Determining the optimal obturation length: a meta-analysis of literature.

The purpose was to aid in determining termination of instrumentation and obturation. A meta-analysis was conducted as to success/failure of different obturation lengths. Inclusion criteria were (a) minimum follow-up of 2 yr, (b) data on obturation length, (c) definition of success/failure, (d) available data on success/failure, (e) radiographic evaluation. Correlations were made as to success/failure as related to length of obturation from the apex. When comparing group A (obturated 0-1 mm from apex) versus group C (obturated past apex) using the DerSimonian and Laird estimates, group A showed a marginally better (p < 0.10) success rate than group C by 28.8%. Group A had better success than group B (obturated >1 mm short); the difference was insignificant. The results were similar after controlling for study quality using a single random effects regression model. In conclusion, the meta-analysis indicated that a better success rate is achieved when treatment includes obturation short of the apex.

[1]  S. Seltzer,et al.  Biologic Aspects of Endodontics Part III. Periapical Tissue Reactions to Root Canal Instrumentation , 2004 .

[2]  S. Cohn.  Endodontic Therapy 6th Edition:By Franklin S. Weine , 2004 .

[3]  S. Seltzer,et al.  Biologic aspects of endodontics part III. periapical tissue reactions to root canal instrumentation. 1968. , 1968, Journal of endodontics.

[4]  K. Inamoto,et al.  Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis. , 2004, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[5]  R E Walton,et al.  Apical terminus location of root canal treatment procedures. , 2000, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[6]  K Langeland,et al.  Apical limit of root canal instrumentation and obturation, part 2. A histological study. , 2002, International endodontic journal.

[7]  D. Ricucci.  Apical limit of root canal instrumentation and obturation, part 1. Literature review. , 2002, International endodontic journal.

[8]  George Davey Smith,et al.  Meta-analysis: Principles and procedures , 1997, BMJ.

[9]  G. Sundqvist,et al.  Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. , 1997, International endodontic journal.

[10]  C S Berkey,et al.  A random-effects regression model for meta-analysis. , 1995, Statistics in medicine.

[11]  D J Setchell,et al.  Factors influencing the success of conventional root canal therapy--a five-year retrospective study. , 1993, International endodontic journal.

[12]  T. J. Stein,et al.  Radiographic "working length" revisited. , 1992, Oral surgery, oral medicine, and oral pathology.

[13]  E. Burdick,et al.  Quality assessment and meta-analysis of systemic tetracycline use in chronic adult periodontitis. , 1992, Journal of clinical periodontology.

[14]  A. Wennberg,et al.  Follow-up study of endodontic status in an adult Swedish population. , 1991, Endodontics & dental traumatology.

[15]  G Sundqvist,et al.  Factors affecting the long-term results of endodontic treatment. , 1990, Journal of endodontics.

[16]  Richard E. Walton,et al.  Principles and Practice of Endodontics , 1989 .

[17]  Y. Kawai,et al.  Factors affecting successful prognosis of root canal treatment. , 1987, Journal of endodontics.

[18]  R P Happonen,et al.  Healing of periapical lesions of pulpless teeth after endodontic treatment with controlled asepsis. , 1987, Endodontics & dental traumatology.

[19]  A. Halse,et al.  Overextended gutta-percha and Kloroperka N-O root canal fillings. Radiographic findings after 10-17 years. , 1987, Acta odontologica Scandinavica.

[20]  N. Laird,et al.  Meta-analysis in clinical trials. , 1986, Controlled clinical trials.

[21]  M Lucotte,et al.  [Endodontic therapy]. , 1985, Le Chirurgien-dentiste de France.

[22]  A E Skidmore,et al.  Twenty years of endodontic success and failure. , 1983, Journal of endodontics.

[23]  K. Kerekes,et al.  Long-term results of endodontic treatment performed with a standardized technique. , 1979, Journal of endodontics.

[24]  K. Kerekes.  Radiographic assessment of an endodontic treatment method. , 1978, Journal of endodontics.

[25]  Stephen Cohen,et al.  Pathways of the Pulp , 1976 .

[26]  F. Harty,et al.  Success rate in root canal therapy. A retrospective study of conventional cases , 1970, British Dental Journal.

[27]  S. Seltzer,et al.  Biologic aspects of endodontics. IV. Periapical tissue reactions to root-filled teeth whose canals had been instrumented short of their apices. , 1969, Oral surgery, oral medicine, and oral pathology.

[28]  H Schilder,et al.  Filling root canals in three dimensions. , 1967, Dental clinics of North America.

[29]  S. Seltzer,et al.  Endodontic success—A reappraisal of criteria , 1966 .

[30]  S. Seltzer,et al.  Endodontic success--a reappraisal of criteria. II. , 1966, Oral surgery, oral medicine, and oral pathology.

[31]  D GREEN,et al.  Stereomicroscopic study of 700 root apices of maxillary and mandibular posterior teeth. , 1960, Oral surgery, oral medicine, and oral pathology.

[32]  D GREEN,et al.  A stereomicroscopic study of the root apices of 400 maxillary and mandibular anterior teeth. , 1956, Oral surgery, oral medicine, and oral pathology.

[33]  L. Strindberg.  The dependence of the results of pulp therapy on certain factors. An analytic study baced on radiographic and clinical followup examination , 1956 .

[34]  Y. Kuttler,et al.  Microscopic investigation of root apexes. , 1955, Journal of the American Dental Association.

[35]  E. D. Coolidge.  Anatomy of the Root Apex in Relation to Treatment Problems , 1929 .