IADR Abstract Archives
25-year Prospective Follow-up of 2500 Endodontic Treatments
Objectives: The aims of the present work were 1) to assess the long-term outcome of endodontic treatments and 2) to identify the predictive factors for treatment success among a large set (>150) of potential predictors.
Methods: Data were collected systematically at the School of Dentistry of the UCLouvain (Brussels, Belgium) since 1990 in a Filemaker database. All treatments (n=2500) were performed by a single operator specialized in endodontics (JPVN) in his University clinics practice.
Information was recorded among clinical, technical, radiographic, patient-related characteristics.
Outcome was considered at the tooth level, and success was defined as the absence of clinical signs and symptoms as well as the absence of periapical radiolucencies. When several controls were performed for a given tooth, only the last one was eligible for analysis.
The data were analysed by performing univariate analyses, followed by multiple logistic regression. Survival curves were generated with Cox regression to illustrate long-term treatment success. Due to the number of candidate predictors, statistical significance level was set at 0.01.
Results: The follow-up period ranged from 0 to 298 months, with a mean of 77.5 months and a median of 59 months. Complete follow-up was achieved for 63.1% of the treatments. On the survival curve based on the 6 covariates significantly associated with treatment success (Fig. 1), the mean success rate was approximatively 90% at 5 years, 80% at 10 years, and 70% at 20 years. The inclusion of additional variables did not significantly improve the fit of the model.
Conclusions: Endodontic treatment success is not a static outcome, but evolves with time. Over the large number of variables included, only a small proportion were significantly predictive of success. This observation, and the disease- and patient-related characteristics of these variables challenge the current byzantine considerations related to endodontic procedures.
Methods: Data were collected systematically at the School of Dentistry of the UCLouvain (Brussels, Belgium) since 1990 in a Filemaker database. All treatments (n=2500) were performed by a single operator specialized in endodontics (JPVN) in his University clinics practice.
Information was recorded among clinical, technical, radiographic, patient-related characteristics.
Outcome was considered at the tooth level, and success was defined as the absence of clinical signs and symptoms as well as the absence of periapical radiolucencies. When several controls were performed for a given tooth, only the last one was eligible for analysis.
The data were analysed by performing univariate analyses, followed by multiple logistic regression. Survival curves were generated with Cox regression to illustrate long-term treatment success. Due to the number of candidate predictors, statistical significance level was set at 0.01.
Results: The follow-up period ranged from 0 to 298 months, with a mean of 77.5 months and a median of 59 months. Complete follow-up was achieved for 63.1% of the treatments. On the survival curve based on the 6 covariates significantly associated with treatment success (Fig. 1), the mean success rate was approximatively 90% at 5 years, 80% at 10 years, and 70% at 20 years. The inclusion of additional variables did not significantly improve the fit of the model.
Conclusions: Endodontic treatment success is not a static outcome, but evolves with time. Over the large number of variables included, only a small proportion were significantly predictive of success. This observation, and the disease- and patient-related characteristics of these variables challenge the current byzantine considerations related to endodontic procedures.
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