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

Abstract

IntroductionThe 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. MethodsA 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). ResultsThe 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%. ConclusionsThe 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.