Restorative Treatment Subsequent to Endodontic Treatment in Predoctoral Dental Education

Objective: To evaluate the receipt and timeliness of restorative treatment following endodontic treatment by predoctoral dental students.

Methods: Administrative data obtained from an electronic patient record system were analyzed to identify all root canal procedures (D3310-D3330) performed during calendar years 2003-2006. For patients characterized as “patients of record,” i.e., receiving a course of treatment at the institution, subsequent restorative and prosthetic treatment provided for the endodontically treated tooth was identified and the elapsed time between obturation and placement of the initial permanent restoration was calculated. Analyses were initially performed for each year separately, and were combined after no trends in performance were observed. Anterior teeth, premolars, and molars were analyzed separately.

Results: For anterior teeth (n=232) 66% subsequently received a restoration. The median time to restoration receipt was 117 days, with 24% of teeth receiving the restoration within 30 days. For premolars (n=281) 75% were subsequently restored, median=101 days, with 26% within 30 days. For molars (N=273) these statistics were 83% restored, median=85 days, with 22% within 30 days. Ultimately, 39% of restored anterior teeth, 74% of restored premolars and 74% of restored molars received a cast restoration.

Conclusion: Most but far from all endodontically treated teeth are subsequently restored. To improve this proportion, the institution might consider withholding academic credit until a permanent restoration is placed. To reduce the risk of leakage represented by the inappropriately long period between endodontic treatment and restoration, the institution might consider requiring an effective intra-orifice barrier be placed in the endodontic treatment clinic, providing academic credit for a permanent restoration placed in this clinic, or establishing a maximum time until restoration after which academic credit for the endodontic treatment is lost.