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The outcome of endodontic treatment using an enhanced infection protocol in specialist practice

British Dental Journal volume 232, pages 805–811 (2022)Cite this article

Abstract

Objectives This study aims to determine the outcome of primary root canal treatment with specific enhanced infection control protocol. The secondary aim was to compare percentages of successful outcomes in this study with a previous study undertaken by the same operator using both periapical radiograph (PR) and cone beam computed tomography (CBCT).

Materials and methods Root canal treatment of 110 teeth in 95 patients carried out by a single operator using an enhanced infection control procedure (disinfection of gutta percha before obturation, changing of gloves after each intraoperative radiograph and also before the start of the root canal obturation). PR and CBCT scans of 94 teeth in 87 patients were assessed 12 months after completion of primary root canal treatment and compared with their respective pre-treatment (diagnostic) PR and CBCT scans. Healing was assessed by a consensus panel consisting of two calibrated examiners. Comparison of the PR and CBCT images for 'healed' and/or 'healing' outcomes was performed using McNemar's test.

Results The 'healed' rate (absence of periapical radiolucency) was 89.4% using PR and 78.7% for CBCT (p <0.046). This rate increased to 95.7% for PR and 92.6% for CBCT when the 'healing' group (reduced size of periapical radiolucency) was included (p <0.046).

Conclusion The frequent changing of gloves during the course of endodontic treatment and disinfection of gutta percha points before obturation, together with the use of contemporary rotary files, resulted in a high success rate of primary root canal treatment compared to similar clinical studies conducted previously.

Key points

  • Endodontic treatment is a predictable option to retain compromised teeth.

  • Changing gloves regularly during endodontic treatment as well as disinfecting gutta percha points before obturation improves success rates.

  • Cone beam computed tomography is more accurate than periapical radiographs for detecting apical disease.

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Authors and Affiliations

  1. Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK; Specialist Practice, London, UK

    Shanon Patel

  2. Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK

    Taranpreet Puri & Francesco Mannocci

  3. Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK; Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia

    Abdulaziz A. Bakhsh

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  1. Shanon Patel
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  2. Taranpreet Puri
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Contributions

Shanon Patel: conceptualisation; methodology; validation; formal analysis; investigation; resources; data curation; writing - original draft; writing - review and editing; visualisation; supervision; and project administration. Taranpreet Puri: methodology; validation; formal analysis; investigation; data curation; writing - original draft; visualisation; and project administration. Francesco Mannocci: formal analysis; investigation; data curation; writing - review and editing; supervision; and project administration. Abdulaziz A. Bakhsh: validation; formal analysis; investigation; resources; data curation; visualisation; and project administration.

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Correspondence to Shanon Patel.

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Patel, S., Puri, T., Mannocci, F. et al. The outcome of endodontic treatment using an enhanced infection protocol in specialist practice. Br Dent J 232, 805–811 (2022). https://doi.org/10.1038/s41415-022-4339-y

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