Fonzar, F;
Kalemaj, Z;
Fabian Fonzar, R;
Buti, J;
Buttolo, P;
Forner Navarro, L;
Fonzar, A;
(2021)
The Prognosis of Root Canal Therapy: a 20-year Follow-up Ambispective Cohort Study on 411 Patients With 1169 Endodontically Treated Teeth.
Clinical Trials in Dentistry
, 03
(02)
, Article 05. 10.36130/ctd.02.2021.02.
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Abstract
PURPOSE To evaluate the 20-year prognosis of endodontically treated/re-treated teeth in a population with multiple patient/tooth/site risk factors, and to investigate the prognostic factors that could predict the long-term outcome of endodontic therapy. MATERIALS AND METHODS This ambispective cohort study included patients who received primary/secondary root canal therapy from 1986 to 1998 performed by a single operator in a private practice. Outcomes measures were: tooth survival; clinical and radiographic success, as assessed by the treating clinician and an independent outcome assessor; and complications, as evaluated 20 years after treatment. Descriptive statisti-cs, life table and Cox regression analyses for survival were fitted. RESULTS Four hundred and eleven patients (59% affected by advanced periodontitis) with 1169 endodontically treated teeth were identified (703 treatment, 466 retreatment). Drop-outs at 20-year follow-up were 128 patients (31.1%) with 388 (33.2%) teeth. Forty teeth (3.4%) in 30 patients experienced endodontic complications, subsequently successfully treated. Clinical and radiographic evaluation revealed: complete clinical success in 542 teeth (69.7%), partial success in 10 (1.3%), partial failure in 75 (9.6%), and failure in 151 (19.4%) (10 extracted for endodontic reasons, 58 due to periodontitis, and 58 vertical fracture). Life table analysis revealed 86% tooth survival at 20-year follow-up. The chance of survival decreased with increasing patient age (P = 0.006). Re-treated teeth had better survival than treated teeth (P = 0.024) Canines and premolars had better chances of survival than incisors (P = 0.002 and P = 0.015, respectively). Teeth treated at two sittings (with intermediate medication) had reduced chances of survival as compared to teeth treated at one sitting (P = 0.027). Teeth treated for the first time for endodontic reasons exhibited a better chance of survival than teeth treated for periodontal and prosthetic reasons (P = 0.012). CONCLUSIONS The 20-year prognosis of endodontically treated/re-treated teeth as part of multidisciplinary rehabilitation of patients affected by advanced periodontitis is good. Aging, two-stage endodontic treatment, and endodontic treatment for non-endodontic reasons are important predictors of failure.
| Type: | Article |
|---|---|
| Title: | The Prognosis of Root Canal Therapy: a 20-year Follow-up Ambispective Cohort Study on 411 Patients With 1169 Endodontically Treated Teeth |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.36130/ctd.02.2021.02 |
| Publisher version: | http://dx.doi.org/10.36130/CTD.02.2021.02 |
| Language: | English |
| Additional information: | This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Root canal therapy, Perio-prosthetic rehabilitation, Clinical and radiographic evaluation, Tooth survival, Endodontic prognostic factors |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute > Restorative Dental Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10157487 |
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