Top

Published in:

01-04-2018 | Original Article

Outcome of secondary root canal treatment filled with Thermafil: a 5-year follow-up of retrospective cohort study

Authors: Chiara Pirani, Francesco Iacono, Maria Rosaria Gatto, Raquel Michelle Fitzgibbon, Stefano Chersoni, Hagay Shemesh, Carlo Prati

Published in: Clinical Oral Investigations | Issue 3/2018

Abstract

Objectives

The aim of the present retrospective cohort study was to assess the 5-year outcome and survival of secondary root canal treatments (2°RCT), exploring the influence of pre-, intra-, and post-operative variables.

Materials and methods

One hundred thirty-two endodontically retreated teeth were radiographically and clinically re-examined after 5 years. 2°RCT had been performed during a Masters program following standardized protocols and filled with AH Plus/Thermafil (TF). Pre-, intra-, and post-operative data were collected. The 5-year outcome was blindly evaluated and categorized as healed/diseased on the basis of the periapical index. Bivariate analysis and chi-square test evaluated the association between outcome and 31 demographic/clinical parameters. Multilevel analysis was performed at both patient and tooth level. Statistical significance was calculated at 5% level.

Results

At 5-year evaluation, survival rate was 80% with 7.5% lost for endodontic reasons. Eighty-three percent of the teeth were classified as healed. Multilevel analysis identified significant predictors of increased survival: female gender (p = 0.012), absence of a pre-operative metal post (p = 0.017), conservative apical preparation (diameter size < #35) (p = 0.039), teeth restored with a crown (p = 0.009), and final PAI (after 5 years) ≤ 2 (p = 0.001). Multilevel analysis identified as predictor healing: not being a smoker (p = 0.048) and conservative apical preparation < size #35 (p = 0.037).

Conclusions

Outcome of 2°RCT filled with Thermafil was successful at 5 years, showing a high rate of survived and healed teeth comparable to that reported previously for other obturation techniques.

Clinical relevance

Present findings confirm 2°RCT as a valid therapeutic option to retain natural teeth.

de Chevigny C, Dao TT, Basrani RB, Marquis V, Farzaneh M, Abitbol S, Friedman S (2008) Treatment outcome in endodontics: the Toronto study. Phases 3 and 4: orthograde retreatment. J Endod 34:131–137CrossRefPubMed

Farzaneh M, Abitbol S, Friedman S (2004) Treatment outcome in endodontics: the Toronto study. Phase I and II: orthograde retreatment. J Endod 30:627–633CrossRefPubMed

Friedman S (1998) Prevention and treatment of apical periodontitis. In: Ørstavik D, Pitt Ford TR (eds) Essential endodontology. Blackwell Science, Oxford, pp 367–391

Torabinejad M, White SN (2016) Endodontic treatment options after unsuccessful initial root canal treatment: alternatives to single-tooth implants. JADA 147:214–220PubMed

Kvist T, Reit (1999) Results of endodontic retreatment: a randomized clinical study comparing surgical and nonsurgical procedures. J Endod 25:814–817CrossRefPubMed

Paik S, Sechrist C, Torabinejad M (2004) Levels of evidence for the outcome of endodontic retreatment. J Endod 30:745–750CrossRefPubMed

Siqueira JF Jr (2001) Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J 34:1–10CrossRefPubMed

European Society of Endodontology (2006) Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J 39:921–930CrossRef

Ng YL, Mann V, Gulabivala K (2008) Outcome of secondary root canal treatment: a systematic review of the literature. Int Endod J 41:1026–1046CrossRefPubMed

10.

Gorni F, Gagliani M (2004) The outcome of endodontic retreatment: a 2-yr follow-up. J Endod 30:1–4CrossRefPubMed

11.

Mirfendereski M, Roth K, Bing F, Dubrowski A, Carnahan H, Azarpazhooh A, Basrani B, Torneck CD, Friedman S (2009) Technique acquisition in the use of two thermoplasticized root filling methods by inexperienced dental students: a micro-CT analysis. J Endod 35:1512–1517CrossRefPubMed

12.

Gagliani MA, Cerutti A, Bondesan A, Colombo M, Godio E, Giacomelli G (2004) A 24-month survey on root canal treatment performed by NiTi engine driven files and warm gutta-percha filling associated system. Minerva Stomatol 53:543–554PubMed

13.

Chu CH, Lo ECM, Cheung GSP (2005) Outcome of root canal treatment using Thermafil and cold lateral condensation filling techniques. Int Endod J 38:179–185CrossRefPubMed

14.

Hale R, Gatti R, Glickman GN, Opperman LA (2012) Comparative analysis of carrier-based obturation and lateral compaction: a retrospective clinical outcomes study. Int J Dent. https://doi.org/10.1155/2012/954675

15.

Tennert C, Jungback IL, Wrbas KT (2013) Comparison between two thermoplastic root canal obturation techniques regarding extrusion of root canal filling—a retrospective in vivo study. Clin Oral Investig 17:449–454CrossRefPubMed

16.

Pirani C, Friedman S, Gatto MR, Iacono F, Tinarelli V, Gandolfi MG, Prati C (2017) Survival and periapical health after root canal treatment with carrier-based root fillings: five-year retrospective assessment. Int Endod J. https://doi.org/10.1111/iej.12757

17.

Demirci GK, Çalişkan MK (2016) A prospective randomized comparative study of cold lateral condensation versus core/gutta-percha in teeth with periapical lesions. J Endod 42:206–210CrossRef

18.

World Medical Association Declaration of Helsinki (2000) Ethical principles for medical research involving human subjects. The Journal of American Medical Association 284:3043–3045CrossRef

19.

Ørstavik D, Kerekes K, Eriksen HM (1986) The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol 2:20–34CrossRefPubMed

20.

Friedman S, Abitbol S, Lawrence HP (2003) Treatment outcome in endodontics: the Toronto Study. Phase I: initial treatment. J Endod 29:787–793CrossRefPubMed

21.

Kirkevang LL, Væth M, Hörsted-Bindslev P, Bahrami G, Wenzel A (2007) Risk factors for developing apical periodontitis in a general population. Int Endod J 40:290–299CrossRefPubMed

22.

Hussein FE, Liew AKC, Ramlee RA, Abdullah D, Chong BS (2016) Factors associated with apical periodontitis: a multilevel analysis. J Endod 10:1441–1445CrossRef

23.

Fonzar F, Fonzar A, Buttolo P, Worthington HW, Esposito M (2009) The prognosis of root canal therapy: a 10-year retrospective cohort study on 411 patients with 1175 endodontically treated teeth. Eur J Oral Implantol 2:201–208PubMed

24.

Salehrabi R, Rotstein I (2010) Epidemiologic evaluation of the outcomes of orthograde endodontic retreatment. J Endod 36:790–792CrossRefPubMed

25.

Ng YL, Mann V, Gulabivala K (2011) A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 2: tooth survival. Int Endod J 44:610–625CrossRefPubMed

26.

Sjӧgren U, Hägglund B, Sundqvist G, Wing K (1990) Factors affecting the long-term results of endodontic treatment. J Endod 16:498–504CrossRef

27.

Çalişkan MK (2005) Nonsurgical retreatment of teeth with periapical lesions previously managed by either endodontic or surgical intervention. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 100:242–248CrossRefPubMed

28.

Imura N, Pinheiro, Gomes B, Zaia AA, Ferraz CCR, Souza-Filho FJ (2007) The outcome of endodontic treatment: a retrospective study of 2000 cases performed by a specialist. J Endod 33:1278–1282

29.

Pirani C, Chersoni S, Montebugnoli L, Prati C (2015) Long-term outcome of non-surgical root canal treatment: a retrospective analysis. Odontology 103:185–193CrossRefPubMed

30.

Sundqvist GS, Figdor D, Persson S, Sjögren U (1998) Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:86–93CrossRefPubMed

31.

Ricucci D, Russo J, Rutberg M, Burleson JA, Spångberg LS (2011) A prospective cohort study of endodontic treatments of 1369 root canals: results after 5 years. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112:825–842CrossRefPubMed

32.

Carr GB, Schwartz RS, Schaudinn C, Gorur A, Costerton W (2009) Ultrastructural examination of failed molar retreatment with secondary apical periodontitis: an examination of endodontic biofilms in an endodontic retreatment failure. J Endod 35:1303–1309CrossRefPubMed

33.

Chávez de Paz L (2007) Redefining the persistent infection in root canals: possible role of biofilm communities. J Endod 33:652–662CrossRefPubMed

34.

Pirani C, Pelliccioni GA, Marchionni S, Montebugnoli L, Piana G, Prati C (2009) Effectiveness of three different retreatment techniques in canals filled with compacted gutta-percha or Thermafil. A SEM study. J Endod 35:1433–1440CrossRefPubMed

35.

Gandolfi MG, Parrilli AP, Fini M, Prati C, Dummer PMH (2013) 3D micro-CT analysis of the interface voids associated with Thermafil root fillings used with AH Plus or a flowable MTA sealer. Int Endod J 46:253–263CrossRefPubMed

36.

Ng Y-L, Mann V, Rahbaran S, Lewsey J, Gulabivala K (2007) Outcome of primary root canal treatment: systematic review of the literature—part 1. Effects of study characteristics on probability of success. Int Endod J 40:921–939

37.

Peak JD, Hayes SJ, Bryant ST, Dummer PM (2001) The outcome of root canal treatment. A retrospective study within the armed forces (Royal Air Force). Br Dent J 190:140–144PubMed

38.

Torabinejad M, Corr R, Handysides R, Shabahang S (2009) Outcomes of nonsurgical retreatments and endodontic surgery: a systematic review. J Endod 35:930–937

39.

Hoskinson SE, Ng YL, Hoskinson AE, Moles DR, Gulabivala K (2002) A retrospective comparison of outcome of root canal treatment using two different protocols. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 93:705–715CrossRefPubMed

40.

Alley BS, Kitchens GG, Alley LV, Eleazer PD (2004) A comparison of survival of teeth following endodontic treatment performed by general dentists or specialists. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:115–118CrossRefPubMed

41.

Burry JC, Stover S, Eichmiller F, Bhagavatula P (2016) Outcomes of primary endodontic therapy provided by endodontic specialists compared with other providers. J Endod 42:702–705CrossRefPubMed

42.

Fransson H, Dawson VS, Frisk F, Bjørndal L, Kvist T (2016) Survival of root-filled teeth in the Swedish adult population. J Endod 42:216–220CrossRefPubMed

43.

Ferrari M, Mason PN, Goracci C, Pashley DH, Tay FR (2004) Collagen degradation in endodontically treated teeth after clinical function. J Dent Res 83:414–419CrossRefPubMed

44.

Ng YL, Mann V, Gulabivala K (2010) Tooth survival following non-surgical root canal treatment: a systematic review of the literature. Int Endod J 43:171–189CrossRefPubMed

45.

Landys Borén D, Jonasson P, Kvist T (2015) Long-term survival of endodontically treated teeth at a public dental specialist clinic. J Endod 41:176–181CrossRefPubMed

46.

Kirkevang LL, Ørstavik D, Bahrami G, Wenzel A, Væth (2017) Prediction of periapical status and tooth extraction. Int Endod J 50:5–14CrossRefPubMed

47.

Dammaschke T, Steven D, Kaup M, Reiner KH (2003) Long-term survival of root-canal-treated teeth: a retrospective study over 10 years. J Endod 29:638–643CrossRefPubMed

48.

Lazarsky MP, Walker WA, Flores CM, Schindler WG, Hargreaves KM (2001) Epidemiological evaluation of the outcomes of nonsurgical root canal treatment in a large cohort of insured dental patients. J Endod 27:791–796CrossRef

49.

García-Guerrero C, Parra-Junco C, Quijano-Guauque S, Molano N, Pineda GA, Marín-Zuluaga DJ (2017) Vertical root fractures in endodontically treated teeth: a retrospective analysis of possible risk factors. J Investig Clin Dent. https://doi.org/10.1111/jicd.12273

50.

Aminoshariae A, Kulid JC (2015) Master apical file size—smaller or larger: a systematic review of healing outcomes. Int Endod J 48:639–647CrossRefPubMed

51.

Saini HR, Tewari S, Sangwan P, Duhan J, Gupta A (2012) Effect of different apical preparation sizes on outcome of primary endodontic treatment: a randomized controlled trial. J Endod 38:1309–1315CrossRefPubMed

52.

Wu MK, R’oris A, Barkis D, Wesselink PR (2000) Prevalence and extent of long oval canals in the apical third. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:739–743CrossRefPubMed

53.

Ricucci D, Rôças IN, Alves FRF, Loghin S, Siqueira JF Jr (2016) Apically extruded sealers: fate and influence on treatment outcome. J Endod 42:43–249CrossRef

54.

Sarkis-Onofre R, Fergusson D, Cenci MS, Moher D, Pereira-Cenci D (2017) Performance of post-retained single crowns: a systematic review of related risk factors. J Endod 43:175–183CrossRefPubMed

55.

Kishen A (2006) Mechanisms and risk factors for fracture predilection in endodontically treated teeth. Endod Top 13:57–83CrossRef

56.

Azim AA, Griggs JA, Huang GTJ (2016) The Tennessee study: factors affecting treatment outcome and healing time following nonsurgical root canal treatment. Int Endod J 49:6–16CrossRefPubMed

57.

Duncan HF, Pitt Ford R (2006) The potential association between smoking and endodontic disease. Int Endod J 39:843–854CrossRefPubMed

58.

Kirkevang LL, Wenzel A (2003) Risk indicators for apical periodontitis. Community Dent Oral Epidemiol 31:59–67CrossRefPubMed

Title: Outcome of secondary root canal treatment filled with Thermafil: a 5-year follow-up of retrospective cohort study
Authors: Chiara Pirani
Francesco Iacono
Maria Rosaria Gatto
Raquel Michelle Fitzgibbon
Stefano Chersoni
Hagay Shemesh
Carlo Prati
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 3/2018
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-017-2229-5

At a glance: The STEP trials

Springer Medicine

Outcome of secondary root canal treatment filled with Thermafil: a 5-year follow-up of retrospective cohort study

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 3/2018

No difference between manual and different power toothbrushes with and without specific instructions in young, oral healthy adults—results of a randomized clinical trial

Mechanical characteristics of the maxillary sinus Schneiderian membrane ex vivo

A new albumin-depletion strategy improves proteomic research of gingival crevicular fluid from periodontitis patients

Effectiveness and predictability of titanium-prepared platelet-rich fibrin for the management of multiple gingival recessions

Risk factors associated with new caries lesions in permanent first molars in children: a 5-year historical cohort follow-up study

Clinical evaluation of coronally advanced flap with or without platelet-rich fibrin for the treatment of multiple gingival recessions