Kocaeli University Faculty of Dentistry between 2015 and 2020 were retrospectively analyzed. In total, 20,646 teeth were examined; 1,604 teeth that had undergone root canal treatment met the criteria and were included in the study. The relationship between periapical status of the endodontically treated teeth and the quality of the root canal treatment was recorded. Periapical status was assessed using a modified CBCT periapical index (PAI) by two independent observers. The relation between periapical status and quality of root canal fillings (RCFs) was analyzed statistically using the chi-square test. <h3>Results</h3> The prevalence of apical periodontitis (AP) for teeth with RCF was 56.8%, while 7.8% of all teeth had had endodontic treatment. The prevalence of AP was 44.3% in teeth with short RCF, 10.8% with overextended RCF, 35.7% with inadequate RCF, and 15.5% with untreated root canals. 76.2% of root canal obturated teeth with procedural errors were associated with AP. No statistically significant differences were found between genders in terms of AP (p>0,05). AP developed more frequently in teeth treated with procedural errors. <h3>Conclusion</h3> The quality of root canal treatment was poor in this subpopulation. There is a substantial need to improve the technical quality of endodontic treatment. <b>Statement of Ethical Review</b> Human/Animal subjects were used and this study was approved by an institutional ethics panel

Radiological Assessment of Prevalance and Quality of Periapical Status of Endodontic Treatments.

BackgroundThe aim of this study was to determine the current prevalence and quality of endodontic treatments and investigate the relationship of various factors with posttreatment endodontic disease (PTED) in a Turkish subpopulation.Material/MethodsThe cone beam computed tomography (CBCT) images of 1069 patients (male, 50.9%; female, 49.1%; mean age, 45.32±13.50 years) were retrospectively analyzed. A total of 20 646 teeth were examined; 1604 had undergone root canal. Periapical status was assessed using a modified CBCT periapical index. The relationship between periapical status and quality of root canal fillings (RCFs) was analyzed statistically using the chi-square test. Multivariate logistic regression was performed to evaluate the effect of individual parameters by adjusting them for other variables.ResultsA total of 7.8% of all teeth had RCF. The prevalence of poor filling (having at least 1 procedural error) was 54.1%; the prevalence of PTED was 56.8%. The prevalence of PTED was 44.3% in teeth with short RCF, 10.8% with overextended RCF, 35.7% with nonhomogeneous RCF, and 15.5% in teeth with untreated root canals. The rate of RCF teeth with procedural errors associated with PTED was 76.2%. There was no significant difference between sexes in apical periodontitis (P>0.05), which developed more frequently in teeth with procedural errors.ConclusionsThe overall prevalence of poor fillings (having at least 1 procedural error) among RCF teeth was high (54.1%) in this subpopulation. There is a substantial need to improve the technical quality of endodontic treatment.

Factors affecting the quality of endodontic treatment in general dental practice in Scotland: a qualitative focus group study

Introduction The quality of endodontic treatment worldwide is variable despite clear clinical guidelines being available.Aims Identify the factors that affect the quality of endodontic treatment in general dental practice in Scotland and how to overcome the barriers identified.Methods Four online focus group interview sessions were conducted in which a total of 16 participants were recruited, including general dental practitioners, endodontic specialists and educationalists. Topics for facilitated discussion were based on healthcare system theory and included education/training, patient factors, resources and equipment factors; themes were identified via template analysis.Results A number of themes and subthemes affecting the quality of care are reported, including aspects to do with remuneration, time, education, training, support from secondary care and the impact of COVID-19.Conclusion Findings support: increase practical experience for undergraduates; access to postgraduate mentoring and training; development of a managed clinical network to facilitate access to appropriately trained specialists; and increased remuneration to allow sufficient time and adequate equipment to achieve clinical standards.

Comparative morphometric characteristics of the working surface of endodontic rotary nickel-titanium instruments after maximum cyclic loading

Aim. Is the morphometric analysis of the working surfaces of endodontic rotating nickel-titanium instruments.Materials and methods. The chemical composition and physical properties of the three types of endodontic rotating nickel-titanium F2 instruments have been analyzed: proptaper Universal (PTu, Dentsply, Maillefer, Ballaigues, Switzeland), Ultrataper (Eurofile, China) and Superfile (Eurofile, China) protapers. The evaluation of endodontic treatment of 75 endoblocks was also carried out.Results. The research work shows that endodontic rotary instruments have both different chemical composition and heterogeneity of the alloy. The average comparable percentage of titanium and nickel in the studied alloy samples has been revealed. The quality of endodontic treatment of the endoblocks’ channels with various rotating nickel-titanium instruments is also comparable and meets the specified criteria.Conclusion. The morphometric analysis has revealed a difference in the structure of the metal alloy of the F2 protapers, with a comparable content of nickel (46-52%) and titanium (38-41%). The content of pure nickel-titanium alloy along the periphery of the endodontic instrument in Universal protapers ensures high cutting ability of the faces. The obtained data on different resistance to cyclic loads should be taken into account in the endodontic treatment of multi-root teeth. The analysis of the structure of the nickel-titanium alloy indicates the predetermination of the development of the tool’s fracture with prolonged use and the need to take into account the cycles of the endodontic rotary tool.

Structural features of the roots and root canals of mandibular premolars and molars based on data of modern radiological methods of investigation used in dentistry

Objective. To determine the structural features of the root canals of mandibular premolars and molars, to assess the quality of endodontic treatment on the basis of cone-beam computed tomography (CBCT).Materials and methods. The structure of 50 teeth (premolars and molars of the mandible) after performed endodontic treatment was studied retrospectively on the basis of CBCT in 50 patients. The number of roots, as well as root canals and their angle of inclination, the presence of additional canals were taken into account. The obtained data were processed statistically.Results. No significant differences in the angle of inclination of the root canals and the number of roots were found. The ratio of unsatisfactory episodes of endodontic treatment was 82 %. Destructive processes in the periapical region were revealed in all the examined teeth.Conclusion. The results of the study prove the neсessity to develop the differentiated use of surgical methods for the treatment of foci of chronic odontogenic infections in the periapical region of mandibular molars and premolars.

Retrospective study of endodontic treatment performed by undergraduate students using reciprocating instrumentation and single-cone obturation.

The aim of this cross-sectional retrospective study was to evaluate radiographically the technical quality of root canal treatment performed by undergraduate students using reciprocating NiTi instrumentation and single-cone obturation. Endodontic treatment on 1102 teeth performed by undergraduate students from the School of Dentistry of the University of Santa Cecilia (Brazil) was evaluated. All root canal preparations were performed using Reciproc files and were irrigated with 1% NaOCl. The root canal was filled with gutta-percha, along with AH Plus sealer, using the single-cone obturation technique. The technical quality of the root canal treatment was evaluated based on immediate postoperative radiographs. Distance between the end of the filling and the radiographic apex, the filling density, and the taper of the root filling was assessed. Inter-examiner agreement statistic (Kappa) and Chi-square statistic test were used for statistical evaluation of the results. Differences were considered statistically significant when p < 0.05. Anterior teeth, maxillary premolars, and molars presented better results than mandibular premolars and molars (p < 0.05). Mandibular premolars presented a high incidence of a short length of obturation (33.34%) and mandibular molars presented a high incidence of overfilling (6.55%). The majority of the treatment analyzed (62.46%) fulfilled all the criteria showing acceptable working length, taper, and density of obturation. Instrument fractures occurred in eighteen root canals (0.81%). The use of NiTi reciprocating instruments with the single-cone obturation technique provided an acceptable quality of endodontic treatment in the majority of the cases performed by undergraduate students.

EVALUATION OF ENDODONTIC TREATMENT IN THE PRACTICE OF THERAPEUTIC DENTISTRY

Aim of the study is to study the need for a qualitative diagnosis before endodontic treatment, as well as methods for determining additional root canals, ways of passing the root system of the tooth, irrigation and obturation methods and the frequency of possible complications during endodontic treatment. Materials and Method: The quality of endodontic treatment was studied using the social research method (questionnaire) among dentists from Penza and Penza Region (Russia). 140 practicing doctors participated in the study. Results and discussion: According to the results of the survey, most doctors note a favorable result of endodontic treatment and associate this with the use of X-ray imaging, especially computed tomography, which greatly contributes to the qualitative and accurate mapping of the root system and the surrounding bone structure. Conclusion: After the conducted research, we can assume that in the near future no intervention in the root system will be complete without preliminary X-ray diagnosis and without means of magnification.

Factors related to apical periodontitis in a southern Brazilian population: a multilevel analysis.

The aim of this cross-sectional study was to evaluate the effects of individual-level and tooth-level factors on apical periodontitis (AP) in an urban population in southern Brazil. A random sample of digital panoramic radiographs (n = 545) from a dental school database was evaluated. The diagnosis of AP was determined by using a dichotomous scale (yes/no). AP was assessed according to gender, age, presence and quality of endodontic treatment (ET), presence of an intracanal post, coronal condition, and dental group. Data were analyzed descriptively and through multilevel Poisson regression analysis, considering teeth characteristics (level 1) nested in individuals (level 2). In this sample of 545 participants, the prevalence of AP was 49.5% (n =2 70) and ET was 43.5% (n = 237). Considering 13,595 teeth, AP was identified in 596 (4.4%) and ET in 617 (4.5%). Of the teeth with ET, 153 (24.8%) presented AP. Among individual-level factors, the disease was not significantly associated with gender or age. For tooth-level factors, AP was significantly associated with ET quality: teeth with short fillings (< 3 mm) and teeth with over-fillings had 2.77 (CI: 1.95-3.94, p < 0.001) and 1.08 (CI: 0.39-2.98, p < 0.001) higher prevalence of AP, respectively. There was no association between AP and age, gender, dental group, coronal condition, or the presence of an intracanal post. AP was highly prevalent in this population, and multilevel analysis indicated a significant association with ET quality.

Evaluation of Endodontic Treatment Quality and Periapical Health Status of Maxillary Molars Using Cone-Beam Computed Tomography

ÖZET Amaç: Bu çalışmanın amacı, retrospektif konik ışınlı bilgisayarlı tomografi (KIBT) görüntülerinde endodontik tedavi görmüş üst büyük azı dişlerinin endodontik tedavi kalitelerinin ve periapikal bölge sağlıklarının, periapikal ve endodontik durum indeksi (PEDİ) kullanılarak değerlendirilmesidir. Gereç ve Yöntem: Çalışmaya endodontik tedavi görmüş 80 adet üst büyük azı dişine (47 birinci, 33 ikinci azı) ait toplam 240 kök dahil edilmiştir. Endodontik tedavi kalitesi ve periapikal bölgenin sağlık durumu değerlendirilmiştir. Veriler istatistiksel olarak analiz edilmiştir (p 0.05). Kökler içerisindei se AP en çok meziobukkal kökte tespit edilmiştir. Dişlerin büyük bir çoğunluğunda AP’nin anatomik yapılar ile ilişkili (D2) olduğu (%53.2n=33) gözlenmiştir. Kök kanal dolgusu normal sınırlardan eksik (L2) veya taşkın (L3) olduğunda AP görülmesi anlamlı derecede yüksek bulunmuştur (p=0.001). Distal ve palatinal köklerde yetersiz obtürasyon (H2) ile AP varlığı arasında anlamlı ilişki gözlenmiştir (p=0.001). Dişlerin %16.2’sinde (n=13) komplikasyona rastlanırken, bunlar içerisinde en sık apikal rezorpsiyon (CF5) (n=59) ve tedavi edilmemiş kanal (CF2) (n=17) tespit edilmiştir. Sonuç: Kanal tedavili üst büyük azı dişlerinde AP yüksek oranda saptanmıştır. İncelenen kökler içerisinde AP en çok, kompleks bir anatomik yapı sergileyen meziobukkal kökte tespit edilmiştir. Eksik, taşkın ve/veya homojen olmayan kanal dolumları AP oluşumunda etkili olabilecek faktörler olarak tespit edilmiştir.