Root canal retreatment: a retrospective investigation using regression and data mining methods for the prediction of technical quality and periapical healing

Abstract Objectives This study aimed to investigate patterns and risk factors related to the feasibility of achieving technical quality and periapical healing in root canal non-surgical retreatment, using regression and data mining methods. Methodology This retrospective observational study included 321 consecutive patients presenting for root canal retreatment. Patients were treated by graduate students, following standard protocols. Data on medical history, diagnosis, treatment, and follow-up visits variables were collected from physical records and periapical radiographs and transferred to an electronic chart database. Basic statistics were tabulated, and univariate and multivariate analytical methods were used to identify risk factors for technical quality and periapical healing. Decision trees were generated to predict technical quality and periapical healing patterns using the J48 algorithm in the Weka software. Results Technical outcome was satisfactory in 65.20%, and we observed periapical healing in 80.50% of the cases. Several factors were related to technical quality, including severity of root curvature and altered root canal morphology (p<0.05). Follow-up periods had a mean of 4.05 years. Periapical lesion area, tooth type, and apical resorption proved to be significantly associated with retreatment failure (p<0.05). Data mining analysis suggested that apical root resorption might prevent satisfactory technical outcomes even in teeth with straight root canals. Also, large periapical lesions and poor root filling quality in primary endodontic treatment might be related to healing failure. Conclusion Frequent patterns and factors affecting technical outcomes of endodontic retreatment included root canal morphological features and its alterations resulting from primary endodontic treatment. Healing outcomes were mainly associated with the extent of apical periodontitis pathological damages in dental and periapical tissues. To determine treatment predictability, we suggest patterns including clinical and radiographic features of apical periodontitis and technical quality of primary endodontic treatment.

Development of an oral health database for the management of clinical records / Desenvolvimento de um banco de dados de saúde bucal para administração de registros clínicos

Purpose: The aim of this article was to present the conceptual model and development of an oral health database for storage, organization, and recovery of data from dental clinical records of a university dental school. Method: This is a joint project of the Graduate Programs in Dentistry and in Computational Science of the Pontifical Catholic University of Rio Grande do Sul (PUCRS). During a period of three months in 2008, semi-structured interviews were conducted with the dental faculty of five clinical areas of the PUCRS Dental School (FO-PUCRS). Collected data were used to build the database language and architecture. Results: Conceptual, logical, and physical database models were developed, as well as the generation of a script in SQL (Structured Query Language). After generating the script, the tool Oracle SQL Developer (Oracle Corporation, Redwood Shores, CA, USA) was used to import and create the FO-PUCRS OHDB (Oral Health Database) implemented in the Oracle 10g, a relational database management system (RDBMS). Conclusion: The FO-PUCRS OHDB represents an important advancement towards automating the institutional operational demands and will contribute to organize the clinical and social information of the patient population for administrative, educational, and research purposes.

Objetivo: Este artigo teve como objetivo documentar o trabalho realizado em conjunto pelos Programas de Pós-Graduação em Odontologia (PPGO), e Ciência da Computação (PPGCC) da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), visando à construção de um ambiente de armazenamento, organização e recuperação de dados provenientes de prontuários odontológicos. Método: Durante 3 meses em 2008 foram realizadas entrevistas semi-estruturadas com docentes de cinco áreas de atendimento odontológico da Faculdade de Odontologia (FO-PUCRS) para análise e coleta de requisitos. Resultados: Com base nas informações obtidas neste processo, foram desenvolvidas as modelagens conceitual, lógica e física do banco de dados, bem como a geração de um script em SQL (Structured Query Language). Após a geração do script, foi utilizada a ferramenta Oracle SQL Developer (Oracle Corporation, Redwood Shores, CA, USA) para sua importação e criação do BDSB (Banco de Dados em Saúde Bucal) implementado no SGBD (Sistema Gerenciador de Banco de Dados) relacional Oracle 10g. Conclusão: A construção do BDSB junto ao PPGO-PUCRS representa um importante avanço em direção a automatização das demandas operacionais da organização, mas principalmente a exploração de uma fonte valiosa de conhecimento, rica em informações clínicas e sociais.