Assessment of The Quality Of Endodontic Retreatment On A Postgraduate Endodontic Clinic In Hbmcdm (2008-2015)

Abstract

INTRODUCTION The main objective of endodontic therapy is to prevent or cure apical periodontitis by shaping and cleaning the endodontic pulp space and provide three dimensional obturation. However, shaping and cleaning the entire canal system can be a challenge particularly in retreatment cases which are generally considered high difficulty endodontic cases.

AIM The aim of this study is to assess endodontic retreatment outcomes in terms of quality of obturation, causes of endodontic failure and healing on a postgraduate clinic.

MATERIALS AND METHODS A total number of 223 radiographs of patients who had received endodontic retreatment during the period (2008-2015) at Hamdan Bin Mohammed College of Dental Medicine- Mohammed Bin Rashid University were selected (For the period between 2008 to 2012 the Institute was called Boston University). Unreadable radiographs due to technical errors and superimposed anatomical structures, third molars, cases treated by faculty and incomplete treatments were all excluded. From the original sample of 223, in total 24 iii radiographs were discarded. The final sample thus consisted of 199 root canal fillings of 140 patients treated by the endodontic residents. All radiographs were individually evaluated for the density of the root filling and the distance between the end of the root canal filling and radiographic apex based on a six-point scoring system. Subsequently, teeth were reviewed and follow up periapical radiographs were exposed. The outcome of healing was assessed using the Periapical Index (PAI) scoring system.

RESULTS The results of the study revealed that 78.9% of the endodontic retreatments were homogeneity and length acceptable. The corresponding figure was only 13.1% before endodontic treatment and was statistically significant. Conversely, homogeneity and length unacceptable before endodontic retreatment was 47.2% reducing to a mere 2.5% after retreatment. The results were statistically significant (P<0.001).

CONCLUSION There was a significant improvement in outcome after endodontic retreatment on the postgraduate endodontic clinic. The success rate of endodontic retreatment was over 70% which is in line with the endodontic literature. Radiographic follow up confirmed some 60% improvement in healing rate following endodontic retreatment.