Czynniki wpływające na niepowodzenie leczenia endodontycznego w praktykach stomatologów ogólnych w Japonii
Factors that cause endodontic failures in general practices in Japan
It has been reported that the prevalence of healing after initial treatment and retreatment of root canals is 86% and 82%, respectively [1, 2]. Several factors, such as perforation and intraoperative complications, affect healing [1, 2].
The purpose of root-canal treatment (RCT) is thorough mechanical and chemical cleaning of an infected root-canal system, followed by its complete obturation with a filling material [3]. Removal of infected substances and avoidance of further intraoperative/postoperative infection are crucial for successful RCT. Failure of RCT can be because of infected substances inside the root canal or at extraradicular areas.
It has been reported that extraradicular infection associated with apical periodontitis does not respond well to RCT according to culture-based [4-8] and molecular studies [9-12]. Morphologic studies by our research team have shown that biofilms develop on root surfaces outside apical foramens of the teeth extracted for refractory periapical periodontitis and that gutta-percha points extrude in extraradicular areas removed during endodontic treatment for chronic periapical periodontitis [13]. Furthermore, bacterial DNA has been detected in extraradicular areas in 14 of 20 samples of refractory periapical periodontitis, and that bacterial species such as Fusobacterium nucleatum, Porphyromonas gingivalis, and Tannerella forsythia are detected frequently [14]. Our study excluded the possibility of contamination during sampling of apical periodontitis lesions for microbial analyses [14]. Furthermore, several case reports [...]
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