Endodontic treatment and restorative outcomes in general practice

Objective: This interim report is from an ongoing retrospective study designed to examine the clinical and patient reported outcomes for teeth endodontically treated and restored 3-5 years previously. This is a PEARL Network, general practice PBRN, effectiveness study.

Methods: Patients were recruited who had teeth treated and restored 3-5 years previously in the dental practice whether endodontic procedures were performed by the GP or specialist. Data collected for subjects included:

1. Status of the tooth prior to initiation of endodontic treatment.

2. All procedures associated with the index tooth after it was designated for endodontic therapy including endodontic treatment(s), restoration(s), re-endodontic treatment(s), extraction, and/or tooth replacement.

3. Current status of the tooth (present or absent; condition of the restoration; presence or absence of tenderness/percussion pain, presence or absence of proximal contacts)

4. Subjective assessment of the tooth (when present) by the subject (pain) and tooth related quality of life.

5. Periapical radiograph (taken for routine evaluation at the study visit or within 180 days of the study period) of the index tooth to detect the presence or absence of periapical or pericemental pathology, or root fracture.

Results: Selected interim findings for 34 PEARL Network enrolling sites and 342 subjects are as follows (mean time since restoration 3.9 years) (inclusion in one failure mode only):

Endo failure (9.6%) comprising

Extracted 5.0%

Endodontic retreatment 2.3%

Pain on percussion 2.3%

Restoration failure (15.1%) comprising

Restoration replaced 7.3%

Restoration needs replacement 5.2%

Teeth cracked or fractured 1.3%

Conclusions: Endodontic treatment and restoration outcomes in the general practice setting are higher than reported in the literature and have a combined failure rate at 3-5 years of 23.4% with 9.6% associated with endodontic failures. Radiographic findings are undergoing review and have not been included in these data. Supported by NIDCR U01- DE016755.