Influence of preoperative factors on the outcome of root canal treatment (Part 1): A retrospective clinical study
Keywords:Factor-affecting outcome, Success rate, root canal treatment, European Society of Endodontology.
Aim: The aim of this study was to evaluate the effect of preoperative prognostic variables (Gender, Age, General medical health, Tooth type, Tooth location, Pulpal and periapical status) on the outcome of the initial endodontic therapy. Material and methods: Ninety-one patients out of 109 were included and had complete medical and dental record. A total of 146 teeth received an endodontic treatment and overall 408 Canals obturated. All treatments were performed through 2018 and 2019, in a private Dental Clinic in Sirte, Libya. Two independent endodontists, who have analyzed all preoperative and postoperative radiographs. Treatment effectiveness was evaluated using the European Society of Endodontology's standards. The periapical index was used to grade the periapical state. Setting the level of significance at p ˂ 5% by applying chisquare Pearson test. Results: The initial root canal procedure had an overall success rate of 89.7%. The health status showed their power effect on success rate with 83.6% (p-value =0.0001). Periapical status had a strong effect on the outcome. Apical periodontitis (AP) was existing in 49 of all teeth, with a PAI >3 in 17 teeth. The success rate (SR) was 61.6%, 11.6%, 6.8% & 9.7% with teeth has PAI 1, PAI 2, PAI 3 and PAI >3, respectively (p-value = 0.004). However, pulpal status shows that the success rate for vital teeth was 57.5% and for nonvital teeth was 32.2%.Conclusion: Within the parameters of the investigation, medical health and periapical condition have demonstrated to be powerful significant outcome predictors
ABBOTT PV. 2012. Endodontics – Current and future. Journal of Conservative Dentistry, 13, 202-205.
AN GK, M. D., KUNIN M, GOLDBERGER RS, PSOTER WJ. 2016. Association of radiographically diagnosed apical periodontitis and cardiovascular disease: A hospital records-based study. Journal of endodontic, 42, 916-920.
BARBAKOW FH, C.-J. P., FRIEDMAN D 1981. Endodontic treatment of teeth with periapical radiolucent areas in a general dental practice. Oral Surgery, Oral Medicine, and Oral Pathology, 51, 552–9.
BARBAKOW FH, C.-J. P., FRIEDMAN D. 1980a. An evaluation of 566 cases of root canal therapy in general dental practice. 1. Diagnostic criteria and treatment details. Journal of Endodontics 6, 456–60.
BARBAKOW FH, C.-J. P., FRIEDMAN D. 1980b. An evaluation of 566 cases of root canal therapy in general dental practice. 2. Postoperative observations. Journal of Endodontics, 6, 485–9.
BENDER IB, S. S. 1961. Roentgenographic and direct observation of experimental lesions in bone:I. Journal of American Dental Association, 62, 152-60.
BENDER IB, S. S., FREEDLAND J. 1963. The relationship of systemic disease to endodontic failures and treatment procedures. Oral Surgery Oral Medicine Oral Pathology, Sep, 1102-15.
BENDER IB. 1982. Factors influencing the radiographic apperance of bone lesions. Journal of Endodontics, 8, 161-70.
BENENATI FW, K. S. 2002. A radiographic recall evaluation of 894 endodontic cases treated in a dental school setting. Journal of Endodontics, 28, 391-5.
BERLIN-BRONER Y., F. M., AND LEVIN I. 2017 Sep. Association between apical periodontitis and cardiovascular diseases: Asystematic review of the literature. International endodontic journal, 50, 847-859.
BRITTO LR, K. J., GUELMANN M, HEFT M. 2003 Periradicular radiographic assessment in diabetic and
control individuals. Oral Surgery Oral Medicine Oral Pathology Oral Radiology Endodontic, 96, 449-52.
CABANILLAS-BALSERA D, M.-G. J., MONTERO-MIRALLES P, SÁNCHEZ-DOMÍNGUEZ B, JIMÉNEZ-SÁNCHEZ 2006. Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health and Nutrition Examination Survey 1999–2002. Diabetes Care, 29, 1263-8.
CABANILLAS-BALSERA D, M.-G. J., MONTERO-MIRALLES P, SÁNCHEZ-DOMÍNGUEZ B, JIMÉNEZ-SÁNCHEZ 2019 Mar. Association between diabetes and nonretention of root filled teeth: a systematic review and meta-analysis. International endodontic journal, 52, 297-306.
CAPLAN DJ, C. J., KRALL EA, CAI J, KANG S, GARCIA RI, OFFENBACHER S, BECK JD. 2006. Lesions of endodontic origin and risk of coronary heart disease. Journal of dental research, 85, 996-1000.
CHERASKIN E, R. W. J. 1968 Jul. The biology of the endodontic patient. 3. Variability in periapical healing and blood glucose. Journal of Oral Medicine, 23, 87-90.
CHERNOFF R. 2004. Protein and older adults. Journal of American College of Nutrition, 236, 627-30.
CHEUNG GS, C. T. 2003. Long-term survival of primary root canal treatment carried out in a dental teaching hospital. International Endodontic Journal, 36, 117-28.
CHEUNG GS. 2002. Survival of first-time nonsurgical root canal treatment performed in a dental teaching hospital. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 93, 596-604.
COSTA TH, D. F. N. J., DE OLIVEIRA AE, LOPES E MAIA MDE F, DE ALMEIDA AL. 2014. Association between chronic apical perodontitis and coronary artery disease. Journal of endodontic, 40, 164-167.
DE CHEVIGNY C, D. T., BASRANI BR, MARQUIS V, FARZANEH M, ABITBOL S, FRIEDMAN S. 2008. Treatment outcome in endodontics: the Toronto study–phase 4: initial treatment. Journal of Endodontics 34, 258-63.
EUROPEAN SOCIETY OF ENDODONTOLOGY. 2006. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. International Endodontic Journal, 39, 921-930.
FALK H, H. A., THORSTENSSON H. 1989 Number of teeth, prevalence of caries and periapical lesions in insulin-dependent diabetics. Scandaniva Journal of Dental Research, 97, 198-206.
FERREIRA MM, C. E., CARRILHO F. 2014. [Diabetes mellitus and its influence on the success of endodontic treatment: a retrospective clinical study]. Acta Med Port., 27, 15-22.
FOROUHI NG, M. D., GOYDER E, FERGUSON BA, ABBAS J, LACHOWYCZ K, WILD SH 2006. Diabetes prevalence in England, 2001 – estimates from an epidemiological model. Diabetic Medicine, 23, 189-97.
FOUAD AF, B. J. 2003. The effect of diabetes mellitus on endodontic treatment outcome. Journal of American Dental Association 134, 43-51.
FRIEDMAN S, L. S. C., ZARRABIAN M, TROPE M 1995. Evaluation of success and failure after endodontic therapy using glass– ionomer cement sealer. Journal of Endodontics, 21, 384–90.
GOMES MS, H. F., HILGERT JB, SANT'ANA FILHO M, PADILHA DM, SIMONSICK EM, FERRUCCI L, REYNOLDS MA. 2016. Apical periodontitis and incident cardiovascular events in the Baltimore Longitudinal Study of Ageing. International endodontic journal, 49, 334-342.
GRAHNE´N H, H. L. 1961. The prognosis of pulp and root canal therapy. Odontologisk Revy, 12, 146-65.
HARGREAVES K., L. A. 2011. Pathway of the pulp. Mosby Elsevier.
HARTY FJ, P. B., WENGRAF AM 1970. Success rate in root canal therapy. A retrospective study on conventional cases. British Dental Journal, 128, 65-70.
HEBLING E, M. L., DIAS PV. 2007. Geriatric dentistry: a new specialty in Brazil. Gerodontology, 24, 177-80.
HOSKINSON SE, N. Y., HOSKINSON AE, MOLES DR, GULABIVALA K 2002. A retrospective comparison of outcome of root canal treatment using two different protocols. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 93, 705-15.
HUUMONEN S, Ø. D. 2002. Radiological aspects of apical periodontitis. Endodontic Topics, 1, 3-25.
INGLE JL, B. E., GLICK DH, WEICHMAN JA 1965. Modern endodontic therapy, Baltimore: Williams and Wilkins.
JANSSON L, L. S., FRITHIOF L, THEOBALD H. 2001. Relationship between oral health and mortality in cardiovascular disease. Journal of Clinical Periodontology, 28, 762-768.
KOJIMA K, I. K., NAGAMATSU K, HARA A, NAKATA K, MORITA I, NAKAGAKI H, NAKAMURA H. 2004. Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis. Oral Surgery Oral Medicine Oral Pathology Oral Radiology Endodontic, 97, 95–9.
LAUKKANEN E, V. M., KOTIRANTA AK. 2019a.
Impact of systemic diseases and tooth-based factors on outcome of root canal treatment. International endodontic journal, 52, 1417-1426.
LAUKKANEN E, V. M., KOTIRANTA AK., 2019b. Impact of type of tooth on outcome of non-surgical root canal treatment. Clinical Oral Investigations, 23, 4011-8.
LEE AH, C. G., WONG MC. 2012. Long-term outcome of primary non-surgical root canal treatment. Clin Oral Investig, 16, 1607-17.
LILIESTRAND J.M. 2016. Association of endodontic lesions with coronary artery disease. Journal of dental research, 95, 1358-1365.
LÓPEZ-LÓPEZ J, J.-S. E., ESTRUGO-DEVESA A, VELASCO-ORTEGA E, MARTÍN-GONZÁLEZ J, SEGURA-EGEA JJ. 2011 May. Periapical and endodontic status of type 2 diabetic patients in Catalonia, Spain: a cross-sectional study. Journal of endodontic, 37, 598-601.
MARENDING M, P. O., ZEHNDER M, 2005. Factors affecting the outcome of orthograde root canal therapy in a general dentistry hospital practice. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 99, 119-24.
MAROTTA PS, F. T., ARMADA L, LIMA KC, RÔÇAS IN, SIQUEIRA JF JR. 2012 Mar. Type 2 diabetes mellitus and the prevalence of apical periodontitis and endodontic treatment in an adult Brazilian population. Journal of endodontic, 38, 297-300.
MESSING M. 2019. Investigating potential correlations between endodontic pathology and cardiovascular diseases using epidemiological and genetic approaches. Journal of endodontic, 45, 104-110.
MOGFORD JE, S. M., BONOMO SR, ROBINSON AM, MUSTOE TA 2004. Impact of aging on gene expression in a rat model of ischemic cutaneous wound healing. Journal of Surgical Research, 118, 190-6.
NAGENDRABABU V, S.-E. J., FOUAD AF, PULIKKOTIL SJ, DUMMER PMH. 2019 Nov. Association between diabetes and the outcome of root canal treatment in adults: an umbrella review. International endodontic journal.
NAIR PN, H. S., CANO V, VERA J 2005. Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after ‘one-visit’ endodontic treatment. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics, 99, 231-52.
NELSON IA. 1982. Endodontics in general practice – a retrospective study. International Endodontics Journal, 15, 168–72.
NG LY, M. V., GULABIVALA K 2011a. A prospective study of the factors affecting outcomes of
non-surgical root canal treatment: part 2: tooth survival. International endodontic journal, 44, 610-25.
NG LY, M. V., GULABIVALA K 2011b. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. International Endodontic Journal, 44, 583–609.
NG YL, M. V., RAHBARAN S, LEWSEY J, GULABIVALA K. 2008. Outcome of primary root canal treatment: systematic review of the literature – part 2. Influence of clinical factors. International Endodontic Journal 41, 6-31.
OLIET S 1983. Single-visit endodontics: a clinical study. Journal of Endodontics, 9, 147–52.
ØRSTAVIK D, H.-B. P. 1993. A comparison of endodontic treatment results at two dental schools. International Endodontic Journal, 26, 348–54.
ORSTAVIK D., K. K., AND ERIKSEN H.M, 1986. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endodontics and Dental Traumatology, 2, 20-34.
PAREDES-VIEYRA J, J. E. F. 2012. Success rate of single versus two-visit root canal treatment of teeth with apical periodontitis: a randomized controlled trial. Journal of Endodontics, 38, 1164-1169.
PASQUALINI D, B. L., PALUMBO L, BORRACCINO A, DAMBRA V, ALOVISI M, MIGLIARETTI G, FERRARO G, GHIGO D, BERGERONE S, SCOTTI N, AIMETTI M, BERUTTI E. 2012. Association among oral health, apical periodontitis, CD14 polymorphisms, and coronary heart disease in middle-aged adults. Journal of endodontic, 38, 1570-1577.
RESTREPO-RESTREPO FA, C.-J. S., ROMERO-ALBARRACıN RD, VILLA-MACHADO PA, PEREZ-CANO MI, TOBON-ARROYAVE SI. 2019. Prognosis of root canal treatment in teeth with preoperative apical periodontitis: a study with cone-beam computed tomography and digital periapical radiography. International Endodontic Journal, 52, 1533-1546.
RICUCCI D, R. J., RUTBERG M, BURLESON JA, SPÅNGBERG LS. 2011. A prospective cohort study of endodontic treatments of 1,369 root canals: results after 5 years. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 112, 825-842.
SEGURA-EGEA JJ, M.-G. J., CABANILLAS-BALSERA D, FOUAD AF, VELASCO-ORTEGA E, LÓPEZ-LÓPEZ J. 2016 Jul. Association between diabetes and the prevalence of radiolucent periapical lesions in root-filled teeth: systematic review and meta-analysis. Clinical Oral investigation, 20, 1133-41.
SEGURA-EGEA JJ., J.-P. A., RÍOS-SANTOS JV, VELASCO-ORTEGA E., CISNEROS-CABELLO
R., POYATO-FERRERA M 2005 Aug. High prevalence of apical periodontitis amongst type 2 diabetic patients. International endodontic journal, 38, 564-9.
SEGURA-EGEA JJ., M.-G. J., CASTELLANOS-COSANO L. 2015. Endodontic medicine: connections between apical periodontitis and systemic diseases. International endodontic journal, 48, 933-51.
SELTZER S, B. I., TURKENKOPF S 1963. Factors affecting successful repair after root canal therapy. Journal of American Dental Association, 57, 651–62.
SHAKIBA B, H. R., PAK JG, BARBIZAM JV, OGAWA R, WHITE SN. 2017. Influence of increased patient age on longitudinal outcomes of root canal treatment: a systematic review. Gerodontology, 34, 101-109.
SJO¨GREN U, H. G. B., SUNDQVIST G, WING K 1990. Factors affecting the long-term results of endodontic treatment. Journal of Endodontics, 16, 498-504.
SMITH CS., S. D., HARTY FJ 1993. Factors influencing the success of conventional root canal therapy – a five-year retrospective study. International Endodontic Journal, 26, 321-33.
STAVROPOULOS A, W. A. 2007. Accuracy of cone beam dental CT, intraoral digital and conventional film radiography for the detection of periapical lesions. An ex vivo study in pig jaws. Clinical Oral Investigations, 11, 101-6.
STORMS JL 1969. Factors that influence the success of endodontic treatment. Journal of Canadian Dental Association, 35, 83–97.
STRINDBERG LZ 1956. The dependence of the results of pulp therapy on certain factors – an analytical study based on radiographic and clinical follow-up examinations. Acta Odontologica Scandinavica, 14, 1-175.
SUMAN ARYA, J. D., SANJAY TEWARI , PANKAJ SANGWAN , VEENA GHALAUT , SAMEER AGGARWAL 2017 Oct. Healing of Apical Periodontitis after Nonsurgical Treatment in Patients with Type 2 Diabetes. Journal of endodontic, 43 1623-1627. .
SUNDQVIST G. 1976. Bacteriological Studies of Necrotic Dental Pulps. Umea: Umea University.
SWARTZ DB, S. A., GRIFFIN JA 1983. Twenty years of endodontic success and failure. Journal of Endodontics 9, 198–202.
TAYLOR JJ, P. P., LALLA E. 2013. A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. Journal of Clinical Periodontology, 40 (Suppl), S113-S34.
VIRTANEN E., N. T., SODER P.O, AIRILA-MANSSON S., SODER B., AND MEURMAN J.H. 2017. Apical periodontitis associates with cardiovascular diseases: A cross-sectional study from Sweden. BMC Oral Health, 17, 1-8.
WADA M, T. T., NAKANUMA K, ARISUE K, NAGAHAMA F, YAMAZAKI M. 1998. Clinical study of refractory apical periodontitis treated by apicectomy. Part 1. Root canal morphology of resected apex. International Endodontic Journal, 31, 53-6.