Long-term Follow-up for Apical Microsurgery of Teeth with Core and Post Restorations.


  • 影响因子:3.69
  • DOI:10.1016/j.joen.2019.11.002
  • 作者列表:"Truschnegg A","Rugani P","Kirnbauer B","Kqiku L","Jakse N","Kirmeier R
  • 发表时间:2020-02-01

INTRODUCTION:Orthograde retreatment was recommended before apical surgery to achieve high success rates. The aim of this study was to determine the success rates of apicoectomy of core and post-restored teeth without prior root canal retreatment followed for up to 13 years. METHODS:Seventy-three patients with 87 teeth with apical periodontitis underwent apical microsurgery from 2004 to 2006 at the Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria. After 1.5-5 years and 10-13 years, 85 and 49 teeth, respectively, were followed up by 4 independent, calibrated examiners. Absolute and relative frequencies of the dichotomous outcome (healed vs nonhealed) were analyzed considering patient-, tooth-, and treatment-related factors. The significance of the obtained values was determined with the chi-square and Fisher exact tests. RESULTS:All of the 85 (100%) investigated teeth were in situ 1.5-5 years after surgery, whereas only 49 of 62 analyzed teeth (79%) remained after 10-13 years. Radiologically documented periapical healing was 97.6% (83/85 teeth) for the first follow-up period but decreased to 75.8% (47/62 teeth) by the second follow-up. Smokers showed significantly worse results after 10-13 years. None of the other investigated potential influencing factors significantly affected results. CONCLUSIONS:This clinical study showed that apical microsurgery on teeth with core and post restoration using Intermediate Restorative Material (Dentsply Caulk, Milford, DE) as filling material achieves excellent results after 1.5-5 years (97.6%) and still shows good results after 10-13 years (75.8%). Accordingly, it is a reliable alternative to root canal retreatment, eliminating the risk of post removal-related complications.


简介: 建议在根尖手术前进行正位再治疗,以获得高成功率。本研究的目的是确定核心牙和后修复牙的根尖切除术的成功率,没有root管再治疗,随访长达 13 年。 方法: 2004 年至 2006 年在奥地利格拉茨医科大学口腔医学系接受根尖显微手术治疗的根尖周炎患者 73 例,87 颗患牙。在 1.5-5 年和 10-13 年后,分别由 4 名独立、校准的检查者对 8 5 颗和 4 9 颗牙齿进行随访。考虑到患者、牙齿和治疗相关因素,分析了二分结局 (愈合与未愈合) 的绝对和相对频率。用卡方和Fisher精确检验确定所得值的显著性。 结果: 8 5 颗 (100%) 患牙均为原位 1 颗。术后 5-5 年,而 62 颗分析牙中只有 49 颗 (79%) 在 10-13 年后仍然存在。放射学记录的根尖周愈合在第一个随访期为 97.6% (83/85 颗牙),但在第二个随访期降至 75.8% (47/62 颗牙)。吸烟者在 10-13 年后表现出明显更差的结果。其他研究的潜在影响因素均未显著影响结果。 结论: 本临床研究表明,采用中间修复材料 (Dentsply cauk,Milford,DE) 作为充填材料,对核心和后修复的牙齿进行根尖显微手术,1 年后取得了优异的效果。5-5 年 (97.6%),10-13 年后仍然显示出良好的结果 (7 5。8%)。因此,它是一个可靠的替代root管再治疗,消除风险移除相关并发症.



作者列表:["Denadai R","Seo HJ","Lo LJ"]

METHODS:BACKGROUND:The anterior oronasal fistulae neighboring the alveolar cleft could persist or reappear after the alveolar reconstruction with cancellous bone grafting. The persistent symptomatic anterior oronasal fistulae need to be repaired, but surgery remains a challenge in cleft care. Surprisingly, this issue has rarely been reported in the literature. The purpose of this long-term study was to report a single surgeon experience with a therapeutic protocol for persistent symptomatic anterior oronasal fistula repair. METHODS:This is a retrospective study of consecutive patients with Veau type III and IV clefts and persistent symptomatic anterior oronasal fistulae managed according to a therapeutic protocol from 1997 to 2018. Depending on fistula size, patients were treated with local flaps associated with an interpositional graft or two-stage tongue flaps (small/medium or large fistulae, respectively). The surgical outcomes were classified as "good" (complete fistula closure with no symptoms), "fair" (asymptomatic narrow fistula remained), or "poor" (failure with persistent symptoms). RESULTS:Forty-four patients with persistent symptomatic anterior oronasal fistulae were reconstructed with local flaps associated with interpositional fascia or dermal fat grafting (52.3%) or two-stage tongue flaps (47.7%). Most of patients (93.2%) presented "good" outcomes, ranging from 87% to 100% (local and tongue flaps, respectively). Three (6.8%) patients presented symptomatic residual fistula ("poor" outcomes). CONCLUSIONS:For the repair of persistent symptomatic anterior oronasal fistulae, this therapeutic protocol provided satisfactory outcome with low fistula recurrence rate.

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作者列表:["Cleary B","Loane M","Addor MC","Barisic I","de Walle HEK","Matias Dias C","Gatt M","Klungsoyr K","McDonnell B","Neville A","Pierini A","Rissmann A","Tucker DF","Zurriaga O","Dolk H"]

METHODS:OBJECTIVE:Methadone is a vital treatment for women with opioid use disorder in pregnancy. Previous reports suggested an association between methadone exposure and Pierre Robin sequence (PRS), a rare craniofacial anomaly. We assessed the association between gestational methadone exposure and PRS. DESIGN/SETTING:This case-malformed control study used European Surveillance of Congenital Anomalies population-based registries in Ireland, the Netherlands, Italy, Switzerland, Croatia, Malta, Portugal, Germany, Wales, Norway and Spain, 1995-2011. PATIENTS:Cases included PRS based on International Classification of Disease (ICD), Ninth Edition-British Paediatric Association (BPA) code 75 603 or ICD, Tenth Edition-BPA code Q8708. Malformed controls were all non-PRS anomalies, excluding genetic conditions, among live births, fetal deaths from 20 weeks' gestation and terminations of pregnancy for fetal anomalies. An exploratory analysis assessed the association between methadone exposure and other congenital anomalies (CAs) excluding PRS. Methadone exposure was ascertained from medical records and maternal interview. RESULTS:Among 87 979 CA registrations, there were 127 methadone-exposed pregnancies and 336 PRS cases. There was an association between methadone exposure and PRS (OR adjusted for registry 12.3, 95% CI 5.7 to 26.8). In absolute terms, this association reflects a risk increase from approximately 1-12 cases per 10 000 births. A raised OR was found for cleft palate (adjusted OR 5.0, 95% CI 2.7 to 9.2). CONCLUSIONS:These findings suggest that gestational methadone exposure is associated with PRS. The association may be explained by unmeasured confounding factors. The small increased risk of PRS in itself does not alter the risk-benefit balance for gestational methadone use. The association with cleft palate, a more common CA, should be assessed with independent data.

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作者列表:["Jahanbin A","Eslami N","Torkamanzadeh N"]

METHODS::Orthopedic treatment to improve deficient maxillary growth of cleft lip and palate patients is an important part of treatment. The success of this treatment is strongly dependent on the time of initiation of therapy. There has been a large controversy in the available literature regarding the skeletal age of these patients. The aim of the present study was to compare the skeletal age of cleft lip and palate patients with normal individuals.37 unilateral and 14 bilateral cleft lip and palate patients and 47 healthy individuals participated in this cross-sectional study. The patients were classified into 8 to 10 and 11 to 14-year-old individuals. Cervical vertebral maturational stage of participants was evaluated in the lateral cephalometry. The skeletal age of cleft lip and palate patients was compared with normal controls. Chi-square was used for statistical analysis. There was not a significant difference in the skeletal developmental stage of unilateral and bilateral cleft compared to their normal peers according to their age and sex. Also, significant difference in skeletal maturational stage of cleft lip and palate patients was not found between boys and girls (P = 0.8). Similarly, no significant difference was found in the skeletal age of the 3 studied groups without considering the age and sex of participants (P = 0.5). Regarding the similar skeletal maturational stage of cleft lip and palate patients with normal controls in our study, their maxillofacial orthopedic treatment can be initiated at similar time to normal peers.

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