scholarly journals Vital Pulp Therapy in Permanent Mature Posterior Teeth with Symptomatic Irreversible Pulpitis: A Systematic Review of Treatment Outcomes

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 573
Author(s):  
João Miguel Santos ◽  
Joana F. Pereira ◽  
Andréa Marques ◽  
Diana B. Sequeira ◽  
Shimon Friedman
Keyword(s):  
Systematic Review ◽  
Root Canal ◽  
Small Sample ◽  
Risk Of Bias ◽  
Root Canal Treatment ◽  
Cochrane Library ◽  
Posterior Teeth ◽  
Pulp Therapy ◽  
Vital Pulp Therapy ◽  
Irreversible Pulpitis

Background and Objectives: Symptomatic irreversible pulpitis in permanent mature teeth is a common indication for nonsurgical root canal treatment (NSRCT), but contemporary studies have reported on vital pulp therapy (VPT) applied in such teeth as a less invasive treatment. This systematic review assessed the outcomes of VPT, including partial and full pulpotomy performed with hydraulic calcium silicate cements (HCSCs) in permanent mature posterior teeth diagnosed with symptomatic irreversible pulpitis. Materials and Methods: The PRISMA guidelines were followed. The search strategy included PubMed®, EMBASE, Cochrane library and grey literature electronic databases. The quality assessment of the identified studies followed the Cochrane Collaboration Risk of Bias, ROBINS-I and Newcastle–Ottawa Scale tools. Results: The search of primary databases identified 142 articles, of which 9 randomized controlled trials and 3 prospective cohort studies were selected for review. The risk-of-bias was assessed as ‘high’ or ‘serious’, ‘fair’, and ‘low’ for three, seven and two articles, respectively. One to five years after VPT using HCSCs, the success rates mostly ranged from 78 to 90%. Based on two articles, the outcomes of the VPT and NSRCT were comparable at one and five years. Despite the necessity for the intra-operative pulp assessment in VPT procedures, the majority of the studies did not fully report on this step or on the time needed to achieve hemostasis. Small sample sizes, of under 23 teeth, were reported in three studies. Conclusions: The reviewed 12 articles reported favorable outcomes of the VPT performed with HCSCs in permanent mature posterior teeth with symptomatic irreversible pulpitis, with radiographic success in the range of 81 to 90%. Two articles suggested comparable outcomes of the VPT and root canal treatment. Universal case selection and outcome criteria needs to be established for VPT when considered as an alternative to NSRCT. This evidence supports the need for further research comparing longer-term outcomes of both of the treatment modalities.

Supplementary techniques for pain control during root canal treatment of lower posterior teeth with irreversible pulpitis: A systematic review and meta-analysis

2017 ◽  
Vol 44 (1) ◽  
pp. 14-25 ◽  
Author(s):  
Pinpana Tupyota ◽  
Pattama Chailertvanitkul ◽  
Malinee Laopaiboon ◽  
Chetta Ngamjarus ◽  
Paul V. Abbott ◽  
...  
Keyword(s):  
Systematic Review ◽  
Root Canal ◽  
Pain Control ◽  
Meta Analysis ◽  
Root Canal Treatment ◽  
Posterior Teeth ◽  
Irreversible Pulpitis

Does Smear Layer Removal Influence Root Canal Therapy Outcome? A Systematic Review

2016 ◽  
Vol 40 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Andréa Vaz Braga Pintor ◽  
Marcello Rotter Marins dos Santos ◽  
Daniele Masterson Ferreira ◽  
Roberta Barcelos ◽  
Laura Guimarães Primo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Root Canal ◽  
Assessment Tool ◽  
Clinical Signs ◽  
Risk Of Bias ◽  
Smear Layer ◽  
Root Canal Treatment ◽  
Cochrane Library ◽  
Root Canal Therapy ◽  
Removal Group

Objective: The aim of this systematic review was to determine whether the smear layer (SL) removal procedure influences the outcome of root canal treatment. Study design: We performed a search on Pubmed, Scopus, ISI Web of Science, Cochrane Library, Lilacs and SIGLE. We included randomized controlled clinical trials (RCT), with clinical and radiographic outcomes, conducted on subjects who had undergone root canal therapy. The protocol differed only in the SL removal or maintenance procedure. We evaluated the papers for risk of bias according to the Cochrane assessment tool. Results: A total of 1,983 articles were found, after removal of duplicates, 892 remained. We included two studies in this review. One study revealed a low risk of bias and a high success rate for the SL removal group compared to the non SL removal group (P = 0.04), while the other study had a high risk of bias and found no difference between the SL removal and non SL removal groups (P = 1.00). Conclusion: We concluded that the SL removal for root canal treatment of primary teeth with initial clinical signs and symptoms or pulpal necrotic status, could benefit the outcome, although further RCT should be performed to achieve evidence.

Patient education for preventing recurrence of venous leg ulcers: a systematic review

2020 ◽  
Vol 29 (2) ◽  
pp. 79-91 ◽  
Author(s):  
Emer Shanley ◽  
Zena Moore ◽  
Declan Patton ◽  
Tom O’Connor ◽  
Linda Nugent ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Education ◽  
Small Sample ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
The Impact

Objective: To investigate the impact of patient education interventions on preventing the recurrence of venous leg ulcers (VLU). Method: A systematic review was undertaken using the following databases: Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library); Ovid; Ovid (In-process and Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL. Trial registries and reference lists of relevant publications for published and ongoing trials were also searched. There were no language or publication date restrictions. Randomised controlled trials (RCTs) and cluster RCTs of patient educational interventions for preventing VLU recurrence were included. Review authors working independently assessed trials for their appropriateness for inclusion and for their risk of bias, using pre-determined inclusion and quality criteria. Results: A total of four studies met the inclusion criteria (274 participants). Each trial explored different interventions as follows: the Lively legs programme; education delivered via a video compared with education delivered via a pamphlet; the Leg Ulcer Prevention Programme and the Lindsay Leg Club. Only one study reported the primary outcome of incidence of VLU recurrence. All studies reported at least one of the secondary outcomes: patient behaviours, patient knowledge and patient quality of life (QoL). It is uncertain whether patient education programmes make any difference to VLU recurrence at 18 months (risk ratio [RR]: 0.82; 95% confidence interval: [CI] 0.59 to 1.14) or to patient behaviours (walked at least 10 minutes/five days a week RR: 1.48; 95%CI: 0.99 to 2.21; walked at least 30 minutes/five days a week: RR 1.14; 95%CI: 0.66 to 1.98; performed leg exercises: RR: 1.47; 95%CI: 1.04 to 2.09); to knowledge scores (MD (mean difference) 5.12, 95% CI –1.54 to 11.78); or to QoL (MD: 0.85, 95% CI –0.13 to 1.83), as the certainty of evidence has been assessed as very low. It is also uncertain whether different types of education delivery make any difference to knowledge scores (MD: 12.40; 95%CI: –5.68 to 30.48). Overall, GRADE assessments of the evidence resulted predominantly in judgments of very low certainty. The studies were at high risk of bias and outcome measures were imprecise due to wide CIs and small sample sizes. Conclusion: It is uncertain whether education makes any difference to the prevention of VLU recurrence. Therefore, further well-designed trials, addressing important clinical, QoL and economic outcomes are justified, based on the incidence of the problem and the high costs associated with VLU management.

scholarly journals Intracanal Cryotherapy and its Effects on the Postoperative Pain in Root Canal Therapy: Systematic Review & Meta-analysis Protocol.

2020 ◽  
Author(s):  
Durre Sadaf ◽  
Muhammad Zubair Ahmad ◽  
Igho Onakpoya
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Root Canal ◽  
Search Strategy ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Root Canal Therapy ◽  
Bias Assessment ◽  
Comprehensive Search ◽  
Comprehensive Search Strategy

Abstract Background: There are many research studies directing in lowering postoperative pain in root canal therapy. The use of intracanal cryotherapy in root canal treatment is recently introduced, and many researchers are inclined towards this techniques. This systematic review will give an insight into its application in endodontic therapy and its effects on postoperative pain.The aim of this systematic review is to evaluate the effect of intracanal cryotherapy on the postoperative pain in patients with pulp diseases and with or without peri-radicular infection during root canal therapy. This systematic review will include randomized controlled trials only. The studies should encompass patients with pulpal diseases, i.e. irreversible pulpitis and pulp necrosis in teeth. Previously root treated teeth, immature, and teeth with root resorption will not be included. Methods: We will conduct a comprehensive search strategy using electronic databases PubMed, EMBASE (Ovid), Scopus, and Cochrane library. A predefined inclusion and exclusion criteria will be utilized for the selection of studies. The reference list of selected studies will be manually searched. We will extract data from studies on a structured data collection form. At the same time, the risk of bias assessment of studies using the Cochrane risk of bias assessment tools will be performed by two reviewers independently. Furthermore, qualitative and quantitative data synthesis will be accomplished. The data will be presented in the form of table of summary of findings. Discussion: This systematic review will assess the role of intracanal cryotherapy in the form of cold saline irrigation as a final irrigant during root canal therapy. The quality of evidence will ranked as high, moderate low or very low using GRADE approach. Comprehensive search strategy, risk of bias assessment using Cochrane risk of bias assessment tool by two reviewers are the strength of this systematic review. Systematic review registration number: The protocol is registered with the International Prospective Register of Systematic Reviews. (PROSPERO CRD 42020163438)

scholarly journals Perawatan Saluran Akar Satu Kunjungan disertai Restorasi Resin Komposit dengan Pasak Parallel Self-Threading Gigi Molar Kedua Kanan Mandibula Pulpitis Ireversibel

2016 ◽  
Vol 1 (1) ◽  
pp. 63
Author(s):  
Gunawan Raharjo ◽  
Pribadi Santosa
Keyword(s):  
Root Canal ◽  
Composite Resin ◽  
Root Canal Treatment ◽  
Posterior Teeth ◽  
Second Molar ◽  
Reinforced Composite ◽  
Composite Resin Restoration ◽  
Male Patients ◽  
Irreversible Pulpitis

Perawatan saluran akar (PSA) satu kunjungan merupakan perawatan saluran akar dengan prinsip triad endodontik (cleaning and shaping, medikasi dan obturasi saluran akar) diselesaikan dalam satu kali kunjungan. Keuntungan perawatan adalah memperkecil risiko kontaminasi mikroorganisme dalam saluran akar antar kunjungan, menghemat waktu perawatan karena tidak dilakukan penggantian medikasi intrakanal tetapi tanpa mengurangi kualitas hasil perawatan. Pulpitis ireversibel merupakan salah satu indikasi perawatan saluran akar satu kunjungan. Gigi posterior pasca PSA dengan kehilangan jaringan sehat yang tidak terlalu banyak dapat dilakukan restorasi menggunakan bahan resin komposit dengan penguat pasak parallel self-threading. Tujuan laporan kasus ini untuk menunjukkan keberhasilan perawatan saluran satu kunjungan pada kasus pulpitis ireversibel dan restorasi akhir menggunakan resin komposit yang diperkuat pasak parallel self-threading. Pasien laki-laki 47 tahun dilakukan perawatan saluran akar pada gigi molar kedua kanan mandibula dengan diagnosa pulpitis ireversibel. Pada pemeriksaan radiograf terlihat kavitas yang melibatkan pulpa dan tidak terdapat area radiolusen pada daerah periapikal. Kasus ini dilakukan PSA satu kunjungan dilanjutkan restorasi resin komposit dengan penguat pasak parallel self-threading pada kunjungan berikutnya. Perawatan saluran akar satu kunjungan disertai restorasi resin komposit dengan penguat pasak parallel self-threading berhasil dilakukan pada kasus pulpitis ireversibel pada gigi molar kedua kanan mandibula. Abstract: One Visit Endodontic Followed with Parallel Self Threading Dowel Reinforced Composite Resin Restoration on The Irreversible Pulpitis of Mandibular Right Second Molar. One visit endodontic root canal treatment (RCT) which endodontic triad (cleaning and shaping, medication, and obturation of the root canal) were completed in one visit. The advantages treatment is to minimize the risk of microorganisms contamination in the root canal, that saves time. In this treatment there is no intracanal medication replacement without reducing the quality of treatment. Irreversible pulpitis is one of one visit endodontic’s indications. Parallel self-threading dowel reinforced composite resin can be performed at minimal destruction post endodontically treated posterior teeth. The purpose of this case report is to demonstrate the irreversible pulpitis were treated by one visit root canal treatment successfully and its restorations with parallel self-threading dowel reinforced composite resin. Male patients 47years old who diagnosed irreversible pulpitis was treated by one visit root canal treatment on the mandibular right second molars. The radiographs image showed cavity involving to the pulp and there was no radiolucent area in the periapical region. Endodontic treatment was done by one visit root canal treatment and followed with composite resin restoration with parallel self-threading dowel. One visit endodontic followed with restored using composite resin material that reinforced by parallel self-threading dowel successfully performed on the mandibular right second molar with irreversible pulpitis diagnosis.

Apexogenesis

1990 ◽  
Vol 7 (3) ◽  
pp. 12-13 ◽  
Author(s):  
Chris J. Visser
Keyword(s):  
Root Canal ◽  
Root Canal Treatment ◽  
Permanent Teeth ◽  
Canal System ◽  
Tooth Formation ◽  
Pulp Therapy ◽  
Biological Approach ◽  
Immature Teeth ◽  
Vital Pulp Therapy ◽  
Pulp Exposure

The permanent teeth erupt while undergoing tooth formation and root lengthening. These immature teeth are more vulnerable to pulp exposure. Faced with the necessity for root canal treatment, and taking into account the unlikely possibility of successful obturation of an immature canal system, it is recommended that these developing teeth be treated by a biological approach. When the vital pulp of a tooth is exposed and the pulp is not irreversibly inflamed and apical development and closure is incomplete apexogenesis procedures are recommended. Vital pulp therapy techniques are described.

scholarly journals Comparison of the effectiveness of single- and multiple-sessions disinfection protocols against endotoxins in root canal infections: systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gustavo G. Nascimento ◽  
Diego G. D. Rabello ◽  
Bruna J. M. Corazza ◽  
Ana P. M. Gomes ◽  
Eduardo G. Silva ◽  
...  
Keyword(s):  
Systematic Review ◽  
Root Canal ◽  
Meta Analysis ◽  
Group Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Single Session ◽  
Literature Searches ◽  
Endodontic Infections

AbstractThis systematic review (SR) addressed the following common clinical question: What is more effective in reducing or eliminating endotoxin in endodontic infections—single or multiple-session treatments using calcium hydroxide medications? Literature searches of Medline/PubMed, Embase, Cochrane Library, Scielo, Science Direct, Web of Knowledge, Scopus, and Google Scholar databases. Two reviewers independently assessed the eligibility for inclusion, extracted data, and evaluated the quality of the studies using the risk of bias tools. Electronic searches resulted in 358 articles, of which 32 studies were included for full-text assessment, and nine were included in this review. Meta-analysis pooling all the nine studies revealed lower levels of endotoxin for multiple-session treatment (P < 0.001). The sub-group analysis indicated no difference between single-session and 7 days of Ca(OH)2 medication (SMD − 0.32; P = 0.22). However, 14-days (I2 = 80.5%, P < 0.001) and 30-days (I2 = 78.9%, P < 0.01) of Ca(OH)2 medication was more effective than single-session treatment (both, p < 0.001). Overall, Overall, this SR provides evidence to support that multiple-session disinfection protocols with the placement of Ca(OH)2 medications are more effective in reducing the levels of endotoxin from root canal infections compared to single-session when applied for 14 and 30 days.

scholarly journals A Protocol on Antimicrobial effectiveness of adjunctive disinfection techniques during root canal therapy in patients with pulp necrosis and apical periodontitis. A Systematic Review & Meta-analysis

2019 ◽  
Author(s):  
Durre Sadaf ◽  
Zubair Ahmad ◽  
Igho - Onakpoya
Keyword(s):  
Systematic Review ◽  
Root Canal ◽  
Risk Of Bias ◽  
Apical Periodontitis ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Root Canal Therapy ◽  
Related Factors ◽  
Mesh Terms ◽  
Antimicrobial Effectiveness

Abstract Background The primary objective of root canal therapy is to eliminate bacteria from the root canal system of teeth. However, standard chemo-mechanical disinfection has been found unable to remove bacteria within the root canals. Clinicians tempted to use additional disinfection techniques to achieve adequate level of disinfection. There is no such systematic review that could comprehensively compare the efficiency of all currently used disinfection techniques. This systematic review aims to compare the antimicrobial effectiveness of various adjunctive disinfection techniques with standards chemo-mechanical disinfection technique(needle syringe irrigation) used during root canal therapy in patients with pulp necrosis and apical periodontitis.Methods A well-defined structured clinical question in the form of PICO (Patients/Problem, Intervention, Comparison, Outcome) is designed. The unit of analysis in this review is a tooth. Teeth with apical periodontitis is a problem (P). Interventions (I) are supplemental disinfection techniques that include photodynamic therapy, passive ultrasonic irrigation, and negative pressure techniques. Comparison (C) will be standard chemo-mechanical disinfection technique. Outcome (O) is the effectiveness of antimicrobial activity in the form of detection of bacteria and colony-forming units (CFU). Keywords, MeSH terms, and synonyms will be searched through previous literature, books, and Medline database. We will perform a comprehensive search strategy using electronic databases MEDLINE (Ovid), EMBASE (Ovid), and Cochrane library. Hand searching of top endodontic journals and reference lists of selected studies will be carried out. Selection of studies will be made under predefined inclusion and exclusion criteria. Data extraction of selected studies will be done with two reviewers using a structured data collection form. At the same time, the risk of bias using the Cochrane risk of bias assessment tools will be carried out. A qualitative and quantitative data synthesis will be done. The data will be presented in the form of tables of summary of findings.Discussion All potential clinical, methodological, and patient's related factors responsible for heterogeneity will be explored and discussed. We will also compare the results of our systematic review with existing literature. Strength and limitations of the systematic review will be discussed.Systematic Review registration Our protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO-CRD#42019099141).

scholarly journals Calcium Silicate-Based Sealers Do Not Reduce the Risk and Intensity of Postoperative Pain after Root Canal Treatment when Compared with Epoxy Resin-Based Sealers: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Emílio Carlos Sponchiado Junior ◽  
Walbert de Andrade Vieira ◽  
Ana Gabriela Costa Normando ◽  
Juliana Vianna Pereira ◽  
Caio Cezar Randi Ferraz ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Epoxy Resin ◽  
Root Canal ◽  
Calcium Silicate ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Root Canal Treatment ◽  
Cochrane Library ◽  
Significant Difference

AbstractThis review aims to evaluate whether root canal obturation with calcium silicate-based (CSB) sealers reduces the risk and intensity of endodontic postoperative pain when compared to epoxy resin-based (ERB) sealers. The review was registered at PROSPERO (CRD42020169255). Two independent reviewers conducted an electronic search in PubMed, Scopus, EMBASE, Web of Science, Cochrane Library and LILACS until November 2020 and included only randomized clinical trials with adult health participants undergoing root canal treatment. After selection, the JBI Critical Appraisal tool was used to assess the risk of bias. A fixed-effect meta-analysis was performed to summarize the results of pain risk and pain intensity at time intervals of 24 and 48 hours. Finally, the certainty of evidence was assessed using the GRADE approach. The search resulted in 1,206 records, of which five studies (n = 421 patients) met the eligibility criteria and presented moderate to low risk of bias. There was no significant difference between groups in the risk of pain in the first 24 hours (relative risk or RR = 0.83, 95% confidence interval or CI: 0.60, 1.16, I 2 =) or 48 hours (RR = 0.56, 95% CI: 0.26, 1.21, I 2 =). Silicate-based sealers led to lower pain intensity only at 48 hours (mean and standard deviation = 0.37, 95% CI: 0.69, 0.05). All analyses revealed low heterogeneity (I 2 < 25%). The evidence presented moderate level of certainty. Currently available evidence has shown that there is no difference between CSB and ERB sealers in the risk or intensity of postoperative pain.

scholarly journals Effectiveness of Nutritional Education for Obese Older Adults With Frailty: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 401-401
Author(s):  
Yue-Heng Yin ◽  
Liu Yat Justina
Keyword(s):  
Systematic Review ◽  
Physical Function ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Well Being ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Nutritional Education ◽  
Hand Search ◽  
Education Interventions

Abstract Obesity has been shown to intensify the decline of physical function and lead to frailty. Nutrition is an important method in managing obesity and frailty, while seldom reviews have ever explored the effects of nutritional education interventions. We conducted a systematic review (PROSPERO: CRD42019142403) to explore the effectiveness of nutritional education interventions in managing body composition and physio-psychosocial parameters related to frailty. Randomized controlled trials and quasi-experimental studies were searched in CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed and Scopus from 2001 to 2019. Hand search for the reference lists of included papers was conducted as well. We assessed the quality of included studies by Cochrane risk of bias tool. Meta-analyses and narrative synthesis were used to analyse the data. Two studies with low risk of bias were screened from 180 articles, which involved 177 older people with an average age of 69.69±4.08 years old. The results showed that nutritional education was significantly effective in reducing body weight and fat mass than exercises, and it was beneficial to enhancing physical function and psychosocial well-being. But the effects of nutritional education in increasing muscle strength were not better than exercises. The combined effects of nutritional education and exercises were superior than either exercises or nutritional education interventions solely in preventing the loss of lean mass and bone marrow density, and in improving physical function. Due to limited numbers of relevant studies, the strong evidence of effectiveness of nutritional education interventions on reversing frailty is still lacking.

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