JOE — Volume 37, Number 1, January 2011
Long-Term Prognosis of Endodontically Treated Teeth: A Retrospective Analysis of Preoperative Factors in Molars
Frank C. Setzer, DMD, PhD, MS, Keith R. Boyer, DDS, Joshua R. Jeppson, DDS, Bekir Karabucak, DMD, MS, and Syngcuk Kim, DDS, PhD
Introduction: Long-term predictability of restored endodontically treated teeth is important for the deci- sion of tooth retention versus extraction and implant placement. The purpose of this study was to validate the hypothesis that preoperative factors can predict the long-term prognosis of molars requiring endodontic and restorative treatment for future prognostic investi- gations.
Methods: A clinical database was searched for molar endodontic treatments with crown placement and a minimum of 4-year follow-up. Charts of 42 patients with 50 individual treatments were randomly selected. Information concerning crown lengthening; periodontal diagnosis; attachment loss; furcation involvement; mobility; and internal, external, or periradicular resorp- tion was recorded. Radiographs from treatment initiation and follow-up were digitalized. The presence of apical periodontitis was evaluated. Available ferrule was calcu- lated from bitewing radiographs using CAD software (AutoCAD; Autodesk, Cupertino, CA). The resulting data, age, sex, and times of restoration and follow-up were analyzed for correlation with the presence of apical radiolucency at follow-up and the following four possible outcome scenarios: ‘‘no event,’’ ‘‘nonsurgical retreat- ment,’’ ‘‘surgical retreatment,’’ or ‘‘extraction’’ using Spearman rank order correlation analysis.
Results: Patients’ ages ranged from 19 to 87 years, 22 were male and 20 female, and 48 teeth (96.0%) were retained at follow-up. Of those, 44 (88.0%) were without interven- tion (‘‘no event’’), and four (8.0%) underwent surgical or nonsurgical retreatment. Two teeth (4.0%) had been ex- tracted. Significant positive correlations existed between ‘‘untoward events’’ (any form of retreatment or extraction) and ‘‘prognostic value according to periodontal status’’ (p = 0.047) and ‘‘attachment loss’’ (p = 0.042).
Conclusion
Within the limitations of this study, it may be concluded that, for endodontically treated molars, certain preoperative periodontal conditions are reliable indicators for the longterm clinical outcome in terms of the necessity of extraction or retreatment. An enlarged patient pool will be needed to define predictive criteria for the longterm prognosis of endodontically treated teeth. The current model appears to be valid for the evaluation of retrospective data to find ad hoc information; however, prospective investigations are advised to reveal the true longterm prognosis of teeth with endodontic treatment and restoration.
(J Endod 2011;37:21–25)
Key Words
Endodontic therapy, endodontic treatment, outcome, prognosis, restoration, root canal therapy, root canal treatment, success
Clique para ampliar:
