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Treatment Outcome in Endodontics: The Toronto Study. Phase 1: Initial Treatment

  • Shimon Friedman
    Correspondence
    Address requests for reprints to Dr. Shimon Friedman, Professor and Head, Endodontics, Faculty of Dentistry University of Toronto, 124 Edward Street, Toronto, Ontario M5G 1G6, Canada
    Affiliations
    Drs. Friedman and Abitbol are affiliated with the Discipline of Endodontics, and Dr. Lawrence is affiliated with the with the Discipline of Community Dentistry, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
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  • Sarah Abitbol
    Affiliations
    Drs. Friedman and Abitbol are affiliated with the Discipline of Endodontics, and Dr. Lawrence is affiliated with the with the Discipline of Community Dentistry, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
    Search for articles by this author
  • Herenia P. Lawrence
    Affiliations
    Drs. Friedman and Abitbol are affiliated with the Discipline of Endodontics, and Dr. Lawrence is affiliated with the with the Discipline of Community Dentistry, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
    Search for articles by this author
      This study assessed the 4- to 6-yr outcome of initial endodontic treatment during Phase 1 of the “Toronto Study” project. A total of 450 teeth were treated, alternating the “Schilder” technique and step-back with lateral condensation, and examined clinically and radiographically by an independent examiner. Apical periodontitis was recorded as absent (periapical index < 3) or present (periapical index ≥ 3) and outcome dichotomized as “healed” (no apical periodontitis, no signs or symptoms) or “disease.” Univariate, bivariate, and multivariate analyses were performed (p = 0.05) on 120 examined teeth. The “healed” rate (81% overall) was significantly higher for teeth treated without apical periodontitis (92%) than with apical periodontitis (74%). Several other factors were associated with healing rate differential of 10% or higher, but no statistical significance. This study confirmed apical periodontitis as the main prognostic factor in initial endodontic treatment. Continuation of the project will allow assessment of other prognostic factors with better power.
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      References

        • Friedman S
        Prognosis of initial endodontic therapy.
        Endod Topics. 2002; 2: 59-88
        • Anderson JD
        Need for evidence-based practice in prosthodontics.
        J Pros Dent. 2000; 83: 58-65
        • Sackett D
        • Richardson W
        • Rosenberg W
        • Haynes R
        Evidence-based medicine: how to practice and teach EBM. Churchill Livingstone, London1997
        • Fletcher RH
        • Fletcher SW
        • Wagner EH
        Clinical epidemiology: the essentials. 3rd edition. Williams & Wilkins, Baltimore1996
        • Bader JD
        • Shugars DA
        Variation, treatment outcomes and practice guidelines in dental practice.
        J Dent Ed. 1995; 59: 61-95
        • Strindberg LZ
        The dependence of the results of pulp therapy on certain factors. An analytic study based on radiographic and clinical follow-up examination.
        Acta Odont Scand. 1956; 14: 21
        • Engström B
        • Hard AF
        • Segerstad L
        • Ramstrom G
        • Frostell G
        Correlation of positive cultures with the prognosis for root canal treatment.
        Odont Revy. 1964; 15: 257-270
        • Kerekes K
        • Tronstad L
        Long-term results of endodontic treatment performed with a standardized technique.
        J Endodon. 1979; 5: 83-90
        • Byström A
        • Happonen RP
        • Sjögren U
        • Sundqvist G
        Healing of periapical lesions of pulpless teeth after endodontic treatment with controlled asepsis.
        Endod Dent Traumatol. 1987; 3: 58-63
        • Ørstavik D
        • Kerekes K
        • Eriksen HM
        Clinical performance of three endodontic sealers.
        Endod Dent Traumatol. 1987; 3: 178-186
        • Sjögren U
        • Hägglund B
        • Sundqvist G
        • Wing K
        Factors affecting the long-term results of endodontic treatment.
        J Endodon. 1990; 16: 498-504
        • Ørstavik D
        Time-course and risk analyses of the development and healing of chronic apical periodontitis in man.
        Int Endod J. 1996; 29: 150-155
        • Sjögren U
        • Figdor D
        • Persson S
        • Sundqvist G
        Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis.
        Int Endod J. 1997; 30: 297-306
        • Trope M
        • Delano O
        • Ørstavik D
        Endodontic treatment of teeth with apical periodontitis: single vs. multivisit treatment.
        J Endodon. 1999; 25: 345-350
        • Weiger R
        • Rosendahl R
        • Löst C
        Influence of calcium hydroxide intracanal dressings on the prognosis of teeth with endodontically induced periapical lesions.
        Int Endod J. 2000; 33: 219-226
        • Peters LB
        • Wesselink PR
        Periapical healing of endodontically treated teeth in one and two visits obturated in the presence or absence of detectable microorganisms.
        Int Endod J. 2002; 35: 660-667
        • Ørstavik D
        • Kerekes K
        • Eriksen HM
        The periapical index: a scoring system for radiographic assessment of apical periodontitis.
        Endod Dent Traumatol. 1986; 2: 20-34
        • Landis JR
        • Koch GG
        The measurement of observer agreement for categorical data.
        Biometrics. 1977; 33: 159-174
        • Sundqvist G
        Taxonomy, ecology, and pathogenicity of the root canal flora.
        Oral Surg. 1994; 78: 522-530