scholarly journals Factors Affecting the Outcome of Periapical Surgery; a Prospective Longitudinal Clinical Study

2021 ◽  
Vol 11 (24) ◽  
pp. 11768
Author(s):  
Muhammad Adeel Ahmed ◽  
Nouman Mughal ◽  
Syed Hani Abidi ◽  
Muhammad Furqan Bari ◽  
Mohammed Mustafa ◽  
...  
Keyword(s):  
Smoking Status ◽  
Lesion Size ◽  
Endodontic Treatment ◽  
Periapical Lesion ◽  
Preoperative Pain ◽  
Patient Age ◽  
Anterior Teeth ◽  
Patient Âgé ◽  
Periapical Healing ◽  
Prospective Longitudinal

Wound healing following periapical surgery is influenced by age, gender, smoking, periapical lesion size, type of root-end filling, method of root-end cavity preparation and the use of microsurgical or conventional technique. This study aimed to evaluate the influence of various preoperative factors such as age, gender, smoking, preoperative pain, and preoperative periapical lesion size on the outcome of surgical endodontic treatment. A thorough history, examination, and investigation were performed to establish patient age, gender, smoking status, periapical lesion size, and the presence of preoperative pain. Forty patients aged between 15–57 years presented with persistent chronic apical periodontitis of single-rooted anterior teeth after conventional re-root canal treatment were enrolled for periapical surgery. Following periapical surgery, all patients were recalled for evaluation of periapical healing after 12 months based on clinical and periapical X-ray examination due to inaccessibility of an advanced imaging system (CBCT). Chi-squared and Fisher’s exact test were applied, which revealed a statistically significant association of periapical healing with age (p = 0.025), smoking (p = 0.029), and lesion size (p < 0.001). Although, the success of periapical healing was higher in males 78.6% (22/28) compared to females 58.3% (7/12) however, no statistically significant relationship was found between gender and healing (p = 0.254). Patient age, smoking status, and size of the preoperative lesion had a strong influence on periapical healing after surgical endodontic treatment.

scholarly journals Post-Endodontic Treatment Flare-Up of Patients Treated By General Dentists and Endodontic Specialists

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Mohammed Sarhan Alzahrani
Keyword(s):  
Postoperative Pain ◽  
Statistical Significance ◽  
Lesion Size ◽  
Endodontic Treatment ◽  
Categorical Variables ◽  
Preoperative Pain ◽  
Patient Factors ◽  
Chi Square ◽  
Dental Practitioners ◽  
General Dentists

Objective: This study aims to determine post-endodontic flare-up incidence for patients treated by endodontic specialists and general dental practitioners. Methods: The investigators measured the postoperative pain using a visual analog scale after 24 and 48 hours for patients treated endodontically by specialists and general dentists. The patient factors and operative variables were documented for every patient. The data was then analyzed using SPSS. A Chi-square test was used to evaluate a relationship between categorical variables, where a P < 0.05 was taken to indicate statistical significance. Results: In total, 143 participants were included in this study (male: n=62, 43.3%; and female: n=81, 56.7%). The incidence of post-endodontic treatment flare-ups was 14.8%. The incidence of 48 hours postoperative pain was higher (29%) with the endodontic specialists compared to the general practitioners. The factors that were associated with a higher postoperative flare-up include; patient age, smoking, preoperative pain, and periapical lesion size. Conclusion: Post-endodontic flare-up incidence in this study was within the reported range of flare-up. Patient factors are associated with the occurrence of the postoperative flare-up more than the operative factors.

scholarly journals Incidence of Coexisting Talar and Tibial Osteochondral Lesions Correlates With Patient Age and Lesion Location

2018 ◽  
Vol 6 (8) ◽  
pp. 232596711879096 ◽  
Author(s):  
Rebecca M. Irwin ◽  
Yoshiharu Shimozono ◽  
Youichi Yasui ◽  
Robin Megill ◽  
Timothy W. Deyer ◽  
...  
Keyword(s):  
Older Patients ◽  
Distal Tibia ◽  
Case Series ◽  
Lesion Size ◽  
Magnetic Resonance Images ◽  
Osteochondral Lesions ◽  
Level Of Evidence ◽  
Patient Age ◽  
Morphologic Characteristics ◽  
Patient Âgé

Background: The incidence of coexisting osteochondral lesions (OCLs) of the tibia and talus has been negatively correlated with successful clinical outcomes, yet these lesions have not been extensively characterized. Purpose: To determine the incidence of coexisting tibial and talar OCLs, assess the morphologic characteristics of these lesions, and evaluate whether these characteristics are predictive of outcome. Study Design: Case series; Level of evidence, 4. Methods: A total of 83 patients who underwent surgery for a talar OCL were evaluated for coexisting OCLs of the distal tibia with preoperative magnetic resonance images. Size, location, containment, International Cartilage Repair Society (ICRS) grade, patient age, and patient sex were analyzed for predictors of coexisting lesions or patient outcome. The talar and tibial surfaces were each divided into 9 zones, with 1 corresponding to the most anteromedial region and proceeding laterally and then posteriorly. The Foot and Ankle Outcome Score (FAOS) was evaluated pre- and postoperatively. Results: Twenty-six patients (31%) had coexisting tibial and talar OCLs, with 9 (35%) identified as kissing lesions. Age correlated with coexisting lesion incidence, as older patients were more likely to have a coexisting tibial OCL ( P = .038). More than half of talar OCLs were found in zone 4 (61%), whereas the majority of tibial OCLs were located in zones 2, 4, and 5 (19% each). Patients with coexisting lesions were more likely to have a lateral talar OCL ( P = .028), while those without a coexisting tibial lesion were more likely to have a talar OCL in zone 4 ( P = .016). There was no difference in FAOS result or lesion size between patients with and without coexisting OCLs, but patients with coexisting lesions were more likely to have an ICRS grade 4 talar OCL ( P = .034). For patients with coexisting lesions, kissing lesions were more likely to be located in zone 6 ( P = .043). There was no difference in OCL size or containment between kissing and nonkissing coexisting OCLs. Conclusion: The incidence of coexisting talar and tibial OCLs may be more prevalent than what previous reports have suggested, with older patients being more likely to present with this pathology. The location of a talar OCL correlates with the incidence of a coexisting tibial OCL.

Incidence and Morphologic Characteristics of Benign Calcaneal Cystic Lesions on MRI

2007 ◽  
Vol 28 (6) ◽  
pp. 707-714 ◽  
Author(s):  
Ilan Elias ◽  
Adam C. Zoga ◽  
Steven M. Raikin ◽  
Mark E. Schweitzer ◽  
William B. Morrison
Keyword(s):  
Incidental Findings ◽  
Subtalar Joint ◽  
Total Population ◽  
Lesion Size ◽  
Patient Age ◽  
Morphologic Characteristics ◽  
Patient Âgé ◽  
Ganglion Cysts ◽  
Mean Size ◽  
Calcaneal Cyst

Background: Since we have frequently noted osseous cyst-like lesions within the calcaneus on MRI studies, we sought to systematically evaluate this finding to determine the incidence and morphologic characteristics on MRI. Methods: Three observers blinded to age evaluated 198 MRIs of the ankle (74 males, 124 females; mean age 47 years, range 13 to 99 years), recording the presence and size of calcaneal cyst-like foci. Statistical analysis was performed to determine if there was an association with age. Additionally, MRI of 12 ankles precontrast and postcontrast were reviewed for the presence of blood vessels in the calcaneus corresponding to the location of the cyst-like lesions and 24 ankle MR arthrograms were reviewed to evaluate communication of the cyst with the adjacent joint. Results: Of the 198 ankle MRI examinations, 81 (40%) had hyperintense foci, all within the mid-calcaneal body. The size ranged from 0.01 cm 2 to 2.47 cm 2 , with a mean size of 0.36 cm 2 (± 0.45 cm 2 ). Thirty-seven (46%) were linear or elongated, whereas 44 (54%) were ovoid or round. Seven of the 81 foci (8.6% or 3.5% of the total population) were 1 cm 2 or larger. There was no significant association of patient age and presence ( p = 0.49) or size ( p = 0.48) of the focus. Location of the cyst-like foci, which often are ovoid or linear, corresponds to penetrating microvessels on precontrast and postcontrast MRI. One MR arthrogram showed communication of a cyst-like focus and the subtalar joint. Conclusions: Calcaneal lesions are relatively common incidental findings on MRI. These lesions appear to represent intraosseous ganglion cysts that arise from the anterior margin of the posterior facet of the subtalar joint in the anatomical neighborhood where vessels penetrate the superior calcaneal cortex. The lesions can vary is size; however, there is no correlation between patient age and lesion size and no significant association between age and presence of these foci.

scholarly journals A comparative clinical study of bioceramic and calcium hydroxide based root canal sealer in the treatment of non-vital permanent tooth with periapical lesion

2021 ◽  
Vol 11 (2) ◽  
pp. 26-31
Author(s):  
Farzana Hoque Tanmi ◽  
Md Abdul Hannan Sheikh ◽  
Mozammal Hossain ◽  
SM Abdul Quader ◽  
Salahuddin Ahmed ◽  
...  
Keyword(s):  
Calcium Hydroxide ◽  
Root Canal ◽  
Standard Procedure ◽  
Lesion Size ◽  
Permanent Tooth ◽  
Permanent Teeth ◽  
Periapical Lesion ◽  
Root Canal Sealer ◽  
Anterior Teeth ◽  
Short Period

Introduction: The use of Bioceramic sealer in the obduration of the root canal system has been expected by many of the previous studies. However, the clinical outcome has not yet been established. Objective: To compare the effectiveness of bioceramic and calcium hydroxide based root canal sealer in treatment of non-vital permanent teeth with periapical lesion (Periapical periodontitis). Materials and Methods: A total 100 mature permanent anterior teeth were selected after clinical and radiological examination which had non-vital pulp with periapical lesion. Clinically pulp vitality test, palpation and percussion test was performed maintaining standard procedure. Following cavity preparation and biomechanical preparation, each canal was obturated either with bioceramic (Endosequence BC) or calcium hydroxide based sealer  (Sealapex, Kerr). All participants were evaluated immediately after obturation, at  3 and 6 months for the assessment of change in size of periapical lesion, condition of periodontal ligament space, lamina dura and incidence of post-operative pain, swelling. Statistical analysis was performed using Chi- square(X2) test and t-test. A value of p<0.05 was considered as statistically significant. Results: Bioceramic was more effective in reducing the lesion size than that of calcium hydroxide. At 6 months, the mean lesion size was reduced from 3.52±0.7 to 1.30±0.462 mm in Bioceramics and from 3.48±1.07 to 1.58± 0.498 mm in sealapex treated teeth.. Furthermore, 98% of bioceramic treated teeth and 94% of sealapex treated teeth showed absence of swelling. The differences between two groups were statistically significant (p<0.05). Conclusion: In this short period of study, Bioceramics based sealer seems to be more effective than calcium hydroxide based sealer in repair of periapical lesions of the nonvital teeth. Update Dent. Coll. j: 2021; 11(2): 26-31

scholarly journals Cone Beam Computed Tomography Evaluation of the Periapical Status of Nonvital Tooth with Open Apex Obturated with Mineral Trioxide Aggregate: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Vijay Shekhar ◽  
K. Shashikala
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Cone Beam Computed Tomography ◽  
Mineral Trioxide Aggregate ◽  
Endodontic Treatment ◽  
Cone Beam ◽  
Periapical Lesion ◽  
Dental Practitioners ◽  
Periapical Healing ◽  
Radiographic Followup

Management of a tooth with open apex is a challenge to the dental practitioners. Evaluation of the periapical healing is required in such cases by radiographic techniques. The objective of this paper was to assess the healing of a periapical lesion in a non-vital tooth with open apex treated with mineral trioxide aggregate (MTA) obturation using cone beam computed tomography (CBCT). The endodontic treatment of a fractured non-vital discolored maxillary left lateral incisor with an open apex was done with MTA obturation. The clinical and radiographic followup done regularly showed that the tooth was clinically asymptomatic and that the size of the periapical lesion observed by intraoral periapical (IOPA) radiographs and CBCT was decreased remarkably after two years. CBCT and IOPA radiographs were found to be useful radiographic tools to assess the healing of a large periapical lesion in a non-vital tooth with open apex managed by MTA obturation.

scholarly journals Healing of periapical lesion with mineral trioxide aggregate apexification

2018 ◽  
Vol 11 (2) ◽  
pp. 122
Author(s):  
Sultana Parveen ◽  
Mozammal Hossain ◽  
Md. Abdul Hannan Sheikh ◽  
Md. Joynal Abdin
Keyword(s):  
Clinical Outcome ◽  
Clinical Success ◽  
Mineral Trioxide Aggregate ◽  
Lesion Size ◽  
Periapical Lesion ◽  
Anterior Teeth ◽  
Mean Size ◽  
The Mean ◽  
Radiological Examinations ◽  
Observation Period

<p class="Abstract">In the present study, the ability of mineral trioxide aggregate in the formation of apical plug for healing of large periapical lesion with open apex was assessed and evaluated the clinical outcome. Fifteen participants with periapical lesion at the upper anterior teeth with open apex were treated with mineral trioxide aggregate. The effect on healing of apical size was evaluated at 3, 6, and 12 months by radiological examinations in the form of periapical index criteria, diameter of the lesion size and the presence or absence of apical tissue barrier. The results found that neither pain nor any sinus was detected at 12 months. The mean size of the apical lesion was gradually reduced from 5.1 × 3.8 to 1.5 × 0.9 mm and mean PAI was reduced from 3.3 to 1.7 mm. The differences between mean size of periapical lesion at preoperative and 12 months observation period was also statistically significant (p&lt;0.05). The clinical success shown significant success rate of 93.3% analyzed with Z-test. In conclusion, tooth with open apex can be successfully treated with mineral trioxide aggregate apexification technique followed by root canal obturation.</p>

A valuable approach to the use of electronic medical data in primary care research: Panning for gold

2016 ◽  
Vol 46 (2) ◽  
pp. 51-57 ◽  
Author(s):  
Stephen Barnett ◽  
Joan Henderson ◽  
Adam Hodgkins ◽  
Christopher Harrison ◽  
Abhijeet Ghosh ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Care Delivery ◽  
Smoking Status ◽  
Distribution Patterns ◽  
Medical Data ◽  
Patient Age ◽  
Primary Care Research ◽  
Care Research ◽  
Patient Âgé

Background: Electronic medical data (EMD) from electronic health records of general practice computer systems have enormous research potential, yet many variables are unreliable. Objective: The aim of this study was to compare selected data variables from general practice EMD with a reliable, representative national dataset (Bettering the Evaluation and Care of Health (BEACH)) in order to validate their use for primary care research. Method: EMD variables were compared with encounter data from the nationally representative BEACH program using χ2 tests and robust 95% confidence intervals to test their validity (measure what they reportedly measure). The variables focused on for this study were patient age, sex, smoking status and medications prescribed at the visit. Results: The EMD sample from six general practices in the Illawarra region of New South Wales, Australia, yielded data on 196,515 patient encounters. Details of 90,553 encounters were recorded in the 2013 BEACH dataset from 924 general practitioners. No significant differences in patient age ( p = 0.36) or sex ( p = 0.39) were found. EMD had a lower rate of current smokers and higher average scripts per visit, but similar prescribing distribution patterns. Conclusion: Validating EMD variables offers avenues for improving primary care delivery and measuring outcomes of care to inform clinical practice and health policy.

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