Dentists’ perspectives on the choice of treatment of teeth with apical periodontitis

Kui, Andreea; Labuneț, Anca; Popescu, Codruța Alina; Popa, Daniela; Lascu, Liana

doi:10.15386/cjmed-789

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…In case of tooth extraction, the edentulous area can be restored by fixed or removable dental prostheses (FDP and RDP, respectively), implant supported crowns (ISC), or remains edentulous. Another possible treatment modality includes apicoectomy after an unsuccessful RCT [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

German Dentists’ Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

Conrad

Retelsdorf

Attia

et al. 2020

IJERPH

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Currently, there is no standard treatment protocol for apical periodontitis (AP). Thus, restorable teeth might get extracted and replaced prosthetically. This study evaluated German dentists’ preferred AP treatment decisions and the influencing factors for selecting tooth retention by initial/repeated surgical/non-surgical root-canal treatment (RCT) or extraction with/without prosthetic replacement. Through an online-survey, participants (n = 260) rated different treatment options for four case scenarios with AP in anterior/posterior teeth without/with previous RCT. Statistical analysis included the Friedman test for intra-case comparisons and Chi-squared test for factor-associations (p ≤ 0.05). Tooth retention using initial/repeated RCT was ranked first in all scenarios and rated as (very) appropriate by most participants, while implant-supported crowns (ISC) and apicoectomy had the second ratings. ISC were preferred more on posterior teeth or previous root-canal-treated teeth. Rating levels of treatment options displayed significant differences for all case scenarios. Posterior tooth retention by RCT demonstrated a significant association with work experience. Tooth retention with previous RCT displayed a significant correlation with dentists’ privately insured patients. Most dentists preferred tooth preserving with initial/repeated RCT, while others selected non-evidence-based choices. This reflects a lack of consensus of AP treatment decisions in Germany. Fixed treatment guidelines and further evaluation of treatment–decision-correlated factors are recommended for correct treatment planning.

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Section: Introductionmentioning

confidence: 99%

German Dentists’ Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

Conrad

Retelsdorf

Attia

et al. 2020

IJERPH

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“…There is no evidence of superiority of surgical compared to non-surgical approach to the treatment of CAP after one year, nor after 4 and 10 years [18]. For the treatment of primary lesions, clinicians generally opt for an endodontic approach, while for the treatment of secondary lesions, they more often opt for a surgical approach [19,20]. However, in the era of endodontic microscopes, ultrasound preparation and irrigation, as well as better instrumentation that ensures a more certain retreatment outcome, the need for primary surgical therapy is decreasing [21,22].…”

Section: Discussionmentioning

confidence: 99%

“…Ne postoje dokazi o superiornosti hirurškog u odnosu na nehirurški pristup lečenju HAP-a posle godinu dana, kao ni posle 4 i 10 godina [18]. Kliničari se za lečenje primarnih lezija uglavnom odlučuju za endodontski pristup, dok se za lečenje sekundarnih lezija češće odlučuju za hirurški pristup [19,20]. Međutim, sa pojavom endodontskih mikroskopa, ultrazvučne preparacije i irigacije, kao i boljeg instrumentarijuma koji obezbeđuje izvesniji ishod retretmana, potrebe za primarnom hirurškom terapijom se smanjuju [21,22].…”

Section: Diskusijaunclassified

Root canal treatment of an extensive periapical lesion

Vucetic

Ilić

2022

SERBIAN DENT J

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Chronic apical periodontitis (CAP) is one of the most common endodontic diagnosis caused by microbial infection within the root canal system of the affected tooth. Endodontic therapy is one of the possible treatment modalities for CAP, but the prognosis depends on numerous factors. The size of the periapical lesion is always singled out as one of the most significant, as its increase drastically decreases the degree of success of endodontic therapy. Certain periapex radiographic indices (PAI, CBCT-PAI, PESS) are used to evaluate the size and characteristics of the periapical lesion, as well as to monitor the outcome of the implemented therapy. A 30-year-old patient presented with pain caused by an acute exacerbation of CAP on tooth 37. Radiographic analysis revealed the presence of an extensive, diffuse radiolucency in the area of tooth 37. A complete endodontic procedure was performed. One year after, there were clear, radiographic signs of the reduction of the lesion. Findings of periapical radiographic indices indicated the success of therapy as well. The aim of this paper was to present, on one case from clinical practice, complete endodontic therapy protocol of an extensive periapical lesion with symptoms of exacerbation.

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“…Apicoectomy (periapical surgery) is such a combination method, representing the last line of defence of a natural tooth before extraction. It is indicated when non-surgical approaches of endodontics are unable to preserve the tooth, and is employed routinely in appropriate cases 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Follow-up dental examination a day after apicoectomy using the store-and-forward method

Miladinović¹,

Živković²,

Zivkovic³

et al. 2021

VOJNOSANIT PREGL

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Introduction: Although apicoectomy is performed routinely and yields excellent results, a close patient observation during the postoperative course is desirable in order to avoid possible complications. This study aims to investigate the adequacy of postoperative control visits a day after surgery using the "store and forward" telemedicine method compared to clinical "in person" controls. Methods: There were 122 teeth with apicoectomy performed during 115 dental surgery interventions. Follow-up dental examination a day after apicoectomy consisted of the review of extraoral and intraoral photographs on the Internet and the review of responses to the questionnaire, and after that patients were examined in person. Cohen's kappa (κ) coefficient, diagnostic sensitivity (SE), sensitivity (SP) and efficiency were determined. Statistical significance and comparisons were performed using the Z-test, and non-parametric characteristics were tested using Mc Nemmar's χ 2-test at the statistical significance cutoff value of p=0.05. Results: The patients reported for control dental examination in 106 (92%) cases. The agreement between "in person" and "store and forward" telemedicine method was found in 104 cases (98%). The obtained agreement values indicated an almost complete diagnostic agreement. Conclusion: Based on the Internet transmission of digital photographs of the patients and accompanying patient medical history records, the study showed that control dental examinations "in person" can be successfully replaced with distance "store and forward" method of telemedicine.

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Dentists’ perspectives on the choice of treatment of teeth with apical periodontitis

Cited by 6 publications

References 11 publications

German Dentists’ Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

German Dentists’ Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

Root canal treatment of an extensive periapical lesion

Follow-up dental examination a day after apicoectomy using the store-and-forward method

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