Kliniske retningslinjer for behandling af apikal parodontitis

Abstract

Introduction: The European Society of Endodontology (ESE) has updated it’s clinical guidelines for the diagnosis and management of apical periodontitis. These updates reflect advances made in clinical endodontics and in the methodology used for development of guidelines. The aim of this article is to present the new recommendations for the management of apical periodontitis, with the ultimate goal of reducing the risk of tooth loss. Materials and methods: The S3-level guidelines were developed through a comprehensive, systematic and evidence-based process involving experts and external stakeholders, and are based on 14 systematic reviews. Evidence- and expert-based recommendations were formulated through a structured consensus process. These guidelines include clinical recommendations focusing on instrumentation, irrigation, inter-appointment dressings, root filling materials and adjunctive therapies. Results: For restorable teeth, root canal treatment using aseptic technique and rubber dam isolation is recommended. Instrumentation should be performed with rotary NiTi file systems, and irrigation with sodium hypochlorite (NaOCl; 1–5.25 %) followed by EDTA (ethylenediaminetetraacetic acid) and a final rinse with NaOCl. The root canal system should then be sealed with gutta-percha in combination with one of the sealers using a technique of choice. Long-term follow-up is advised to ensure healing. A thorough history and case-specific assessment is essential prior to treatment planning. Conclusion: The S3-level guidelines in endodontics provide clear, evidence-based recommendations for dental practitioners, healthcare providers and stakeholders, supporting effective management of apical periodontitis and the long-term preservation of teeth. Keywords: apical periodontitis, practice guideline, root canal therapy, tooth survival