Endodontic Treatment and OHRQoL Outcomes in General Practice

Objective: Report preliminary findings from an ongoing retrospective study to determine the clinical and patient-oriented outcomes for teeth endodontically treated and restored 3-5 years previously. This is a PEARL Network study, a dental Practice-Based Research Network

Methods: Participants were enrolled in a PEARL Network study, a dental practice-based research consortium. These participants had had teeth endodontically treated and restored 3-5 years previously by either the GP or specialist. Individuals were categorized by endodontic treatment and restorative care outcomes. Data collected included status of the tooth prior to endodontic treatment, current status of tooth, and oral health-related quality of life (OHRQoL) using the OHIP 14. OHRQoL scores were compared between individuals having endodontic and/or associated restorative failures and those who experienced successful treatment. Wilcoxon two sample tests compared OHIP scores between those with endodontic and/or restorative failures and those with successful treatment.

Results: Interim findings are from 34 PEARL Practitioner-Investigators who enrolled 342 participants (mean time since restoration was 3.9 years. Endodontic failures (e.g., tooth extracted, endodontic retreatment, pain on percussion) = 9.6%; and restoration failures (e.g., restoration replaced, tooth cracked or fractured) = 13.7%. OHIP results revealed significant OHRQoL differences (p<0.01) between those individuals with endodontic and related restoration failures versus those with successful treatment. Statistically significant differences were observed on each of the OHIP items. The most significant impact (>2 impact scores) were found in the Physical Pain subscale: 10/63 (15.9%) in the failure group versus 8/254 (3.2%) in the non-failure group (chi sq=15.26; p<.001).

Conclusions: Endodontic treatment and restoration outcomes in the GP setting have a combined failure rate at 3-5 years of 23.4% with 9.6% associated exclusively with endodontic failures. Significant OHRQoL differences are observed among those with reported failures, particularly in physical pain, compared to those without clinical treatment failures. Supported by NIDCR U01- DE016755.