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      Impact of the quality of coronal restoration and root canal filling on the periapical health in adult syrian subpopulation

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          Abstract

          Background:

          The purpose of this study was to determine the status of periapical tissues of endodontically treated teeth according to coronal restorations and root canal fillings separately and in concomitant in adult Syrian subpopulation.

          Methods:

          784 endodontically treated teeth from two hundred randomly selected Syrian adult patients were radiographically evaluated. According to predetermined criteria, the quality of coronal restorations and root canal filling of each tooth was scored as adequate or inadequate. The status of periapical tissues was also classified as healthy or diseased. Results were analyzed using Chi-squared test.

          Results:

          Adequate coronal restorations were determined in 58.54% of cases which was accompanied with less periapical pathosis than that in teeth with inadequate restorations ( P < 0.01). 14% of teeth were restored by posts which showed no significant impact on the periapical tissues health. 18.5% of endodontic treatments were evaluated as adequate with less number of periapical radiolucencies than that of inadequate root canal fillings ( P < 0.01). Absence of periapical pathosis was 96.6% in cases with both adequate coronal restorations and root canals fillings. The rate was 88.5% in cases with only adequate root canals fillings, and about 70% in cases with only adequate coronal restorations. When the treatment was inadequate in both coronal and root canals fillings, success rate was only observed in 48.8%.

          Conclusion:

          The most important factor with regard to the periradicular tissue health is the quality of root canal filling without neglecting the influence of coronal restoration (regardless of its type). There is a high prevalence rate of periapical pathosis in Syrian subpopulation due to poor dental practice.

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          Most cited references26

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          In vitro bacterial penetration of coronally unsealed endodontically treated teeth.

          Forty-five root canals were cleaned, shaped, and then obturated with gutta-percha and root canal sealer, using a lateral condensation technique. The coronal portions of the root filling materials were placed in contact with Staphylococcus epidermidis and Proteus vulgaris. The number of days required for these bacteria to penetrate the entire root canals was determined. Over 50% of the root canals were completely contaminated after 19-day exposure to S. epidermidis. Fifty percent of the root canals were also totally contaminated when the coronal surfaces of their fillings were exposed to P. vulgaris for 42 days.
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            Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis.

            Thorough cleaning and shaping of root canals are essential for periapical healing. Restoration of endodontically treated teeth is also required for them to function and prevent coronal leakage. This study compared the impact of the quality of root canal treatment versus the quality of coronal restoration in treatment outcomes.
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              Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration.

              The purpose of this study was to evaluate the relationship of the quality of the coronal restoration and of the root canal obturation on the radiographic periapical status of endodontically treated teeth. Full-mouth radiographs from randomly selected new patient folders at Temple University Dental School were examined. The first 1010 endodontically treated teeth restored with a permanent restoration were evaluated independently by two examiners. Post and core type restorations were excluded. According to a predetermined radiographic standard set of criteria, the technical quality of the root filling of each tooth was scored as either good (GE) or poor (PE), and the quality of the coronal restoration similarly good (GR) or poor (PR). The apical one-third of the root and surrounding structures were then evaluated radiographically and the periradicular status categorized as (a) absence of periradicular inflammation (API) or (b) presence of periradicular inflammation (PPI). The rate of API for all endodontically treated teeth was 61.07%. GR resulted in significantly more API cases than GE, 80% versus 75.7%. PR resulted in significantly more PPI cases than PE, 30.2% versus 48.6%. The combination of GR and GE had the highest API rate of 91.4%, significantly higher than PR and PE with a API rate of 18.1%.
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                Author and article information

                Journal
                Indian J Dent
                Indian J Dent
                IJD
                Indian Journal of Dentistry
                Medknow Publications & Media Pvt Ltd (India )
                0975-962X
                2213-3666
                Apr-Jun 2014
                : 5
                : 2
                : 75-80
                Affiliations
                [1] Department of Endodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
                Author notes
                Address for correspondence: Dr. Hisham Alafif, Department of Endodontics, Faculty of Dentistry, Damascus University, Damascus, Syria. E-mail: Alafifhf63@ 123456hotmail.com
                Article
                IJD-5-75
                10.4103/0975-962X.135265
                4184332
                60021ec4-83bc-4d05-97d5-c55c2896e4d5
                Copyright: © Indian Journal of Dentistry

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                coronal restoration,periapical tissue,root canal filling

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