Association of Endodontic Involvement with Tooth Loss in the Veterans Affairs Dental Longitudinal Study

Abstract

Introduction The effect of endodontic involvement on tooth loss has not been quantified, so the present study aimed to assess this relationship after controlling for other relevant risk factors for tooth loss. Methods We analyzed data from 791 participants (18,798 teeth) in the Veterans Affairs Dental Longitudinal Study. Potential tooth-level and person-level covariates were fitted into marginal proportional hazards models, including both apical radiolucencies (AR) and root canal therapy (RCT) status as time-dependent variables. Survival curves were plotted for teeth according to their AR and RCT status. Results Both current AR and RCT status were associated with increased risk of tooth loss ( P < .01), after controlling for baseline levels of periodontal disease, caries, tooth type, number of proximal contacts, number of teeth, age, education, and smoking history. Root canal filled (RCF) teeth seemed to have better survival than non-RCF teeth among teeth with AR but worse survival than non-RCF teeth among teeth without AR. Conclusions Endodontic involvement was associated with tooth loss, controlling for other potential risk factors. Additional prospective studies are needed to provide better evidence as to the impact of endodontic involvement on tooth loss.