Success of Root Canal Treatment on patients with HIV Infection

Objectives: This retrospective study evaluated the success rate of root canal therapy in 157 HIV positive patients who had undergone non-surgical endodontic treatment during 1998-2004 in a dedicated clinic.  Success was defined as (1) absence of complaint – pain/swelling, (2) periapical lesion absent or smaller at recall than on preoperative radiographs. Methods: Dental records and x-rays were reviewed to describe age, gender, medical history, antiretroviral medication, treatment dates and follow up evaluation. All root canal treatment was performed by endodontics residents following the American Academy of Endodontics guidelines. Radiographs were reviewed by a single practitioner who was responsible for seeing all the patients at 6 months recall. Results: The final group comprised of 157 HIV patients. 79.6% (n= 125) of the study group were males and 20.4 % (n=32) were females. There were no statistically significant findings when the success of the root canal therapy was related to the antiretroviral therapy, CD4 count or viral load.  

N= 157; 100%	Success (n=140; 89.8%)		Failure (n=17; 10.9%)
	Males	Females	Males	Females
European American     (n= 94; 59.9% )	78	8	6	2
African American        (n=54; 34.4% )	29	16	4	5
Hispanic American      (n=9; 5.7%)	8	1	0	0

 

N= 157; 100%	Success (n=140; 89.8%)	Failure (n=17; 10.9%)
No Oral Lesions                      (n=120; 76.4%)	116	4
Oro-pharyngeal Candidiasis   (n=23; 14.7%)	11	12            (p<0.05)
Kaposi’s Sarcoma                   (n=2; 1.3%)	2	0
Oral Hairy Leukoplakia          (n=5; 3.2%)	4	1
Herpes Simplex                       (n=7; 4.5%)	7	0

Conclusions: The results of this study indicate that root canal treatment can be carried out following standard procedures in the HIV positive patient and without the need for antibiotic prophylaxis. The role of yeasts in root canal infection is not completely understood. Further studies should be carried out to assess the role of candidiasis and whether this affects the success of treatment.