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Methods of Diagnosis and Treatment in Endodontics

SBU Assessment

presents a comprehensive, systematic assessment of available scientific evidence. The certainty of the evidence for each finding is systematically reviewed and graded. Full assessments include economic, social, and ethical impact analyses.

SBU assessments are performed by a team of leading professional practitioners and academics, patient/user representatives and SBU staff. Prior to approval and publication, assessments are reviewed by independent experts, SBU’s Scientific Advisory Committees and Board of Directors.

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Tables of included studies

  • Because of the lack of studies it is not possible to determine which diagnostic methods can disclose whether a vital but injured pulp can be maintained or whether it should be removed and replaced with a root filling. The available research provides limited direction as to what distinguishes a treatable from a non-treatable pulpal inflammation (pulpitis).
  • The effects of different methods used for instrumentation, disinfection and root filling associated with root canal therapy are insufficiently investigated.
  • An investigation of common practice among Swedish dentists shows that great variations exist in treatment strategies and choice of materials. This applies, for example, to the management of the exposed pulp or when a root filling is retreated. An exception is the use of engine driven instrumentation, which to a varying degree are used by almost two-thirds of the dentists.
  • There is a need for prospective studies of root canal therapy, which show how teeth can be preserved in the long-term, without risk of recurrence of symptoms, periradicular inflammation or tooth fracture. The lack of good research in this field clearly indicates that priority should be given to well-planned and carefully conducted clinical studies of methods for diagnosis and treatment of the disease conditions of the pulp.
  • There is a need for a national registry with quality indicators to be applied for follow-up evaluations of pulpal and root canal treatments.

How to cite this report: SBU. Methods of diagnosis and treatment in endodontics. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2010. SBU report no 203 (in Swedish).

Published: 8/13/2010 Report no: 203

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Mejare IA, Bergenholtz G, Petersson K, Tranaeus S. Estimates of sensitivity and specificity of electric pulp testing depend on pulp disease spectrum: a modelling study. Int Endod J 2015;48:74-8.
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Frisk F, Kvist T, Axelsson S, Bergenholtz G, Davidson T, Mejare I, et al. Pulp exposures in adults--choice of treatment among Swedish dentists. Swed Dent J 2013;37:153-60.
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Bergenholtz G, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T, et al. Treatment of pulps in teeth affected by deep caries - A systematic review of the literature. Singapore Dent J 2013;34:1-12.
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Mejare IA, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T, et al. Diagnosis of the condition of the dental pulp: a systematic review. Int Endod J 2012;45:597-613.
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Petersson A, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T, et al. Radiological diagnosis of periapical bone tissue lesions in endodontics: a systematic review. Int Endod J 2012;45:783-801.
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