(PO74) Minimally Invasive Endodontic Protocol: An Assessment of Treatment Outcome

Abstract: This multicenter retrospective analysis aims to compare the treatment outcomes of conventional endodontic treatment utilizing syringe needle irrigation with sonic active (CI/NI), with the more conservative minimally instrumented endodontic treatment combined with multisonic enhanced irrigation (MI/EI). The study addresses the limited research in this area and aims to optimize treatment protocols. A total of 116 out of 1152 teeth treated by two endodontists in the province of British Columbia were consented to and selected retrospectively according to the inclusion criteria. Teeth with obvious signs of periapical pathosis were treated utilizing either MI/EI or CI/NI and obturated using single cone and bioceramic sealers. Teeth were evaluated clinically and radiographically at 12 and 36 months. Statistical analyses were performed using the chi-squared test and multivariate regression analysis. At 12 months, 92.3% of MI/EI and 84% of CI/NI cases exhibited healed or healing conditions. MI/EI showed a statistically significant reduction in post-operative pain compared to CI/NI. However, at 36 months, success rates decreased to 89.1% for MI/EI and 74.4% for CI/NI. Furthermore, the apical surgery rate was 7.8% when MI/EI was used, which was statistically less compared to the CI/NI group (16.7%). Multivariate logistic regression showed that the size of the lesion preoperatively was the main determinant of the outcome, with a reverse relationship. This study highlights the importance of optimizing irrigation techniques to achieve favorable results with a minimal instrumentation protocol. Utilizing an enhanced multisonic irrigation device in conjunction with the minimally instrumented endodontic protocol yielded more successful treatment outcomes and reduced post-operative pain.