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Title Influence of Infection At The Time of Root Filling on The Outcome of Endodontic Treatment of Teeth with Apical Periodontitis
Clinical Question Is the overall prognosis for success different for root canal therapy in patients who have bacteria present at the time of obturation compared to those who do not?
Clinical Bottom Line Patients who have active disease at the time of root canal filling (obturation) are less likely to have a successful outcome compared to those patients who have a negative culture at time of obturation. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 9477818Sjogren 199755 single rooted teeth, 22 root canals had a (+) culture at of obtur, while 33 had (-) cultureCohort
Key results94% success was noted in cases with a negative culture compared to 68% with a positive culture at the time of obturation.
Evidence Search Pubmed search: Endodontics, one-visit, bacteria, success rate
Comments on
The Evidence
One other article was found with the evidence search but it was on dogs, therefore it was not included.
Applicability Teeth with apical periodontitis must have special consideration prior to obturation completion.
Specialty/Discipline (Endodontics) (General Dentistry)
Keywords Endodontics, bacteria, one-visit, success rate
ID# 286
Date of submission: 11/11/2009spacer
E-mail PachecoMA@uthscsa.edu
Author Marc Pacheco, DDS
Co-author(s) e-mail
Faculty mentor/Co-author
Faculty mentor/Co-author e-mail
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
Comments and Evidence-Based Updates on the CAT
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by Brent Winward (San Antonio, TX) on 07/07/2012
A study done in 2005 (PubMed ID 16306819) confirms the results found in this CAT. The study evaluated the efficacy of treatment procedures on limiting bacterial growth prior to obturation. At a one year follow-up there was a significant difference on healing of periapical lesions between the positive/negative culture groups.
by Diane Banks (San Antonio, TX) on 04/03/2012
I conducted research through PubMed on this topic and was able to find another article more current than the one stated that supports the clinical bottom line. PubMed ID 16911098. This experimental study was done in 2006 on 175 root canals of monkeys. This study is more recent and a greater amount of teeth were used.

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