The restoration of root filled teeth: a review of the clinical literature

Bhuva, Bhavin; Giovarruscio, Massimo; Rahim, Noushad M; Bitter, Kerstin; Mannocci, Francesco

doi:10.1111/iej.13438

Cited by 64 publications

(66 citation statements)

References 148 publications

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“…The clinical samples were followed up to 18 years and failures were observed mainly within the first years of clinical service. This finding showed that when root fracture was avoided by covering cusps with the crown or the direct restoration, the teeth were protected from occlusal loading [ 32 ]. Moreover, when partial or complete healing of the periapical lesion was achieved, the restored root remained in clinical service without any clinical sign or symptom.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Endodontic Treatments and Restorations with and without Posts Up to 18 Years

Pontoriero

Grandini

Spagnuolo

et al. 2021

JCM

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Background: The aim of this study was to collect long-term restorative and endodontic outcomes of endodontically treated teeth (ETT). Methods: 298 teeth were included in the study and were recalled up to 18 years with a media of 10.2 years. At baseline, 198 sample teeth (66.44%) showed symptoms and 164 (55%) had periapical radiolucency. The most frequently used obturation techniques were warm gutta-percha in 80% of cases, and by carrier in 20%. A total of 192 ETT were restored by direct resin composite restorations, and 106 posts were luted. Moreover, 75 (25.16%) direct restorations remained as final restorations, 137 single crowns (45.97%), 42 (14.09%) partial adhesive crowns, and 42 (14.09%) abutments of fixed bridges were the final treatments. Descriptive and inferential statistics were performed (α = 0.05). A Cox regression model was made. Results: results showed success for 92.6% of ETT up to 18 years, 2.68% (8 ETT) showed irreversible failures, and 14 (4.69%) reversible complications. Four ETT (1.34%) failed because of root fracture and the other four (1.34%) because of endodontic complications. Eight ETT (2.69%) showed non-irreversible periodontal complications and the other six (2.01%) prosthodontic complications. Accordingly, with Kaplan–Meier analysis, the survival rate after 18 years was 97.3% (Interval of Confidence (IC) 95.1–98.3). The presence of a short or long (at least 1 mm related to radiographic apex) quality endodontic filling displayed a statistically significant higher risk of complication (hazard ratio (HR) = 17.00 (IC 5.68–56.84). Furthermore, a clinically detectable not precise coronal margins predicts the presence of any clinical complication with a hazard ratio almost seven times higher than endodontically treated teeth with a proper margin (HR = 6.89 (IC 2.03–23.38), while the presence of lucency at the baseline did not affect the risk of complication (HR = 0.575 (IC 0.205–1.61). The presence of post, tooth position in the arch, and the type of it did not show a high-risk rate (HR = 1.85, 1.98, and 2.24, respectively). Conclusions: a correct filling (at the apex) of root canals combined with proper coronal margins allow obtaining a long-term high success rate in teeth with a periapical lesion at the baseline. The use of a post or not, when its placement is related to the residual amount of the crown, does not change the final outcome of the ETT.build-up; clinical trial; endodontic outcomes; endodontic retreatments; posts

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Endodontic Treatments and Restorations with and without Posts Up to 18 Years

Pontoriero

Grandini

Spagnuolo

et al. 2021

JCM

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“…To restore fracture resistance in teeth, modern dentistry has shifted towards bonded restorative procedures. [13][14][15][16] Since the modulus of elasticity of composite resin is close to that of dentin, restoring endodontic cavities with composite resin showed a minimal stress jump at the resin-dentin interface, reduced cuspal flexure, and lowered probability of coronal fracture as suggested by Soares PV (2008), Taha NA (2014) [13,[18][19][20] . Therefore, in the present study restoration of PCD was done by dentin bonded composite and its impacts on microstrain distribution and load to failure was studied.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of the fracture resistance of endodontically treated teeth with different access designs

Hegde¹,

Singh²,

Ansari³

2021

Int. J. Appl. Dent. Sci.

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Background: Most important step for successful endodontic treatment is access cavity preparation. However, the removal of tooth structure needed for access cavity leads to compromise of pericervical dentin and remaining dentin thickness undermining the strength of tooth and increasing the root fracture propensity under functional loads. Therefore, in the present study fracture resistance of endodontically treated teeth with Traditional endodontic cavity [TEC] to Conservative endodontic cavity [CEC] and pericervical bonding of composite resin in different root filled teeth was evaluated by using Universal Testing Machine. Materials and Methods: Freshly extracted single rooted premolars were selected and randomly divided into two groups: Group 1: Traditional Endodontic Cavity (TEC) (n=24) Group 2: Conservative endodontic cavity (CEC) (n=24) Access cavity preparation and shaping cleaning followed by obturation was done according to the respective groups. The specimens were further subdivided into: 1. GROUP 1a: TEC restored with Cavit 2. GROUP 1b: TEC restored with nanocomposite 3. GROUP 2a: CEC restored with Cavit 4. GROUP 2b: CEC restored with nanocomposite 5. The specimens were then loaded to fracture in Instron Universal Testing machine and the fracture resistance data was further analysed and compared. Results: The mean fracture strength for CEC restored with nanocomposite was significantly higher than all the other groups. (p<0.05) Conclusion: Specimen with CEC showed better fracture resistance when compared with TEC. Pericervical bonding of composite resins contribute in increasing fracture strength for endodontically treated teeth.

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“…The patient inclusion criteria were as follows: No self-reported systemic diseases present At least one tooth with AP (necrotic pulp and/or filled root canals with radiographically determined signs of post-treatment endodontic disease requiring root canal retreatment) Absence of clinical periodontal inflammation on the tooth indicated for treatment, either anatomically intact or, with the reduced periodontium [ 18 ] Baseline CBCT images available prior to the study (images taken for general oral rehabilitation planning purposes no earlier than 1 month prior to endodontic procedures). …”

Section: Methodsmentioning

confidence: 99%

“…Absence of clinical periodontal inflammation on the tooth indicated for treatment, either anatomically intact or, with the reduced periodontium [ 18 ]…”

Section: Methodsmentioning

confidence: 99%

Prognostic validity of the Periapical and Endodontic Status Scale for the radiographically assessed 2-year treatment outcomes in teeth with apical periodontitis: a prospective clinical study

2021

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Background Endodontic treatment planning and treatment success evaluation are largely based on radiographic assessment of anatomical and treatment-related parameters of teeth with apical periodontitis (AP). This prospective clinical study aimed to assess radiographically the 2-year endodontic treatment outcomes for teeth with AP, and to evaluate prognostic validity of Periapical and Endodontic Status Scale (PESS). Methods A total of 128 patients, representing 176 teeth with AP were examined by cone-beam computed tomography at baseline and at 24 months after endodontic treatment. Treatment outcome was evaluated using estimates of periapical radiolucency and the relationship between anatomical structures and location. The strength of the associations between these and treatment-related parameters was tested by logistic regression analysis. PESS sensitivity and specificity were calculated for every treatment risk group (low, moderate, high) of teeth. Results One hundred and fifty-seven teeth, representing 350 root canals had a positive treatment outcome, while 19 teeth, representing 53 root canals had a negative treatment outcome at 24 months. The probability of negative outcome was 25 times higher in the moderate/high-risk group than in the mild-risk group of teeth (OR = 25.1; 95%CI [12.2–51.5]). Pre-treatment complications and retreatment cases with radiolucency were associated with negative outcomes (OR = 35.9; 95%CI [12.6–102.4]; OR = 26.437; 95%CI [10.9–64.1], respectively). PESS sensitivity and specificity was over 80% in all risk groups except for high risk group, due to very low number of cases. Conclusions Endodontic treatment outcome depends on the severity of periapical changes. The presence of complications and retreatment cases with periapical lesions are associated with negative treatment outcome. The PESS is a valid instrument to predict outcome of teeth with low-moderate treatment risk of AP.

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The restoration of root filled teeth: a review of the clinical literature

Cited by 64 publications

References 148 publications

Clinical Outcomes of Endodontic Treatments and Restorations with and without Posts Up to 18 Years

Clinical Outcomes of Endodontic Treatments and Restorations with and without Posts Up to 18 Years

Comparative evaluation of the fracture resistance of endodontically treated teeth with different access designs

Prognostic validity of the Periapical and Endodontic Status Scale for the radiographically assessed 2-year treatment outcomes in teeth with apical periodontitis: a prospective clinical study

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