Endodontic Case Assessment

Advances in the understanding of endodontic pathosis, aseptic technique, and principles of canal preparation and obturation have led to significantly increased and predictable healing rates for endodontic treatment—95% and higher under ideal conditions (Salehrabi R, Rotstein I. J Endod. 2004 Dec;30(12):846-50). However, the treatment must be delivered in a predictable manner by the treating practitioner to optimize the healing potential.

The AAE has developed practical tools to help every dentist overcome case assessment pitfalls:

Outcomes of Primary Endodontic Therapy Provided by Endodontic Specialists Compared with Other Providers

Burry, Jacob C., et al. Journal of endodontics 42.5 (2016): 702-705.

Introduction

The objective of this study was to compare the outcomes of initial nonsurgical root canal therapy for different tooth types provided by both endodontists and other providers.

Methods

By using an insurance company database, 487,476 initial nonsurgical root canal therapy procedures were followed from the time of treatment to the presence of an untoward event indicated by Current Dental Terminology codes for retreatment, apical surgery, or extraction. Population demographics were computed for provider type and tooth location. Kaplan-Meier survival estimates were calculated for 1, 5, and 10 years. Hazard ratios for provider type and tooth location were calculated by using the Cox proportional hazards model.

Results

The survival of all teeth collectively was 98% at 1 year, 92% at 5 years, and 86% at 10 years. Significant differences in survival on the basis of provider type were noted for molars at 5 years and for all tooth types at 10 years. The greatest difference discovered was 5% higher survival rate at 10 years for molars treated by endodontists. A hazard ratio of 1.394 was found when comparing other providers’ success with that of endodontists within this 10-year molar group.

Conclusions

These findings show that survival rates of endodontically treated teeth are high at 10 years after treatment regardless of provider type. Molars treated by endodontists after 10 years have significantly higher survival rates than molars treated by non-endodontists.