Outcome of Root Canal Treatment of Teeth with Asymptomatic Apical Periodontitis Treated with Foraminal Enlargement and 2% Chlorhexidine Gel: A Retrospective Cohort Study.

Abstract

INTRODUCTION:

This retrospective cohort study aimed to estimate the success rate (SR) of primary root canal treatment on teeth with a diagnosis of pulp necrosis (PN) and asymptomatic apical periodontitis (AAP) when using 2% chlorhexidine gel as an auxiliary chemical substance and foraminal enlargement instrumentation technique.

METHODS:

This study evaluated 178 patients with 206 teeth submitted to primary root canal treatment performed by graduate residents in endodontics. The inclusion criteria were patients who underwent treatment over a period of 1-7 years on teeth with a diagnosis of PN and AAP. The SR was evaluated clinically and radiographically and categorized considering strict (complete resolution of the periradicular lesion) or loose (reduction in the size of the existing periradicular lesion) criteria. Cases of clinical and/or radiographic absence of repair were classified as a failure. Two calibrated examiners independently assessed treatment outcomes using ImageJ software (National Institutes of Health, Bethesda, MD).

RESULTS:

The SRs were 81.1% (95% confidence interval, 75.7%-86.4%) and 87.4% (95% confidence interval, 82.8%-91.9%) when considering the strict or loose criteria, respectively. Females had a higher SR when strict criteria were applied. Also, the SR was significantly reduced when there was an increase in the patient's age.

CONCLUSIONS:

Teeth with a diagnosis of PN and AAP and treated with 2% chlorhexidine gel and foraminal enlargement achieved substantial SR. Sex and age were prognostic factors that played a significant role in the SR. Future randomized controlled trials should further investigate the effects of foraminal enlargement and 2% chlorhexidine gel as an auxiliary chemical substance.

• Authors: Tamares Andrade da Silva, Lucas Peixoto de Araújo, Leandro Bueno Gobbo, Adriana de-Jesus-Soares, Brenda P F A Gomes, José Flávio Affonso de Almeida, Caio Cezar Randi Ferraz
• Journal: Journal of endodontics (J Endod) Vol. 49 Issue 8 Pg. 972-979 (Aug 2023) ISSN: 1878-3554 [Electronic] United States
• PMID: 37307870 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Chemical References

• Chlorhexidine

Topics

• Female
• Humans
• Chlorhexidine (therapeutic use)
• Dental Pulp Cavity
• Retrospective Studies
• Root Canal Therapy
• Periapical Periodontitis (therapy, drug therapy)
• Treatment Outcome
• Dental Pulp Necrosis (drug therapy)
• Root Canal Preparation