Abstract
Introduction
Limited prospective data are available on the long-term prognosis of teeth receiving
nonsurgical root canal treatment (NSRCT) in patients with systemic diseases including
diabetes mellitus (DM), hypertension (HT), and coronary artery disease (CAD). This
prospective study aimed to elucidate the impact of systemic diseases on the risk of
tooth extraction after NSRCT.
Methods
A total of 49,334 NSRCT teeth were randomly selected from databank in October 2003
and were followed for 2 years for tooth extraction after NSRCT. Cox proportional hazards
model was used to estimate the risk of tooth extraction after NSRCT.
Results
Of the 49,334 teeth, 1592 (3.2%) were extracted during the 2-year follow-up period,
yielding a 2-year tooth retention rate of 96.8%. We found that DM (hazard ratio [HR],
1.79), HT (HR, 1.75), and CAD (HR, 1.70) were significant risk factors for tooth extraction
after NSRCT (all P values <.0001) in univariate Cox proportional analyses. After adjustment for age,
gender, and tooth type in multivariate analyses, DM (HR, 1.29) and HT (HR, 1.18) remained
as independent risk factors (both P values <.05). Simultaneous possession of 2 diseases of DM, HT, and CAD was a significant
and robust predictor for an increased long-term risk of tooth extraction after NSRCT
(P for trend <.001).
Conclusions
An increased risk of tooth extraction after NSRCT is significantly associated with
DM, HT, and CAD individually. Moreover, the constellation of systemic disease burden
also manifests the importance in addition to other potential confounders.
Key Words
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Article info
Publication history
Published online: October 21, 2010
Identification
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© 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
