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Reasons for extractions
Reasons for extractions Background.—Tooth extraction is an important therapeutic procedure. Most extractions are done for carious or periodontal disease. Endodontic treatment is performed to avoid tooth extraction, but one must assess the possible outcome of any endodontically treated tooth. Studies documenting the reasons for extractions of missing teeth are few. The reasons for extracting permanent endodontically treated teeth were investigated prospectively. Methods.—The data from questionnaires concerning 119 endodontically treated teeth were collected, noting type of tooth; presence and type of coronal restoration; motive for consulting the dental practitioner; reasons for extraction; and the patient’s age, gender, level of education, and smoking status. Relationships between factors were evaluated using c2 analysis. Results.—The patient’s mean age was 37.5 years, and 50.9% were women. Patients came for relief of pain in 68.9% of cases, dental mobility in 10.9%, trauma in 8.5%, and esthetics in 2.5% cases. The teeth removed most often were first mandibular molars (29.4%), second and third mandibular molars (21.9%), maxillary premolars (11.7%), incisors and maxillary canines (6.7%), second and third maxillary molars (6%), and mandibular incisors and canines (3.2%). Coronal restorations were present in 76.5% of the teeth, with 67.2% of these restorations without posts. Reasons for tooth extraction included periodontal disease in 40.3%, endodontic treatment failure in 19.3%, vertical root fracture in 13.4%, nonrestorable cuspid and crown fracture in 15.1%, nonrestorable caries in 5.3%, iatrogenic
perforations and stripping in 4.2%, prosthetic needs in 0.8%, and total crown destruction in 1.7%. None of these reasons correlated significantly with gender, educational level, or smoking status. Discussion.—The mandibular first molar without a crown was the tooth removed most often. The majority of teeth were removed for periodontal disease, but endodontic failure and nonrestorable tooth damage caused by fracture or caries were also noted.
Clinical Significance.—Most of the extractions were done for periodontal disease, endodontic failure, and nonrestorable tooth damage caused by fracture or caries. The mandibular first molar without a crown was the most common tooth involved, probably because of its susceptibility to caries and the frequency of treatments. None of the factors were significantly related to gender, educational level achieved, or smoking status.
Tour e B, Faye B, Kane AW, et al: Analysis of reasons for extraction of endodontically treated teeth: A prospective study. J Endod 37:15121515, 2011 Reprints available from B Tour e, Ma^ıtre de Conf erences Agr eg e Conservative Dentistry and Endodontics, PO Box 12465, Colobane Dakar, Faculty of Medicine Pharmacy and Odontology, Univ Cheikh Anta Diop, Dakar, S en egal; e-mail: [email protected]
Prevention Root caries Background.—Root surface caries have been known for a very long time, as excavations of dental remains have been shown in prehistoric populations. Whether there are effective interventions available to prevent root caries was investigated, comparing individualized oral hygiene instruction (OHI) every 3 months, OHI plus chlorhexidine varnish applications every 3 months, or OHI and applications of silver diamine fluoride (SDF) solution annually. The subjects were elderly patients who had at least five teeth with
276
Dental Abstracts
exposed roots, no serious medical problems, and the ability to perform basic self-care. Participants’ teeth were cleaned and dried using gauze, then water (placebo), chlorhexidine varnish, sodium fluoride varnish, or SDF solution was applied to the exposed surfaces using a disposable microbrush. Participants were instructed not to eat for 30 minutes after the treatment. Water or SDF solution applications were repeated every 12 months. Chlorhexidine varnish or sodium fluoride varnish applications were
perforations and stripping in 4.2%, prosthetic needs in 0.8%, and total crown destruction in 1.7%. None of these reasons correlated significantly with gender, educational level, or smoking status. Discussion.—The mandibular first molar without a crown was the tooth removed most often. The majority of teeth were removed for periodontal disease, but endodontic failure and nonrestorable tooth damage caused by fracture or caries were also noted.
Clinical Significance.—Most of the extractions were done for periodontal disease, endodontic failure, and nonrestorable tooth damage caused by fracture or caries. The mandibular first molar without a crown was the most common tooth involved, probably because of its susceptibility to caries and the frequency of treatments. None of the factors were significantly related to gender, educational level achieved, or smoking status.
Tour e B, Faye B, Kane AW, et al: Analysis of reasons for extraction of endodontically treated teeth: A prospective study. J Endod 37:15121515, 2011 Reprints available from B Tour e, Ma^ıtre de Conf erences Agr eg e Conservative Dentistry and Endodontics, PO Box 12465, Colobane Dakar, Faculty of Medicine Pharmacy and Odontology, Univ Cheikh Anta Diop, Dakar, S en egal; e-mail: [email protected]
Prevention Root caries Background.—Root surface caries have been known for a very long time, as excavations of dental remains have been shown in prehistoric populations. Whether there are effective interventions available to prevent root caries was investigated, comparing individualized oral hygiene instruction (OHI) every 3 months, OHI plus chlorhexidine varnish applications every 3 months, or OHI and applications of silver diamine fluoride (SDF) solution annually. The subjects were elderly patients who had at least five teeth with
276
Dental Abstracts
exposed roots, no serious medical problems, and the ability to perform basic self-care. Participants’ teeth were cleaned and dried using gauze, then water (placebo), chlorhexidine varnish, sodium fluoride varnish, or SDF solution was applied to the exposed surfaces using a disposable microbrush. Participants were instructed not to eat for 30 minutes after the treatment. Water or SDF solution applications were repeated every 12 months. Chlorhexidine varnish or sodium fluoride varnish applications were