Selective Root Retreatment: A Randomized Clinical Trial

Authors

  • Mohamed Nagy Associate Professor of Endodontics Faculty of Dentistry, Ain Shams University, cairo, Egypt http://orcid.org/0000-0001-9016-1999
  • Ahmed Ghobashy Associate Professor of Endodontics . Department of Conservative Dentistry. Faculty of Dentistry. Misr International University. Cairo. Egypt

DOI:

https://doi.org/10.5195/d3000.2022.339

Keywords:

Clinical trial, minimally invasive dentistry, retreatment, secondary periodontitis

Abstract

Abstract

Objectives: Post-treatment apical periodontitis is an inflammatory disorder of peri-radicular tissues caused by either persistent or secondary intra-radicular infection . The present study compared the prognosis of cases treated with the “selective root retreatment”  concept to the traditional retreatment approach. Material and Methods: Forty patients complaining of failed root canal treatment having  a periapical lesion in one root were selected. The cases were randomly divided into two groups; group (S): selective root canal retreatment in which only the affected root was retreated and group (T): traditional root canal retreatment in which all canals were retreated. The peri-radicular condition was evaluated radiographically using the Periapical Index (PAI) for one year. The chi-square test statistical tests analyzed the outcome data. Results: At the baseline examination, There was no significant difference between the two groups regarding the patients’ baseline mean periapical indices . After one year, we found that the mean periapical index declined without a significant difference between the two groups. Conclusions: The present study points to selective root retreatment as a successful “minimally invasive alternative” in cases of an independently diseased root. The remaining treated roots can be retained without intervention provided that they are confirmed: “healthy”. Clinical Relevance: Selective root retreatment is a promising conservative option in the treatment of failed endodontic cases with periapical pathosis related to an individual root.

References

Ricucci D, Siqueira JF. Recurrent apical periodontitis and late endodontic treatment failure related to coronal leakage: A case report. J Endod. 201l; 37:1171–1175. PMID: 21763916

Siqueira JF, Rôças IN, Ricucci D, Hülsmann M. Causes and management of post-treatment apical periodontitis. Br Dent J. 2014; 216:305–312. PMID: 24651336

Costerton W, Veeh R, Shirtliff M, Pasmore M, Post C, Ehrlich G. The application of biofilm science to the study and control of chronic bacterial infections. J. Clin. Invest. 2003; 112:1466–1477. PMID: 14617746

Yan MT. The management of periapical lesions in endodontically treated teeth. Aust Endod J 2006; 32:2–15. PMID: 16603040

Roda RS, Gettleman BH. Nonsurgical Retreatment. In: Cohen’s Pathways of the Pulp. 2011; pp 890–952

Ruddle CJ. Nonsurgical retreatment. J Endod. 2004; 30:827–845. PMID: 15564860

Murdoch-Kinch CA, McLean ME. Minimally invasive dentistry. J Am Dent Assoc. 2003;134:87–95. PMID: 12555961

Nagasiri R, Chitmongkolsuk S. Long-term survival of endodontically treated molars without crown coverage: A retrospective cohort study. J Prosthet Dent. 2005; 93:164–170. PMID: 15674228

Tang W, Wu Y, Smales RJ. Identifying and Reducing Risks for Potential Fractures in Endodontically Treated Teeth. J. Endod. 2010; 36:609–617. PMID: 20307732

Ee J, Fayad MI, Johnson BR. Comparison of endodontic diagnosis and treatment planning decisions using cone-beam volumetric tomography versus periapical radiography. J Endod 2014; 40:910–916. PMID: 24935534

Patel S, Wilson R, Dawood A, Foschi F, Mannocci F. The detection of periapical pathosis using digital periapical radiography and cone beam computed tomography - Part 2: A 1-year post-treatment follow-up. Int Endod J. 2012; 45:711–723. PMID: 22775142

Lo Giudice R, Nicita F, Puleio F, Alibrandi A, Cervino G, Lizio AS, Pantaleo G. Accuracy of periapical radiography and CBCT in endodontic evaluation. Int J Dent 2018;2018 PMID: 30410540

Venskutonis T, Plotino G, Juodzbalys G, Mickevičiene L. The importance of cone-beam computed tomography in the management of endodontic problems: A review of the literature. J. Endod. 2014; 40:1895–1901. PMID: 25287321

Liang YH, Li G, Wesselink PR, Wu MK. Endodontic outcome predictors identified with periapical radiographs and cone-beam computed tomography scans. J Endod. 2011; 37:326–331. PMID: 21329816

Nudera WJ. Selective Root Retreatment: A Novel Approach. J Endod 2015; 41:1382–1388. PMID: 25906919

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. In: Behavior Research Methods. Psychonomic Society Inc. 2007;39:175–191. PMID: 17695343

Ørstavik D, Kerekes K, Eriksen HM. The periapical index: A scoring system for radiographic assessment of apical periodontitis. Dent Traumatol 1986; 2:20–34. PMID: 29326509

Aryanpour S, Van Nieuwenhuysen JP, D’Hoore W. Endodontic retreatment decisions: No consensus. Int Endod J. 2000; 33:208–218. PMID: 11307437

Ørstavik D. Time-course and risk analyses of the development and healing of chronic apical periodontitis in man. Int Endod J. 1996;29:150–155. PMID: 9206419

Anjum AS, Hegde S, Mathew S, Graduate Student P. Minimally Invasive Endodontics-A Review. J Dent Oro-facial Res. 2019;15:77-88.PMID: 34513652

Wong AW, Zhu X, Zhang S, Li SK, Zhang C, Chu CH. Treatment time for non-surgical endodontic therapy with or without a magnifying loupe. BMC Oral Health. 2015; 15:1–6. PMID: 25887978

Siqueira JF, Rôças IN, Alves FRF, Campos LC. Periradicular status related to the quality of coronal restorations and root canal fillings in a Brazilian population. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2005; 100:369–374. PMID: 16122668

Kirkevang LL, Væth M, Hörsted-Bindslev P, Wenzel A. Longitudinal study of periapical and endodontic status in a Danish population. Int Endod J 2006; 39:100–107. PMID: 16454789

Segura‐Egea JJ, Jiménez‐Pinzón A, Poyato‐Ferrera M, Velasco‐Ortega E, Ríos‐Santos JV. Periapical status and quality of root fillings and coronal restorations in an adult Spanish population. Int Endod J. 2004;37:525–530. PMID: 15230905

Borlina SC, de Souza V, Holland R, Murata SS, Gomes-Filho JE, Junior ED, de Carvalho Marion JJ, dos Anjos Neto D. Influence of apical foramen widening and sealer on the healing of chronic periapical lesions induced in dogs’ teeth. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology 2010; 109:932–940. PMID: 20451847

Norman Weller R, Niemczyk SP, Kim S. Incidence and position of the canal isthmus. Part 1. Mesiobuccal root of the maxillary first molar. J Endod. 1995; 21:380–383. PMID: 7499980

Cleghorn BM, Christie WH, Dong CCS. Root and Root Canal Morphology of the Human Permanent Maxillary First Molar: A Literature Review. J Endod. 2006; 32:813–821. PMID: 16934622

de Pablo ÓV, Estevez R, Sánchez MP, Heilborn C, Cohenca N. Root anatomy and canal configuration of the permanent mandibular first molar: A systematic review. J Endod. 2010; 36:1919–1931. PMID: 21092807

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Published

2022-10-06

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Section

Adults & the Elderly