Instruction for pulp therapy done purposefully in patients with severe bone loss around the tooth.

Not yet recruiting

Brief Summary: Iatrogenic pulpitis can occur following the periodontal treatment of tooth with severe periodontal bone loss involving the apex. This might lead to anxiety and apprehension in the minds of patients and may force the patient to feel that periodontal treatment has led to the endodontic problem. To allay the anxiety of future endodontic problem, there is a need for periodontist to suggest for intentional root canal therapy in patients with severe periodontal bone loss extending upto the apex of the root.

This study is aimed to provide guidlines for suggesting intentional root canal therapy in patients with severe periodontal bone loss.

A total of 105 chronic generalised periodontitis patients were assessed. With the help of radiovisography(RVG) ,the distance between the root apex and the residual bone was measured and pulp vitality test was carried out on respective tooth with the bone loss. All patients underwent periodontal treatment according to the treatment needs.Patients who did not undergo intentional root canal therapy was evaluated 6 weeks later after periodontal treatment to assess the development of secondary endodontic signs and symptoms.

The mean distance between the root apex and the base of the residual bone of the tooth with severe periodontal bone loss was -2.007Â±0.495mm in patients who underwent root canal therapy and -1.311Â±1.574mm in patients who did not undergo root canal therapy.

Recruitment & Eligibility

Inclusion Criteria

Moderate to advanced chronic periodontitis patients, of clinical attachment level(CAL)>3mm in 30% or more sites.
Well-aligned mandibular molars with the radiographic evidence of bone loss extending beyond the root apex, no spacing, no crowding, no rotation and no intrusion and no extrusion were included.
3.Patients between the age group of 25-70 years.
4.Patients who were willing to consent for the study.

Exclusion Criteria

â€¢Systemic diseases that can alter the course of periodontal disease.
â€¢Subjects on any medication taken within last 6 months which may alter the periodontal status.
â€¢Pregnant women.
â€¢Molars with fused roots, caries and proximity to maxillary sinus â€¢Subjects with limited mouth opening â€¢Patients with intra oral conditions present that interfere with radiographic evaluation such as orthodontic wire, extensive restorative work, shallow palatal vault.
â€¢Single rooted teeth with extensive bone loss and poor prognosis.

Primary Outcome Measures

Name	Time	Method
The amount of bone loss beyond the root apex and the amount of residual bone in tooth with severe periodontal bone loss, irrespective of root canal treatment.	Patients who did not undergo intentional root canal therapy was assessed at 6 weeks postperiodontal therapy for any developed secondary endodontic signs and symptoms.

Secondary Outcome Measures

Name	Time	Method
The amount of bone loss beyond the root apex and the amount of residual bone in tooth with severe periodontal bone loss, irrespective of root canal treatment.	Patients who did not undergo intentional root canal therapy was assessed at 6 weeks postperiodontal therapy for any developed secondary endodontic signs and symptoms.

Locations (1): Rajarajeshwari dental college and hospital
🇮🇳
Bangalore, KARNATAKA, India
Rajarajeshwari dental college and hospital
🇮🇳Bangalore, KARNATAKA, India
DR Shivaprasad BM
Principal investigator
9901759011
drspbmath@gmail.com