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Case Selection and Treatment Planning

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Complications in Endodontic Surgery

Abstract

The first part of this chapter is concerning cases of exploratory surgery. The section about alleviation of symptoms of apical periodontitis focuses on drainage. Indications for endodontic surgery in cases of ongoing root canal treatment are discussed. A method for retrograde root canal treatment in case of difficult orthograde access is presented. The discussion about root-filled teeth without unsatisfactory healing results occupies lion’s share of this chapter. Special attention is given to the controversies of “success” and “failure” in endodontics. Factors that generally point to a surgical approach to endodontic retreatment are examined. The meaning of informed consent is in particular focus. This chapter ends up with an examination of the medical considerations, which is the basis for the risk assessment of the individual patient compulsory before any endodontic surgery.

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References

  1. Abbott PV. Analysis of a referral-based endodontic practice: Part 1. Demographic data and reasons for referral. J Endod. 1994;20(2):93–6.

    Article  PubMed  Google Scholar 

  2. Abramovitz I, Better H, Shacham A, Shlomi B, Metzger Z. Case selection for apical surgery: a retrospective evaluation of associated factors and rational. J Endod. 2002;28:527–30.

    Article  PubMed  Google Scholar 

  3. Barthel CR, Zimmer S, Trope M. Relationship of radiologic and histologic signs of inflammation in human root-filled teeth. J Endod. 2004;30:75–9.

    Article  PubMed  Google Scholar 

  4. Beauchamp TL, Childress JF. Principles of biomedical ethics. 5th ed. New York: Oxford University Press; 2001.

    Google Scholar 

  5. Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone: II. 1961. J Endod. 2003;29(11):707–12; discussion 701.

    Article  PubMed  Google Scholar 

  6. Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone: I. 1961. J Endod. 2003;29(11):702–6.

    Article  PubMed  Google Scholar 

  7. Bender IB, Seltzer S, Soltanoff W. Endodontic success – a reappraisal of criteria. Oral Surg Oral Med Oral Pathol. 1966;22:780–802.

    Article  PubMed  Google Scholar 

  8. Bhaskar SN. Bone lesions of endodontic origin. Dent Clin North Am. 1967;Nov:521–33.

    Google Scholar 

  9. Boucher Y, Sobel M, Sauveur G. Persistent pain related to root canal filling and apical fenestration: a case report. J Endod. 2000;26(4):242–4.

    Article  PubMed  Google Scholar 

  10. Brynolf I. Histological and roentgenological study of periapical region of human upper incisors. Odontol Revy. 1967;18 Suppl 11:1–176.

    Google Scholar 

  11. Bystrom A, Happonen RP, Sjogren U, Sundqvist G. Healing of periapical lesions of pulpless teeth after endodontic treatment with controlled asepsis. Endod Dent Traumatol. 1987;3:58–63.

    Article  PubMed  Google Scholar 

  12. Caplan DJ, Pankow JS, Cai J, Offenbacher S, Beck JD. The relationship between self-reported history of endodontic therapy and coronary heart disease in the Atherosclerosis Risk in Communities Study. J Am Dent Assoc. 2009;140:1004–12.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Carrillo C, Peñarrocha M, Bagán JV, Vera F. Relationship between histological diagnosis and evolution of 70 periapical lesions at 12 months, treated by periapical surgery. J Oral Maxillofac Surg. 2008;66:1606–9.

    Article  PubMed  Google Scholar 

  14. Christiansen R, Kirkevang LL, Gotfredsen E, Wenzel A. Periapical radiography and cone beam computed tomography for assessment of the periapical bone defect 1 week and 12 months after root-end resection. Dentomaxillofac Radiol. 2009;38:531–6.

    Article  PubMed  Google Scholar 

  15. Cotti E, Dessì C, Piras A, Flore G, Deidda M, Madeddu C, Zedda A, Longu G, Mercuro G. Association of endodontic infection with detection of an initial lesion to the cardiovascular system. J Endod. 2011;37:1624–9.

    Article  PubMed  Google Scholar 

  16. Del Fabbro M, Taschieri S, Testori T, Francetti L, Weinstein RL. Surgical versus non-surgical endodontic re-treatment for periradicular lesions (Review). Cochrane Database Syst Rev. 2007;18(3):CD005511

    Google Scholar 

  17. Dogné J-M, de Leval X, Benoit P, Delarge J, Masereel B, David JL. Recent advances in antiplatelet agents. Curr Med Chem. 2002;9:577–89.

    Article  PubMed  Google Scholar 

  18. Eriksen HM. Endodontology–epidemiologic considerations. Endod Dent Traumatol. 1991;7:189–95.

    Article  PubMed  Google Scholar 

  19. Estrela C, Decurcio DA, Silva JA, Mendonça EF, Estrela CR. Persistent apical periodontitis associated with a calcifying odontogenic cyst. Int Endod J. 2009;42(6):539–45.

    Article  PubMed  Google Scholar 

  20. Faitaroni LA, Bueno MR, De Carvalhosa AA, Bruehmueller Ale KA, Estrela C. Ameloblastoma suggesting large apical periodontitis. J Endod. 2008;34(2):216–9.

    Article  PubMed  Google Scholar 

  21. Figdor D. Apical periodontitis: a very prevalent problem. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:651–2.

    Article  PubMed  Google Scholar 

  22. Figueiredo MAZ, Figueiredo JAP, Porter S. Root resorption associated with mandibular bone erosion in a patient with scleroderma. J Endod. 2008;34:102–3.

    Article  PubMed  Google Scholar 

  23. Friedman S, Mor C. The success of endodontic therapy-healing and functionality. J Calif Dent Assoc. 2004;32(6):493–503.

    PubMed  Google Scholar 

  24. Frisk F. Epidemiological aspects on apical periodontitis. Studies based on the Prospective Population Study of Women in Göteborg and the Population Study on Oral Health in Jönköping, Sweden. Swed Dent J Suppl. 2007;(189):11–78.

    Google Scholar 

  25. Frisk F, Hakeberg M, Ahlqwist M, Bengtsson C. Endodontic variables and coronary heart disease. Acta Odontol Scand. 2003;61:257–62.

    Article  PubMed  Google Scholar 

  26. Gillen BM, Looney SW, Gu LS, Loushine BA, Weller RN, Loushine RJ, Pashley DH, Tay FR. 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. J Endod. 2011;37:895–902.

    Article  PubMed  Google Scholar 

  27. Gorni FG, Gagliani MM. The outcome of endodontic retreatment: a 2-yr follow-up. J Endod. 2004;30:1–4.

    Article  PubMed  Google Scholar 

  28. Green TL, Walton RE, Taylor JK, Merrell P. Radiographic and histologic periapical findings of root canal treated teeth in cadaver. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83:707–11.

    Article  PubMed  Google Scholar 

  29. Harty FJ. A survey of endodontic procedures performed by practitioners in limited practice. Int Endod J. 1992;25:25–8.

    Article  PubMed  Google Scholar 

  30. Heimdahl A, Hall G, Hedberg M, Sandberg H, Söder P-Ö, Tunér K, Nord CE. Detection and quantitation by lysis-filtration of bacteremia after different oral surgical procedures. J Clin Microbiol. 1990;28:2205–9.

    PubMed Central  PubMed  Google Scholar 

  31. Hirsh J, Dalen J, Anderson DR, Poller L, Bussey H, Ansell J, Deykin D. Oral anticoagulants: mechanism of action, clinical effectiveness, and optimal therapeutic range. Chest. 2001;119(suppl):8S-21.

    Google Scholar 

  32. Huumonen S, Kvist T, Gröndahl K, Molander A. Diagnostic value of computed tomography in re-treatment of root fillings in maxillary molars. Int Endod J. 2006;39(10):827–33.

    Article  PubMed  Google Scholar 

  33. Jereczek-Fossa BA, Orecchia R. Radiotherapy-induced mandibular bone complications. Cancer Treat Rev. 2002;28:65–74.

    Article  PubMed  Google Scholar 

  34. Jonasson P, Lennholm C, Kvist T. Surgical versus conventional root canal treatment. A randomized controlled trial. 2014. In manuscript.

    Google Scholar 

  35. Jonasson P, Reit C, Kvist T. A preliminary study on the technical feasibility and outcome of retrograde root canal treatment. Int Endod J. 2008;41:807–13.

    Article  PubMed  Google Scholar 

  36. Jorgić-Srdjak K, Plancak D, Bosnjak A, Azinović Z. Incidence and distribution of dehiscences and fenestrations on human skulls. Coll Antropol. 1998;22(Suppl):111–6.

    PubMed  Google Scholar 

  37. Khayat BG. The use of magnification in endodontic therapy: the operating microscope. Pract Periodontics Aesthet Dent. 1998;10:137–44.

    PubMed  Google Scholar 

  38. Kirkevang LL, Vaeth M, Wenzel A. Ten-year follow-up observations of periapical and endodontic status in a Danish population. Int Endod J. 2012;45(9):829–39.

    Article  PubMed  Google Scholar 

  39. Kvist T, Reit C. The perceived benefit of endodontic retreatment. Int Endod J. 2002;35:359–65.

    Article  PubMed  Google Scholar 

  40. Kvist T, Reit C, Esposito M, Mileman P, Bianchi S, Pettersson K, Andersson C. Prescribing endodontic retreatment: towards a theory of dentist behaviour. Int Endod J. 1994;27(6):285–90.

    Article  PubMed  Google Scholar 

  41. Kvist T, Heden G, Reit C. Endodontic retreatment strategies used by general dental practitioners. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97:502–7.

    Article  PubMed  Google Scholar 

  42. Lee JJ, Cheng SJ, Lin SK, Chiang CP, Yu CH, Kok SH. Gingival squamous cell carcinoma mimicking a dentoalveolar abscess: report of a case. J Endod. 2007;33(2):177–80.

    Article  PubMed  Google Scholar 

  43. Malamed SF. Medical emergencies in the dental office. 5th ed. St. Louis: Mosby; 2000. p. 41–4.

    Google Scholar 

  44. McMullen 3rd AF, Himel VT, Sarkar NK. An in vitro study of the effect endodontic access preparation has upon the retention of porcelain fused to metal crowns of maxillary central incisors. J Endod. 1989;15:154–6.

    Google Scholar 

  45. Metska ME, Aartman IH, Wesselink PR, Özok AR. Detection of vertical root fractures in vivo in endodontically treated teeth by cone-beam computed tomography scans. J Endod. 2012;38:1344–7.

    Article  PubMed  Google Scholar 

  46. Molven O, Halse A, Fristad I, MacDonald-Jankowski D. Periapical changes following root-canal treatment observed 20–27 years postoperatively. Int Endod J. 2002;35:784–90.

    Article  PubMed  Google Scholar 

  47. Mulvay PG, Abbott PV. The effect of endodontic access cavity preparation and subsequent restorative procedures on molar crown retention. Aust Dent J. 1996;41:134–9.

    Article  PubMed  Google Scholar 

  48. Nair PN. New perspectives on radicular cysts: do they heal? Int Endod J. 1998;31:155–60.

    Article  PubMed  Google Scholar 

  49. Nair PN. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol Med. 2004;15(6):348–81.

    Article  PubMed  Google Scholar 

  50. Natkin E, Oswald RJ, Carnes LI. The relationship of lesion size to diagnosis, incidence, and treatment of periapical cysts and granulomas. Oral Surg Oral Med Oral Pathol. 1984;57:82–94. Review.

    Article  PubMed  Google Scholar 

  51. Nixdorf DR, Moana-Filho EJ, Law AS, McGuire LA, Hodges JS, John MT. Frequency of persistent tooth pain after root canal therapy: a systematic review and meta-analysis. J Endod. 2010;36:224–30.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature – part 1. Effects of study characteristics on probability of success. Int Endod J. 2007;40:921–39.

    Article  PubMed  Google Scholar 

  53. Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature – Part 2. Influence of clinical factors. Int Endod J. 2008;41:6–31.

    Article  PubMed  Google Scholar 

  54. Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: Periapical health. Int Endod J. 2011;44:583–609.

    Article  PubMed  Google Scholar 

  55. Nobuhara WK, del Rio CE. Incidence of periradicular pathoses in endodontic treatment failures. J Endod. 1993;19:315–8.

    Article  PubMed  Google Scholar 

  56. Nygaard-Östby B. Introduction to endodontics. Oslo: Universitetsförlaget; 1971.

    Google Scholar 

  57. Orstavik D. Time-course and risk analyses of the development and healing of chronic apical periodontitis in man. Int Endod J. 1996;29:150–5.

    Article  PubMed  Google Scholar 

  58. Orstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol. 1986;2:20–34.

    Article  PubMed  Google Scholar 

  59. Pak JG, Fayazi S, White SN. Prevalence of periapical radiolucency and root canal treatment: a systematic review of cross-sectional studies. J Endod. 2012;38(9):1170–6.

    Article  PubMed  Google Scholar 

  60. Pasqualini D, Scotti N, Ambrogio P, Alovisi M, Berutti E. Atypical facial pain related to apical fenestration and overfilling. Int Endod J. 2012;45(7):670–7.

    Article  PubMed  Google Scholar 

  61. Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J. 1995;28:12–8.

    Article  PubMed  Google Scholar 

  62. Reit C, Gröndahl H-G. Management of periapical lesions in endodontically treated teeth. A study on clinical decision making. Swed Dent J. 1984;8:1–7.

    PubMed  Google Scholar 

  63. Reit C, Hollender L. Radiographic evaluation of endodontic therapy and the influence of observer variation. Scand J Dent Res. 1983;91:205–12.

    PubMed  Google Scholar 

  64. Rigolone M, Pasqualini D, Bianchi L, Berutti E, Bianchi SD. Vestibular surgical access to the palatine root of the superior first molar: “low-dose cone-beam” CT analysis of the pathway and its anatomic variations. J Endod. 2003;29(11):773–5.

    Article  PubMed  Google Scholar 

  65. Rosenberg PA, Frisbie J, Lee J, Lee K, Frommer H, Kottal S, Phelan J, Lin L, Fisch G. Evaluation of pathologists (histopathology) and radiologists (cone beam computed tomography) differentiating radicular cysts from granulomas. J Endod. 2010;36:423–8.

    Article  PubMed  Google Scholar 

  66. Rupprecht RD, Horning GM, Nicoll BK, Cohen ME. Prevalence of dehiscences and fenestrations in modern American skulls. J Periodontol. 2001;72(6):722–9.

    Article  PubMed  Google Scholar 

  67. Selden HS, Manhoff DT, Hatges NA, Michel RC. Metastatic carcinoma to the mandible that mimicked pulpal/periodontal disease. J Endod. 1998;24(4):267–70.

    Article  PubMed  Google Scholar 

  68. Shanti RM, Aziz SR. Should we wait for development of an abscess before we perform incision and drainage? Oral Maxillofac Surg Clin North Am. 2011;23(4):513–8.

    Article  PubMed  Google Scholar 

  69. Slutzky-Goldberg I, Heling I. Healing of a fibrous dysplastic lesion in a permanent molar after endodontic therapy. J Endod. 2007;33(3):314–7.

    Article  PubMed  Google Scholar 

  70. Smith J, Crisp J, Torney D. A survey: controversies in endodontic treatment and re-treatment. J Endod. 1981;7:477–83.

    Article  PubMed  Google Scholar 

  71. Song M, Chung W, Lee SJ, Kim E. Long-term outcome of the cases classified as successes based on short-term follow-up in endodontic microsurgery. J Endod. 2012;38(9):1192–6.

    Article  PubMed  Google Scholar 

  72. Strindberg LZ. The dependence of the results of pulp therapy on certain factors. Acta Odontol Scand. 1956;14(Suppl 21):1–175.

    Google Scholar 

  73. Swedish Council on Health Technology Assessment. Rotfyllning – en systematisk litteraturöversikt (In Swedish), Swedish Council on Health Technology Assessment. Report 203, 2010. English translation, Methods of diagnosis and treatment in endodontics, available at http://www.sbu.se as well as on the ESE website.

  74. Takai S, Kuriyama T, Yanagisawa M, Nakagawa K, Karasawa T. Incidence and bacteriology of bacteremia associated with various oral and maxillofacial surgical procedures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99(3):292–8.

    Article  PubMed  Google Scholar 

  75. Tomas I, Alvarez M, Limeres J, Potel C, Medina J, Diz P. Prevalence, duration and aetiology of bacteraemia following dental extractions. Oral Dis. 2007;13(1):56–62.

    Article  PubMed  Google Scholar 

  76. Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod. 2009;35:930–7.

    Article  PubMed  Google Scholar 

  77. Tsesis I, Rosen E, Taschieri S, Telishevsky Strauss Y, Ceresoli V, Del Fabbro M. Outcomes of surgical endodontic treatment performed by a modern technique: an updated meta-analysis of the literature. J Endod. 2013;39(3):332–9.

    Article  PubMed  Google Scholar 

  78. Tyndall DA, Kohltfarber H. Application of cone beam volumetric tomography in endodontics. Aust Dent J. 2012;57 Suppl 1:72–81.

    Article  PubMed  Google Scholar 

  79. Van Nieuwenhuysen JP, Aouar M, D'Hoore W. Retreatment or radiographic monitoring in endodontics. Int Endod J. 1994;27(2):75–81.

    Article  PubMed  Google Scholar 

  80. Wu MK, Shemesh H, Wesselink PR. Limitations of previously published systematic reviews evaluating the outcome of endodontic treatment. Int Endod J. 2009;42:656–66.

    Article  PubMed  Google Scholar 

  81. Wu MK, Wesselink P, Shemesh H. New terms for categorizing the outcome of root canal treatment. Int Endod J. 2011;44:1079–80.

    Article  PubMed  Google Scholar 

  82. Yoshioka T, Kikuchi I, Adorno CG, Suda H. Periapical bone defects of root filled teeth with persistent lesions evaluated by cone-beam computed tomography. Int Endod J. 2011;44(3):245–52.

    Article  PubMed  Google Scholar 

  83. Yu VS, Messer HH, Yee R, Shen L. Incidence and impact of painful exacerbations in a cohort with post-treatment persistent endodontic lesions. J Endod. 2012;38:41–6.

    Article  PubMed  Google Scholar 

  84. Zehnder M, Gold SI, Hasselgren G. Pathologic interactions in pulpal and periodontal tissues. J Clin Periodontol. 2002;29:663–71.

    Article  PubMed  Google Scholar 

  85. Zitzmann NU, Krastl G, Hecker H, Walter C, Waltimo T, Weiger R. Strategic considerations in treatment planning: deciding when to treat, extract, or replace a questionable tooth. J Prosthet Dent. 2010;104(2):80–91.

    Article  PubMed  Google Scholar 

  86. Zuolo ML, Ferreira MO, Gutmann JL. Prognosis in periradicular surgery: a clinical prospective study. Int Endod J. 2000;33:91–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Endodontology, Institute of Odontology at The Sahlgrenska Academy, University of Gothenburg, 450, SE 405 30, Göteborg, Sweden

    Peter Jonasson DDS, PhD & Thomas Kvist PhD, DDS

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  1. Peter Jonasson DDS, PhD
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  2. Thomas Kvist PhD, DDS
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Correspondence to Thomas Kvist PhD, DDS .

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Editors and Affiliations

  1. Dept. of Endodontology, Maurice and Gabriela Goldschleger, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel

    Igor Tsesis

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Jonasson, P., Kvist, T. (2014). Case Selection and Treatment Planning. In: Tsesis, I. (eds) Complications in Endodontic Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54218-3_3

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