Retrospective study of orthograde-endodontics in a NSW tertiary referral hospital

Methods:

A retrospective cohort study model of patients having received primary endodontics at Sydney Dental Hospital between January 1996 and December 2002 was carried out.  Over 7000 patients were identified and randomly selected for review with specific inclusion and exclusion criteria determining eligibility. Treatment details, clinical and radiographic assessment at review from time of treatment were recorded to assess outcome at least 8 years after treatment.  Kaplan-Meir and Cox regression analyses determined overall success, survival and failure.

Results:

Two Hundred and Thirty Nine teeth were included in the study. At review, 188 teeth (78%) were retained and 51 teeth (22%) were lost/failed due to endodontic complications. Radiographic assessment showed 104 (43.5%) teeth with evidence of healing (success), while 135 teeth (56.5%) showed evidence of disease (survival).

It was seen that the risk of failure increased per year by 2.1%, a trend seeing increasing age directly related to endodontic failure. General Practitioners were 46% times less likely to result in failure compared to an Endodontist . A significant difference in the failure rate of smokers compared with non-smokers was found, with smokers at a 2.6 times  or 160% increased risk.

Conclusions: Approximately 78% of teeth survived at least 8 years following endodontics, with 43.5 % of teeth found to be disease free (success).  Age, operator and patient smoking were found significant in affecting the outcome