Radiographic evaluation of periapical healing after obturation of infected root canals: an in vivo study

By Katebzadeh N, Sigurdsson A, Trope M

Date: 02/2001
Journal: JOE

Summary: 

Purpose: (i) to determine radiographically, the role of obturation alone in the healing of teeth with apical periodontitis, and (ii) to compare radiographic periapical healing of teeth with infected canals obturated with or without prior Ca(OH)2 disinfection.

N= 72 vital roots of 24 premolars and 24 incisors in three adult dogs.

•Materials/Methods:

•All the roots were aseptically instrumented to ISO #45.

•12 roots were not infected and served as control, 60 teeth were infected with dental plaque and restored coronally with IRM. 6 weeks later AP was confirmed radiographically in the infected teeth. 

•The teeth then were assigned to 4 groups:

•G 1: (n=24) one-step; roots were irrigated with 10 cc saline, obturated, and permanently restored.

•G2: (n=24) roots were treated as in group 1, except that after saline irrigation Ca(OH)2 medicament was placed in the canal 1 week before obturation.

•G3: positive control; the roots were irrigated with saline, access permanently closed but canals were not obturated.

•G4: negative control; roots without AP were obturated and permanently restored.

•6 months later, 3 evaluators evaluated the pre and post-op RGs and rated each root as: failed, improved or  healed.

•All the roots were aseptically instrumented to ISO #45.

•12 roots were not infected and served as control, 60 teeth were infected with dental plaque and restored coronally with IRM. 6 weeks later AP was confirmed radiographically in the infected teeth. 

•The teeth then were assigned to 4 groups:

•G 1: (n=24) one-step; roots were irrigated with 10 cc saline, obturated, and permanently restored.

•G2: (n=24) roots were treated as in group 1, except that after saline irrigation Ca(OH)2 medicament was placed in the canal 1 week before obturation.

•G3: positive control; the roots were irrigated with saline, access permanently closed but canals were not obturated.

•G4: negative control; roots without AP were obturated and permanently restored.

•6 months later, 3 evaluators evaluated the pre and post-op RGs and rated each root as: failed, improved or  healed.

Most highlighted Results: 

•The positive control group was significantly different from one-step and Ca(OH)2 group, but the one-step and Ca(OH)2 groups were not significantly different from each other. 

•The percentage of cases that completely healed were similar for the one-step and Ca(OH)2 groups (35.3% vs. 36.8%). The positive control group showed the most `failed’ rating (90%) whilst the Ca(OH)2 group showed the least (15.8%).

•Clinical significance:  at 6 months follow-up, the use CaOH2 reduced the % of failure  compared to single step RCT (the difference was not significant). longer evaluation periods and larger samples are required.