RESUMEN
OBJECTIVE: This study evaluated the radiographic outcome of root canal treatments (RCTs) performed by general dental practitioners (GDPs) with focus on tooth type and quality of root filling. MATERIALS AND METHODS: The target population included all patients receiving root filling by GDPs in City of Helsinki in 2010-2011. Equal numbers of each tooth type (anteriors, premolars, molars) by jaw were included, resulting in 426 teeth. Pre- and post-operative periapical radiographs were assessed to evaluate periapical status and quality of root filling. Statistical evaluation utilized Chi-squared tests, Cohen's kappa and logistic regression modelling. RESULTS: The overall success rate of RCT was 67.4%, being 76.8%, 69.7% and 55.6% (p < .001) for anteriors, premolars and molars, respectively. The quality of root fillings varied by tooth type (p < .001); optimal fillings were least frequent (43%) in molars. In multifactorial analysis, RCTs were more likely to succeed in non-molars (OR = 1.8), in teeth with optimal root fillings (OR = 3.6) and in teeth without apical periodontitis (OR = 3.2). CONCLUSION: The quality of root fillings and radiographic outcome of RCTs varied considerably according to tooth type; success was least likely in molars. Improvement is needed in quality of RCTs by GDPs.
Asunto(s)
Cavidad Pulpar , Periodontitis Periapical , Odontología General , Humanos , Periodontitis Periapical/diagnóstico por imagen , Periodontitis Periapical/terapia , Pronóstico , Obturación del Conducto Radicular , Tratamiento del Conducto Radicular , Resultado del TratamientoRESUMEN
OBJECTIVES: We assessed the impact of type of tooth on the outcome of root canal treatment (RCT) according to factors potentially weakening the prognosis such as preoperative apical periodontitis (AP) and treatment modality (primary or secondary RCT). MATERIALS AND METHODS: We scrutinized patient documents including pre- and postoperative radiographs of 640 permanent teeth receiving non-surgical RCT at Helsinki University Clinic in 2008-2011. Of teeth, 44% were molars, 32% premolars, and 24% anterior teeth. Patients' mean age was 51.5 years; 51% were male. AP was present in 60.5% of teeth preoperatively. We used the periapical index (PAI) to assess the radiographs and defined radiographically "healthy" and "healing" cases as successful. Statistical evaluation included chi-squared tests, Fisher's exact tests, t tests, and logistic regression modeling. RESULTS: The overall success rate (SR) was 84.1%; 88.3% for primary and 75.5% for secondary RCT (p < 0.001). The SRs for anterior teeth, premolars and molars were 85.6%, 88.8%, and 79.7%, respectively. Teeth with and without AP had SRs of 77.3% and 94.5%, respectively (p < 0.001). The RCTs were more likely to succeed in anterior teeth and premolars than in molars (OR 1.7; 95% CI 1.1-2.7) and in females than in males (OR 1.9; 95% CI 1.2-3.1). CONCLUSIONS: Apart from existing AP and retreatment scenario, also, the type of tooth and gender had a significant influence on the outcome of RCT in this study. CLINICAL RELEVANCE: The prognosis of RCT varies by type of tooth; special attention should be given to RCT of molar teeth.