DOI

https://doi.org/10.25772/CD42-4W39

Defense Date

2024

Document Type

Thesis

Degree Name

Master of Science in Dentistry

Department

Dentistry

First Advisor

Garry Myers

Second Advisor

Caroline Carrico

Third Advisor

Alexandra Howell

Abstract

Objective: To determine associations of pulpally necrotic teeth with demographics, clinical findings, radiographic presentation, and periapical status.

Methods: Virginia Commonwealth University uses AxiUm software to record dental treatment and treatment notes. The current study involves a keyword search using the term “pulpal necrosis”. Factors compiled and evaluated included but not limited to patient demographics, location in the dental arch, clinical findings, radiographic presentation, and periapical status.

Results: Data has revealed that teeth with pulpal necrosis can present with a variety of different clinical findings. All of the following were observations of teeth with pulpal necrosis. A total of 325 teeth were included in the study. Of those, 39% were mandibular posterior teeth and 37% were maxillary posterior. The average age of the patient was 47 (SD=21.2) and ranged from 11-89. There were slightly more females than males (61% vs 39%). The majority of the patients were ASA Class I (44%) or Class II (53%). The majority of the cases had a diagnosis of symptomatic apical periodontitis (SAP, 52%). 14% of teeth presented with a sinus tract. A radiolucency was present for 76% of the cases and 57% had preoperative symptoms. Upon clinical access, 93% of the teeth had necrotic pulps. A crack was present for 8% of the cases and caries were present for 33%. A direct restoration was present for half of the cases (50%), indirect for 22%, and no restoration for the remaining 29%. Nine percent of the cases were traumatic in nature.

Conclusion: Pulpal necrosis is a common diagnosis in endodontics, yet it can exhibit many differing clinical presentations. Furthering our knowledge about how pulpally necrotic teeth can present, will aid us in the often subjective field of diagnostic sciences with objective data from the graduate endodontics department patient pool. This project was funded in part by the Foundation of Endodontics.

Rights

© William Banks Lee

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

5-3-2024

Available for download on Saturday, May 03, 2025

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