Effect of restorative factors on the periapical status of well-obturated endodontically treated teeth: A retrospective cohort study
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Abstract
Objectives: This retrospective cohort study evaluated the effect of restorative factors on the periapical status of well-obturated endodontically treated teeth.
Materials and Methods: The clinical/radiographic data of restorative factors were gathered from patients receiving non-surgical root canal treatment at the Faculty of Dentistry/Mahidol University, Thailand, from October 2017 to December 2020; only well-obturated endodontically treated teeth were included. Coronal restoration quality, type of restoration, definitive restoration status, defective restorations during follow-up, waiting period for the definitive restoration, post placement, and other factors associated with post-retained restorations were collected. From the clinical/radiographic assessments, endodontic outcomes were evaluated as success (healed) or failure (healing/disease) rate. Multivariable modified Poisson regression analyses were conducted to identify significant risk factors to the outcome.
Results: The study analyzed 405 well-obturated endodontically treated teeth from 319 patients, 9-83 years old. At the 29.9 + 13.9-month recall, the overall success rate (healed) was 84.4%. The restorative factors that significantly decreased the success rate were (1) inadequate/unsealed coronal restoration, (2) temporary (e.g. Cavit or IRM) restoration, (3) absence of a definitive restoration, and (4) >6-month waiting period for definitive indirect restoration. For teeth with post-retained restorations, <4-mm remaining root filling and misdirected post-space preparation significantly reduced the success rate.
Conclusions: The success rate of well-obturated endodontic treatment was 84.4%. The adequate/sealed, definitive coronal restoration and placing an indirect restoration within 6 months improved the success rate. Moreover, >4-mm remaining root filling and appropriate post-space preparation significantly increased the success rate.
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