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Establishing Apical Patency and its Effect on Endodontic Outcomes

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Technical Report

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Uniformed Services University Of The Health Sciences Bethesda United States

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Introduction Apical patency is open communication between the root canal space and periodontal ligament. Establishing apical patency is controversial with only 50 of dental programs in the United States teaching the concept. Both sides can cite articles favoring their position. However, the clinical impact of establishing patency on endodontic treatment outcome has not been well documented in the dental literature. The purpose of this study was to compare treatment outcome to establishment of apical patency with a minimum of 1 year follow-up exam. Methods Data were collected from 2 formalized databases containing patient diagnostic and treatment information maintained in the Naval Postgraduate Dental School Endodontics Department. Outcomes were based on clinical examination and radiographic analysis using periapical index PAI scores. The primary outcome was based on clinical examination and the follow up radiograph alone. A secondary outcome was based upon the clinical examination and a composite PAI of the immediate post-operative and follow up radiographs. All data was analyzed using Pearsons Chi-Square 0.05. Cohens Kappa was used to evaluate interexaminer agreement. Results Eighty seven teeth met study inclusion criteria of which 78.1were patent. In the 68 teeth with patency, 68 were healed while in the 19 non-patent teeth, 63 were healed. No significant difference was noted with respect to achieving apical patencyp0.785. Conclusion There was no significance difference in endodontic outcome relative to establishment of apical patency.

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