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Research Articles
Prevalence of apical periodontitis and quality of root canal treatment in an adult Kuwaiti sub-population: a cross-sectional study
Abdulrahman A. Alhailaa, Saad A Al-Nazhan, Mazen A Aldosimani
Restor Dent Endod 2024;49(2):e16.   Published online March 22, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e16
AbstractAbstract PDFPubReaderePub
Objectives

This cross-sectional study evaluated the prevalence of apical periodontitis (AP) and the technical quality of root canal fillings in an adult Kuwaiti subpopulation using cone-beam computed tomography (CBCT) images.

Materials and Methods

Two experienced examiners analyzed 250 CBCT images obtained from Kuwaiti patients aged 15–65 years who attended government dental specialist clinics between January 2019 and September 2020. The assessment followed the radiographic scoring criteria proposed by De Moor for periapical status and the technical quality of root canal filling. Chi-square and Fisher’s exact tests were used for statistical analysis, with significance level set at p < 0.05.

Results

Among the 2,762 examined teeth, 191 (6.91%) exhibited radiographic signs of AP, and 176 (6.37%) had undergone root canal filling. AP prevalence in root canal-treated teeth was 32.38%, with a significant difference between males and females. Most of the endodontically treated teeth exhibited adequate root canal filling (71.5%).

Conclusions

The study demonstrated a comparable prevalence of AP and satisfactory execution of root canal treatment compared to similar studies in different countries.

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Incidence of interappointment emergencies in multiple-visit root canal treatments performed with or without intracanal medicament by undergraduate students
Annemarie Baaij, Corine Mirjam Visscher, Manon Jansen, Ahmet Rifat Özok
Restor Dent Endod 2023;48(3):e31.   Published online August 14, 2023
DOI: https://doi.org/10.5395/rde.2023.48.e31
AbstractAbstract PDFPubReaderePub
Objectives

This retrospective cohort study examined the incidence of interappointment emergencies during multiple-visit molar root canal treatments conducted by undergraduate students. Treatments performed without the use of intracanal medicament were compared to treatments that incorporated calcium hydroxide as an intracanal medicament.

Materials and Methods

Interappointment emergencies, defined as instances of pain or swelling that required the patient to make an unscheduled follow-up visit, were recorded for up to 2 months after the intervention. To avoid the influence of obturation on the observed incidence of emergency visits, only unscheduled visits occurring between the start and end of the root canal treatment were included.

Results

Of the 719 patients included in this study, 77 (10.7%) were recorded as experiencing interappointment emergencies. Of these emergencies, 62% occurred within 2 weeks following the most recent intervention. In the group of patients who did not receive intracanal medicament, the incidence of interappointment emergencies was 11.9% (46 of 385 patients). In comparison, this rate was 9.3% (31 of 334 patients) among those who received calcium hydroxide as an intracanal medicament (odds ratio, 1.33; 95% confidence interval, 0.82–2.15; p = 0.249).

Conclusions

Interappointment emergencies may arise at any point during root canal treatment, but they most commonly occur within the first 2 weeks following intervention. The omission of intracanal medicament in multiple-visit molar root canal treatments, performed by undergraduate students, did not significantly increase the incidence of these emergencies.

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Outcome of endodontic treatments performed by Brazilian undergraduate students: 3- to 8-year follow up
Jéssica Gabriele da Rocha, Isabella Marian Lena, Jéssica Lopes Trindade, Gabriela Salatino Liedke, Renata Dornelles Morgental, Carlos Alexandre Souza Bier
Restor Dent Endod 2022;47(3):e34.   Published online August 18, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e34
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome.

Materials and Methods

A 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.

Results

The 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).

Conclusions

The 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.

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Clinical and radiographic outcomes of regenerative endodontic treatment performed by endodontic postgraduate students: a retrospective study
Hadi Rajeh Alfahadi, Saad Al-Nazhan, Fawaz Hamad Alkazman, Nassr Al-Maflehi, Nada Al-Nazhan
Restor Dent Endod 2022;47(2):e24.   Published online May 9, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e24
AbstractAbstract PDFPubReaderePub
Objectives

Regenerative endodontic treatment is a clinical procedure aimed at biologically regenerating damaged root canal tissue of immature permanent teeth. This study aimed to report the outcomes of regenerative endodontic treatment performed by endodontic postgraduate students.

Materials and Methods

Clinical and radiographic data of 27 patients, aged 10–22 years, who underwent regenerative treatment of immature permanent teeth from 2015 to 2019 were followed up, wherein clinical and radiographic examinations were performed for each patient. Postoperative success rate and tooth survival were analyzed, and the postoperative radiographic root area changes were quantified.

Results

A total of 23 patients attended the dental appointments, showing that all teeth survived and were asymptomatic. Specifically, 7 periapical pathosis cases were completely healed, 12 were incompletely healed, and 4 cases failed. Moreover, significant differences were found between discolored and non-discolored teeth, and between the presence or absence of periapical radiolucency. Additionally, 3 anterior teeth showed complete closure of the apical foramen, while the apical foramen width was reduced in 17 teeth and failed in 3 teeth. Root length was also found to have been increased in 7 anterior and 4 posterior teeth, and the average length ranged from 4.00–0.63 mm in the anterior teeth, 2.85–1.48 mm of the mesial root, and 2.73–2.16 mm of the molar teeth distal root. Furthermore, calcified tissue deposition was observed in 7 teeth.

Conclusions

A favorable outcome of regenerative endodontic treatment of immature permanent teeth with necrotic pulp was achieved with a high survival rate.

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Case Report
Periodontal healing following non-surgical repair of an old perforation with pocket formation and oral communication
Saeed Asgary, Prashant Verma, Ali Nosrat
Restor Dent Endod 2018;43(2):e17.   Published online April 13, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e17
AbstractAbstract PDFPubReaderePub

Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.

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Clinical Research
Prognostic factors influencing clinical outcome of nonsurgical endodontic treatment
Seonah Kim
J Korean Acad Conserv Dent 2010;35(6):436-444.   Published online November 30, 2010
DOI: https://doi.org/10.5395/JKACD.2010.35.6.436
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to assess prospectively the clinical outcome of nonsurgical endodontic treatment and identify patient- and tooth-related factors, rather than treatment-related factors, that were the best predictors of this outcome.

Materials and Methods

The inception cohort comprised 441 teeth (320 patients) and 175 teeth (123 patients) were followed up for 1-2 years. Age, gender, presence of medical disease, number of canals, previous endodontic treatment, presence of sensitivity and pain, pulp vitality, swelling or sinus tract of pulpal origin on the gingiva, periapical radiolucency and tendency of unilateral bite on the affected tooth were recorded at treatment start.

Results

The outcome was classified on the basis of periapical radiolucency as healed or non healed. The overall healed rate in these cases, including nonsurgical retreatment, was 81.1%. Four tooth-related factors had a negative impact in the bivariate analysis: previous endodontic treatment, necrotic pulp, preoperative gingival swelling or sinus tract of pulpal origin, and preoperative periapical radiolucency. Stepwise logistic regression analysis including patient-, tooth-related factors and level of the root canal filling as a treatment-related factor showed that preoperative gingival lesion (odds ratio [OR]: 4.4; p = 0.005), preoperative periapical radiolucency (OR: 3.6; p = 0.011), and ≤ 1-2 mm under root filling length (OR: 9.6; p = 0.012) were significant predictors of failure.

Conclusions

A preoperative gingival lesion of pulpal origin can influence the outcome of nonsurgical endodontic treatment in addition to preoperative periapical radiolucency.

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