ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Fractured Endodontic Instrument has No Effect On Healing
Clinical Question Does a retained fractured endodontic instrument affect the healing of a periapical lesion?
Clinical Bottom Line There is no significant difference in healing between teeth in which a fractured instrument is retained and teeth in which no fragmentation and retention occurs. (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) 20416418Panitvisai /2010199 patientsMeta-analysis of 2 case-control studies
Key resultsA retained instrument fragment did not significantly influence healing. The healing rate was 91% when a retained instrument fragment was present (80.7% when a periapical lesion was present; 92.4% when no lesion was present initially.
Evidence Search "Root Canal Preparation"[Mesh] AND ("Equipment Failure"[Mesh] OR "Dental Instruments/adverse effects"[Mesh] OR retained instrument) ...view in PubMed
Comments on
The Evidence
The authors performed a systematic review of the published literature. Two case-control studies were identified and included, covering 199 endodontic cases. Meta-analysis was performed.
Applicability This evidence should be taken into account when considering the prognosis of a tooth with a retained endodontic instrument fragment.
Specialty/Discipline (Endodontics) (General Dentistry)
Keywords Retained endodontic instrument fragment
ID# 875
Date of submission: 04/28/2011spacer Revised: 01/19/2012
E-mail browned@livemail.uthscsa.edu
Author Eric Brown
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author S. Thomas Deahl, II, DMD, PhD
Faculty mentor/Co-author e-mail DEAHL@uthscsa.edu
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?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Brandon Pitcher & Nancy Quach (San Antonio, TX) on 10/03/2014
A PubMed search was conducted (Sept 2014) and a more recent article was found on the subject. McGuigan et al (2013) PMID 23518972 comes to the same conclusion that separated files do not significantly affect healing of periodical lesions.
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