ปัจจัยที่มีความสัมพันธ์กับอัตราการอยู่รอดของฟันที่ได้รับการรักษาคลองรากฟัน ในโรงพยาบาลเลย

Wannee  Sirisak; Pichai  Bunmasri

Authors

Wannee Sirisak Dental Department, Loei Hospital
Pichai Bunmasri Community Nursing Department ,Loei Hospital

Keywords:

Root canal treatment, Tooth survival, Crown, Periapical lesion, Prediction

Abstract

A retrospective study was conducted to investigate factors associated with the survival of endodontically treated teeth and to develop a predictive model for long-term survival. The study included 361 teeth that underwent root canal treatment at Loei Hospital between 2020 and 2022, with a minimum follow-up of 24 months. Factors associated with tooth survival were analyzed using Cox proportional hazards regression, and a prognostic model was developed using Weibull regression analysis.

Results Weibull regression analysis demonstrated that full-coverage crown restoration was significantly associated with improved tooth survival (adjusted hazard ratio [Adj HR] = 0.32, p = 0.005), whereas age ≥60 years was associated with an increased risk of tooth loss (Adj HR = 2.35, p = 0.042). No statistically significant differences were observed for sex, tooth position and type, pre-treatment periapical lesions, or root canal filling quality.

Conclusion Age and post-treatment crown restoration are important factors influencing the survival of root canal–treated teeth. However, pre-treatment periapical lesions showed a clinically relevant increased risk and were therefore retained in the final Weibull survival model. This model provides useful prognostic information and may support treatment planning and patient counseling in clinical practice.

References

Friedman S, Mor C. The success of endodontic therapy-healing and functionality. J Calif Dent Assoc 2004;32(6):493-503.

American Association of Endodontists. Glossary of endodontic terms. 7th ed. Chicago: American Association of Endodontists; 2004.

Ng YL, Mann V, Gulabivala K. Tooth survival following non-surgical root canal treatment: A systematic review of the literature. Int Endod J 2010;43(3):171-89.

Gillen BM, Looney SW, Gu L-S, Loushine BA, Weller RN, Loushine RJ, et al. Impact of the quality of coronal restoration versus the quality of root canal treatment on periapical status: A systematic review and meta-analysis. J Endod 2011;37(7):895-902.

Thyvalikakath T, LaPradd M, Siddiqui Z, Duncan WD, Eckert G, Medam JK, et al. Root canal treatment survival analysis in National Dental Practice-Based Research Network practices. J Dent Res 2022;101(11):1328-34.

Rödig T, Vu M-T, Kanzow P, Haupt F. Long-term survival of endodontically treated teeth: A retrospective analysis of predictive factors at a German dental school. J Dent 2025;156:105662.

Laajala A, Nuutinen M, Luttinen A, Vähänikkilä H, Tanner T, Laitala M-L, et al. Survival of endodontically treated teeth in public dental service in Northern Finland: A practise-based register study. Acta Odontol Scand 2024;83:190-6.

Kim S-M, Ahn E. Tooth survival following non-surgical root canal treatment in South Korean adult population: An 11-year follow-up study of a historical cohort. Eur Endod J 2022;7(1):20-6.

Abu-Awwad M. Direct restorations versus full crowns in endodontically treated molar teeth: A three-year randomized clinical trial. J Dent 2025;105:105699.

Chotvorrarak K, Suksaphar W, Banomyong D. Fracture survival in endodontically treated molars restored with full-coverage crowns or resin composite restorations: A retrospective cohort study. Restor Dent Endod 2021;46(2):e29.

Caplan DJ, Kolker J, Rivera EM, Walton RE. Relationship between number of proximal contacts and survival of root canal treated teeth. Int Endod J 2002;35(3):193-9.

Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: Part 1: Periapical health. Int Endod J 2011;44(7):583-609.

Chugal NM, Clive JM, Spångberg LS. Endodontic infection: Some biologic and treatment factors associated with outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96(1):81-90.

de Chevigny C, Dao TT, Basrani BR, Marquis V, Farzaneh M, Abitbol S, et al. Treatment outcome in endodontics: The Toronto Study—Phases 3 and 4: Orthograde retreatment. J Endod 2008;34(2):131-7.

Ahmed MA, et al. Factors affecting outcome of periapical surgery: size of periapical lesion. Appl Sci 2021;11(24):11768.

Baseri M, Radmand F, Milani AS, Faraji Gavgani L, Salehnia F, Dianat O. The effect of periapical lesion size on the success rate of different endodontic treatments: A systematic review and meta-analysis. Evid Based Dent 2023;24(1):43-50.

Ng Y-L, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: Systematic review of the literature–Part 2. Influence of clinical factors. Int Endod J 2008;41(1):6-31.

Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: Part 2: Tooth survival. Int Endod J 2011;44(7):610-25.

Naito T, Toyoshima Y, Ito K, Inoue H. A meta-analysis of the effect of root canal filling length on the outcome of primary root canal treatment. J Endod 2005;31(6):469-74.

Silva EJNL, Belladonna FG, Zuolo AS, Souza EM. Clinical studies on core-carrier obturation: A systematic review and meta-analysis. BMC Oral Health 2017;17:164.

Kim S, Kim Y, Kim S, Jeon M. Influence of root canal filling technique on the success rate of primary non-surgical endodontic treatment: A systematic review. Restor Dent Endod 2022;47(3):e40.

Jirathanyanatt T, Suksaphar W, Banomyong D, Ngoenwiwatkul Y. Endodontically treated posterior teeth restored with or without crown restorations: A 5-year retrospective study of survival rates from fracture. J Investig Clin Dent 2019;10(4):e12426.