Clinical outcome of the endodontic treatment of teeth with apical periodontitis using an antimicrobial protocol

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Nov;106(5):757-62. doi: 10.1016/j.tripleo.2008.06.007. Epub 2008 Aug 20.

Abstract

Objective: This study investigated the long-term (1-4 years) outcome of the endodontic treatment of teeth with apical periodontitis lesions performed by undergraduate students using a defined antimicrobial protocol.

Study design: Treatment protocol included a crown-down instrumentation technique, apical enlargement to predetermined sizes and apical level, irrigation with 2.5% sodium hypochlorite, and intracanal medication with calcium hydroxide/camphorated paramonochlorophenol (CPMC) paste. The first 100 teeth from patients who returned for follow-up were examined. The outcome was assessed based on radiographic and clinical criteria as healed (success), healing (uncertain), or not healed (failure).

Results: Overall results showed that 76% of the teeth healed, 19% were healing, and 5% had not healed. Most healed cases (75%) or failed cases (80%) were already evident at 2 years. Seven cases took 4 years to heal completely.

Conclusions: The low failure rate observed in this study reinforces the importance of using an evidence-based antimicrobial strategy during endodontic treatment of teeth with apical periodontitis.

MeSH terms

  • Anti-Infective Agents, Local / therapeutic use
  • Bismuth
  • Calcium Hydroxide
  • Camphor
  • Chlorophenols
  • Clinical Protocols
  • Dental Plaque / therapy
  • Dental Pulp Necrosis / therapy
  • Dental Restoration Failure
  • Drug Combinations
  • Follow-Up Studies
  • Gutta-Percha
  • Humans
  • Periapical Periodontitis / therapy*
  • Root Canal Filling Materials
  • Root Canal Irrigants / therapeutic use
  • Root Canal Obturation / methods
  • Root Canal Preparation / methods
  • Root Canal Therapy / methods*
  • Rubber Dams
  • Sodium Hypochlorite / therapeutic use
  • Treatment Outcome

Substances

  • Anti-Infective Agents, Local
  • Chlorophenols
  • Drug Combinations
  • Root Canal Filling Materials
  • Root Canal Irrigants
  • Sealer 26
  • Camphor
  • camphorated parachlorophenol
  • Gutta-Percha
  • Sodium Hypochlorite
  • Calcium Hydroxide
  • Bismuth