Effectiveness of 1-Visit and Retreatment of Teeth with Persistent/Secondary Endodontic Infection: A Randomized Clinical Trial with 18 Months of Follow-up

Author(s)

Toia, Cassia Cestari ^[1] ; Khoury, Rayana Duarte ^[1] ; Corazza, Bruna Jordao Motta ^[1] ; Orozco, Esteban Isai Flores ^[1] ; Valera, Marcia Carneiro ^[1]

Affiliation

^[1] Sao Paulo State Univ, Dept Operat Dent, Endodont Div, Inst Sci & Technol, Sao Jose Dos Campos, SP - Brazil

• Document type: Journal article
• Source: JOURNAL OF ENDODONTICS; v. 48, n. 1, p. 4-14, JAN 2022.
• Web of Science Citations: 0

Abstract

Introduction: This randomized clinical trial aimed to compare the effectiveness of endodontic retreatment of teeth with posttreatment apical periodontitis (PTAP) performed in 1 visit versus 2 visits on the reduction of cultivable bacteria (colony-forming units {[}CFUs]), lipopolysaccharides (LPSs), lipoteichoic acid (LTA), and the periapical lesion volume (mm3) after 18 months of follow-up. Methods: Forty patients diagnosed with PTAP were selected and randomly divided into the following 2 groups: 1-visit retreatment and 2-visit retreatment with the placement of calcium hydroxide medication for 14 days. Cone-beam computed tomographic scans were performed at 2 stages: preoperatively and after 18 months of followup. Samples were collected before and after root canal procedures. A chromogenic limulus amebocyte lysate assay test was used to quantify endotoxins (EU/mL). LTA levels were measured using the enzyme-linked immunosorbent assay (pg/mL). Culture techniques were used to determine cultivable bacteria by counting the CFU (CFU/mL). The volume of the periapical lesions at the onset of the trial and at the 18-month posttreatment follow-up was obtained by the ITK-SNAP program (Cognitica, Philadelphia, PA). Results: All samples showed baseline values greater than those collected after the retreatment protocol for all investigated parameters. A higher bacterial load and lower LTA level were found in the 2-visit group after the retreatment protocol (P , .05), with no statistical differences between the groups regarding endotoxin levels and periapical lesion volume (mm3) at the 18-month follow-up analyzed by cone-beam computed tomographic imaging (P . .05). Conclusions: Endodontic retreatment in 1 or 2 visits exhibited equally favorable periapical healing at 18 months, with no statistically significant differences between groups. (J Endod 2022;48:4-14.) (AU)

• FAPESP's process: 14/25789-9 - Quantification of endotoxins and its relationship with signs / symptoms and volumetric lesion periapical in primary endodontic infection
• Grantee: Marcia Carneiro Valera Garakis
• Support Opportunities: Regular Research Grants
• FAPESP's process: 18/01703-9 - Primary versus secondary endodontic infection: inflammatory and lipidic profile, microbial load, endotoxin and lipoteichoic acid levels before and during the root canal therapy and success after 18 months follow-up.
• Grantee: Marcia Carneiro Valera Garakis
• Support Opportunities: Regular Research Grants