Predicting Factors For One-Year Endodontic Treatment Outcome

Objectives: We recently reported that endodontic mishaps occurred frequently in cases in high difficulty category rather than in cases instrumented with engine-driven reciprocating files. Previous studies have shown that diagnosis has an impact on treatment outcome. However, the presence of mishaps in combination with case difficulty has not been reported before. The aim of this study was to investigate the treatment outcome in endodontic cases that were included in a previous study.
Methods: Recall data on 257 endodontically treated teeth that was previously included in a quality assurance study was collected from the electronic patient journal system at University of Bergen, Norway. All patients who received endodontic treatment were offered a one-year recall appointment. Treatment outcome was categorized according to Halse & Molven as success, failure and uncertain. Recall data was collected between a 6-18 month period after obturation. Failures related to the endodontic treatment before 6 months were also included in this study. A binary logistic regression analysis was done to identify predicting factors for treatment outcome.
Results: Out of 257 treated teeth, recall data was registered for 160 teeth (62.3%). Three teeth failed within the first 6 months. Treatment outcome was registered as successful in 129 (80.6%), uncertain 21 (13.1%) and failed 10 (6.3%) teeth. Significantly more teeth with endodontic mishaps had uncertain or failed treatment outcome (p=0.02). Significantly more teeth with periapical lesion had uncertain or failed treatment outcome (p=0.05). Neither case difficulty nor instrumentation method influenced the treatment outcome. Between presence of mishaps or periapical lesion, the main factor predicting uncertain or failed outcome was presence of mishaps with an odds ratio of 2.48 (95% CI:1.05-5.86).
Conclusions: Endodontic mishaps have a significant contribution to treatment outcome.