Factors Affecting Outcomes of Teeth Endodontically Treated in Sjögren’s Patients

Objectives: Sjögren’s Syndrome patients (SSP) have reported in 2 surveys conducted by SSF and us that they spend 3 times what their healthy peers spend on dental care. The aim of this record review study was to identify factors affecting failure of endodontically treated teeth in SSP, and assess factors associated with failure and identify treatments that help manage the care of SSP impacted by hyposalivation and increased caries susceptibility.
Methods: Dental records of SSP seen in the Oral Medicine Clinic at Tufts University School of Dental Medicine were compiled, and their radiographs reviewed to identify which SSP had RCT Dental records of SSP seen in the Oral Medicine Clinic at Tufts University School of Dental Medicine were compiled, and their radiographs reviewed to identify which SSP had RCT implant placement. Of 373 records reviewed, 165 RCT (n=165) patients were identified. Using radiographs, date of the procedure (RCT) and date of the most recent radiograph were noted, and evaluated to determine treatment success/failure. Treatment success was defined as the tooth being functionally present. Factors potentially impacting failure for each treatment modality were recorded, including age, tooth number, restoration type, pre-operative proximal contacts, stimulated and unstimulated saliva flow, sialogogue usage, preventive oral hygiene with 1.1% NA F and MI paste, and fluoride varnish use.
Results: RCT teeth had a failure rate of 43.64%. An 82% reduction in odds of failing was found comparing preventive oral hygiene to no prevention. Use of a sialogogue showed a statistically signifigant lower rate of RCTteeth failure (0.039). Type of restoration, pre-operative proximal contacts, stimulated and unstimulated saliva flow were not significant.

Conclusions: It was confirmed that RCT is associated with higher failure rate when a strict preventive protocol is not adhered to. A combination of stimulation of flow and use of multiple preventive measures can reduce the impact of caries in a high risk population.Further studies with larger numbers of patients will be necessary to determine the best preventive protocol for Sjogrens patients.