A Scoping Review of Four Decades of Outcomes in Nonsurgical Root Canal Treatment, Nonsurgical Retreatment, and Apexification Studies: Part 3—A Proposed Framework for Standardized Data Collection and Reporting of Endodontic Outcome Studies

Azarpazhooh, Amir; Khazaei, Saber; Jafarzadeh, Hamid; Malkhassian, Gevik; Sgro, Adam; Elbarbary, Mohamed; Cardoso, Elaine; Oren, Ariel; Kishen, Anil; Shah, Prakesh S.

doi:10.1016/j.joen.2021.09.017

Cited by 10 publications

(2 citation statements)

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“…The study was conducted in a private practice and patients were referred from general dental practices to reflect the regular work of an endodontist. The most current methodological recommendations were taken into consideration to make the results comparable with similar studies (Azarpazhooh, Khazaei, et al., 2022; Azarpazhooh, Sgro, et al., 2022; El‐Karim et al., 2023; Kirkevang et al., 2022; Nagendrababu et al., 2023). The pre‐operative prognostic factors of lesion diameter and PAI index were used, the latter with a five score PAI system for better prognostic value (Kirkevang et al., 2015).…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the outcome of root canal treatment—A cohort study conducted in a private practice

Jurič,

Vidmar,

Blagus

et al. 2024

Int Endodontic J

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AimTo investigate the association of various pre‐, intra‐ and post‐operative factors on root canal treatment outcome.MethodologyIn this cohort study, primary or secondary root canal treatment of mature permanent teeth was performed by a single endodontist in a private practice over 13 years, and followed 1–4 years after treatment. Treatment details and clinical and radiographic data were collected. The proportion of successfully treated teeth and roots based on strict radiographic (periapical index (PAI) ≤2) and clinical criteria (absence of pain, swelling or sinus tract) was estimated. To evaluate joint associations of prognostic factors and treatment success probability, 44 pre, intra‐ and post‐operative factors were investigated using bivariate associations, and a multiple logistic regression model was fitted using Generalized Estimating Equations.Results1259 teeth (2445 roots, 3149 canals) were assessed with a recall rate of 91%. The proportion of successfully treated teeth was 79.9% [95% confidence interval 77.7–82.1]. Eleven prognostic factors were identified that significantly reduced the odds ratio (OR) for treatment success at tooth level. Six were preoperative: injury history (OR = 0.05[0.01–0.24]), root PAI (OR = 0.29[0.20–0.42], 0.21[0.13–0.34] and 0.22[0.12–0.42] for PAI = 3, 4 and 5, respectively, against PAI = 1), lesion diameter (OR = 0.30[0.21–0.43] and 0.24[0.16–0.37] for diameters of 1‐5 mm and ≥6 mm, respectively, against no lesion), tooth type (OR = 0.51[0.27–0.97] and OR = 0.45[0.24–0.83] for premolars and molars, respectively, against incisors or canines), tenderness to periapical palpation (OR = 0.64[0.43–0.94]) and two canals per root (OR = 0.67[0.54–0.83]). Four factors were intraoperative: root filling of unsatisfactory quality (OR = 0.18[0.08–0.40]) or extending beyond or shorter than 2 mm from the apex (OR = 0.44[0.26–0.75] and 0.62[0.40–0.97] respectively), resin sealer (OR = 0.58[0.39–0.87] against bioceramic sealer) and single visit treatment (OR = 0.40[0.21–0.75] against multiple visits). One factor was post‐operative: defective coronal restoration (OR = 0.35[0.21–0.56]).ConclusionThe following factors were associated with unsuccessful root canal treatment: (i) history of injury, apical periodontitis with increased severity (larger lesion, higher PAI, tenderness to periapical palpation), or complicated anatomic conditions (premolar or molar, two canals in a single root); (ii) technically suboptimal root filling (of unsatisfactory quality or not ending within 2 mm of radiographic apex) performed in a single‐visit, or use of resin sealer instead of novel bioceramic sealer; (iii) suboptimal quality coronal restoration.

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Section: Discussionmentioning

confidence: 99%

Factors associated with the outcome of root canal treatment—A cohort study conducted in a private practice

Jurič,

Vidmar,

Blagus

et al. 2024

Int Endodontic J

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“…Thus, an excel sheet was created to gather all the needed information: starting from patients' demographics, through preoperative clinical and radiographic condition of the included cases, procedural steps, then short and long term outcome criteria. This tool, though very much conforming to the recently suggested template by Azarpazooh et al (20,22) , it was tailored at the time of the investigation for clear standardized recording of the research data (22) .…”

Section: Outcome Of Root Canal Retreatment Performed In Single Visit ...mentioning

confidence: 99%

Outcome of root canal retreatment performed in single visit. A cohort retrospective study.

Nasr

Harmoodi

Hussain

2022

Egyptian Dental Journal

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Introduction:The purpose of this retrospective study was to assess the outcome of endodontic retreatment performed in single visit.Methods: Retreatments were identified from the pool of patients treated in Dubai Health Authority (DHA) endodontic clinics between 2018 and 2019. The cases included were retreated in a single visit and followed up for at least 6 months. Data were retrieved from 139 cases and a template was created to collect demographic, procedural, clinical and radiographic information. Short term flare up and long term clinical and radiographic outcome were assessed, in addition to calculation of tooth survival. Moreover, the preoperative apical status and quality of root canal filling were studied as prognostic factors and were analyzed for their impact on the outcome.Results: Data from 127 patients, where 99 cases from women and 40 cases from men with a mean age of 46.5 years, showed that flare up occurred in 2.9% of the cases; a success rate of 92.1 % and survival rate of 94%. Statistical analysis did not discern an association between the quality of the previous root canal filling and outcome of retreatment. Conversely, there was an association between the presence of a preoperative apical periodontitis and outcome of treatment (p= 0.006) Conclusion: Single visit endodontic retreatment performed by specialists on asymptomatic teeth is a predictable therapy with a high incidence of healing and tooth retention.

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The effect of hard tissue defects on the clinical outcome of endodontic microsurgery: a systematic review and meta-analysis

Sabeti,

Ihsan,

Kharat

et al. 2023

Clin Oral Invest

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Objectives The purpose of this systematic review was to appraise the existing literature on the effect of hard tissue defects on the clinical outcome of endodontic microsurgery (EMS). Methods MEDLINE (PubMed), Embase, Web of Science, Cochrane Library and grey literature were searched from January 2000 to May 2023. Study selection and data extraction were performed in duplicate. Eligible studies were critically appraised for the risk of bias using the Cochrane Risk of bias tool. The quality of evidence was assessed using GRADE. Review Manager (RevMan Computer program Version 5.4, The Cochrane Collaboration, 2020) was utilized and the Mantel Haenszel fixed or random effects model was applied, depending on the heterogeneity of the studies. Meta-analysis was performed to estimate the Risk ratio (RR) and 95% Confidence Interval (CIs) to correlate the effects of these factors on treatment outcomes. Results Nineteen studies were included. The EMS overall pooled success rate was 84.5%. Five characteristics of hard tissue were identified. The size of the lesion (Small ≤ 5 mm: 78.4% vs. Large > 5 mm: 63.3%, RR = 1.12, 95% CI 1.00–1.26, P ≤ .05), significantly affected the outcomes of EMS. Endodontic lesions exhibited slightly better outcomes than endodontic-periodontal lesions (81.4% vs. 68.2%, RR = 1.14 95% CI 0.98–1.33, P > .05). Cases with the height of the buccal bone > 3 mm also exhibited slightly better outcomes (91.5% vs. 71.4%, RR = 1.20, 95% CI 0.88–1.62, P > .05). Additionally, through and through lesions exhibited better outcomes when grafting was completed during the EMS procedure both in 2D (RR = 1.12 95% CI 0.97–1.29, P > .05) and 3D evaluation ((RR = 1.28 95% CI 0.69–2.37 P > .05). The overall quality of evidence was graded as low to high. Conclusion With a low to high quality of evidence, the size of the lesion is a key prognostic variable that significantly affects the outcome of EMS, as lesions ≤ 5 mm exhibit better outcomes as compared to larger lesions. Clinical significance The presence of hard tissue defects can affect the outcome of endodontic microsurgery (EMS). The presented data can aid the clinicians’ decision-making process by examining certain pre-operative prognostic variables, when considering EMS as a treatment option. Clinical cases with more favorable hard tissue characteristics lead to a better prognosis in EMS.

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A Scoping Review of Four Decades of Outcomes in Nonsurgical Root Canal Treatment, Nonsurgical Retreatment, and Apexification Studies: Part 3—A Proposed Framework for Standardized Data Collection and Reporting of Endodontic Outcome Studies

Cited by 10 publications

References 54 publications

Factors associated with the outcome of root canal treatment—A cohort study conducted in a private practice

Factors associated with the outcome of root canal treatment—A cohort study conducted in a private practice

Outcome of root canal retreatment performed in single visit. A cohort retrospective study.

The effect of hard tissue defects on the clinical outcome of endodontic microsurgery: a systematic review and meta-analysis

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