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:
- Endodontic Case Difficulty Assessment Article (PDF File, 587KB)
This newsletter discusses endodontic treatment planning, case assessment, and referral from a specialist’s perspective.
- Reading List (PDF File, 48KB)
A comprehensive list of references supporting the topic of case assessment and referral.
- AAE Case Difficulty Assessment Form and Guidelines (PDF File, 411KB)
The Assessment Form enables a practitioner to assign levels of difficulty to a particular case by assessing risk factors that may affect the outcome of treatment. The form may also be used to assist with referral decision-making and record-keeping.
- Educator’s Guide to Using the AAE Endodontic Case Difficulty Assessment Form (PDF File, 44KB)
This guide is designed to assist educators in teaching predoctoral dental students objective evaluation and decision-making skills in endodontics.
- Forging Effective Alliances for Quality Patient Care (PDF File, 127KB)
This article discusses the value of effective referral relationships.
Outcomes of Primary Endodontic Therapy Provided by Endodontic Specialists Compared with Other Providers
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.
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.
The survival of all teeth collectively was 98% at 1 year, 92% at 5 years, and 86% at 10 years. Significant differences in survival based on provider type were noted for molars at 5 years and all tooth types at 10 years. The greatest difference discovered was a 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.
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.