Outcomes of Primary Endodontic Therapy Provided by Endodontic Specialists Compared with Other Providers

Published:March 19, 2016DOI:



      The objective of this study was to compare the outcomes of initial nonsurgical root canal therapy for different tooth types provided by both endodontists and other providers.


      By using an insurance company database, 487,476 initial nonsurgical root canal therapy procedures were followed from the time of treatment to the presence of an untoward event indicated by Current Dental Terminology codes for retreatment, apical surgery, or extraction. Population demographics were computed for provider type and tooth location. Kaplan-Meier survival estimates were calculated for 1, 5, and 10 years. Hazard ratios for provider type and tooth location were calculated by using the Cox proportional hazards model.


      The survival of all teeth collectively was 98% at 1 year, 92% at 5 years, and 86% at 10 years. Significant differences in survival on the basis of provider type were noted for molars at 5 years and for all tooth types at 10 years. The greatest difference discovered was 5% higher survival rate at 10 years for molars treated by endodontists. A hazard ratio of 1.394 was found when comparing other providers' success with that of endodontists within this 10-year molar group.


      These findings show that survival rates of endodontically treated teeth are high at 10 years after treatment regardless of provider type. Molars treated by endodontists after 10 years have significantly higher survival rates than molars treated by non-endodontists.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Endodontics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • American Dental Association Survey Center
        2005-2006 Survey of Dental Services Rendered.
        American Dental Association, Chicago, IL2007
        • Pak J.G.
        • Fayazi S.
        • White S.N.
        Prevalence of periapical radiolucency and root canal treatment: a systematic review of cross-sectional studies.
        J Endod. 2012; 38: 1170-1176
        • Friedman S.
        Prognosis of initial endodontic therapy.
        Endodontic Topics. 2002; 2: 59-88
        • de Chevigny C.
        • Dao T.T.
        • Basrani B.R.
        • et al.
        Treatment outcome in endodontics: the Toronto study: phase 4—initial treatment.
        J Endod. 2008; 34: 258-263
        • Salehrabi R.
        • Rotstein I.
        Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study.
        J Endod. 2004; 30: 846-850
        • Chen S.C.
        • Chueh L.H.
        • Hsiao C.K.
        • et al.
        An epidemiologic study of tooth retention after nonsurgical endodontic treatment in a large population in Taiwan.
        J Endod. 2007; 33: 226-229
        • Lazarski M.P.
        • Walker 3rd, W.A.
        • Flores C.M.
        • et al.
        Epidemiological evaluation of the outcomes of nonsurgical root canal treatment in a large cohort of insured dental patients.
        J Endod. 2001; 27: 791-796
        • Strindberg L.
        The dependence of the results of pulp therapy on certain factors: an analytic study based on radiographic and clinical follow-up examinations.
        Acta Odontol Scand. 1956; 14: 1-175
        • Sjogren U.
        • Hagglund B.
        • Sundqvist G.
        • Wing K.
        Factors affecting the long-term results of endodontic treatment.
        J Endod. 1990; 16: 498-504
        • Cheung G.S.
        Survival of first-time nonsurgical root canal treatment performed in a dental teaching hospital.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 93: 596-604
        • Friedman S.
        • Mor C.
        The success of endodontic therapy: healing and functionality.
        J Calif Dent Assoc. 2004; 32: 493-503
        • Chen S.C.
        • Chueh L.H.
        • Hsiao C.K.
        • et al.
        First untoward events and reasons for tooth extraction after nonsurgical endodontic treatment in Taiwan.
        J Endod. 2008; 34: 671-674
        • Torabinejad M.
        • Anderson P.
        • Bader J.
        • et al.
        Outcomes of root canal treatment and restoration, implant-supported single crowns, fixed partial dentures, and extraction without replacement: a systematic review.
        J Prosthet Dent. 2007; 98: 285-311
        • Vire D.
        Failure of endodontically treated teeth: classification and evaluation.
        J Endod. 1991; 17: 338-342
        • Reeh E.
        • Messer H.
        • William D.
        Reduction in tooth stiffness as a result of endodontic and restorative procedures.
        J Endod. 1989; 15: 512-516
        • Ricucci D.
        • Siqueira Jr., J.F.
        Biofilms and apical periodontitis: study of prevalence and association with clinical and histopathologic findings.
        J Endod. 2010; 36: 1277-1288
        • Aquilino S.
        • Caplan D.
        Relationship between crown placement and the survival of endodontically treated teeth.
        J Prosthet Dent. 2002; 87: 256-263
        • Lin P.Y.
        • Huang S.H.
        • Chang H.J.
        • Chi L.Y.
        The effect of rubber dam usage on the survival rate of teeth receiving initial root canal treatment: a nationwide population-based study.
        J Endod. 2014; 40: 1733-1737
        • Goldfein J.
        • Speirs C.
        • Finkelman M.
        • Amato R.
        Rubber dam use during post placement influences the success of root canal-treated teeth.
        J Endod. 2013; 39: 1481-1484
        • Witherspoon D.
        • Small J.
        • Regan J.
        Missed canal systems are the most likely basis for endodontic retreatment of molars.
        Tex Dent J. 2013; 130: 127-139
        • Borén D.
        • Jonasson P.
        • Kvist T.
        Long-term survival of endodontically treated teeth at a public dental specialist clinic.
        J Endod. 2015; 41: 176-181
        • Kvist T.
        Endodontic retreatment: aspects of decision making and clinical outcome.
        Swed Dent J. 2001; : 1-57
        • Alley B.S.
        • Gray Kitchens G.
        • Alley L.W.
        • Eleazer P.D.
        A comparison of survival of teeth following endodontic treatment performed by general dentists or by specialists.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 98: 115-118
        • Gillen B.M.
        • Looney S.W.
        • Gu L.S.
        • et al.
        Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis.
        J Endod. 2011; 37: 895-902