Root canal treatment of compromised teeth as alternative treatment for patients receiving bisphosphonates: 60‐month results of a prospective clinical study

Abstract

AimThis 60‐month prospective study aimed to evaluate tooth survival and healing rates after root canal treatment in patients taking bisphosphonates (BPs). Secondary outcomes were complications and clinical variables observed during and after treatment.MethodsRoot canal treatment was performed using manual K‐file canal instrumentation and a carrier‐based filling technique with an epoxy resin‐based sealer. Teeth without adequate root/crown integrity were restored by trained operators at the tissue level (TL group) to prevent occlusal/mechanical stress and to enable periapical lesion healing without the risk of root fracture. Other teeth were restored with normal occlusal contacts (OC group). Healthy patients who had undergone one or more root canal treatments of the same type constituted the control group. The relationships of the following variables to survival and health status were examined (chi‐squared test and multivariate analysis, P = 0.05): age, gender, smoking habit, tooth location, treatment type, BPs treatment, BPs exposure, initial periapical index (PAI) and occlusal restoration. Survival curves were constructed using Kaplan–Meier analysis, with extraction serving as the end‐point.ResultsIn total, 65 patients with 109 root canal‐treated teeth who were taking BPs were included. At 60 months, data from 57 patients (52F, 5M; median age 65.7 ± 8.6 years) who had undergone 96 root canal treatments were analysed (drop‐out rate = 16.9%). The survival rate was 85%, and the success rate was 76%. The control group consisted of 46 patients (21F, 25M; median age 60.3 ± 7.2 years) who had undergone 102 root canal treatments. The survival rate was 88%, with 12 teeth lost during follow‐up. The success rate was 73%. In the BP group, 55 teeth were restored normally (OC group) and 41 teeth were restored at the tissue level (TL group). No difference in the success or survival rate was observed between the BP and control groups (P > 0.05). Univariate Kaplan–Meier analysis revealed that only tooth type significantly affected survival status in the BP group. The analysis revealed the clinical relevance of smoking, tooth location and initial PAI on patients’ health status (P < 0.05).ConclusionRoot canal treatments and post‐endodontic restoration with tissue‐level filling procedures represent a safe approach for severely damaged teeth in patients receiving BPs having comparable results to root filled teeth restored with occlusal contacts and to the control group.

Risks of Aerosol Contamination in Dental Procedures during the Second Wave of COVID-19—Experience and Proposals of Innovative IPC in Dental Practice

“…An apparently healthy patient may potentially create the condition for a sequence of serious contaminations. For these reasons, HDWs i.e., dentists, dental staff personnel, students and patients must be protected (Figure 2D,E), in particular whose affected by systemic diseases [31].…”

The Use of Premixed Calcium Silicate Bioceramic Sealer with Warm Carrier-Based Technique: A 2-Year Study for Patients Treated in a Master Program

“…In the presence of calcified root canals, 3.0 mL of 10% EDTA solutions was used as a calcium chelating agent. A final irrigation of 2.0 mL sterile water was made before root canal filling procedures [ 26 , 27 , 28 ]. No intracanal medication was placed in accordance with previous studies [ 26 , 29 ].…”

“…In the presence of calcified root canals, 3.0 mL of 10% EDTA solutions was used as a chelating agent. A final irrigation of 2.0 mL sterile water was made before the root canal filling procedures [ 26 , 27 ]. When necessary, a dental surgery microscope (Pico, Zeiss, Germany) was used to detect the access to root canal orifices and to identify the presence of residual filling materials.…”

Evaluation of stress distribution on an endodontically treated maxillary central tooth with lesion restored with different crown materials: A finite element analysis

“…In addition to the results of this study, which created 5 different clinical scenarios requiring post core restoration after crown destruction, it is inevitable that there are clinical situations that require more conservative treatment needs where root canal treatment cannot be applied due to the use of various medications that may develop osteonecrosis. At this point, it has also been reported that tissue level filling procedures after root canal treatments and endodontic restoration are a safe approach in severely damaged teeth, especially in patients taking Bisphosphonates [ 58 ]. This is one of the limitations of this study.…”