Post on 30-Dec-2015
Tooth survival of endodontically treated molars
Nagasiri R, Chitmongkolsuk S. Long-term survival of endodontically treated molars without crown coverage: a retrospective cohort study. J Prosthet Dent. 2005 Feb;93(2):164-70.
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.
7. Jahrestagung DGEndoDr. Dag Ørstavik
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, ..
Tooth survival of endodontically treated molars
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Class I MOD No safe wall
Nagasiri R, Chitmongkolsuk S. Long-term survival of endodontically treated molars without crown coverage: a retrospective cohort study. J Prosthet Dent. 2005 Feb;93(2):164-70.
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!
7. Jahrestagung DGEndoDr. Dag Ørstavik
Apical regeneration after endodontic surgery
7. Jahrestagung DGEndoDr. Dag Ørstavik
Wang Q, Cheung GS, Ng RP. Survival of surgical endodontic treatment performed in a dental
teaching hospital: a cohort study. Int Endod J. 2004
Nov;37(11):764-75.
Apical regeneration after endodontic surgery
7. Jahrestagung DGEndoDr. Dag Ørstavik
Wang Q, Cheung GS, Ng RP. Survival of surgical endodontic treatment performed in a dental
teaching hospital: a cohort study. Int Endod J. 2004
Nov;37(11):764-75.
Apical regeneration after endodontic surgery
7. Jahrestagung DGEndoDr. Dag Ørstavik
Wang Q, Cheung GS, Ng RP. Survival of surgical endodontic treatment performed in a dental
teaching hospital: a cohort study. Int Endod J. 2004
Nov;37(11):764-75.
Apical regeneration after endodontic surgery: material effect?
7. Jahrestagung DGEndoDr. Dag Ørstavik
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Outcome
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IRM
MTA
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. 2003 Aug;36(8):520-6.
Apical regeneration after endodontic surgery: material effect?
7. Jahrestagung DGEndoDr. Dag Ørstavik
0
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Complete Incomplete Uncertain Unsatisfactory
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IRM 1y (n = 58) MTA 1y (n = 64)
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. 2005 Oct;100(4):495-500.
Apical regeneration after endodontic surgery: material effect?
7. Jahrestagung DGEndoDr. Dag Ørstavik
0
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Complete Incomplete Uncertain Unsatisfactory
No
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IRM 2y (n = 47) MTA 2y (n = 61)
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. 2005 Oct;100(4):495-500.
Endodontics vs implantatApples 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
7. Jahrestagung DGEndoDr. Dag Ørstavik
Endodontics vs implant
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Success Survival Repair Failure
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. 2006 Sep;32(9):822-7. NSRCT outcomes were affected by periradicular periodontitis (p = 0.001), post placement (p = 0.013), and overfilling (p = 0.003).
7. Jahrestagung DGEndoDr. Dag Ørstavik
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. 2008 Nov;34(11):1302-5.
7. Jahrestagung DGEndoDr. Dag Ørstavik
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. 2008 Nov;34(11):1302-5.
7. Jahrestagung DGEndoDr. Dag Ørstavik
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. 2008 Nov;34(11):1302-5.
7. Jahrestagung DGEndoDr. Dag Ørstavik
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. 2008 Nov;34(11):1302-5.
7. Jahrestagung DGEndoDr. Dag Ørstavik
Endodontics vs implant
Hannahan JP, Eleazer PD. Commparison of success of implants versus endodontically treated teeth. J Endod. 2008 Nov;34(11):1302-5.
7. Jahrestagung DGEndoDr. Dag Ørstavik
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Success Uncertain Failures
Implants 129
Endo 143
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
7. Jahrestagung DGEndoDr. Dag Ørstavik