Ronald B Baran DDS PC
mesialbuccal@gmail.com

For Your Information

Here are a few citations from the Journal Of Endodonics that you might be interested in:

November 2016: Volume 42, Issue 11, Pages 1598–1603

Eight-Year Retrospective Study of the Critical Time Lapse between Root Canal Completion and Crown Placement: Its Influence on the Survival of Endodontically Treated Teeth

”The authors investigated the effect of the type of restoration after RCT on the survival rate of ETT. The 8-year survival rate after RCT was 84% with full coverage crowns. For ETT with core buildup restorations without receiving a full coverage crown, the 8-year survival rate after RCT was 71%. Also, root canal treated teeth that did not subsequently receive any permanent restorations had the lowest 8-year survival rate of 58%”

“It was shown that endodontically treated teeth that received a crown 4 months after RCT were extracted at 3 times the rate of teeth that received a crown within 4 months after RCT.”

So now when a patient asks "Can I wait a year or so before I get my crown?" you can definitively respond that yes they can if they want to watch their chance of success go way down.

April 2016: Volume 42, Issue 4, Pages 527–532

The Effect of Sodium Hypochlorite and Chlorhexidine as Irrigant Solutions for Root Canal Disinfection: A Systematic Review of Clinical Trials

“Two studies reported effective and similar reductions in bacterial levels for both irrigants. Sodium hypochlorite was more effective than chlorhexidine in reducing microorganisms in 1 study, and another reported opposite findings. Both root irrigants were ineffective in eliminating endotoxins from necrotic pulp root canals in 1 study. Trial design and information regarding randomization procedures were not clearly described in the clinical trials. No study compared laboratory results with clinical outcomes.”

Conclusion: “The available evidence on this topic is scarce, and the findings of studies were not consistent. Additional randomized clinical trials using clinical outcomes to compare the use of sodium hypochlorite and chlorhexidine during root canal therapy are needed.”

There you have it – and the beat goes on.

February 2016: Volume 42, Issue 2, Pages 243–249

Apically Extruded Sealers: Fate and Influence on Treatment Outcome

“Not all extruded sealers were predictably removed from the periradicular tissues. Treatment outcome was not significantly affected by the type of extruded sealer. A significantly better outcome was observed for teeth with no lesion in comparison with teeth with apical periodontitis.”

Doesn’t seem to make a difference but it still looks unseemly to squirt a big glob of sealer into the periapical tissues.

February 2017: Volume 43, Issue 2, Pages 188–193

Long-term Clinical Outcomes of Endodontically Treated Teeth Restored with or without Fiber Post–retained Single-Unit Restorations

“The overall tooth survival rate was 89.6% after a mean observation time of 8.8 ± 2.3 years. The survival rate of teeth with a fiber post amounted to 94.3%, and for teeth without a post, it was 76.3% (P < .001). The main reason for tooth loss was root fracture (9.7%). No loss of post retention was observed. Successfully treated teeth without any biological and/or technical complications and requiring no additional treatment during the entire observation period amounted to 79.9%.”

How about that? Makes you want to go stock up on fiber posts. If you want to take it one step further you might think of doing the post and buildup right after the RCT before the dam comes off.

May 2017 Volume 43, Issue 5, Pages 674–678

A Randomized Clinical Trial Comparing 2 Ibuprofen Formulations in Patients with Acute Odontogenic Pain

“The median time to onset of 50% pain relief after administration of ibuprofen sodium dihydrate was significantly faster compared with ibuprofen acid (26.5 vs 44 minutes, P = .08). Ibuprofen sodium dihydrate provided a greater reduction in spontaneous pain (50.8% vs 33.3%, P < .05) and mechanical allodynia (15% vs 9%, P > .05).”

Ibuprofen is a pretty good odontogenic pain reliever but the sodium dehydrate is better.