Authors: Kerekes K, Tronstad L.
Title: Long-term results of endodontic treatment performed with a standardized technique.
Journal: J Endod
Date: Mar 1979
Citation: 5(3):83-90
Category: Success and Failure
Evidence-based Ranking: 2
Purpose/Objectives: To assess the long-term results of endodontic treatment according to the standardized technique. Materials & Methods: The study consisted of follow-up of 501 roots that were treated by dental students in 1971. The teeth were typically treated in 2-3 appts. The standardized technique, according to Ingle, reamers sizes 10-140 were used in a rotating motion to give the apical portion of the canal a circular, tapered form and to make a ledge or “stop” in the canal approximately 2 mm short of the apex in vital teeth and 0-1 mm from the apex in necrotic or “total pulpectomies”. Hedstroem files size 20-140 were used to clean and shape the coronal parts of the canals. 30% H2O2 and 0.5% benzalkonium chloride in 70% ethanol were used as medicaments in between appts. Edetate and 5% chloramine-T were used to irrigate the canals. In necrotic teeth, 3.7% formaldehyde was used to disinfect the canals. For obturation, standardized GP coated with Kloroperka N-O was used. In extremely narrow and curved canals, silver points were used in combination with the GP and Kloroperka N-O. Follow-up was at least 3 years after initial RCT and was done by radiographic examination with a magnifying glass to determine “success” (radiographic width and contour of PDL normal), “uncertain” (questionable results” and “failure” (PARL observed). Factors such as age of pt, type of tooth, number of appts and length of treatment time, irrigation fluids and medicaments, preoperative dx, complications during tx, results of culturing, technical standard of root fillings and subsequent preparation of canals for posts were all looked at and analyzed. Results: Results are listed in tables 1-6; In general, an “adequate seal” was found in 97% of the roots; overfilling of the canal with material greater than 1 mm was observed in 3% of the roots; overall success rate was 91% with no significant difference amongst anteriors, premolars or molars; roots without PARL showed better results than roots with PARL. Author’s Conclusions: The following conclusions were drawn: 1) a standardized preparation and obturation technique may be used regularly in all groups of teeth; 2) the technical standard of all the root canal fillings was greatly improved by means of the standardized technique; 3) the improvement in the technical standard of the root canal fillings led to a statistically significant improvement in the success rate; 4) the undergraduate students understood the principles of the technique and learned how to make use of it in all groups of teeth. Reviewer’s Comments: This was a very comprehensive study designed to look at the success of this particular technique.