Factors Affecting Treatment Visit Frequency in a Postdoctoral Endodontic Program

Objectives: To analyze the relationship between number of endodontic treatment visits per case (tooth) versus clinical diagnoses, anatomic tooth group and year of residents training in a 2-year postdoctoral program.
Methods: Analyses were based on 10 years of data (2006-2015), n = 9700 completed cases. Included in the study were teeth undergoing primary treatment or retreatment. The relationship of the number of treatment appointments per case (one versus more than one) to pulpal and periapical diagnoses, anatomic tooth group (anterior, premolar, molar), and year of training (first, second), were evaluated. These associations were analyzed using Chi-square tests and logistic regression models, averaging over 10 years of data, at p-value <0.05 as the level of significance.
Results: The proportions of teeth completed in a single visit ranged from 6.5% to 32.5% over 10-years, and varied by the individual classes, p<0.001. In the overall analysis, the proportions of teeth completed in a single visit, were the highest for normal pulp (36.0%) and smallest for retreatment (7.8%), p<0.001. However, the relationship between pulpal diagnosis and the probability of single visit treatment was affected by the periapical diagnosis, p<0.001. The proportions of teeth that were completed in a single visit were the highest for normal periapex (26.3%), followed by apical periodontitis (10.4%), acute apical abscess (7.1%) and lastly chronic apical abscess (3.0%), p<0.001. This relationship was consistent across different pulpal diagnoses. The proportions of teeth that were completed in a single visit were higher for anteriors (20.2%) and premolars (21.4%) as compared to molars (10.9%). The proportion of teeth that were completed in a single visit was 22.6% in the second year vs 12% in the first year of the program, p<0.001.
Conclusions: Frequency of treatment visits was affected by multiple factors. The probability of single visit treatment was least likely for retreatment with chronic apical abscess.