Advertisement

Survival of Endodontically Treated Roots/Teeth Based on Periapical Health and Retention: A 10-year Retrospective Cohort Study

Published:October 20, 2017DOI:https://doi.org/10.1016/j.joen.2017.08.003

      Abstract

      Introduction

      The purpose of this retrospective longitudinal cohort study was to evaluate the outcome of nonsurgical root canal treatment (NSRCT), expressed as survival for both periapical health and retention of roots/teeth, as determined by clinical evaluation, periapical film/digital radiography (PFR/DPR), and cone-beam computed tomography (CBCT) over 10 years, to determine the prognostic factors that influenced successful treatment outcomes.

      Methods

      A total of 132 teeth (208 roots) with vital pulp received NSRCT at a university clinic. Eighteen factors (preoperative, intraoperative, and postoperative) were documented from the dental records and radiographs. Periapical indices with scores ≥2 (PFR/DPR) and ≥1 (CBCT) indicated the presence of a periapical lesion. Data were analyzed using the Kaplan-Meier test and the Cox proportional hazards regression model (P < .05).

      Results

      The estimated 10-year overall survival rates for periapical health of roots/teeth were 89.4%/88.6% with PFR, 89.4%/89.3% with DPR, and 72.6%/69.7% with CBCT; the survival rate for root/tooth retention was 90.4%/91.6%.

      Conclusions

      The long-term outcome of NSRCT expressed as survival for periapical health was different with each radiographic method. Approximately more than 90% of the roots/teeth were retained for up to 10 years. The prognostic factors for periapical health were the disinfection of gutta-percha, missed canals, age, treatment sessions, and density of root filling (voids); the age and presence of a post were for root/tooth retention.

      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:

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

      References

        • Hoskinson S.E.
        • Ng Y.-L.
        • Hoskinson A.E.
        • et al.
        A retrospective comparison of outcome of root canal treatment using two different protocols.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 93: 705-715
        • Marquis V.L.
        • Dao T.
        • Farzaneh M.
        • et al.
        Treatment outcome in endodontics: the Toronto Study. Phase III: initial treatment.
        J Endod. 2006; 32: 299-306
        • 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
        • Ørstavik D.
        • Qvist V.
        • Stoltze K.
        A multivariate analysis of the outcome of endodontic treatment.
        Eur J Oral Sci. 2004; 112: 224-230
        • Ng Y.-L.
        • Mann V.
        • Gulabivala K.
        Tooth survival following non-surgical root canal treatment: a systematic review of the literature.
        Int Endod J. 2010; 43: 171-189
        • Landys 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
        • Imura N.
        • Pinheiro E.T.
        • Gomes B.P.F.A.
        • et al.
        The outcome of endodontic treatment: a retrospective study of 2000 cases performed by a specialist.
        J Endod. 2007; 33: 1278-1282
        • Ricucci D.
        • Russo J.
        • Rutberg M.
        • et al.
        A prospective cohort study of endodontic treatments of 1,369 root canals: results after 5 years.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 112: 825-842
        • Leonardi Dutra K.
        • Haas L.
        • Porporatti A.L.
        • et al.
        Diagnostic accuracy of cone-beam computed tomography and conventional radiography on apical periodontitis: a systematic review and meta-analysis.
        J Endod. 2016; 42: 356-364
        • Kanagasingam S.
        • Lim C.X.
        • Yong C.P.
        • et al.
        Diagnostic accuracy of periapical radiography and cone beam computed tomography in detecting apical periodontitis using histopathological findings as a reference standard.
        Int Endod J. 2017; 50: 417-426
        • Wu M.-K.
        • Shemesh H.
        • Wesselink P.R.
        Limitations of previously published systematic reviews evaluating the outcome of endodontic treatment.
        Int Endod J. 2009; 42: 656-666
        • Liang Y.-H.
        • Li G.
        • Wesselink P.R.
        • Wu M.-K.
        Endodontic outcome predictors identified with periapical radiographs and cone-beam computed tomography scans.
        J Endod. 2011; 37: 326-331
        • Fernández R.
        • Cadavid D.
        • Zapata S.M.
        • et al.
        Impact of three radiographic methods in the outcome of nonsurgical endodontic treatment: a five-year follow-up.
        J Endod. 2013; 39: 1097-1103
        • Ng Y.-L.
        • Mann V.
        • Gulabivala K.
        A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival.
        Int Endod J. 2011; 44: 610-625
        • Tyndall D.A.
        • Kohltfarber H.
        Application of cone beam volumetric tomography in endodontics.
        Aust Dent J. 2012; 57: 72-81
        • Ørstavik D.
        • Kerekes K.
        • Eriksen H.M.
        The periapical index: a scoring system for radiographic assessment of apical periodontitis.
        Endod Dent Traumatol. 1986; 2: 20-34
        • Estrela C.
        • Bueno M.R.
        • Azevedo B.C.
        • et al.
        A new periapical index based on cone beam computed tomography.
        J Endod. 2008; 34: 1325-1331
        • Landis J.R.
        • Koch G.G.
        The measurement of observer agreement for categorical data.
        Biometrics. 1977; 33: 159-174
        • Straus S.E.
        • Glasziou P.
        • Richardson W.S.
        • et al.
        Evidence-based Medicine: How to Practice and Teach It.
        4th ed. Churchill Livingstone Elsevier, London2011
        • Friedman S.
        • Mor C.
        The success of endodontic therapy–healing and functionality.
        J Calif Dent Assoc. 2004; 32: 493-503
        • Petersson A.
        • Axelsson S.
        • Davidson T.
        • et al.
        Radiological diagnosis of periapical bone tissue lesions in endodontics: a systematic review.
        Int Endod J. 2012; 45: 783-801
        • Patel S.
        • Dawood A.
        • Mannocci F.
        • et al.
        Detection of periapical bone defects in human jaws using cone beam computed tomography and intraoral radiography.
        Int Endod J. 2009; 42: 507-515
        • Chang E.
        • Lam E.
        • Shah P.
        • et al.
        Cone-beam computed tomography for detecting vertical root fractures in endodontically treated teeth: a systematic review.
        J Endod. 2016; 42: 177-185
        • Gomes BPF de A.
        • Vianna M.E.
        • Matsumoto C.U.
        • et al.
        Disinfection of gutta-percha cones with chlorhexidine and sodium hypochlorite.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100: 512-517
        • Subha N.
        • Prabhakar V.
        • Koshy M.
        • et al.
        Efficacy of peracetic acid in rapid disinfection of Resilon and gutta-percha cones compared with sodium hypochlorite, chlorhexidine, and povidone-iodine.
        J Endod. 2013; 39: 1261-1264
        • Vertucci F.J.
        Root canal anatomy of the human permanent teeth.
        Oral Surg Oral Med Oral Pathol. 1984; 58: 589-599
        • Cleghorn B.M.
        • Christie W.H.
        • Dong C.C.
        Root and root canal morphology of the human permanent maxillary first molar: a literature review.
        J Endod. 2006; 32: 813-821
        • Matherne R.P.
        • Angelopoulos C.
        • Kulild J.C.
        • et al.
        Use of cone-beam computed tomography to identify root canal systems in vitro.
        J Endod. 2008; 34: 87-89
        • Baratto Filho F.
        • Zaitter S.
        • Haragushiku G.A.
        • et al.
        Analysis of the internal anatomy of maxillary first molars by using different methods.
        J Endod. 2009; 35: 337-342
        • Ng Y.-L.
        • Mann V.
        • Rahbaran S.
        • et al.
        Outcome of primary root canal treatment: systematic review of the literature—part 2. Influence of clinical factors.
        Int Endod J. 2008; 41: 6-31
        • Ng Y.-L.
        • Mann V.
        • Gulabivala K.
        A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 1: periapical health.
        Int Endod J. 2011; 44: 583-609
        • Manfredi M.
        • Figini L.
        • Gagliani M.
        • et al.
        Single versus multiple visits for endodontic treatment of permanent teeth.
        Cochrane Database Syst Rev. 2016; 12: CD005296
        • 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
        • Ray H.A.
        • Trope M.
        Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration.
        Int Endod J. 1995; 28: 12-18
        • Huybrechts B.
        • Bud M.
        • Bergmans L.
        • et al.
        Void detection in root fillings using intraoral analogue, intraoral digital and cone beam CT images.
        Int Endod J. 2009; 42: 675-685
        • Tang W.
        • Wu Y.
        • Smales R.J.
        Identifying and reducing risks for potential fractures in endodontically treated teeth.
        J Endod. 2010; 36: 609-617