Dental School

Endodontics

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Staff Research Publications 


The overall goals of the Endodontics Research Program are to (a) improve clinicians’ ability to understand and apply diagnostic tests, (b) improve the outcomes of root canal treatment, (c) improve the patient experience via better and predictable pain control during treatment, (d) improve case selection processes through a better understanding of the biomechanics of teeth affected by disease, (e) provide evidence for the many technical aspects of root canal treatment that have not been investigated previously, and (f) improve the outcomes for teeth that have suffered trauma.

Endodontics

Program leader: Winthrop Professor Paul Abbott AO

Program members: Dr Jacky Castro Salgado, Dr Christine Yu

HDR Postgraduate students: Dr Naseem Alampath (MPhil)
DClinDent students: Dr Mehdi Habibi, Dr Michael Khoury 
DMD students: 
Janni Newby, Julia Lai-Tong, Kelly Goh, Lahiru Chandraweera, Caitlin Foote, Elissa Biniecki, Grace Gilbert, Ching Wen Tan, Parnian Zareie, Joycelyn Ho

Collaborators: Prof. Masoud Parirokh (Kerman University, Iran), Prof. Laurie Walsh (Uni Qld), Dr Basil Athanassiadis (Uni Qld), Dr David Semeniuk (Uni North Carolina, USA), Dr Dilek Helvacioglu-Yigit (Turkey), Dr Domenico Ricucci (Italy), Dr Fariborz Moazami (Shiraz Uni, Iran), Dr Hamid Jafarzadeh (Mashad Uni, Iran), Prof. Tim Sercombe (Engineering, UWA), Prof. Yinong Liu (Engineering, UWA), W/Prof. Mark Bush (Engineering, UWA), Assoc. Prof. Pattama Chailertvanitkul (Khon Kaen Uni, Thailand), Prof. Wenmei Wang (Nanjing Uni, China), Dr Mithran Goonewardene (Dentistry, UWA), Dr Julio Rincon (Dentistry, UWA).

Industry Partners: Nil

Research Program Objectives

The Endodontics Research Program has 6 main objectives:

  • Investigate the use of diagnostic tests by dentists and to determine their usefulness for different disease presentations.
  • Investigate and improve the outcomes of root canal treatment by testing various approaches to treatment.
  • Test various local anaesthetic solutions and techniques, plus various drug regimens to improve the patient experience via better and predictable pain control during treatment.
  • Investigate the biomechanics of teeth with particular emphasis on their strength and avoiding fractures, in order to improve case selection processes for teeth with pulp or root canal conditions.
  • Investigate various technical aspects of root canal treatment that have not been investigated previously.
  • Investigate various treatment approaches for the management of traumatised teeth in order to improve their outcomes, and in particular with respect to preventing external inflammatory resorption. 

Research Program Summary

The Endodontics Research Program has been active since 1986 with various research projects and interests. Interests have evolved over time with most projects leading to new ideas and identification of the need for more research in a related aspect. Initial work focused on the use and benefits of medicaments during root canal treatment. This then lead to work on irrigating solutions and other methods for eliminating bacteria from the root canal system.

Pain management has been a major focus over the years with projects investigating the reasons for continuing pain following treatment, management of intra-operative pain and post-operative pain control. The use of different local anaesthetic solutions and techniques has been a more recent focus with the particular emphasis on controlling pain whilst managing acute irreversible pulpitis cases.

The early work on continuing pain identified many factors associated with root canal treatment that were not being ideally managed by dentists or endodontists. This led to various clinical research projects to improve treatment outcomes and the predictability of treatment.

Diagnosis is the key to all aspects of dentistry with Endodontics being no exception. The dental pulp is the tissue that is by far the most commonly associated with patients presenting to dentists with pain – not all cases will require root canal treatment as some may require simple restorations (e.g. when reversible pulpitis) or extraction. Hence, it is essential that the dental profession improves the diagnostic aspects of their work in order to ensure appropriate and effective pain management for patients. The Endodontic group has investigated various aspects of diagnosis and in particular, pulp testing.

Mechanical testing of teeth has been undertaken to determine the true effects of root canal treatment on tooth structure. This work has been done in collaboration with colleagues from the Engineering Faculty of UWA and has been designed to disprove many of the concepts and misperceptions that exist within the profession. The group has also investigated cracks and their propagation through teeth with Engineering colleagues. This work has included clinical studies, simulated clinical studies laboratory studies. It has led to more reliable diagnosis of cracks in teeth, knowledge of how to manage cracks and their effects on the tooth structure and how long-term prognosis and restorative dental needs can be better assessed.  

Current Research Projects 

  • A retrospective study of avulsed teeth
  • A survey of factors associated with fractured roots and teeth restored with post/crowns.
  • A review of potential aetiological factors associated with external invasive resorption
  • A review of the clinical management of external invasive resorption.
  • Dentine diffusion of hydroxyl ions when Ledermix paste is combined with a calcium hydroxide paste as a 50:50 mixture.
  • Interim restorations used during endodontic treatment.
  • A concurrent bacterial and dye penetration model.
  • The use of stainless steel bands and their effects on bacterial penetration into teeth.
  • The effects of simulated mastication on teeth following root canal treatment and restoration.
  • Radiation protection in the dental setting.
  • Retrospective review of the outcome of conservative endodontic re-treatment.
  • A retrospective review of the reasons for undertaking endodontic surgery in a private specialist endodontic practice.
  • Incidence of the different types of periapical pathosis associated with endodontic surgical cases - a histological analysis.
  • Outcome of endodontic surgery - a clinical review.
  • Clinical management of inflammatory root resorption.
  • Influence of access cavity design, canal preparation taper, irrigation and intracanal  medicaments on fracture susceptibility of endodontically treated teeth
  • Use of pulp tests in private general dental practice
  • Audit of general dentists use of diagnostic equipment and methods
  • The frequency of pulp disease following restorative dental treatment