2017

Question 1

Sedgley - “NSAIDs for managing post-op endodontic pain in pts who present with pre-op pain”

Answer 1

A combination of ibuprofen 600mg and acetaminophen 1000mg is more effective than placebo but not significantly different that ibuprofen 600mg at 6hrs post-op. Ibuprofen 600mg is more effective than placebo.

Question 2

Nixdorf, Law - “Examining the sensitivity and specificity of 2 screening instruments: Odontogenic pain or TMD pain?”

Answer 2

TMD screener has high sensitivity for true positives but lacks diagnostic accuracy for differentiating TMD pain from odontogenic pain without adjunctive tests. Would be useful as a screening instrument when one can definitively exclude odontogenic origin etiology.

Question 3

Patel - “External cervical resorption: comparison of diagnostic efficacy using 2 different CBCTs and PAs”

Answer 3

Diagnostic accurace for PA, Kodale and Morita CBCTs 0.872, 0.99, and 0.994 respectfully. Both CBCTs were equal in diagnosing ECR and significantly better than PA. CBCTs more likely to accurately categorize the ECR to correct Hithersay classifications compared to PA.

Question 4

Brazil - “Performance of post-retained single-crowns”

Answer 4

Teeth without ferrule highest values of variation of success and failure (0%-97%). Posts with high elastic modulus show better performance when restoring endodontically treated teeth with no ferrule.

Question 5

Parker, UNC - “CBCT uses in clinical endo: observer variability in detecting PA lesions”

Answer 5

Endo faculty highest kappa 0.68, followed by endo residents 0.48, then dental students 0.28. Clinicians experience level correlates w/ ability to correctly diagnose PA diseases in CBCT. Experience leads to better inter-rater reliability.

Question 6

Patel - “Influence of CBCT in clinical decision making among specialists”

Answer 6

CBCT scans only had influence on tx plan when endo case was classified as high difficulty. After viewing CBCT the extraction option increased significantly.

Question 7

**Teixiera (on board) - “Diversity of E. faecalis genotypes from multiple oral sites associated with endodontic failure using repetitive sequence-based PCR and arbitrarily primed PCR”

Answer 7

E. Faecalis genotypes isolated from saliva, pulp chamber, and root canal were similar using the rep-PCR and AP-PCR methods. These findings point towards coronal microleakage as a conceivable cause of endo failure.

Question 8

*India - “Comparative analysis of 2 calcium silicate-based cements (biodentine and MTA) as direct pulp capping agent in young permanent molars”

Answer 8

100% success with both MTA and biodentine at 6 and 12 month recalls in 7-9 year olds.

Question 9

***Fouad - “Association b/w systemic diseases and endo outcome”

Answer 9

HIV and oral bisphosphonate use did not appear to be related to endodontic outcomes. Results of this systematic review suggests that some systemic diseases may be associated with endodontic outcomes. Inconclusive in regards to DM and CVD.

Question 10

***Asma Khan - “A randomized clinical trial comparing 2 ibuprofen formulations in pts with acute odontogenic pain”

Answer 10

In endo pain pts a single dose of ibuprofen sodium dihydrate provides faster onset of pain relief (26.5min vs 44min to 50% pain level) and a greater reduction in both spontaneous pain (51% vs 33%) and evoked pain (15% vs 9%) compared to ibuprofen acid.

Question 11

***Hatton - “Coronal and intraradicular appearances affect radiographic perception of PA region”

Answer 11

Differing coronal and intraradicular areas of the radiograph appear to influence endodontists interpretations of PA area.

Question 12

***Von Arx - “Changes of periodontal parameters after apical surgery: Correlation of clinical and CBCT data”

Answer 12

More CAL and recession based on biotype and older pts. No difference in incision techniques. No difference in marginal bone.

Question 13

Diogenes, Ruparel - “Effect of bacterial biofilm on the osteogenic differentiation of SCAP”

Answer 13

Stem cells of apical papilla in presence of E. faecalis is significantly down-regulated in dentinogenic genes such as DSPP and upregulated osteoblastic genes like bone sialoproteine, osteocalcin, etc. Current disinfection protocols were ineffective in eliminating bacteria from root tips and the levels of the residual biofilm and its by-products were able to significantly alter osteogenic-differentiation of SCAP.

Question 14

***Italy - “Fracture strength of endodontically treated teeth with different access cavity designs”

Answer 14

Teeth with TEC access showed lower fracture resistance than teeth with CEC or NEC. Ninja access did not increase fracture strength vs CEC. Intact teeth showed more restorable fractures than prepared ones.

Question 15

***Nair - “Prevalence of middle mesial canals and isthmi in the mesial root of mandibular molars”

Answer 15

Of 122 teeth, 20 (16.4%) had true MM canals. MM canal prevalence 26% in 1st molars and 8% in second molars. Isthmi in 64.7%.

Question 16

Glickman - “Prevalence of PA rarefying osteitis in pts w/ rheumatoid arthritis”

Answer 16

Prevalence of PAR and endo tx NSSD in individuals w/ RA vs control pts.

Question 17

***Japan - “Painful trigeminal neuropathy attributed to a space-occupying lesion presenting as a toothache”

Answer 17

MRIs completed and once cranial lesions were removed their pain symptoms resolved.

Question 18

**Turkey - “Detectability of MM root canal orifices by troughing technique in mandibular molar by micro-CT”

Answer 18

77.4% of MMC were at orifice level (CEJ), 5.4% at 1mm depth, 9.7% at 2mm depth, and 7.5% not accessible even with troughing.

Question 19

***Taha - “Partial pulpotomy in mature permanent teeth with clinical signs of irreversible pulpitis”

Answer 19

85% MTA at 2 years. 43% CaOH. MTA partial pulpotomy good success at 2 years in mature symptomatic irreversible teeth.

Question 20

**Patel - “Influence of CBCT on endo re-tx strategies among GPs and endodontists”

Answer 20

Altered tx plans in about 50% of cases. EXT option increased to 20% after CBCT.

Question 21

**Siqueira - “Human exoproteome in acute apical abscesses”

Answer 21

Exoproteome explains complex host-pathogen relationship.

Question 22

***Mavridou - “Descriptive analysis of factors associated w/ ECR”

Answer 22

ECR most often in maxillary central incisors. Most cases have more than 1 factor. ECR mainly multifactorial. Most common factors: ortho tx, iatrogenic or accidental trauma, poor oral health.

Question 23

***Aggarwal - “Healing of apical periodontitis after NSRCT in pts with DM II”

Answer 23

DM may have a negative impact on outcome on endo tx in terms of PA healing. (Delayed but not compromised healing)

Question 24

**Torabinejad - “Prevalence of MB2 in maxillary first molars using CBCT, direct occlusal access, and coronal plane grinding” (opposite the 2018 article)

Answer 24

MB2 present up to 92% of the time. Direct access found more MB2s than CBCT alone. Therefore exposing all pts to CBCTs may be inappropriate. However, when not found clinically, CBCT can significantly increase chances of finding MB2.

Question 25

Nosrat - “Variations of palatal canal morphology in maxillary molars”

Answer 25

Overall prevalence of morphology variations less than 2%, but high in some ethnicities.

Question 26

***London, Saeed - “Bacterial contamination of endodontic materials before and after clinical storage”

Answer 26

All materials tested showed contamination at all points. Propionibacterium 42% and staphylococcus 32% were the most common isolated genera. These nosocomial infections could have an effect on tx success.

Question 27

***Brazil - “Determination of the influence of chronic periodontitis on pulp sensibility by means of electric and thermal cold testing”

Answer 27

Pulp clinical involvement with a negative response to cold and EPT occurs only in the most advanced stage of chronic periodontitis with apical involvement.

Question 28

***India - “Comparative evaluation of post-op pain and success rate after pulpotomy and RCT in cariously exposed mature permanent molars”

Answer 28

Recall every 3 months for 18 months and pain every 24 hours for 7 days. At end of recall 85% pulpotomy success, 87.5% RCT success. SSD in pain with lower pain in the pulpotomy group.

Question 29

Mainkar - “A systematic review of the survival of teeth intentionally replanted with a modern technique and cost-effectiveness compared with single-tooth implants”

Answer 29

Meta analysis showed survival rate of approx. 89.1%. High survival rate and more cost-effective than STI.

Question 30

***China - “Assessment of MB2 in maxillary 1st molars: CBCT study”

Answer 30

3-rooted maxillary 1st molar MB2 85.4%. Distance ratio of intercanal distances between main MB and P : DB and P larger ratio. >1.26 indicated high probability. None had MB2 when ratio was <1.16 and all had MB2 when ratio was >1.37.

Question 31

***Brazil - “Correlation between endodontic infection and periodontal disease and their association with chronic sinusitis: a clinical-tomographic study”

Answer 31

Periodontal disease and proximity to the maxillary sinus are more common in cases of CMS, requiring dental assessment and CBCT evaluation in pts with CMS and ineffective tx.

Question 32

***Columbia - “Survival of endodontically treated roots/teeth based on PA health and retention: A 10-year retrospective cohort study”

Answer 32

10 year survival rates of PA health 89% for PAs, 89% for digital PAs, 70-73% for CBCT. Survival rate for root/tooth retention 91%. Prognostic factors were the disinfection of GP, missed canals, age, treatment sessions, and density of the root filling (voids). The pts age and the presence of a post were prognostic factors for root/tooth retention.

Question 33

**Hatton - “Intraradicular appearances affect radiographic interpretation of the periapical area”

Answer 33

Significant difference noted with in all 3 test groups: voids, length, and density. Length of obturation had the most significant effect of PA interpretation with 3mm short radiographic obturation length image interpreted less favorably.

Question 34

***Mo K. Kang - “Revascularization-associated intracanal calcification: Assessment of prevalence and contributing factors”

Answer 34

RAIC is common 62.1% of all revascularization cases. CaOH (77%) had higher incidence vs antibiotic canal medicaments (46%). Induced bleeding also higher 70% vs 33%.