Use Of Rubber Dam Research Articles

Longevity of lithium disilicate indirect restorations in posterior teeth prepared by undergraduate students: A retrospective study up to 8.5 years

ObjectivesTo analyze retrospectively the clinical performance and survival of lithium disilicate inlays, partial crowns and crowns placed by undergraduate students. Methods250 lithium disilicate posterior restorations (IPS™Emax Press) were evaluated. Mean service time was 6.6 years (79 months) with a maximum observation time of 8.5 years (102 months). Clinical performance was assessed using FDI Criteria. Descriptive statistics were used to display the distribution of the criteria. Success and survival of the restorations were calculated with the Kaplan Meier method. A Cox regression analysis was performed to detect influencing parameters for the survival or the success of the restorations. ResultsSurvival and success rates of lithium disilicate indirect restorations were calculated at 6.6 years with 96.3 % and 93.8 %, respectively. After 8.5 years the survival rate was calculated with 94 % and the success rate with 83.8 %. 10 out of 250 restorations (4%) failed, while the main reasons for failure were fracture of material, debonding/loss of restoration, endodontic complications as well as recurrence of caries. A Cox regression analysis failed to show a correlation between restoration failure and the experience level of the students, an existing root canal treatment, type of tooth, bruxism or the use of rubber dam. ConclusionsLithium disilicate indirect posterior restorations demonstrate a high success and survival rate after a mean service of 6.6 years when placed by undergraduate students with different levels of experience. Co-factors influencing the survival or success rate of these restorations could not be identified. Clinical significanceLithium disilicate restorations show a good clinical performance up to 8.5 years when prepared by undergraduate students.

Infection Control Practices Among Private Practicing Dentists in Nairobi During the Pre-coronavirus Disease 2019 Period.

Background: Cross-infection control is a dynamic field that requires frequent updates due to emerging diseases, advancement in technology, and scientific knowledge. Despite wide publication of guidelines, a laxity in compliance to the standard precautions for infection control by dental health-care personnel (DHCP) has been reported globally. Therefore, there is need to review previous shortcomings in order to adequately secure dental practices during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to determine knowledge and infection control practices by dentists in private practices. The study was done a few months before the first COVID-19 case was confirmed in Kenya.Materials and Methods: The study design was a descriptive cross-sectional study that was carried out in selected private dental clinics located in Nairobi. Data were collected using an interviewer-administered questionnaire. Convenience sampling method was utilized, while data were analyzed using SPSS 20.0.0.0.Results: A total of 71 private dentists participated in the study. Their mean age was 38 years with an age range of 27–55 years. Almost all (70, 98.6%) the dentists were able to define cross infection correctly. Majority (62, 87.3%) correctly differentiated between sterilization and disinfection, while 9 (12.7%) had difficulties. Most (68, 95.8%) of the respondents were aware of the standard precautions for cross-infection control. All participants used face masks and gloves. About half of them (38, 54%) practiced hand washing after removal of gloves and 31 (43.7%) before and after wearing of gloves, while 2 (2.8%) washed hands only before wearing gloves. Only 31 (42.3%) and 26 (36.6%) participants reported use of rubber dam isolation and impervious barrier, respectively. All the dentists reported disposal of sharps into especially labeled containers, while about half reported use of disposable suction traps and amalgam separators.Conclusion: The dentists had a good knowledge on various aspects of infection control measures that were studied. Use of basic personal protective equipment was widely practiced. There were irregularities in hand hygiene, use of rubber dam, surface barriers, and waste management. The work highlights that many dentists were unprepared to manage infectious risk during the COVID-19 outbreak, which justified the closure of the dental facilities. Development of strategies to promote adequate and safe practice is highly recommended.

Cross sectional study of knowledge and attitude of dental practitioners about the use of rubber dam in endodontic procedures in urban area of Andhra Pradesh

Introduction: One of the prerequisite for the numerous endodontic and operative procedures is use of rubber dam which is an absolute necessity. Objectives: To assess the knowledge and attitude of dental practitioners about the rubber dam use during endodontic treatment of anterior and posterior teeth. Materials and Method: A hospital based cross sectional study was carried out in the urban area of Kurnool District of Andhra Pradesh. 90 clinics which were having conservative and endodontics speciality were selected for the study. A prevalidated close ended questionnaire was used. Details about the basic sociodemographic characteristics, information with regard to rubber dam use during procedures, attitude of dentists towards its use and the reasons for whether non use of rubber dam was recorded. Results: A total of 90 questionnaires were mailed to dental practitioners in the urban locality. With respect to response to the use of rubber dam during endodontic procedures 13.72% of males and 12.82% of females responded that they were always using the rubber dam,5.88% of males and 5.19% of females used rubber dam very oftenly.17.64% and 2.56% of male and female participants used it occasionally. With regard to rubber dam use for the endodontic treatment procedures of the root canal of posterior teeth 15.68% of males and 12.82% of females responded that they were always using the rubber dam,5.88% of males and 5.19% of females used rubber dam very oftenly.17.64% and 2.56% of male and female participants used it occasionally. Conclusion: Hence it can be stated that for creating awareness among dental practitioners about the importance of rubber dam in endodontic procedure by continuing dental educations is the need of the hour to improve the quality of dental care. Keywords: Rubber Dam, Endodontics, Knowledge, Attitude

Self-reported habits regarding dental bur use and conditioning among academic and non-academic argentinian dentists

The removal of tissues affected by caries lesions is one of the most frequent procedures in daily dental practice. The aim of this study was to collect information about the habits of members of the academic and non-academic dental community in Argentina regarding the use and conditioning of burs employed in the removal of dentin during the treatment of carious lesions. A 14- item questionnaire was prepared, and once validated in small groups, it was sent to three lists of dental subscribers through the computer services area of the School of Dentistry, University of Buenos Aires, Argentina (FOUBA). By the deadline for receiving responses, which was set as four weeks after the sending date, 294 replies were received. Results: percentage (95%CI): 47.93% (42.18-53.68%) of the respondents were faculty members, of whom 37.24% (31.68-42.81%) claimed to belong to FOUBA. Of the respondents, 26.90% (21.79-32.00%) reported being under 35 years old, 37.59% (32.01-43.16%) 36 to 45 years old, 22.07% (17.30-26.84%) 46 to 55 years and 11.38% (7.72-15.03%) over 55 years. Regarding bur type, 68.07% (62.31%-73.44%) claimed to use round burs to remove carious dentin and 27.72% (22.60%-23.31%) round + others. Regarding rotary speed, 22.07% (17.30-26.84%) use medium speed, 32.76% (27.36-38.16%) use high speed, and 32.76% (27.36-38.16%) use medium + super high. Only 17.93% (13.52- 22.35%) indicated that they know how to quantify the number of times they use their burs, while 50.34% (44.59-56.10%) of the respondents said that they use burs “until they no longer cut”, 23.79% (18.89-28.69%) use them 1 to 5 times. 98.27% (96.77-99.77%) said they clean their burs once used. When the answers regarding the use of rubber dam were compared with area of specialization (Chi-square), it was found that faculty members mention the use of burs under rubber dam always or almost always 74.82% (67.60-82.04%) while outside the academic field, 51.01% (42.98-59.03%) of dentists say that they never or almost never do so (p <0.001). Conclusion: Most respondents state that they sterilize their rotary instruments in some way after use. About half of them do not keep track of the number of uses and use burs “until they no longer cut”.

Isolation of Teeth in Children: A Review

Isolation is done for proper control of moisture, good accessibility and visibility, to provide adequate spacefor instrumentation and operation. Most of the children are non-cooperative during treatment. So, isolation ismandatorily necessary for pediatric patients. Studies have shown that there are successful retention rates ofadhesive restoration when a rubber dam is used rather than any other isolation technique. The judicious useof rubber dam ensures greater patient comfort and delivery of high-quality dental care to pediatric patients.

COVID-19 Pandemic in ASEAN Region and Implication in Dentistry

The coronavirus disease (COVID-19) has spread globally and has influenced every aspect of life worldwide. In the ASEAN region, at present, many nations are still locked the academic organizations, shopping malls, events, and activities, and banks and airports are shut down to prevent the spread of the COVID-19 infection. COVID-19 has affected dental practice, and, in many countries, dentists are affected by COVID-19, leading to deaths. The dental treatments should be done with high standards of care and infection control by following proper recommendations. Personal protective equipment, patient screening, hand hygiene practices, mouth rinsing, disposable instruments, and use of rubber dam, reducing ultrasonic instruments use, treating suspected or confirmed COVID-19 patients in separate rooms, and disinfection of the inanimate surfaces helps in protecting clinicians and patients.

Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases.

Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases.

Teaching, learning and usage of Rubber Dam in Clinical Practice

Introduction: The teaching, learning and practice of rubber dam use are incorporated into dental schools' curricula all over the world. Its usage in operative dentistry and endodontics is highly recommended. Its merits include moisture control and soft tissue retraction leading to better access and visualization of teeth. It also enhances cooperation among children. However, previous studies had shown very low usage of rubber dam by post doctoral dentists. The aim of this study was to determine the effects of teaching, learning and usage of rubber dam during undergraduate studies on the frequency of use of rubber dam post-graduation.
 Materials and methods: This survey was a descriptive cross-sectional study carried out amongst dentists working with private, federal and state governments' hospitals in Lagos State. A convenient simple random sampling was used to select the participants. Newly structured self administered questionnaires were used. They were mostly closed with a few open ended questions. The questionnaires contained fifteen questions based on biodata, knowledge and usage of rubber dam in clinical practices. These were fully completed and returned by consented respondents. Data collected were analyzed by Statisitical Package for Social Science (SPSS) 20 edition. Univariate analysis was done using frequency, percentages, and chart while bivariate analysis was carried out by cross tabulation of categorical variables with Chi-square, p-value ≤0.05 was accepted as statistically significant.
 Results: The total number of respondents was 135 consisting of 50 males and 85 females. Of the 135 respondents, only 8(5.9%) routinely used rubber dam, which is in contrast to 120 (88.9%) and 127(94.1%) that had high knowledge on rubber dam and its merits respectively. Reasons for non-usage included non availability of rubber dam kit in hospital 120(94.5%) and lack of skills 11(8.7%). Test of association showed that knowledge of rubber dam system was significantly affected by age of respondents (p-value =0.001), designation (p-value=0.008) and years of experience (p-value= 0.010). In addition, use of rubber dam was significantly different based on respondents designation.
 Conclusion: The usage of rubber dam amongst dentists working with the federal and state governments in Lagos State was very low in spite of their high knowledge on its merits. Therefore, there is the need to develop a culture of rubber dam use in clinical practice amongst dentists.

Awareness about harmful effects of aerosol contamination among dental students

Possible mechanisms for the transmission of disease in the dental office include close communication with body fluids of patients, interaction with surfaces and instruments which have already been besmirched by the patient, and also interaction with unavoidable particles from patient which have been dispersed airborne. This survey was performed with purpose of assessing the awareness about harmful effects of aerosol contamination in clinical practice among the dental students. A Questionnaire containing ten questions about the awareness and attitudes of dental students toward the harmful effects of aerosol contamination in clinical practice. Then this questionnaire was piloted and distributed to 100 dental students, and information about the opinions and attitudes of dentists aerosol contamination.salivary transmission of aerosols, procedures causing aerosol contamination, use of rubber dam in preventing contamination and use of personal protection equipments were obtained. The collected data were statistically analysed. 87% of the students were aware of harmful effects of areosol contamination.78% were aware of the salivary transmission of aerosol contamination. The awareness about harmful effects of aerosols is adequate among dental students. It is conceivable to limit the hazard with generally basic and reasonable safety measures.

The efficacy of an extraoral scavenging device on reduction of splatter contamination during dental aerosol generating procedures: an exploratory study.

Introduction This study was conducted in light of the SARS-CoV-2 pandemic, which brought UK dentistry to a standstill. The market has seen a recent influx of unproven extraoral scavengers (EOSs), which claim to reduce the risk of particulate spread.Aims To investigate the efficacy of a commercially available EOS device on contamination reduction during dental aerosol generating procedures (AGPs). The secondary aim was to investigate differences between open and closed dental operatories.Method Dental procedures were simulated on a dental manikin using citric acid (10%) added to the water lines with universal indicating paper (UIP) placed in strategic locations in the operatory, on the clinician and assistant. Chromatic change related to settling of splatter containing citric acid on the UIP was analysed to calculate percentage intensity of splatter contamination.Results EOSs resulted in 20% reduction in frequency and 75% reduction in mean intensity of contamination of operatory sites. There was a 33% and 76% reduction in mean intensity contamination for clinician and assistant, respectively. Use of rubber dam and four-handed dentistry resulted in further reduction.Discussion This exploratory study demonstrates contamination by splatter in a simulated dental setting. The concern in dentistry regarding aerosol requires further quantitative investigation of smaller particles.Conclusions The routine use of four-handed dentistry and rubber dam should continue where possible to maximise risk mitigation during AGPs. However, on the basis of our findings, the use of an EOS device can further mitigate the magnitude and concentration of splatter.

Splendid isolation: a practical guide to the use of rubber dam part 2

Rubber dam isolation is generally considered to be the optimal method of moisture control in dentistry and is taught at the vast majority of dental schools worldwide. Unfortunately, undergraduate training does not always translate into use in dental practice, with the majority of clinicians never using a rubber dam, even for endodontic procedures, where its use is regarded as the standard of care nationally and internationally. The COVID-19 pandemic has increased interest in the use of rubber dam as a highly effective infection control barrier. As professional and patient experience of rubber dam isolation is extremely limited, this paper, and the preceding one, are designed to support the practical training of clinical teams in the confident, skilful use of rubber dam. Part two provides a practical guide to rubber dam isolation techniques for endodontic and operative/restorative procedures. CPD/Clinical Relevance: Mastering rubber dam isolation will enhance patient care and be professionally rewarding for clinical teams.

What happened to our former students five to six years after graduation? An endodontic teacher's perspective.

Endodontic teaching follows common concepts in the four Swiss dental schools. The aim of this survey was to ask former Swiss dental students how they adopted these endodontic concepts in clinical practice. All the graduates of the years 2012 and 2013 (n = 196) were targeted in 2018 using an internet-based anonymous questionnaire, which was based on five initial questions. One hundred forty-one individuals (participants) filled in these questions on their work situation and referral concepts (72% response rate). Those 111 participants who performed root canal treatments themselves were the focus group. They answered an additional 11 questions. Their affinity towards performing endodontic treatments was investigated. The use of rubber dam isolation served as a surrogate to see if biological principles were respected. Furthermore, it was asked which instrumentation systems they used in daily practice, and how they perceived the impact of their superior/employer on these choices. Of the 141 survey participants 55 were men and 86 women. Thirty-eight of these (27%) reported to refer difficult endodontic cases. Individuals in the focus group had an overall positive attitude towards endodontics. There was very little variance in the responses between the four Swiss dental schools. The vast majority (86.5%) reported to use rubber dam routinely. More than half in the focus group used reciprocating systems, and only a few (22.5%) would still use the rotary system they were taught at university. There was a significantly (p < 0.05) higher perceived impact of the employer on choice of instrumenting system versus the use of rubber dam.

What happened to our former students five to six years after graduation? An endodontic teacher's perspective.

Endodontic teaching follows common concepts in the four Swiss dental schools. The aim of this survey was to ask former Swiss dental students how they adopted these endodontic concepts in clinical practice. All the graduates of the years 2012 and 2013 (n = 196) were targeted in 2018 using an internet-based anonymous questionnaire, which was based on five initial questions. One hundred forty-one individuals (participants) filled in these questions on their work situation and referral concepts (72% response rate). Those 111 participants who performed root canal treatments themselves were the focus group. They answered an additional 11 questions. Their affinity towards performing endodontic treatments was investigated. The use of rubber dam isolation served as a surrogate to see if biological principles were respected. Furthermore, it was asked which instrumentation systems they used in daily practice, and how they perceived the impact of their superior/employer on these choices. Of the 141 survey participants 55 were men and 86 women. Thirty-eight of these (27%) reported to refer difficult endodontic cases. Individuals in the focus group had an overall positive attitude towards endodontics. There was very little variance in the responses between the four Swiss dental schools. The vast majority (86.5%) reported to use rubber dam routinely. More than half in the focus group used reciprocating systems, and only a few (22.5%) would still use the rotary system they were taught at university. There was a significantly (p < 0.05) higher perceived impact of the employer on choice of instrumenting system versus the use of rubber dam.

Splendid Isolation: a Practical Guide to the Use of Rubber Dam Part 1

Rubber dam isolation is generally considered to be the optimal method of moisture control in dentistry and is taught at the majority of dental schools worldwide. Unfortunately, undergraduate training does not always translate into use in dental practice, with the majority of clinicians never using a rubber dam, even for endodontic procedures, where its use is regarded as best practice in the United Kingdom (UK) and elsewhere. The COVID-19 pandemic has increased interest in the use of rubber dam as a highly effective infection control barrier. As professional and patient experience of rubber dam isolation is extremely limited, these two papers are designed to support the practical training of clinical teams in the confident, skilful use of rubber dam, to outline its advantages and to help overcome barriers to its routine use. Part one provides an update of the latest equipment and materials for rubber dam isolation and part two provides a practical guide to rubber dam isolation techniques for endodontic and operative/restorative procedures.CPD/Clinical Relevance: Mastering rubber dam isolation will enhance patient care and be professionally rewarding for clinical teams.

Investigating acute management of irreversible pulpitis: a survey of general dental practitioners in North East England.

Objective To investigate current strategies of acute management of irreversible pulpitis by general dental practitioners.Design A postal survey was sent to a representative sample based on postal code to 180 dentists registered with the General Dental Council in the North East of England. The questionnaire identified general dental practitioners' strategies for the diagnosis and acute management of irreversible pulpitis.Results One hundred and three questionnaires were returned. Irreversible pulpitis was primarily diagnosed from patients' signs and symptoms. There was a high confidence in anaesthetising a tooth with irreversible pulpitis. Treatment was undertaken with either pulpotomy (with a view to single or multi-stage orthograde root canal treatment) or full extirpation in just over half of respondents (51%). Seventy-one percent of respondents reported using different intrapulpal medicaments. Antibiotics were 'frequently' prescribed in cases of irreversible pulpitis by 25% of respondents. For endodontic procedures, dental dam usage was generally low and used 'occasionally' or 'never' by 40% of respondents.Conclusions Antibiotics were being inappropriately prescribed in the management of irreversible pulpitis, transgressing from NICE guidelines on antibiotic usage. Rubber dam use is not universal during the initial management of pulpitis, or during the definitive endodontic procedure, impacting upon the safety and predicility of outcome. Respondents often placed medicaments into the pulp, in spite of a lack of evidence for their efficacy.

Endodontic considerations of survival rate for autotransplanted third molars: a nationwide population-based study.

To investigate whether the timing of root canal treatment (primary aim) or other endodontic parameters (secondary aim) is associated with the survival probability of autotransplanted third molars, using a nationwide population-based database. A total of 1811 third molars autotransplanted between 2000 and 2013 met the inclusion criteria and were followed until the end of 2016. The teeth were classified into three groups on the basis of timing between root canal treatment and the autotransplantation: preoperative, extraoral and postoperative treatment groups. Univariate and multivariate Cox proportional hazards models were used to estimate the association between the timing of root canal treatment and the risk of tooth extraction after autotransplantation. Of the 1811 autotransplanted third molars, 462 were extracted, yielding a 17-year survival probability of 0.578. The survival probability of autotransplanted teeth that received postoperative root fillings after 17years was 0.583, which was significantly higher than the 0.434 and 0.566 for teeth that received preoperative and extraoral root fillings, respectively (P=0.0013). After adjustment for potential confounding factors, teeth that received postoperative root fillings were associated with a significantly lower tooth extraction hazard ratio (HR) compared with those that received extraoral root fillings (adjusted HR, 1.43; 95% confidence interval [CI], 1.14-1.78) and those that received preoperative root fillings (adjusted HR, 2.13; 95% CI, 1.19-3.82). Furthermore, the use of a rubber dam during postoperative root filling was associated with a significantly lower extraction rate after autotransplantation (adjusted HR, 0.54; 95% CI, 0.43-0.69). Postoperative root canal treatment resulted in a significantly lower extraction rate than did preoperative or extraoral root canal treatment amongst autotransplanted third molars during a mean follow-up period of 8.33years. Rubber dam use is recommended during postoperative root canal treatment to improve the outcomes of autotransplantation.

Application of Quality Control Circle in Promoting the Use of Rubber Dams in the Root Canal Treatment of Primary Teeth.

Objective Study the effect of quality control circle (QCC) in promoting the usage of rubber dams (RD) in root canal treatment of chronic pulpitis in primary teeth. Methods Set up a quality control group to increase the amount of rubber dams used in the treatment of chronic pulpitis in primary teeth. Monthly monitoring results of the usage amount were counted by the outpatient computer system. Relevant data were collected through questionnaires, and causes of low utilization were analyzed, and the improvement measurements were formulated and implemented. Quality control circle activity was evaluated. Results Through the quality control circle activity, the consumption of rubber dams in the root canal treatment of chronic pulpitis was significantly improved, children in treatment became more cooperative, and operation time of root canal treatment has also been shortened. Conclusion The quality control circle activities played a significant role in promoting the use of rubber dams in the root canal treatment of primary teeth, and it can be used as a method to promote new clinical treatment programs.

Endodontic Treatment in Switzerland. A National Survey

The purpose of this study was to collect information about current treatment protocols of endodontic procedures among general practitioners (GP), endodontically interested practitioners (EI) and endodontic specialists (ES) in Switzerland and to compare them with available endodontic quality guidelines and former surveys. A questionnaire was distributed to 1,522 attendees of two national conferences (Swiss Dental Association, 2015; Swiss Society for Endodontology, 2016) addressing socio-demographic characteristics and specific questions about root canal treatments (RCT) including techniques and materials used. Five hundred and six surveys were collected comprising data of 81.8% GP, 14.4% EI and 3.8% ES (response rate: 33.2%). The majority of respondents was male (59.9%), 40–59 years old (55.9%) with >20 years of clinical experience (54.3%). 498 participants (98.4%) stated to perform RCT. Rubber dam was always used in 52.2% of GP, 69.9% of EI and 89.5% of ES, while never-user accounted for 14.1%. Overall, 63.9% used loupes and 13.7% microscopes (mostly by ES). Rotating instruments were selected in 43.2%, followed by conventional hand-instruments (37.8%) and reciprocating instruments (19%). GP rarely activated irrigants and applied NaOCl in lower concentrations (>0.5–1%) compared to ES. GP preferred lateral compaction (57%), ES performed vertical compaction in 89.5%. 92% completed RCT after two or more visits. The majority of dentists in Switzerland follow the available quality guidelines and the present findings are coherent with internationally published surveys. Nonetheless, discrepancies are still present between daily practice and endodontic quality guidelines, especially with the routine use of rubber dam and working length determination, predominantly within the endodontic non-specialists.

Rubber Dam Isolation in Clinical Adhesive Dentistry: The Prevalence and Assessment of Associated Radiolucencies

Aim: This study aims to identify the prevalence of the use of rubber dam (RD) for isolation during resin composite restorations in a clinical scenario. It also aims to evaluate restorations done with and without RD for radiolucencies present postoperatively. Methods: A total of 50 voluntarily participating dentists were asked to do posterior composite restorations for primary caries lesions affecting the occluso-proximal surfaces. The isolation protocols followed were noted, and postoperative bitewing radiographs were evaluated independently by two investigators. The presence of radiolucencies between the tooth-restorative interface and in the body of the restoration was assessed and statistically evaluated using Chi-square test at a significance level of P≤ 0.05. Results: The results showed that 71.5% of the restorations were not done under RD isolation. There was a statistically significant difference in the number of radiolucent areas seen in restorations done with and without RD. Conclusion: This study shows a low percentage of clinicians use RD for isolation during composite restorations. It also indicates that radiolucent areas are more often associated with restorations done without RD isolation. This study stresses that there is a need to change the clinician's convictions about isolation protocols followed during composite restorations.

The 5-Year Survival Rate of Nonsurgical Endodontic Treatment: A Population-based Cohort Study in Korea

IntroductionThe purpose of the current population-based study was to analyze the 5-year survival rate of teeth that received nonsurgical endodontic treatment. Specifically, the variables affecting the 5-year survival rates of endodontically treated teeth were analyzed. MethodsThe present study included all endodontically treated teeth reported in 2010 in the National Health Insurance Cohort database of the Republic of Korea. By tracing the dental records of the sample to the end of 2015, the 5-year survival rates of the initial root canal treatment (RCT) and re-RCT were analyzed. Gender, age, institution type, diagnosis, arch type, tooth type, number of visits, and rubber dam usage were included in the analyses as confounding variables. ResultsIn total, 2,866,749 teeth received initial RCT, and 173,429 teeth received re-RCT. Five-year survival rates were 90.85% and 88.42%, respectively. The survival rate of teeth that received initial RCT was significantly higher than that of those that received re-RCT. Specifically, re-RCT showed a significantly higher rate of extraction within 12 months than during other intervals. Furthermore, the following characteristics significantly positively affected the 5-year tooth survival rate: being female, <20 years of age, hospital as the institution type, mandibular teeth, anterior teeth, initial RCT, and use of rubber dam. ConclusionsBecause of its high 5-year survival rate, endodontic treatment is an effective method for maintaining natural teeth.