Abstract
Aim
The aim was to assess the technical quality of root canal treatment conducted in paediatric patients. No specific data is available assessing endodontic treatment quality in children. General adult populations report satisfactory technical quality between 12.8 and 55.7 %, with higher rates by endodontists (77.4–91.0 %).
Methods
Radiographs of 100 chronological cases, conducted by staff (categorised as; junior staff, middle grades or consultants) in a UK teaching hospital, were evaluated retrospectively. Technical outcomes were compared to the European Society of Endodontology quality guideline consensus. A satisfactory root filling was defined as having: root filling material <2 mm from the radiographical apex; no canal space seen beyond the end of the obturation and an obturation of homogeneous density with no voids. In addition where MTA was used a plug of ≥3 mm was required. Any variation was considered unsatisfactory treatment.
Results
61 % [95 % CI 51–70 %] of cases were deemed satisfactory. Of the remaining obturations 20.5 % were short of the apex, 28.2 % had extruded material and 56.4 % contained voids. Patients with co-operation issues, particularly anxiety, had lower technical outcomes (p = 0.001) and the use of thermoplastic obturation greatly reduced the chance of void inclusion (p = 0.004; OR 0.20 [95 % CI 0.06–0.65]). Although ‘staff grade’ did not show a statistically significant difference, a trend between experience and quality was suspected.
Conclusion
Overall technical quality of treatment was comparable to the higher rates found in the general adult population. Additionally thermal obturation may be superior to cold lateral condensation in improving obturation quality, and anxiety negatively impacts on treatment provision.
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References
Asgarya S, Ehsanib S. MTA resorption and periradicular healing in an open-apex incisor: a case report. Saudi Dent J. 2012;24(1):55–9.
Bierenkrant DE, Parashos P, Messer HH. The technical quality of nonsurgical root canal treatment performed by a selected cohort of Australian endodontists. Int Endod J. 2008;41:561–70.
Boltacz-Rzepkowska E, Pawlicka H. Radiographic features and outcome of root canal treatment carried out in the Lodz region of Poland. Int Endod J. 2003;36:27–32.
Bücher K, Neumann C, Thiering E, et al. Complications and survival rates of teeth after dental trauma over a 5-year period. Clin Oral Investig. 2013;17(5):1311–8.
Di Filippo G, Sidhu SK, Chong BS. Apical periodontitis and the technical quality of root canal treatment in an adult sub-population in London. Br Dent J. 2014;216(10):E22.
European Society of Endodontology. Quality guidelines for the endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2006;39:921–30.
Ertas TE, Ertas H, Sisman Y, Sagsen B, Er O. Radiographic assessment of the technical quality and periapical health of root-filled teeth performed by general practitioners in a Turkish subpopulation. Sci World J 2013. doi:10.1155/2013/514841.
International Association of Dental Traumatology. The dental trauma guide. International Association of Dental Traumatology. 2014 [Online]: http://www.dentaltraumaguide.org/. Accessed 16 Oct 2014.
Kim YJ, Chandler NP. Determination of working length for teeth with wide or immature apices: a review. Int Endod J. 2013;46(6):483–91.
Liang YH, Li G, Shemesh H, Wesselink PR, Wu MK. The association between complete absence of post-treatment periapical lesion and quality of root canal filling. Clin Oral Investig. 2012;16(6):1619–26.
Malhotra N, Agarwal A, Mala K. Mineral trioxide aggregate: a review of physical properties. Compen Cont Educ Dent. 2013;34(2):e25–32.
Martins JN, Marques D, Mata A, Caramês J. Clinical efficacy of electronic apex locators: systematic review. J Endod. 2014;40(6):759–77.
Mente J, Leo M, Panagidis D, et al. Treatment outcome of mineral trioxide aggregate in open apex teeth. J Endod. 2013;39(1):20–6.
Mohammadi Z. Strategies to manage permanent non-vital teeth with open apices: a clinical update. Int Endod J. 2011;61(1):25–30.
Moreno JO, Alves FR, Gonçalves LS, et al. Periradicular status and quality of root canal fillings and coronal restorations in an urban Colombian population. J Endod. 2013;39(5):600–4.
Natera M, Pileggi R, Nair U. A comparison of two gutta-percha obturation techniques to replicate canal irregularities in a split-tooth model. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(5):e29–34.
Nekoofar M, Ghandi M, Hayes S, Dummer P. The fundamental operating principles of electronic root canal length measurement devices. Int Endod J. 2006;39:595–609.
Ng Y-L, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature—Part 2. Influence of clinical factors. Int Endod J. 2008;41:6–31.
Ng Y-L, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J. 2011;44:583–609.
Peng L, Ye L, Tan H, Zhou X. Outcome of root canal obturation by warm gutta-percha versus cold lateral condensation: a meta-analysis. J Endod. 2007;33(2):106–9.
Peretz B, Yakir O, Fuks AB. Follow up after root canal treatment of young permanent molars. J Clin Pediatr Dent. 1997;21(3):237–40.
Pitts N, Harker R. Obvious decay experience: Children’s dental health in the United Kingdom, 2003 (amendement). Office of National Statistics. 2005. http://www.ons.gov.uk/ons/search/index.html?newquery=obvious+dentinal+decay+superseded. Accessed 11 Jan 15.
Potter CM, Kinner DG, Tellez M, Ismail AI, Heimberg RG. Clinical implications of panic symptoms in dental phobia. J Anxiety Disord. 2014;28(7):724–30.
Ricucci D, Langeland K. Apical limit of root canal instrumentation and obturation, part 2. A Histol Study Int Endod J. 1998;31:394–409.
Segura-Egea JJ, Jimenez-Pinzon A, Poyato-Ferrera M, Velasco-Ortega E, Rıos-Santos JV. Periapical status and quality of root fillings and coronal restorations in an adult Spanish population. Int Endod J. 2004;37:525–530.
Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod. 1990;16(10):498–504.
Torabinejad M, Chivian N. Clinical applicatioons of mineral trioxide aggregate. J Endod. 1999;25(3):197–205.
Wigen TI, Agnalt R, Jacobsen I. Intrusive luxation of permanent incisors in Norwegians aged 6–17 years: a retrospective study of treatment and outcome. Dent Traumatol. 2008;24(6):612–8.
Wilson KE, Girdler NM, Welbury RR. Randomized, controlled, cross-over clinical trial comparing intravenous midazolam sedation with nitrous oxide sedation in children undergoing dental extractions. Br J Anaesth. 2003;91(6):850–6.
Wriedt S, Martin M, Al-Nawas B, Wehrbein H. Long-term effects of traumatic injuries to incisors and periodontal tissues during childhood: a retrospective study. J Orofac Orthop. 2010;71(5):318–29.
Zaleckiene V, Peciuliene V, Brukiene V, Drukteinis S. Traumatic dental injuries: etiology, prevalence and possible outcomes. Stomatologija. 2014;16(1):7–14.
Acknowledgments
The authors would like to thank Girvan Burnside for his statistical advice.
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Clarke, P., Jones, A.D.C., Jarad, F. et al. Technical outcome of root canal treatment on permanent teeth in children: a retrospective study. Eur Arch Paediatr Dent 16, 409–415 (2015). https://doi.org/10.1007/s40368-015-0185-9
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DOI: https://doi.org/10.1007/s40368-015-0185-9