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Tooth survival of endodontically treated molars

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Presentation on theme: "Tooth survival of endodontically treated molars"— Presentation transcript:

1 Tooth survival of endodontically treated molars
A total of 220 endodontically treated permanent molar teeth in 203 subjects on a waiting list for fixed prosthodontic treatment at the Faculty of Dentistry-Mahidol University, Thailand. Three levels of remaining tooth structure: Type I remaining tooth structure denoted maximum remaining tooth structure. The amount of remaining coronal tooth structure was approximately that of a Class I cavity preparation with at least 2 mm of surrounding wall thickness. Type II denoted moderate remaining tooth structure. The amount of remaining coronal tooth structure was approximately a Class II cavity preparation with no less than 2 walls with at least 2 mm thickness. Type III denoted minimum remaining tooth structure as the remaining coronal tooth structure had less than 2 walls with at least 2 mm thickness, .. Nagasiri R, Chitmongkolsuk S. Long-term survival of endodontically treated molars without crown coverage: a retrospective cohort study. J Prosthet Dent Feb;93(2): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

2 Tooth survival of endodontically treated molars
A total of 220 endodontically treated permanent molar teeth in 203 subjects on a waiting list for fixed prosthodontic treatment at the Faculty of Dentistry-Mahidol University, Thailand. Cuspal coverage of molars! Nagasiri R, Chitmongkolsuk S. Long-term survival of endodontically treated molars without crown coverage: a retrospective cohort study. J Prosthet Dent Feb;93(2): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

3 Apical regeneration after endodontic surgery
Wang Q, Cheung GS, Ng RP. Survival of surgical endodontic treatment performed in a dental teaching hospital: a cohort study. Int Endod J Nov;37(11): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

4 Apical regeneration after endodontic surgery
Wang Q, Cheung GS, Ng RP. Survival of surgical endodontic treatment performed in a dental teaching hospital: a cohort study. Int Endod J Nov;37(11): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

5 Apical regeneration after endodontic surgery
Wang Q, Cheung GS, Ng RP. Survival of surgical endodontic treatment performed in a dental teaching hospital: a cohort study. Int Endod J Nov;37(11): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

6 Apical regeneration after endodontic surgery: material effect?
Chong BS, Pitt Ford TR, Hudson MB. A prospective clinical study of Mineral Trioxide Aggregate and IRM when used as root-end filling materials in endodontic surgery. Int Endod J Aug;36(8):520-6. Dr. Dag Ørstavik 7. Jahrestagung DGEndo

7 Apical regeneration after endodontic surgery: material effect?
Lindeboom JA, Frenken JW, Kroon FH, van den Akker HP. A comparative prospective randomized clinical study of MTA and IRM as root-end filling materials in single-rooted teeth in endodontic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod Oct;100(4): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

8 Apical regeneration after endodontic surgery: material effect?
Lindeboom JA, Frenken JW, Kroon FH, van den Akker HP. A comparative prospective randomized clinical study of MTA and IRM as root-end filling materials in single-rooted teeth in endodontic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod Oct;100(4): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

9 Endodontics vs implantat
Apples and oranges Comparing case-selected, low-risk implants with heroic salvation efforts by endodontics is biased Comparing case-selected, low-risk endodontics with high-risk, money- or patient-driven implants is biased True comparisons difficult, may be impossible The accumulation and presentation of individual cases give information of the individual possibilities of each method: endodontists need to knbow what implantologists can do, and vice versa Dr. Dag Ørstavik 7. Jahrestagung DGEndo

10 Endodontics vs implant
Doyle SL, Hodges JS, Pesun IJ, Law AS, Bowles WR. Retrospective cross sectional comparison of initial nonsurgical endodontic treatment and single-tooth implants. J Endod Sep;32(9): NSRCT outcomes were affected by periradicular periodontitis (p = 0.001), post placement (p = 0.013), and overfilling (p = 0.003). Dr. Dag Ørstavik 7. Jahrestagung DGEndo

11 Comparison of success of implants versus endodontically treated teeth.
A chart review was carried out in 2 group specialty practices in the same city. Implant data were collected from a periodontic practice and endodontic data from patients presenting for routine recall or treatment of another tooth at an endodontic practice. Charts were selected in alphabetical sequence, with no exclusions made for systemic disorders, time of implant loading, or tooth implant position in the mouth, and were reviewed on patients with clinical and radiographic follow-ups more than 1 year after treatment. Hannahan JP, Eleazer PD. J Endod Nov;34(11): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

12 Endodontics vs implant
Success was defined as radiographic evidence that the implant or treated tooth was still present in the mouth, and that there was no notation of signs or symptoms requiring intervention during the follow-up period in the chart notes. Hannahan JP, Eleazer PD. Commparison of success of implants versus endodontically treated teeth. J Endod Nov;34(11): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

13 Endodontics vs implant
Uncertain findings were defined for implants as charted mobility greater than class I, radiographically detectable bone loss, or additional surgical procedure required. Uncertain findings for endodontic treatments were defined as charted mobility greater than class I, radiograph judged as periapical index score of 3 or greater (Table 2), or orthograde endodontic procedure or apical surgery required (22). Hannahan JP, Eleazer PD. Commparison of success of implants versus endodontically treated teeth. J Endod Nov;34(11): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

14 Endodontics vs implant
Typical surgical interventions for implants were flap exposures for debridement, with or without grafting osseous material. Uncertain findings for endodontic treatments were defined as charted mobility greater than class I, radiograph judged as periapical index score of 3 or greater (Table 2), or orthograde endodontic procedure or apical surgery required (22). Preoperative values were not considered. Hannahan JP, Eleazer PD. Commparison of success of implants versus endodontically treated teeth. J Endod Nov;34(11): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

15 Endodontics vs implant
Hannahan JP, Eleazer PD. Commparison of success of implants versus endodontically treated teeth. J Endod Nov;34(11): Dr. Dag Ørstavik 7. Jahrestagung DGEndo

16 Optimizing Prognosis Case selection: If in doubt, do not wait: prevention is easier than cure Asepsis for vital pulps; antisepsis for infected pulps Bacteria-free canals: adopting procedures known to provide a high probability of no growth Conventional fillings of high quality Coronal filling and molar coverage Judicious inclusion in prosthetic restorations Dr. Dag Ørstavik 7. Jahrestagung DGEndo

17 Thank you for your endurance and kind attention!
Let us all improve! Dr. Dag Ørstavik 7. Jahrestagung DGEndo


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