Ramin Noghreian D.D.S., Inc.
Nooshin Noghreian D.D.S., M.S., Inc.
Diplomates of the American Board of Endodontics
Dear Fellow Colleague,
In this issue of Update on Endodontics, we’ve found several sections very interesting.
Endodontic Outcomes of Untreated Canals:
Missed or untreated root canals have been shown to have an adverse effect on endodontic outcomes. The canals most frequently missed are maxillary molars, mandibular molars, mandibular premolars, and maxillary premolars, respectively. We have seen this to be true quite frequently when we retreat a tooth that has a failing root canal, especially in the maxillary molar area. A tooth is 4.38 times more likely to be associated with a periapical lesion if there is a missed or untreated canal.
Options After Unsuccessful Root Canal Treatment:
The treatment options after root canal failure should reflect the success rates of the procedures to save the tooth. These include nonsurgical retreatment, surgical treatment, tooth replantation and extraction with or without replacement. Ten-year complication rates for teeth with root canals is about 4%, compared to 18% for single tooth implants. We have found a very high success rate with retreatment and apical surgery with proper case selection.
Intrusive Luxation Treatment for Permanent Teeth:
The incidence of intrusive luxation makes up 0.5%-1.9% of all traumatic dental injuries. These teeth can be treated in three different ways including; spontaneous passive eruption, orthodontic repositioning, and immediate surgical repositioning. The less damage to the periodontal ligament, the less chances of replacement resorption in these cases. Therefore, if possible, passive eruption would be a better option, compared to ortho or surgical intervention.
Indications for Use of Antibiotics For Endodontic Infections and Pain
Lastly, we are trying to stay away from prescribing antibiotics with routine root canal therapy, unless there are systemic signs that the infection is progressing. This is due to the multi-drug resistant bacteria which has become a global problem.
Again, thank you for all your support and we hope you enjoy this issue of our Endodontic Newsletter.