Endodontics problems: A current and updated review

Pardis Palizban

Abstract


It is well known that dentists should be able to make intense contributions regarding the care of patients in addition to the patient complains of tooth pain, swollen gums, sensitivity to hot and cold, tooth discoloration, cracked or chipped teeth. In these conditions dentists should not delay regarding attention to endodontics treatment or other strategies. The purpose of this review was to understand the needs to endodontics treatment for each individual patient attending dental clinics. A review of scientific literature (n= 40) was conducted based on the topic of interest by searching; PUBMED.Gov (https://pubmed.ncbi.nlm.nih.gov/), and Web of Science. Occlusal force is associated with the tooth contact and clenching strength. The greater compressing strength, occlusal power upsurges over the molar area, although it is opposite in the anterior and premolar areas. Research designates that dental refurbishments can decrease occlusal strength over a compensatory response mechanism. Therefore, the sort of renovation used throughout reintegration shows a dynamic character in changing occlusal power and communication zone. The properties of features such as the residual dentition, occlusal connection extent, and dissimilar sorts of therapy on occlusal power require additional examination. To avoid endodontics problems dentists should consider: occlusal contact area, clenching strength, occlusal force, and type of detection—attention to modern clinical techniques to avoid endodontic issues suggested. Access to the cavity should be designated based on a correct design of the dentist as an incorrect attempt may make root canals both challenging to recognize and to the device. Pre-operative study of radiographs should be made wisely.  Numerous assistances are obtainable to eliminate cracked tools and unsuccessful root fillings, but the problem must first be properly identified. In conclusion, Dentists should be fully aware of the primary diagnosis and plan strategy based on individualized patients for any endodontic procedures.

Keywords


Endodontics, Tooth Pain, Occlusal Power, Molar Area, clenching strength

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References


Beal M. De la resection de l'apex. Revue de Stomatologie, 1908; 15, 439–446.

Bronkhorst MA, Bergé SJ, Van Damme PA, Borstlap WA, Merkx MA. Gebruik van vulmaterialen bij een chirurgische apicale endodontische behandeling in Nederland [Use of root-end filling materials in a surgical apical endodontic treatment in the Netherlands]. Ned Tijdschr Tandheelkd. 2008 Aug;115(8):423-7. Dutch. PMID: 18751482.

Chen I, Karabucak B, Wang C, Wang HG, Koyama E, Kohli MR, Nah HD, Kim S. Healing after root-end microsurgery by using mineral trioxide aggregate and a new calcium silicate-based bioceramic material as root-end filling materials in dogs. J Endod. 2015 Mar;41(3):389-99. doi: 10.1016/j.joen.2014.11.005. Epub 2015 Jan 14. PMID: 25596728; PMCID: PMC4415855.

Anandapandian PA, Raza FB, Ar PK, Krishnamoorthy S, Ashok V, Anand Kumar V, P V. Digital occlusal analysis of the impact of natural dentition and different types of rehabilitation on the occlusal force variations: systematic review and meta-analysis. J Oral Biol Craniofac Res. 2025 May-Jun;15(3):534-540. doi: 10.1016/j.jobcr.2025.03.006. Epub 2025 Mar 14. PMID: 40144644; PMCID: PMC11937659.

Setzer FC, Kratchman SI. Present status and future directions: Surgical endodontics. Int Endod J. 2022 Oct;55 Suppl 4:1020-1058. doi: 10.1111/iej.13783. Epub 2022 Jul 4. PMID: 35670053.

Murray PE. Review of guidance for the selection of regenerative endodontics, apexogenesis, apexification, pulpotomy, and other endodontic treatments for immature permanent teeth. Int Endod J. 2023 Mar;56 Suppl 2:188-199. doi: 10.1111/iej.13809. Epub 2022 Aug 15. PMID: 35929348.

American Association of Endodontists (AAE). (2016) AAE Clinical considerations for a regenerative procedure. Revised 6 August 2016. Available at: https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/06/currentregenerativeendodonticconsiderations.pdf

Chaniotis A. Treatment Options for Failing Regenerative Endodontic Procedures: Report of 3 Cases. J Endod. 2017 Sep;43(9):1472-1478. doi: 10.1016/j.joen.2017.04.015. Epub 2017 Jul 13. PMID: 28712637.

Chrepa V, Joon R, Austah O, Diogenes A, Hargreaves KM, Ezeldeen M, Ruparel NB. Clinical Outcomes of Immature Teeth Treated with Regenerative Endodontic Procedures-A San Antonio Study. J Endod. 2020 Aug;46(8):1074-1084. doi: 10.1016/j.joen.2020.04.008. Epub 2020 Jun 16. PMID: 32560972.

Elfrink MEC, Heijdra JSC, Krikken JB, Kouwenberg-Bruring WH, Kouwenberg H, Weerheijm KL, Veerkamp JSJ. Regenerative endodontic therapy: a follow-up of 47 anterior traumatised teeth. Eur Arch Paediatr Dent. 2021 Jun;22(3):469-477. doi: 10.1007/s40368-020-00584-0. Epub 2020 Nov 27. PMID: 33245524.

Clark D, Levin L. In the dental implant era, why do we still bother saving teeth? Dent Traumatol. 2019 Dec;35(6):368-375. doi: 10.1111/edt.12492. Epub 2019 Oct 14. PMID: 31132200.

Yamamoto S, Shiga H. Masticatory performance and oral health-related quality of life before and after complete denture treatment. J Prosthodont Res. 2018 Jul;62(3):370-374. doi: 10.1016/j.jpor.2018.01.006. Epub 2018 Mar 13. PMID: 29548978.

Steele JG, Sanders AE, Slade GD, Allen PF, Lahti S, Nuttall N, Spencer AJ. How do age and tooth loss affect oral health impacts and quality of life? A study comparing two national samples. Community Dent Oral Epidemiol. 2004 Apr;32(2):107-14. doi: 10.1111/j.0301-5661.2004.00131.x. PMID: 15061859.

Park HE, Song HY, Han K, Cho KH, Kim YH. Number of remaining teeth and health-related quality of life: the Korean National Health and Nutrition Examination Survey 2010-2012. Health Qual Life Outcomes. 2019 Jan 9;17(1):5. doi: 10.1186/s12955-019-1078-0. PMID: 30626402; PMCID: PMC6327472.

Bansal M, Gupta N, Gupta P, Arora V, Thakar S. Reasons for extraction in primary teeth among 5-12 years school children in Haryana, India- A cross-sectional study. J Clin Exp Dent. 2017 Apr 1;9(4):e545-e549. doi: 10.4317/jced.53076. PMID: 28469820; PMCID: PMC5410675.

Reis T, Barbosa C, Franco M, Baptista C, Alves N, Castelo-Baz P, Martin-Cruces J, Martin-Biedma B. 3D-Printed Teeth in Endodontics: Why, How, Problems and Future-A Narrative Review. Int J Environ Res Public Health. 2022 Jun 29;19(13):7966. doi: 10.3390/ijerph19137966. PMID: 35805624; PMCID: PMC9265401.

Patel S, Brown J, Pimentel T, Kelly RD, Abella F, Durack C. Cone beam computed tomography in Endodontics - a review of the literature. Int Endod J. 2019 Aug;52(8):1138-1152. doi: 10.1111/iej.13115. Epub 2019 Apr 9. PMID: 30868610.

Duncan HF. Present status and future directions-Vital pulp treatment and pulp preservation strategies. Int Endod J. 2022 May;55 Suppl 3(Suppl 3):497-511. doi: 10.1111/iej.13688. Epub 2022 Feb 3. PMID: 35080024; PMCID: PMC9306596.

Chaniotis A, Ordinola-Zapata R. Present status and future directions: Management of curved and calcified root canals. Int Endod J. 2022 May;55 Suppl 3:656-684. doi: 10.1111/iej.13685. Epub 2022 Feb 27. PMID: 35106792.

Carrotte P. Endodontic problems. Br Dent J. 2005 Feb 12;198(3):127-33; quiz 174. doi: 10.1038/sj.bdj.4812037. PMID: 15706373.

Manfredi M, Figini L, Gagliani M, Lodi G. Single versus multiple visits for endodontic treatment of permanent teeth. Cochrane Database Syst Rev. 2016 Dec 1;12(12):CD005296. doi: 10.1002/14651858.CD005296.pub3. Update in: Cochrane Database Syst Rev. 2022 Dec 13;12:CD005296. doi: 10.1002/14651858.CD005296.pub4. PMID: 27905673; PMCID: PMC6463951.

Kirkevang LL. What does epidemiology tell us about treatment outcomes in endodontics. Int Endod J. 2023 Mar;56 Suppl 2:53-61. doi: 10.1111/iej.13850. Epub 2022 Oct 29. PMID: 36254498.

Lara-Mendes STO, Barbosa CFM, Machado VC, Santa-Rosa CC. A New Approach for Minimally Invasive Access to Severely Calcified Anterior Teeth Using the Guided Endodontics Technique. J Endod. 2018 Oct;44(10):1578-1582. doi: 10.1016/j.joen.2018.07.006. Epub 2018 Aug 25. PMID: 30154005.

Todd R, Resnick S, Zicarelli T, Linenberg C, Donelson J, Boyd C. Template-guided endodontic access. J Am Dent Assoc. 2021 Jan;152(1):65-70. doi: 10.1016/j.adaj.2020.07.025. Epub 2020 Nov 6. PMID: 33168140.

Miller WD. The human mouth as a focus of infection. Lancet. 1891;138:340–342.

Peng X, Cheng L, You Y, Tang C, Ren B, Li Y, Xu X, Zhou X. Oral microbiota in human systematic diseases. Int J Oral Sci. 2022 Mar 2;14(1):14. doi: 10.1038/s41368-022-00163-7. PMID: 35236828; PMCID: PMC8891310.

Gao L, Xu T, Huang G, Jiang S, Gu Y, Chen F. Oral microbiomes: more and more importance in oral cavity and whole body. Protein Cell. 2018 May;9(5):488-500. doi: 10.1007/s13238-018-0548-1. Epub 2018 May 7. PMID: 29736705; PMCID: PMC5960472.

Jia X, Jia L, Mo L, Yuan S, Zheng X, He J, Chen V, Guo Q, Zheng L, Yuan Q, Xu X, Zhou X. Berberine Ameliorates Periodontal Bone Loss by Regulating Gut Microbiota. J Dent Res. 2019 Jan;98(1):107-116. doi: 10.1177/0022034518797275. Epub 2018 Sep 10. PMID: 30199654.

Neelakantan P, Romero M, Vera J, Daood U, Khan AU, Yan A, Cheung GSP. Biofilms in Endodontics-Current Status and Future Directions. Int J Mol Sci. 2017 Aug 11;18(8):1748. doi: 10.3390/ijms18081748. PMID: 28800075; PMCID: PMC5578138.

Zhao H, Chu M, Huang Z, Yang X, Ran S, Hu B, Zhang C, Liang J. Variations in oral microbiota associated with oral cancer. Sci Rep. 2017 Sep 18;7(1):11773. doi: 10.1038/s41598-017-11779-9. PMID: 28924229; PMCID: PMC5603520.

Siqueira JF Jr, Rôças IN. Present status and future directions: Microbiology of endodontic infections. Int Endod J. 2022 May;55 Suppl 3:512-530. doi: 10.1111/iej.13677. Epub 2022 Jan 13. PMID: 34958494.

Segura-Egea JJ, Gould K, Şen BH, Jonasson P, Cotti E, Mazzoni A, Sunay H, Tjäderhane L, Dummer PMH. Antibiotics in Endodontics: a review. Int Endod J. 2017 Dec;50(12):1169-1184. doi: 10.1111/iej.12741. Epub 2017 Jan 16. PMID: 28005295.

Contaldo M, D'Ambrosio F, Ferraro GA, Di Stasio D, Di Palo MP, Serpico R, Simeone M. Antibiotics in Dentistry: A Narrative Review of the Evidence beyond the Myth. Int J Environ Res Public Health. 2023 Jun 1;20(11):6025. doi: 10.3390/ijerph20116025. PMID: 37297629; PMCID: PMC10252486.

Musikant BL. Excellent Canal Cleansing, Minimal Root Weakening. Dent Today. 2017 Apr;36(4):70, 72-3. PMID: 29235311.

Lussi A, Nussbächer U, Grosrey J. A novel noninstrumented technique for cleansing the root canal system. J Endod. 1993 Nov;19(11):549-53. doi: 10.1016/S0099-2399(06)81284-7. PMID: 8151242.

Lussi A, Portmann P, Nussbächer U, Imwinkelried S, Grosrey J. Comparison of two devices for root canal cleansing by the noninstrumentation technology. J Endod. 1999 Jan;25(1):9-13. doi: 10.1016/S0099-2399(99)80390-2. PMID: 10196836.

Challagulla A, Chandrappa V, Akurathi R, N Mrudula KJ, Vemagiri CT, Thote K. Evaluation of root canal cleaning efficacy of selfadjusting files, protaper rotary, and manual K-Files in primary teeth - An In vitro Comparative study. Indian J Dent Res. 2023 Jan-Mar;34(1):65-68. doi: 10.4103/ijdr.ijdr_66_22. PMID: 37417060.

Karunakaran JV, Samuel LS, Rishal Y, Joseph MD, Suresh KR, Varghese ST. Root Canal Configuration of Human Permanent Mandibular First Molars of an Indo-Dravidian Population Based in Southern India: An In vitro Study. J Pharm Bioallied Sci. 2017 Nov;9(Suppl 1):S68-S72. doi: 10.4103/jpbs.JPBS_163_17. PMID: 29284938; PMCID: PMC5731046.

Bătăiosu M, Diaconu O, Moraru I, Dăguci C, Tuculină M, Dăguci L, Gheorghiţă L. The failures of root canal preparation with hand ProTaper. Curr Health Sci J. 2012 Jul;38(3):129-31. Epub 2012 Sep 19. PMID: 24778848; PMCID: PMC3945274.

El-Desouky SS, Omer SMM, Ghouraba RF, Latif RMAA, Kabbash IA, Hadwa SM. Zinc oxide-ozonated olive oil as a new root canal filling material in primary molars: a clinical randomized controlled trial. Clin Oral Investig. 2023 Dec;27(12):7395-7405. doi: 10.1007/s00784-023-05329-z. Epub 2023 Oct 21. PMID: 37864602; PMCID: PMC10713656.


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