| 1. |
- Chávez de Paz, Luis, 1974, et al.
(author)
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Gram-positive rods prevailing in teeth with apical periodontitis undergoing root canal treatment.
- 2004
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In: International endodontic journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 37:9, s. 579-87
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Journal article (peer-reviewed)abstract
- AIMS: To identify Gram-positive rods from root canals of teeth with apical periodontitis and to examine their associations with other species. METHODOLOGY: Consecutive root canal samples (RCSs) from 139 teeth undergoing root canal treatment were analyzed prospectively for cultivable microbes. Gram-positive rods in the first RCS submitted after chemo-mechanical preparation were categorised to genus level by selective media and gas-liquid chromatography (GLC), and identified to species level by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). Associations between organisms were measured by odds ratios (OR). RESULTS: In the first samples submitted a total of 158 Gram-positive rods, 115 Gram-positive cocci, 26 Gram-negative rods and 9 Gram-negative cocci, were identified. At genus levels Gram-positive rods were classified into: Lactobacillus spp. (38%), Olsenella spp. (18%), Propionibacterium spp. (13%), Actinomyces spp. (12%), Bifidobacterium spp. (13%) and Eubacterium spp. (6%). The most frequent species were Olsenella uli, Lactobacillus paracasei and Propionibacterium propionicum. In subsequent samples taken during treatment, Gram-positive rods were also identified, although the number of strains was considerably reduced. Positive associations were observed between members of the genus lactobacilli and Gram-positive cocci (OR>2). CONCLUSIONS: Olsenella uli and Lactobacillus spp. predominated over other Gram-positive rods. A possible association exists between Lactobacillus spp. and Gram-positive cocci in root canals of teeth with apical periodontitis receiving treatment.
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| 2. |
- Dahlström, Lisbeth, 1962, et al.
(author)
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Introducing nickel-titanium rotary instrumentation in a public dental service: The long-term effect on root filling quality
- 2011
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In: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. - : Elsevier BV. - 1079-2104. ; 112:6, s. 814-819
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of this study was to study the long-term effect on root filling quality after the introduction of nickel titanium rotary instrumentation (NTRI) within a public dental health organization. STUDY DESIGN: After an education package, including hands-on training and/or lectures, the root filling quality was evaluated at the organizational level. All general dental practitioners (GDPs) employed at primary evaluation (n = 120) and after 4 years (n = 174) were included. RESULTS: The improved root filling quality had been maintained 4 years later. The frequency of excellent root fillings was slightly higher at the long-term follow-up (52%) compared with the short-term follow-up (45%; P = .038). A nonsignificant decrease in very poor-quality root fillings was registered. CONCLUSIONS: A technology shift among GDPs to NTRI will increase the rate of good-quality root fillings. However, the shift per se will not eliminate the problem of substandard clinical performance.
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| 3. |
- Dahlström, Lisbeth, 1962, et al.
(author)
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The impact of a continuing education programme on the adoption of nickel-titanium rotary instrumentation and root-filling quality amongst a group of Swedish general dental practitioners
- 2015
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In: European journal of dental education : official journal of the Association for Dental Education in Europe. - : Wiley. - 1396-5883 .- 1600-0579. ; 19:1, s. 23-30
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Journal article (peer-reviewed)abstract
- INTRODUCTION: The aim of the study was to test the hypothesis that a further education programme relating to nickel-titanium rotary instrumentation (NTRI), with the concurrent activation of social/professional networks amongst all general dental practitioners (GDPs) in a public dental service in Sweden, would increase the adoption rate and improve root-filling quality. MATERIAL AND METHOD: To activate the networks, the GDPs at the 25 clinics elected training coaches from amongst themselves. The coaches were educated by a specialist and were then free to organise and conduct the training of the local GDPs. However, collective hands-on training and discussions were mandatory. Lectures were held by an endodontist. The rate of adoption and root-filling quality was evaluated just before and 6 months after the education. Statistical tests were performed with chi-square using a 95% confidence interval. RESULTS: Nickel-titanium rotary instrumentation was adopted by 88%. Excellent root fillings (score 1) increased from 45% to 59% (P = 0.003). The rate of poor-quality root fillings (score 4 and score 5) was not affected. The quality ratio (score 1/score 5) increased from 5.36 (118/22) to 9.5 (133/14). Eleven dentists (17%) at nine different clinics produced 49% of the poor-quality root fillings (score 4 and score 5). Seventy-three per cent of these dentists stated that they had adopted NTRI. CONCLUSIONS: The introduction of NTRI will increase the adoption rate and the frequency of good-quality root fillings. However, it will not overcome the problems associated with dentists producing a low-quality level, even if a local professional network is activated.
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| 4. |
- Goransson, H., et al.
(author)
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The adoption of nickel-titanium rotary instrumentation increases root-filling quality amongst a group of Swedish general dental practitioners
- 2014
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In: Swedish Dental Journal. - 0347-9994. ; 38:1, s. 15-22
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Journal article (peer-reviewed)abstract
- The aim of the present study was testing the hypothesis that the adoption of nickel-titanium rotary instrumentation (NTRI) will improve the technical quality of root-fillings.The investigation was carried out within a mandatory continuing education program (CEP) for general dental practitioners (GDPs). The study was conducted amongst GDPs employed by the Public Dental Health Service in the County of Stockholm. Identical questionnaires were distributed before the CEP (Pre-Q) and 9 to 12 months after the course (Post-Q).The CEP consisted of two parts: lectures and hands-on training. From each GDP, radiographs of two cases completed before the course and two cases treated 9-12 months after the course were randomly selected. Primarily molars were selected for evaluation.The radiographs were individually evaluated by two endodontists.Teeth treated before and after training were presented in random order. Adoption rate of NTRI increased from 35% to 75%. Cases from 124 GDPs were included in the final analysis.The rate of good quality root-fillings increased from 27% to 49% (p<.001). A significantly increased radiographic quality was found between GDPs adopting NTRI and those who did not.The GDPs produced root-fillings of very poor quality before as well as after the training period. However, the rate decreased from 29% to 12% amongst adopters and from 46% to 28% amongst non-adopters. Dentists considering canal preparation and root-filling as "easy" produced more frequently good quality root-fillings than the others (p
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| 5. |
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| 6. |
- Kvist, Thomas, 1959, et al.
(author)
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Microbiological evaluation of one- and two-visit endodontic treatment of teeth with apical periodontitis: a randomized, clinical trial.
- 2004
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In: Journal of endodontics. - 0099-2399. ; 30:8, s. 572-6
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Journal article (peer-reviewed)abstract
- The antimicrobial efficacy of endodontic procedures performed in one-visit (including a 10-min intraappointment dressing with 5% iodine-potassium-iodide) was compared with a two-visit procedure (including an interappointment dressing with calcium-hydroxide paste). Teeth with apical periodontitis (n = 96) were randomly assigned to either group. Root canal sampling and culturing were performed before and immediately after instrumentation, and after medication. Initial sampling demonstrated the presence of microorganisms in 98% of the teeth. Postinstrumentation sampling showed reduction of cultivable microbiota. Antibacterial dressing further reduced the number of teeth with surviving microbes. In the postmedication samples, residual microorganisms were recovered in 29% of the one-visit teeth and in 36% of the two-visit treated teeth. No statistically significant differences between the groups were discerned. It was concluded that from a microbiological point of view, treatment of teeth with apical periodontitis performed in two appointments was not more effective than the investigated one-visit procedure.
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| 7. |
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| 8. |
- Molander, Anders, 1951, et al.
(author)
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Improved quality of root fillings provided by general dental practitioners educated in nickel-titanium rotary instrumentation.
- 2007
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In: International endodontic journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 40:4, s. 254-60
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Journal article (peer-reviewed)abstract
- AIM: To test the hypothesis that an increased utilization of nickel-titanium rotary instrumentation (NTRI) by general dental practitioners will lead to an increased frequency of good quality root fillings. A second aim was to determine whether the educational format would exert influence on the quality. METHODOLOGY: Dentists were assigned at random to three intervention groups: a 4-h lecture (L-group, n = 40); a 4-h lecture plus a full day hands-on course (LH-group, n = 40); or a control group receiving no instruction (n = 68). The control group received education later on in the study. Radiographs of two root filled molar teeth per dentist were selected at random before the start of the education program and after a 6-month clinical learning period. Using length, seal and shape of root-fillings a 5-level variable was created. RESULTS: The rate of good quality root fillings increased after the introduction of NTRI. Calculated over all types of roots the frequency of excellent (score 1) root fillings increased from 31% to 51% (P = 0.006) in the L-group and from 27% to 47% (P = 0.016) in the LH-group. The frequency of low quality root-fillings (score 5) dropped in the L-group from 22% to 16% (P = 0.29) and in the LH-group from 13% to 9% (P = 0.48). No statistically significant difference was seen among the controls. CONCLUSIONS: When NTRI technology replaced manual stainless steel techniques the rate of good quality root fillings increased. A significant drop in the rate of low quality root fillings was not found.
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| 9. |
- Mota de Almeida, Fernando José, et al.
(author)
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Computed tomography (CT) in the selection of treatment for root-filled maxillary molars with apical periodontitis
- 2016
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In: Dentomaxillofacial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 45:5
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Journal article (peer-reviewed)abstract
- Objectives: The aims of this study were to evaluate whether the use of CT facilitates agreement among endodontists in selecting treatments for root-filled maxillary molars with apical periodontitis and to assess the efficacy of CT in choosing a treatment for such teeth. Methods: 39 root-filled maxillary molars from 34 patients with suspected apical periodontitis were independently evaluated by 4 endodontists and 1 postgraduate student (decision-makers). Treatment decisions were made based on intra-oral radiographs and a fictive clinical history. After 1-3 months, the same decision-makers repeated the examination of the same teeth but with additional information from a CT examination. Agreement between decision-makers with or without the availability of the CT results was measured with Cohen's kappa coefficient. Differences in selected treatments with or without accessibility to the CT results were plotted for the same endodontists using descriptive statistics. Results: The agreement in assessments among endodontists was slight or fair before the CT results were available (range: 0.081-0.535). No increase was observed after reviewing the CT results (range: 0.116-0.379). After the use of CT, the treatment plan was changed 38-76% of the time by all decision-makers, and the changes affected 57.8% of the cases in the study. Conclusions: The endodontists in this study exhibited a low degree of agreement when choosing a treatment for root-filled maxillary molars with apical periodontitis. A CT examination of the investigated teeth did not result in a significantly higher degree of agreement, and CT frequently contributed to a shift in the selected therapy.
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| 10. |
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| 11. |
- Sedgley, C M, et al.
(author)
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Virulence, phenotype and genotype characteristics of endodontic Enterococcus spp.
- 2005
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In: Oral microbiology and immunology. - 0902-0055. ; 20:1, s. 10-9
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Journal article (peer-reviewed)abstract
- BACKGROUND/AIMS: Enterococci have been implicated in persistent root canal infections but their role in the infection process remains unclear. This study investigated the virulence, phenotype and genotype of 33 endodontic enterococcal isolates. METHODS: Phenotypic tests were conducted for antibiotic resistance, clumping response to pheromone, and production of gelatinase, hemolysin and bacteriocin. Genotype analysis involved polymerase chain reaction amplification of virulence determinants encoding aggregation substances asa and asa373, cytolysin activator cylA, gelatinase gelE, gelatinase-negative phenotype ef1841/fsrC, adherence factors esp and ace, and endocarditis antigen efaA. Physical DNA characterization involved pulsed-field gel electrophoresis of genomic DNA, and plasmid analysis. RESULTS: Potential virulence traits expressed included production of gelatinase by Enterococcus faecalis (n=23), and response to pheromones in E. faecalis culture filtrate (n=16). Fourteen strains produced bacteriocin. Five strains were resistant to tetracycline and one to gentamicin, whereas all were susceptible to ampicillin, benzylpenicillin, chloramphenicol, erythromycin, fusidic acid, kanamycin, rifampin, streptomycin and vancomycin. Polymerase chain reaction products encoding efaA, ace, and asa were detected in all isolates; esp was detected in 20 isolates, cylA in six isolates, but asa373 was never detected. The gelatinase gene (gelE) was detected in all isolates of E. faecalis (n=31) but not in Enterococcus faecium (n=2); a 23.9 kb deletion sequence corresponding to the gelatinase-negative phenotype was detected in six of the eight E. faecalis isolates that did not produce gelatinase. Pulsed-field gel electrophoresis and plasmid analyses revealed genetic polymorphism with clonal types evident. Plasmid DNA was detected in 25 strains, with up to four plasmids per strain and a similar (5.1 kb) plasmid occurring in 16 isolates. CONCLUSIONS: Phenotypic and genotypic evidence of potential virulence factors were identified in endodontic Enterococcus spp., specifically production of gelatinase and response to pheromones.
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| 12. |
- Sedgley, Christine, et al.
(author)
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Real-time quantitative polymerase chain reaction and culture analyses of Enterococcus faecalis in root canals.
- 2006
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In: Journal of endodontics. - : Elsevier BV. - 0099-2399. ; 32:3, s. 173-7
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Journal article (peer-reviewed)abstract
- Reports on the prevalence of Enterococcus faecalis in root canals vary considerably, potentially because of variations in clinical sampling and sample analysis methods. This study compared culture and real-time quantitative polymerase chain reaction (qPCR) to detect and quantify E. faecalis in the same root canal sample. Consecutive root canal samples obtained from primary infection (n = 40) and retreatment (n = 48) cases were divided into two equal aliquots that were independently analyzed using culture and qPCR by investigators blinded to the analysis results of the other sample. E. faecalis was detected in 10.2% and 79.5% of samples by culture and qPCR, respectively (p < 0.0001; McNemar's test). E. faecalis was detected in more retreatment than primary infection samples (89.6% versus 67.5%; p = 0.01, Fisher's exact test). qPCR reported a significantly higher prevalence of E. faecalis in endodontic samples than culture techniques.
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