Molars In Patients Research Articles

Morphometric analysis of mandibular corpus relevance to sagittal split osteotomy: Comparison of dentoskeletal Class I and Class III patients

IntroductionThe purpose of this study is to determine the 3-dimensional location of mandibular canal (MC), thickness of the cortical and cancellous bone at distal of 1st and 2nd mandibular molars in patients with Class 3 dentofacial deformity and compare with the dentoskeletal Class I individuals in relevance to sagittal split ramus osteotomy. MethodsThe study was conducted on CBCT images of 30 dentoskeletal Class I patients with a mean age of 22.9 years and 30 dentoskeletal Class III patients with a mean age of 21.27years. ResultsThe comparison of the measurements in the distal root of the first molar area showed that: thickness of the buccal cancellous bone, the distance from buccal aspect of MC to outer buccal cortical margin of mandible and the distance between superior aspect of MC and alveolar crest were significantly greater in Class I patients. The comparison of the measurements in the distal root of the second molar area showed that; the distance between superior aspect of MC and alveolar crest was significantly greater in Class I patients. However, the distances from the distal margin of mental foramen was significantly lower in Class I patients (P<0.05). ConclusionIn case of deviated skeletal development, position and size of anatomical structures can vary significantly. Prognathic mandibles has increased risk of neurovascular complications and bad splits. Morphologic data provided in this study may help practitioners for better surgical planning to reduce complications.

Comparison of the quality of life of patients with mandibular third molars and mild pericoronitis treated by extraction or by a periodontal approach

We have evaluated and compared the outcomes after conservatively treated and surgically managed third molars in patients with mild pericoronitis at the first, third, and sixth postoperative months, and we rated patients' quality of life (QoL) using the Oral Health Impact Profile-14 (OHIP-14) index. Of the 128 patients who were originally assessed as eligible we studied 100 patients who fulfilled the protocol, being diagnosed with mild pericoronitis that affected the third molar teeth and who were followed up for six months. Fifty were treated by the periodontal approach and 50 by extraction of third molars. Their oral health-related QoL was assessed using the OHIP-14 index on a personal assessment question form and then repeated at the first, third, and sixth months. The data were analysed using the Mann Whitney, Friedman's, and Wilcoxon's test, as appropriate. There was a significant difference between the total OHIP-14 scores at different time points (p<0.0001). In both groups the three postoperative total OHIP-14 scores were significantly lower than the baseline score, and we noted a further decrease in OHIP-14 scores in the surgical treatment group. Periodontal treatment of mandibular third molar teeth may effectively reduce (but does not eliminate) symptoms, whereas tooth extraction seems to be more effective at the long term.

The Effect of Maxillary Posterior Space Discrepancy on the Molars and Overbite in Class II Malocclusions with Different Vertical Patterns

The purpose of this cross-sectional study was to investigate the influence of maxillary posterior space discrepancy (MPDD) on angulation and vertical position of molars in patients with skeletal class II malocclusions, presenting long, short, and normal vertical growth patterns. In total, 120 lateral cephalograms of patients (mean age: 23 years) with skeletal class II malocclusion were evaluated. Patients were divided into six groups based on their vertical growth pattern (normal, long, and short faces) and the presence or absence of maxillary posterior discrepancy. Maxillary molars' sagittal angulation and vertical position were measured on cephalograms via Dolphin™ three-dimensional (3D) software (version 11.5). The comparison between groups with the same vertical dimension and different status of MPDD was done with independent t test. The analysis of analysis (ANOVA) was used to make pairwise comparison between all six groups. Finally, a multiple regression analysis was performed to evaluate the influence of molar position and MPDD on the anterior overbite. The results showed that the angulation of the maxillary first molar was not statistically different between groups with the same vertical dimension but varied in terms of MPDD. The maxillary second molar was more distally inclined in patients with MPDD than those without MPDD with short and normal facial types (p value = 0.016 and p value = 0.001, respectively). The second molar had significantly more distal angulation in long face patients than short and normal face participants, without considering the status of MPDD. The upper first and second molars were erupted more in patients with long than short or normal faces, without any influence of MPDD. The presence of MPDD caused more distal inclination of the maxillary second molar, in skeletal class II patients with short and normal vertical growth patterns. The status of MPDD and its effect on the maxillary second molar teeth should be considered in skeletal class II patients with short and normal vertical growth patterns.

Uşak Üniversitesi Diş Hekimliği Fakültesine Başvuran Hastalarda 'Kissing Molars' Sıklığının Araştırılması

Amaç: 'Kissing molars (KMs)' veya 'rosette formasyonu', tek bir foliküler torba içerisinde gömülü daimi molar dişlerin oklüzal yüzeylerinin birbiriyle temas etmesini ve köklerinin zıt yönlere uzanmasını ifade eder. Nadir görülen bir durumdur. Bu çalışmanın amacı, Uşak Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Radyolojisi Kliniğine Kasım 2016-Ağustos 2018 tarihleri arasında başvuran hastalarda KMs vakalarını prevalans, yaş, cinsiyet, sınıflandırma ve ilişkili olabilecek patoloji açısından değerlendirmektir. Gereç ve Yöntemler: Toplam 28984 panoramik radyografi ve 892 konik ışınlı bilgisayarlı tomografi görüntüsü retrospektif olarak incelendi. Radyolojik ve klinik veriler yaş, cinsiyet, medikal anamnez, prevalans, sınıflama ve ilişkili patolojiye göre değerlendirildi. Bulgular: Çalışmaya toplamda 18.792 erkek, 11.084 kadın hasta dâhil edilmiştir. İncelenen 29.876 radyolojik tetkik sonucunda toplam 7 hastada KMs tespit edildi (%0,023). KMs tespit edilen 7 hastanın 4'ü erkek, 3'ü kadındı ve yaş ortalaması 28,2 olarak saptandı. 7 hastada tespit edilen toplam 13 KMs olgusunun 4 tanesi unilateral, 3 tanesi bilateral olarak tespit edildi. Sonuç: KMs vakalarının görülme sıklığı çok düşüktür ve radyolojik tanısında herhangi bir zorluk yaşanmaz. Panoramik radyografi üzerinde KMs'ler görüldüğünde, çevre dokular üzerindeki potansiyel etkiler dikkatle incelenmelidir. KMs, mandibular fraktür, perikoronit, lokal ağrı, kistik değişiklik ve komşu dişlerde kök rezorpsiyonu gibi bazı komplikasyonlara neden olabilir. KMs vakalarının herhangi bir sistemik durumla ilişkisini belirlemek adına daha fazla çalışmaya ihtiyaç duyulmaktadır.

Retrospective analysis of malpositioned mandibular third molars in elderly patients

Objective: To determine the frequency of symptomatic malpositioned mandibular third molars in elderly patients. Method: An analytic study of hospital records of elderly patients with symptomatic impacted mandibular third molars over 17 years was undertaken. Information on demographics, types of impaction, reasons for surgical extraction, and complications after treatment were obtained. Those who were asymptomatic would be excluded from analysis. Results: Altogether, 6214 impacted mandibular third molars were isolated in 5, 431 patients. However, 436 (7.0%) symptomatic impacted teeth were recorded in 436 (8.0%) patients and these were extracted, while the rest, 5778 (93.0%) were asymptomatic. Males were greater than females in the ratio of 1.1:1. The frequency of occurrence of mesio-angular and vertical impactions were significant (P= 0.001) compared with disto-angular and horizontal. Periodontal disease was 211 (48.4%) of the case in addition to dental caries and its clinical sequelae 203 (46.6%) were significant reasons for extractions (P=0.000). The common postoperative complications were alveolar osteitis and hypersensitivity of the adjacent molar 22(68.7%) which related to surgical extraction of disto-angular impactions (P= 0.001). Conclusions: This study showed the older the patient the less likely malpositioned mandibular third molar suggesting that majority of such impactions do not cause pathology after many years of their presence in the oral cavity. Prophylactic extraction of malpositioned mandibular third molars in all patients should be discouraged, but each case should be treated on merit or when symptomatic.

A retrospective cohort study on reasons to retain third molars

The primary goal of this study was to identify and quantify indications for retaining third molars. This retrospective cohort study included 1682 patients (818 male, 864 female; mean age 31 years) who were referred to the University Hospitals Leuven for third molar removal. Eight reasons for retaining the third molars were identified: (1) risk of damaging adjacent structures, (2) compromised health status, (3) adequate space for eruption, (4) third molar serves as abutment tooth, (5) orthodontic reasons, (6) eruption into proper occlusion, (7) symptomless third molars in patients >30 years old, and (8) patient preference. To compare these categories between sex and age groups, a generalized linear model for binary data was fitted with a logit link. A total of 1149 third molars in 548 patients were not extracted. The most frequent reasons for retaining third molar teeth were: eruption into proper occlusion (31.9%), patient preference (31.5%), and symptomless third molars in patients >30 years old (17.5%). Compromised health status and advanced age were often included in the decision regarding whether to retain the third molars. One third of the referred patients had reasons to retain one or more third molars. These findings might facilitate the future development of a consensus statement.

Is prophylactic removal of impacted mandibular third molar justified in all patients? A prospective clinical study of patients 50 years and above.

The prophylactic extraction of asymptomatic impacted mandibular third molar is a contentious issue in dental practice. To evaluate symptomatic impacted mandibular third molars in patients 50 years and above, and determine the burden of the impaction on the adjacent second molar. This was a prospective clinical study over a three-year period. The diagnosis of impacted mandibular third molar and their associated pathology was made by clinical and radiological examination. The data obtained were age, sex, type of impaction, reason for surgical extraction, and the clinical condition of the adjacent second molar. Patients 50 years and above were 33.4%, and those with impaction 22.8%, while the symptomatic cases were in 18.4% patients. The age of the patients ranged from 52 to 84 years with male: female ratio, 2.3:1. In all the asymptomatic impactions, the adjacent second molars were disease-free, whereas 73.6% of the adjacent second molar related to symptomatic cases were asymptomatic (P=0.001). This study showed that 15.9% of impactions in 18.4% of patients were symptomatic and required surgical extraction, whereas the burden of impaction on the adjacent second molar was 26.4%, and these required only preventive and restorative treatments.

Fracture analysis of monolithic CAD-CAM crowns.

The aim of this study was to compare the integrity of zirconia, lithium disilicate, and zirconia-reinforced lithium silicate CAD-CAM crowns after being subjected to cyclic loading and then subjected to static loading until fracture. Zirconia (Zirkonzahn), lithium disilicate (LDS, Ivoclar Vivadent AG), and zirconia-reinforced lithium silicate glass ceramic (ZLS) (Vita Suprinity, Vita Zahnfabrik) monolithic crowns were milled (n = 6). The crowns were bonded using composite resin cements and subjected to cyclic loading under wet conditions. Three specimens from each group were loaded for 10 000 cycles, and the other three specimens were loaded for 50 000 cycles with 250 N. Specimens were subjected to loading until fracture. Load-to-fracture values were analyzed with 2-way (ANOVA) and Tukey-Kramer post hoc test (α = 0.05). Specimens from each group were examined using an SEM. Mean load-to-fracture values among materials were significantly different from each other (P < 0.05). No significant effect of the number of cycles was found on the load-to-fracture values of crowns (P > 0.05). Load-to-fracture values of zirconia were higher than those of LDS, which were higher than those of ZLS. The number of fatigue loading cycles did not affect the load-to-fracture of the tested crowns for a given material. More research needs to be conducted before considering the routine use of ZLS for molars in patients with high risk of parafunctional habits.

Prevalence of impacted third molars among orthodontic patients in different malocclusions.

The aim of this retrospective study was to investigate the prevalence and pattern of third molar impaction and missing third molars in patients over 18 years in different anteroposterior skeletal patterns among central Indian populations. The study reviewed 357 orthopantomograms of patients attending the Government College of Dentistry, Indore, Madhya Pradesh. Patients were evaluated to determine the prevalence of third molar impaction, angulation, and level of eruption in Class I, Class II, and Class III patients using Winter's classification to determine angulation of third molars and Pell and Gregory classification for level of impaction. Out of 357 patients, 187 (52.3%) were present with at least one impacted teeth. The third molar impaction was most commonly present in Class II malocclusion (60.65%). Overall, the most common angulation of impaction in both genders was the mesioangular (39%), and the most common level of impaction in both arches was Level B. In Class I, Class II and Class III malocclusion vertical angulation was the most common finding in the maxillary arch and mesioangular angulation in the mandibular arch. No significant association was observed between different types of malocclusion and third molar impaction (P > 0.4648). This study found that almost half of the adult patients above 18 years had at least one impacted third molar. The anteroposterior relationship does not have any significant role for the third molar impaction.

Incidence of Four Canals in Permanent Mandibular First Molar in Patients Attending Dhulikhel Hospital.

Background &amp; Objectives:The success of root canal therapy greatly depends upon the proper cleaning, shaping and three dimensional sealing. Besides these, the locations of all the canals, is mandatory to achieve the rationale of endodontic therapy. Hence, variation in root canal anatomy has clinical significance. The objective of this study was to assess the presence of four root canals in permanent mandibular first molars in patients attending Dhulikhel Hospital.Materials &amp; Methods:The clinical and radiographic examination of one hundred and nine permanent mandibular first molars, undergoing root canal treatment was conducted. Mandibular first molar teeth of both male and female patients of all age groups were included.Results:Out of 109 samples (46.8% male and 53.2% female), three and four canals were found in 44.1% and 55.9% respectively in root treated permanent mandibular first molars.Conclusion:This study concluded that 55.9% of permanent mandibular first molars have four root canals, indicating higher incidence than that of three canals, in patients attending Dhulikhel hospital.

The effect of horizontal and vertical furcation involvement on molar survival: A retrospective study.

Periodontal involvement of the furcation area (furcation involvement, FI) has been reported to confer molars a higher risk of tooth loss. The aim of this retrospective analysis was to assess the effect of FI on disease progression and tooth loss in molars of patients with chronic periodontitis undergoing supportive periodontal therapy (SPT) in a UK private practice setting. Six-hundred and thirty-three molars were analysed in 100 chronic periodontitis patients treated with active periodontal therapy (APT) and followed up in SPT for at least 5years. Molars were treated with a combination of resective, regenerative or conservative approaches, according to the different clinical needs. Twenty-three molars were extracted during APT and a further 23 were lost during SPT. Multivariable analysis showed that both horizontal FI and vertical furcation component were associated with increased risk of tooth loss during SPT (OR 5.26, 95% CI: 1.46-19.03, p=.012 and OR 9.83, 95% CI: 1.83-50.11, p=.006, respectively). Attention should be placed on both horizontal and vertical FI in molars, owing to their association with tooth loss during SPT.

The mesialization of molars of the lower jaw after performance surgical manipulation with using miniscrew anchorage approach

To improve the effectiveness of the treatment using piezocorticotomy and miniscrew anchorage approach in cases of third and second molar mesialization when first molar is missing. 24 patients (10 men/14 women) aged 25-40 years with a fixed vestibular braces and the absence of molars on the lower jaw. Cone-beam computed tomography was performed before and after orthodontic treatment, as well as immediately after the piezokortikotomy (79 Cone-beam computed tomography). Miniscrews was placed in the area between roots of the first and second premolars (27 miniscrews) and surgical manipulations was performed using device VarioSurg (NSK, Japan). Depending on width of the alveolar ridge piezocorticotomy was performed (16 piezocorticotomies) or splitting using piezosurgery approach (11 splitting). Mesialization speed of molars in patients with support of piezocorticotomy is equal to 1.1±0.1 mm/mo that is higher than in patients without surgery only with miniscrew approach (0.33±0.006 mm/mo Roberts et al, 1996). Mesialization speed of molars in patients with support of splitting is equal to 1.6±0.15 mm/mo. However, we observed that after corticotomies surgery, the speed was increased only within the first 4.5 months, after splitting, the speed was increased only withing 2.5 months, after that period the speed gradually decreases. Bone density after surgery decreased, but at the end of treatment gradually restored. Piezo surgery with corticotomies is an effective method to accelerate the mesialization of molars in the lower jaw, that conduce to reduction duration the treatement and to allow to almost bodily translation of the molars.

Association between impacted mandibular third molars and distal caries in second molars-A radiographic study

Objective: The aim of this study was to evaluate the incidence of caries on distal aspect of mandibular second molars in patients with impacted mandibular third molars using cone beam computed tomography (CBCT) radiography and to identify its association with angular position and depth of the impacted mandibular third molars based on the classification by Pell and Gregory. Methods: Maxillofacial cone beam computed tomography scan records of 35 patients with impacted third molars presenting to the Department of Oral and Maxillofacial Surgery, Saveetha dental college and Hospital were collected and assessed. Using CBCT the radiographic angulation and depth of mandibular third molar impaction were determined and compared to determine the relationship with incidence of caries on the distal surface of the second molar. Data were checked using Sirona software, statistically analyzed and results obtained. Results: Mesioangular position was the most common type of impaction with a distribution of 56% among all the impactions. According to this study results, 45.7% cases showed caries on the distal aspect of mandibular second molars. The incidence of caries was highest with mesioangularly impacted third molars (62%). A majority of these mesioangular cases were Level A and Class I as per the Pell and Gregory classification. Conclusion: The prophylactic extraction of mesioangular impacted mandibular third molars is indicated if the angulation in CBCT is between 30° and 70° and is justified by the incidence of distal caries in the second molars.

The experience of using fiberglass pins for the restoration of diarrhea molars in patients of different age groups

After depulpation significantly reduced the strength of the teeth in cause of the reduction of humidity and changes in tissues and changes in the collagen fibers, which leads to fracturе of the root and coronal. Features devitalic restoring molars in the mandible through direct restavrations using reinforcement fiber post and distance results show recovery devitalic molars 6, 12 and 18 months in patients of different age groups.

Anesthetic Efficacy of Gow-Gates Nerve Block, Inferior Alveolar Nerve Block, and Their Combination in Mandibular Molars with Symptomatic Irreversible Pulpitis: A Prospective, Randomized Clinical Trial

IntroductionThe purpose of this prospective, randomized clinical trial was to evaluate the anesthetic efficacy of the Gow-Gates nerve block (GGNB), the inferior alveolar nerve block (IANB), and their combination for mandibular molars in patients with symptomatic irreversible pulpitis. MethodsOne hundred fifty patients diagnosed with symptomatic irreversible pulpitis of a mandibular molar were selected. The patients randomly received 2 GGNB injections, 2 IANB injections, or 1 GGNB injection plus 1 IANB injection of 1.8 mL 2% lidocaine with 1:80,000 epinephrine. Access cavity preparation was initiated 15 minutes after injections. Lip numbness was a requisite for all of the patients. Success was specified as no or mild pain on the basis of Heft-Parker visual analog scale recordings during access cavity preparation or initial instrumentation. Data were analyzed with the chi-square, Kruskal-Wallis, and analysis of variance tests. ResultsThe success rates of anesthesia were 40%, 44%, and 70% for the GGNB, IANB, and GGNB + IANB groups, respectively. There was no statistically significant difference in the success rate of anesthesia between the GGNB and IANB groups (P > .05). The anesthesia success rate for the GGNB + IANB group was significantly different from those of the GGNB and IANB groups (P < .05). ConclusionsA combination of GGNB and IANB could improve the efficacy of anesthesia in mandibular molars with symptomatic irreversible pulpitis, but it would still require supplemental anesthesia. Further research may be needed to confirm the results of this study.

Clinical and pathologic features related to the impacted third molars in patients of different ages: A retrospective study in the Korean population

Background/purposeThe surgical extraction of impacted third molars (ITMs) is a common surgical procedure in dentistry. If prophylactic removal of ITMs is beneficial, however, is a still disputed issue. The aim of this study was to analysis the pathologic changes in impacted third molars (ITMs) and adjacent teeth according to patient age groups in the Korean population to determine if the prophylactic removal of ITMs is to be supported or not. Materials and methodsA retrospective study of patients who underwent surgical extraction of impacted third molars was performed. The patients were divided into 5 groups according to their age. Each group was analyzed with respect to patients' chief complaints, specific pathologic conditions in ITMs, and the damage to adjacent teeth due to untreated ITMs. ResultsIn this study, 2883 impacted third molars in 1109 patients were analyzed. The most common patients' chief complaint was pain, and the frequency of pain was significantly higher in older age groups. The frequency and severity of pathologic changes in ITMs and adjacent second molars due to ITMs were increased with advancing age. ConclusionBased on the results of this study, we conclude that the prophylactic removal of ITMs that have a higher probability of pathologic changes can be considered to be a reasonable treatment modality in younger patients to reduce morbidity resulting from surgical extraction compared with patients who attained advanced age.

Incidence of distal caries in mandibular second molars due to impacted third molars: Nonintervention strategy of asymptomatic third molars causes harm? A retrospective study.

Background:Removal of impacted third molars is the most common oral surgical procedure. Many investigators have questioned the necessity of removal in patients who are free of symptoms or associated pathologies.Aim:The aim of this retrospective study was to evaluate the incidence of caries on distal aspect of mandibular second molars in patients referred for corresponding third molar assessment and to identify its association with angular position and depth of the impacted mandibular third molars based on the classification of Pell and Gregory.Methodology:Records of 150 patients with impacted third molar presenting to the Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, were assessed retrospectively. The radiographic angulation and depth of mandibular third molar impaction were determined and compared to determine the relationship with incidence of caries on the distal surface of the second molar.Results:According to this study results, 37.5% cases show caries on the distal aspect of mandibular second molars. The incidence of caries with mesioangular impacted third molars was 55%. A majority of these mesioangular cases were Level B and Class I as per the Pell and Gregory classification.Conclusion:The prophylactic extraction of mandibular third molars is indicated if the angulation is between 30° and 70° and is justified by incidence of distal caries in the second molars.

Autologous Platelet-rich Plasma after Third Molar Surgery.

Aim and Objective:The aim of this study is to compare the efficacy of autologous platelet-rich plasma (PRP) in the third molar impactions, with respect to: pain, swelling, healing, and periodontal status distal to the second molar in patients who need surgical removal of bilateral impacted mandibular third molars.Materials and Methods:Twenty-five patients of both sexes aged between 16 and 60 years who required bilateral surgical removal of their impacted third molars and met the inclusion criteria were included in the study. After surgical extraction of the third molar, primary closure was performed in the control group, whereas PRP was placed in the socket followed by primary closure in the case group. The outcome variables were pain, swelling, wound healing, and periodontal probe depth that were follow-up period of 2 months. Quantitative data are presented as mean. Statistical significance was checked by t-test.Results:There was a difference in the pain (0.071) and facial swelling (0.184), reduction between test and control on day 3, but it was not found to be significant. Periodontal pocket depth (0.001) and wound healing (0.001) less in case group compared with the control group was found to be significant.Conclusion:The use of PRP lessens the severity of immediate postoperative sequelae and decreases preoperative pocket depth.

Impacted Lower Second Permanent Molars at the Ramus and Coronoid Process: A New Clinical Symptom of the WNT10A Mutation in Ectodermal Dysplasia.

AimHidrotic ectodermal dysplasia (ED) with the WNT10A mutation produces variable dentofacial symptoms. The aim of this study was to describe a new clinical symptom, i.e., specific to the WNT10A mutation in hidrotic ED. The study investigated the migratory trend of the lower second permanent molars to the ramus or coronoid process. To the best of authors’ knowledge, no data in the literature describe this trend in cases of hidrotic ED.Materials and methodsA three-generation family pedigree was established for seven families after the diagnosis of hidrotic ED in a 10-year-old boy. Thereafter, a genetic and clinical study was conducted on three families with at least one individual affected by hidrotic ED (20 individuals). We selected the children with molar germs 37 and 47. The eruption axes of these germs were then traced on the panoramic images at the initial time (T0) and 1 year later (T0 + 1 year), and the deviations between these axes were measured.ResultsA significant familial consanguinity was shown. Eight subjects presented with the hidrotic ED phenotype. Among them, three individuals carried germs 37 and 47. Over time, the measured deviations between the eruption axes of the latter displayed, in the majority of the cases, a distal inclination toward the ramus.LimitationsA larger sample size is mandatory to assess the frequencies and treatment modalities.ConclusionThe presence of germs in the lower second permanent molars in patients with hidrotic ED is an important clinical symptom that should be monitored to detect and prevent ectopic migration of these teeth.Clinical significanceIn hidrotic ED cases, the study of the presence of the second lower permanent germs must include clinical and radiological examinations. Establishing an inter-ceptive treatment is necessary to prevent the migration of the molars in question.How to cite this article: Sfeir E, Aboujaoude S. Impacted Lower Second Permanent Molars at the Ramus and Coronoid Process: A New Clinical Symptom of the WNT10A Mutation in Ectodermal Dysplasia. Int J Clin Pediatr Dent 2017;10(4):363-368.

Endodontic status and retention of molars in periodontally treated patients: results after 10 or more years of supportive periodontal therapy.

To assess the influence of endodontic status on retention of molars in patients under supportive periodontal treatment (SPT). A total of 136 subjects with 1015 molars at baseline were examined retrospectively, including 188 endodontically treated molars in 90 patients. Multilevel Cox regression analysis identified factors contributing to loss of molars. Root canal treatments contributed significantly to loss of molars during on average 13.2years of SPT (Hazard ratio: 2.98, 95% CI: 1.74-5.1, p<0.001). Endodontic treatment was more frequently present in first molars (p<0.001) and in the maxilla (p=0.01). In endodontically treated molars, degree III furcation involvement could be detected more often compared to molars without root canal treatment (p<0.001). Among the root canal-treated molars, several patient and tooth-related factors showed an impact on tooth retention, but only molars with a periapical index of 4 and 5 (labelled "diseased") were significantly more often lost. The retention of molars in periodontally compromised patients after periodontal treatment is influenced by periodontal as well as endodontal factors. On a long-term basis, it is feasible to retain these teeth via active periodontal treatment and SPT for more than 10years.