Die Prognose wurzelkanalbehandelter Zähne

Die Prognose eines wurzelkanalbehandelten Zahnes wird von zahlreichen prä-, intra- und postoperativen Faktoren sowie von dessen Zusammenspiel beeinflusst. Die kritische Bewertung dieser prognostischen Parameter spielt eine wichtige Rolle, um den Erfolg einer Wurzelkanalbehandlung einschätzen zu können.

Kernaussagen

• Die Prognose eines wurzelkanalbehandelten Zahnes wird von zahlreichen prä-, intra- und postoperativen Faktoren sowie von dessen Zusammenspiel beeinflusst.

• Die kritische Bewertung der prognostischen Parameter spielt eine wichtige Rolle, um den Erfolg einer Wurzelkanalbehandlung einschätzen zu können.

• Es empfiehlt sich, dass der Behandler die Relevanz entscheidender prognostischer Faktoren für das Therapieziel kennt und den Patienten vor der Behandlung darüber mit Verweis auf die Evidenz in der Literatur aufklärt.

• Eine sorgfältige Kontrolle des Ergebnisses einer endodontischen Therapie trägt dazu bei, eine gegebenenfalls nötige erneute therapeutische Intervention bei ausbleibender Heilung einer Läsion endodontischen Ursprungs oder bei ihrer Neubildung nicht zu verzögern.

• Die Wurzelkanalbehandlung ist dank moderner Techniken für eine Vielzahl von Fällen einfacher und arbeitssicherer geworden. Sie gilt bei sorgfältiger Therapieplanung als ein etabliertes und prognostisch gut vorhersagbares Verfahren, um den Zahnerhalt zu ermöglichen.

• Literatur

• 1 Wesselink PR. Root filling Techniques. In: Bergenholtz G, Horsted-Bindslev P, Reit C. eds. Textbook of Endodontology. Oxford, UK: Blackwell Munksgaard; 2003: 286-299
• 2 Ng YL, Mann V, Rahbaran S. et al. Outcome of primary root canal treatment: systematic review of the literature – Part 2. Influence of clinical factors. Int Endod J 2008; 41: 6-31
• 3 Weiger R, Axmann-Krcmar D, Löst C. Prognosis of conventional root canal treatment reconsidered. Endod Dent Traumatol 1998; 14: 1-9
• 4 European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J 2006; 39: 921-930
• 5 Ørstavik D. Time-course and risk analyses of the development and healing of chronic apical periodontitis. Int Endod J 1996; 29: 150-155
• 6 Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J 2011; 44: 583-609
• 7 Ng YL, Mann V, Rahbaran S. et al. Outcome of primary root canal treatment: systematic review of the literature – part 1. Effects of study characteristics on probability of success. Int Endod J 2007; 40: 921-939
• 8 Friedman S, Abitbol S, Lawrence HP. Treatment outcome in endodontics: the Toronto Study. Phase 1: initial treatment. J Endod 2003; 29: 787-793
• 9 Sjögren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J 1997; 30: 297-306
• 10 Zehnder M, Gold SI, Hasselgren G. Pathologic interactions in pulpal and periodontal tissues. J Clin Periodontol 2002; 29: 663-671
• 11 Simon JH, Glick DH, Frank AL. The relationship of endodontic-periodontic lesions. J Periodontol 1972; 43: 202-208
• 12 Pashley DH, Matthews WG. The effects of outward forced convective flow on inward diffusion in human dentine in vitro. Arch Oral Biol 1993; 38: 577-582
• 13 Gomes BP, Pinheiro ET, Gadê-Neto CR. et al. Microbiological examination of infected dental root canals. Oral Microbiol Immunol 2004; 19: 71-76
• 14 Siqueira JF Jr., Rôças IN. Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod 2008; 34: 1291-1301
• 15 Paik S, Sechrist C, Torabinejad M. Levels of evidence for the outcome of endodontic retreatment. J Endod 2004; 30: 745-750
• 16 Friedman S. Considerations and concepts of case selection in the management of posttreatment endodontic disease (treatment failure). Endodontic Topics 2002; 1: 54-78
• 17 Song M, Kim HC, Lee W, Kim E. Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery. J Endod 2011; 37: 1516-1519
• 18 Schilder H. Cleaning and shaping the root canal. Dent Clin North Am 1974; 18: 269-296
• 19 Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod 2004; 30: 559-567
• 20 Kojima K, Inamoto K, Nagamatsu K. et al. Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97: 95-99
• 21 Azim AA, Griggs JA, Huang GT. The Tennessee study: factors affecting treatment outcome and healing time following nonsurgical root canal treatment. Int Endod J 2016; 49: 6-16
• 22 Kirkevang LL, Ørstavik D, Hörsted-Bindslev P. et al. Periapical status and quality of root fillings and coronal restorations in a Danish population. Int Endod J 2000; 33: 509-515
• 23 Figini L, Lodi G, Gorni F. et al. Single versus multiple visits for endodontic treatment of permanent teeth. Cochrane Database Syst Rev 2007; (04) CD005296
• 24 Vera J, Siqueira Jr. JF, Ricucci D. et al. One- versus two-visit endodontic treatment of teeth with apical periodontitis: a histobacteriologic study. J Endod 2012; 38: 1040-1052
• 25 Spili P, Parashos P, Messer HH. The impact of instrument fracture on outcome of endodontic treatment. J Endod 2005; 31: 845-850
• 26 Ungerechts C, Bårdsen A, Fristad I. Instrument fracture in root canals – where, why, when and what? A study from a student clinic. Int Endod J 2014; 47: 183-190
• 27 Arnold M. Systematik einer orthograden Fragmententfernung Teil 2. Endodontie 2013; 22: 257-266
• 28 Hülsmann M. Methods for removing metal obstructions from the root canal. Endod Dent Traumatol 1993; 9: 223-237
• 29 Arnold M. Orthograde Entfernung frakturierter Wurzelkanalinstrumente. Endodontie 2013; 22: 159-169
• 30 Arnold M. Fragmententfernung mit einer modifizierten Schlingentechnik. Endodontie 2016; 25: 133-141
• 31 Gorni FG, Gagliani MM. The outcome of endodontic retreatment: a 2-yr follow-up. J Endod 2004; 30: 1-4
• 32 De Chevigny C, Dao TT, Basrani BR. et al. Treatment outcome in endodontics: the Toronto study – phases 3 and 4: orthograde retreatment. J Endod 2008; 34: 131-137
• 33 Fuss Z, Trope M. Root perforations: classification and treatment choices based on prognostic factors. Endod Dent Traumatol 1996; 12: 255-264
• 34 Bargholz C. Perforation repair with mineral trioxide aggregate: a modified matrix concept. Int Endod J 2005; 38: 59-69
• 35 Lantz B, Persson PA. Periodontal tissue reactions after root perforations in dogʼs teeth. A histologic study. Odontol Tidskr 1967; 75: 209-237
• 36 Holland R, Filho JA, de Souza V. et al. Mineral trioxide aggregate repair of lateral root perforations. J Endod 2001; 27: 281-284
• 37 Zhu Q, Haglund R, Safavi KE, Spangberg LS. Adhesion of human osteoblasts on root-end filling materials. J Endod 2000; 26: 404-406
• 38 Pontius V, Pontius O, Braun A. et al. Retrospective evaluation of perforation repairs in 6 private practices. J Endod 2013; 39: 1346-1358
• 39 Krupp C, Bargholz C, Brüsehaber M. et al. Treatment outcome after repair of root perforations with mineral trioxide aggregate: a retrospective evaluation of 90 teeth. J Endod 2013; 39: 1364-1368
• 40 Mente J, Leo M, Panagidis D. et al. Treatment outcome of mineral trioxide aggregate: repair of root perforations-long-term results. J Endod 2014; 40: 790-796
• 41 Tronstad L, Asbjørnsen K, Døving L. et al. Influence of coronal restorations on the periapical health of endodontically treated teeth. Endod Dent Traumatol 2000; 16: 218-221
• 42 Lynch CD, Burke FM, Ní Ríordáin R. et al. The influence of coronal restoration type on the survival of endodontically treated teeth. Eur J Prosthodont Restor Dent 2004; 12: 171-176
• 43 Nagasiri R, Chitmongkolsuk S. Long-term survival of endodontically treated molars without crown coverage: a retrospective cohort study. J Prosthet Dent 2005; 93: 164-170
• 44 Dammaschke T, Nykiel K, Sagheri D, Schäfer E. Influence of coronal restorations on the fracture resistance of root canal-treated premolar and molar teeth: a retrospective study. Aust Endod J 2013; 39: 48-56
• 45 Federlin M, Hiller KA, Schmalz G. Controlled, prospective clinical split-mouth study of cast gold vs. ceramic partial crowns: 5.5 year results. Am J Dent 2010; 23: 161-167
• 46 Wagner J, Hiller KA, Schmalz G. Long-term clinical performance and longevity of gold alloy vs. ceramic partical crowns. Clin Oral Investig 2003; 7: 80-85
• 47 Frankenberger R, Zeilinger I, Krech M. et al. Stability of endodontically treated teeth with differently invasive restorations: Adhesive vs. non-adhesive cusp stabilization. Dent Mater 2015; 31: 1312-1320
• 48 Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J 1995; 28: 12-18
• 49 Gillen BM, Looney SW, Gu LS. et al. Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis. J Endod 2011; 37: 895-902
• 50 Wu MK, Shemesh H, Wesselink PR. Limitations of previously published systematic reviews evaluating the outcome of endodontic treatment. Int Endod J 2009; 42: 656-666
• 51 Estrela C, Bueno MR, Leles CR. et al. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod 2008; 34: 273-279
• 52 Patel S, Wilson R, Dawood A. et al. The detection of periapical pathosis using periapical radiography and cone beam computed tomography – part 1: pre-operative status. Int Endod J 2012; 45: 702-710
• 53 Patel S, Wilson R, Dawood A. et al. The detection of periapical pathosis using digital periapical radiography and cone beam computed tomography – part 2: a 1-year post-treatment follow-up. Int Endod J 2012; 45: 711-723
• 54 Liang YH, Li G, Shemesh H. et al. The association between complete absence of post-treatment periapical lesion and quality of root canal filling. Clin Oral Investig 2012; 16: 1619-1626
• 55 Pettiette MT, Delano O, Trope M. Evaluation of success rate of endodontic treatment performed by students with stainless-steel K-files and nickel-titanium hand files. J Endod 2001; 27: 124-127
• 56 Cheung GS, Liu CS. A retrospective study of endodontic treatment outcome between nickel-titanium rotary and stainless steel hand filing techniques. J Endod 2009; 35: 938-943
• 57 Sonntag D, Guntermann A, Kim SK. et al. Root canal shaping with manual stainless steel files and rotary Ni-Ti files performed by students. Int Endod J 2003; 36: 246-255
• 58 Bürklein S, Schäfer E. Präparationsbedingte Wurzelkanalbegradigungen. Eine kritische Bewertung. Endodontie 2015; 24: 37-50
• 59 Peng L, Ye L, Tan H. et al. Outcome of root canal obturation by warm gutta-percha versus cold lateral condensation: a meta-analysis. J Endod 2007; 33: 106-109
• 60 Conner DA, Caplan DJ, Teixeira FB. et al. Clinical outcome of teeth treated endodontically with a nonstandardized protocol and root filled with resilon. J Endod 2007; 33: 1290-1292
• 61 Cotton TP, Schindler WG, Schwartz SA. et al. A retrospective study comparing clinical outcomes after obturation with Resilon/Epiphany or Gutta-Percha/Kerr sealer. J Endod 2008; 34: 789-797
• 62 Ozer SY, Aktener BO. Outcome of root canal treatment using Soft-Core and cold lateral compaction filling techniques: a randomized clinical trial. J Contemp Dent Pract 2009; 10: 74-81
• 63 Kandemir Demirci G, Çalışkan MK. A prospective randomized comparative study of cold lateral condensation versus Core/Gutta-percha in teeth with periapical lesions. J Endod 2016; 42: 206-210
• 64 Weiger R, Hitzler S, Hermle G. et al. Periapical status, quality of root canal fillings and estimated endodontic treatment needs in an urban German population. Endod Dent Traumatol 1997; 13: 69-74
• 65 Nair PNR. Non-microbial etiology: foreign body reaction maintaining posttreatment apical periodontitis. Endod Topics 2003; 6: 114-134
• 66 Fristad I, Molven O, Halse A. Nonsurgically retreated root filled teeth – radiographic findings after 20–27 years. Int Endod J 2004; 37: 12-18
• 67 Siqueira JF, Rôças IN, Veiga LM. et al. Ursachen persistierender postoperativer Beschwerden in der Endodontie. Endodontie 2010; 19: 29-36