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The top risk factors for endodontic flare-up: a Monte Carlo simulation

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Abstract

Objectives

The aim of this study was to analyze the strength of risk factors related to endodontic flare-ups and rank them in order of their importance

Materials and methods

A systematic literature search of PubMed, Cochrane Central Register of Controlled Trials, Scopus, and ISI Web of Knowledge, and grey literature was conducted up to November 2019. One hundred ninety-eight publications were identified. Twelve records fulfilled the eligibility criteria, and eight significant risk factors for flare-up, namely, “Periapical lesion,” “multiple-visit treatment,” “preoperative pain,” “necrotic teeth,” “female gender,” “retreatment,” “percussion pain,” and “analgesics,” were selected to construct the simulation model. The final data pool was established by the integration of data of common risk factors in the included articles. Monte Carlo method was used to analyze of combined numerical data, for simulation of the risk factor impacts. Ten thousand iterations were generated in the simulation model.

Results

The results of the simulation revealed that the risk estimates of the factors had varying ranges of influence and probability on the flare-up risk. “Periapical lesion” was found to be the most sensitive risk factor, following by “preoperative pain” which was ranked the second place. The third-ranked risk factor was “multiple-visit treatment.” The least sensitive risk factors for endodontic flare-up were “retreatment,” “female gender,” “necrotic teeth,” and “analgesics.”

Conclusions

The present study provides better comprehension on the importance of risk factors for flare-up based on their risk estimates.

Clinical relevance

A Monte Carlo simulation was adopted to identify the most influential risk factors for endodontic flare-up with a ranking, which can be used to provide meaningful predictions and further insights into clinicians’ perception of flare-up risk.

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Author information

Authors and Affiliations

  1. Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey

    Umut Aksoy

  2. Department of Industrial Engineering, Faculty of Engineering, Girne American University, Kyrenia, Mersin 10, Turkey

    Salahi Pehlivan

  3. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey

    Oğuz Buhara

Authors
  1. Umut Aksoy
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  2. Salahi Pehlivan
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  3. Oğuz Buhara
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Umut Aksoy, Oğuz Buhara, and Salahi Pehlivan. The first draft of the manuscript was written by Umut Aksoy and Oğuz Buhara, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Umut Aksoy.

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Aksoy, U., Pehlivan, S. & Buhara, O. The top risk factors for endodontic flare-up: a Monte Carlo simulation. Clin Oral Invest 25, 3681–3690 (2021). https://doi.org/10.1007/s00784-020-03692-9

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  • DOI: https://doi.org/10.1007/s00784-020-03692-9

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