León-López M, Cabanillas-Balsera D, Martín-González J Prevalence of root canal treatment worldwide: a systematic review and meta-analysis. Int Endod J. 2022; 55:1105-1127 https://doi.org/10.1111/iej.13822
Patel S, Brown J, Semper M European Society of Endodontology position statement: use of cone beam computed tomography in Endodontics. Int Endod J. 2019; 52:1675-1678 https://doi.org/10.1111/iej.13187
Kanagasingam S, Hussaini HM, Soo I Accuracy of single and parallax film and digital peri-apical radiographs in diagnosing apical periodontitis – a cadaver study. Int Endod J. 2017; 50:427-436 https://doi.org/10.1111/iej.12651
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Grey areas in restorative dentistry: part 7. Managing a tooth with a sub-optimal root filling Robert L Caplin Dental Update 2025 52:5, 354-357.
Authors
Robert LCaplin
BDS, MSc, DGDP (RCS Eng), Dip Teach Ed (King's), Retired Senior Teaching Fellow, Faculty of Dentistry and Oral and Craniofacial Sciences, King's College London; General Dental Practitioner, London
The restoration of a root filled tooth is a common procedure in dental practice and should only be undertaken after a thorough assessment of the existing root filling. Of the many root canal fillings that are seen, some will meet the requirements of an optimal filling, and some will be deemed sub-optimal. Some will detected following symptoms presented by the patient and some will appear on routine radiographic assessment. Some will have been present for many years and some for a relatively short period of time. The assessment and management of the sub-optimal root filling present challenges for the general dental practitioner; in understanding the limitations of radiographic appearance, in the ability to improve the existing sub-optimal filling, and in the restorative process required to bring the tooth to aesthetic and/or functional use.
CPD/Clinical Relevance:
All root fillings require thorough assessment and management.
Article
Root canal treatment is a common procedure, and based on raw data from their study, Leon-Lopez et al1 concluded that globally, 8.2% of teeth have been endodontically treated, and 55.7% of adults over the age of 18 years have at least one root-filled tooth.
Root canal treatment in the UK is predominately provided by general dental practitioners, with over 500,000 endodontic treatments completed annually in the NHS alone (pre COVID-19 2018/2019).2 It is likely, therefore, that during an average day, a practitioner will come across several teeth that have been root treated.
According to the European Society of Endodontology:
‘Endodontic treatment encompasses procedures designed to maintain the health of all or part of the dental pulp. When the dental pulp is diseased or injured, treatment is aimed at preserving normal peri radicular tissues. When apical periodontitis has occurred, treatment is aimed at restoring the peri radicular tissues to health; this is usually carried out by root canal treatment, occasionally combined with surgical endodontics.’3
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