Long-Term Follow-Up of Nonsurgical Endodontic Treatments Performed by One Specialist: A Retrospective Cohort Study about Tooth Survival and Treatment Success
Paolo Mareschi, Silvio Taschieri, Stefano Corbella
Abstract
BACKGROUND: The main aim of the retrospective cohort study was to evaluate tooth survival after the endodontic treatment over a period of more than 20 years. Moreover, success of the treatment and the correlation between baseline parameters and the outcomes were analyzed, and causes were recorded. MATERIALS AND METHODS: Clinical records (including radiographs) of subjects treated with endodontic procedures (both primary and secondary (nonsurgical retreatment)) were collected and analyzed, covering a period of up to 29 years. Type of the treatment, technique, adequacy of treatment performed, presence of baseline radiolucency, and symptoms at baseline were recorded. Moreover, failure (presence of radiolucency 2 years after treatment) and tooth extraction data and causes of them were recorded. Outcomes were explored by using survival analysis (Kaplan-Meier estimates and survival table analysis) and regression analysis (Cox regression). RESULTS: A total of 2,679 endodontically treated teeth were included in the analysis. After 20 years from the treatment, the cumulative survival rate for primary and secondary treatments was 84.10% (80.99%-87.21%) and 89.79% (86.68%-92.90%), respectively. No differences were found between primary and secondary treatments or with regard to the technique adopted. The presence of periapical radiolucency was correlated to higher odds of tooth extraction. CONCLUSIONS: Despite the limitations of the study, we can assume that the proportion of retained endodontically treated teeth was significantly high over a long-term period.