Influence of apical overinstrumentation and overfilling on re-treated root canals

Bergenholtz, Gunnar; Lekholm, Ulf; Milthon, Ralph; Engström, B

doi:10.1016/s0099-2399(79)80080-1

Cited by 106 publications

(96 citation statements)

References 2 publications

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“…The periapical inflammation may occur due to a natural defense response against overinstrumentation, over-irrigation or overfilling (18)(19)(20)(21)(22). The root canal preparation and obturation should be restricted to the main root canal if there is no evidence contrary to this therapeutic protocol.…”

Section: Root Canal Infection and Its Consequencesmentioning

confidence: 99%

“…Several studies reported that root canal preparation and obturation short of the radiographic apex were associated with a better prognosis (18)(19)(20)(21)(22). The clinical characterization of apical morphology is extremely complex.…”

Section: Operational Strategies That May Interfere On Successmentioning

confidence: 99%

“…The apical constriction and the apical foramen are not reliable anatomic landmarks for the obturation length at the apical end, and their use to calculate obturation length may result in injury to apical and periapical tissues (28). On the basis of biologic and clinical principles, instrumentation and obturation should not extend beyond the apical foramen (18)(19)(20)(21)(22)(27)(28)(29)(30)(31)(32)(33).…”

Section: Operational Strategies That May Interfere On Successmentioning

confidence: 99%

“…A high rate of failure is associated with endodontically treated teeth associated with AP, overfilling, and teeth that were not properly restored after RCT (18)(19)(20)(21)(22)27,(47)(48)(49).…”

Section: Criteria For the Rct Successmentioning

confidence: 99%

“…A considerable number of clinical studies have discussed the causes of failure of endodontically treated teeth and prospects for prognosis in retreatment . The correlation of RCT failure with infected root canal was evident in several conditions (1,3,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(24)(25)(26)(27)(35)(36)(37)(38)(39)(40).…”

Section: Criteria For the Rct Successmentioning

confidence: 99%

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Characterization of Successful Root Canal Treatment

et al. 2014

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Knowing the outcome of root canal treatment (RCT) is determinant to substantiate the clinical decision making process, especially when RCT is weighed against the extraction of natural teeth or replacement by prosthetic elements. The ideal scenario in all clinical situations should combine healing/prevention of disease (apical periodontitis) and the functional retention of the tooth. Understanding the risk factors associated with endodontic failure is a key factor to increase the chances of success. The logical action is to reverse the existing disease, which requires intervention to neutralize the bacterial invasion and disrupt the bacterial biofilm within the complex anatomy. Success is more predictable when the immune host defenses are favorable. However, success has different meanings to the dentist, to the patient and to the tooth itself. The life of an endodontically treated tooth depends on the accuracy of the diagnosis and planning, excellence of disinfection, instrumentation and filling procedures (antimicrobial strategies, root canal shaping and coronal and apical seal) and finally the rehabilitation management. The interpretation of constant or intermittent pain and/or discomfort associated with apical periodontitis (AP) in endodontically treated tooth may be suggestive of endodontic failure. The success features of RCT, namely absence of pain, regression of AP, tight seal of canal and coronal spaces, and recovery of tooth function, must be reevaluated over time. In case of doubt between success and failure, cone beam computed tomography (CBCT) could be indicated for detection and precise localization of AP. The possibility of map reading on CBCT images characterizes the real multidimensional structure, providing accurate information on the presence, absence or regression of AP. The survival of an endodontically treated tooth implies understanding the biological and mechanical outcomes as multifactorial events over the individual's life span. The objective of this review of literature is to discuss relevant factors associated with patient's health, tooth and dentist that could account for a successful RCT.

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Section: Root Canal Infection and Its Consequencesmentioning

confidence: 99%

Section: Operational Strategies That May Interfere On Successmentioning

confidence: 99%

Section: Operational Strategies That May Interfere On Successmentioning

confidence: 99%

Section: Criteria For the Rct Successmentioning

confidence: 99%

Section: Criteria For the Rct Successmentioning

confidence: 99%

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Characterization of Successful Root Canal Treatment

et al. 2014

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Epidemiology, Treatment Outcome, and Risk Factors for Apical Periodontitis

Kirkevang¹,

Væth²

2019

Essential Endodontology

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Effect of different instrumentation techniques on students’ performance and outcomes of nonsurgical root canal treatment

Medina‐Torres,

Cochran,

Bauer

et al. 2024

Journal of Dental Education

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ObjectivesThis study compared, retrospectively, the incidence of clinical errors and effects on treatment outcomes, when students were exposed to two different instrumentation techniques: a hybrid rotary technique (HYB), consisting of both hand instrumentation with hand stainless steel and Ni‐Ti files plus the use of a rotary system (Vortex Blue, Dentsply Sirona), versus a full reciprocation instrumentation technique (WaveOne Gold [WOG], Dentsply Sirona).MethodsA total of 368 endodontic cases (n = 184) in anterior and premolar teeth, completed by dental students at the University of Michigan School of Dentistry from 2013 to 2022, were used for the study. The groups were evaluated by two calibrated clinicians, observing the incidence of clinical errors: file separations, over‐instrumentation, ledges and transportations. Treatment outcomes were also observed. Data were analyzed statistically by Fisher's exact test and Mann–Whitney U test (p < 0.05).ResultsNo significant difference in file separations, ledges, and transportation was observed between the two groups. However, the WOG Group experienced significantly more over‐instrumentation than HYB group, although this did not significantly affect tooth survival or periapical index (PAI). Cases with PAI scores of 5 were found to have significantly less tooth survival compared to the other PAI scores.ConclusionsIt can be concluded that both techniques in our study are well suited to advancing the endodontic dental education of students and novice operators, anticipating relatively successful outcomes of tooth survival, as long as the cases selected are less severe in progression preoperatively.

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Influence of apical overinstrumentation and overfilling on re-treated root canals

Cited by 106 publications

References 2 publications

Characterization of Successful Root Canal Treatment

Characterization of Successful Root Canal Treatment

Epidemiology, Treatment Outcome, and Risk Factors for Apical Periodontitis

Effect of different instrumentation techniques on students’ performance and outcomes of nonsurgical root canal treatment

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