Elsevier

Journal of Endodontics

Volume 30, Issue 12, December 2004, Pages 846-850
Journal of Endodontics

Clinical Research
Endodontic Treatment Outcomes in a Large Patient Population in the USA: An Epidemiological Study

https://doi.org/10.1097/01.don.0000145031.04236.caGet rights and content

Outcome assessment of endodontic treatment is critical for appropriate case selection and treatment planning. However, reports on outcomes of nonsurgical endodontic treatment vary considerably. Epidemiological studies done in a large patient population and over a long follow-up period can provide the clinician with useful tools for clinical decision-making and assessment of tooth prognosis. In this study, outcomes of initial endodontic treatment done in 1,462,936 teeth of 1,126,288 patients from 50 states across the USA was assessed over a period of 8 yr. Treatment was done by private general practitioners and endodontists participating in the Delta Dental Insurance plan that insures approximately 14 million individuals in the USA. Overall, 97% of teeth were retained in the oral cavity 8 yr after initial nonsurgical endodontic treatment. The combined incidence of untoward events such as retreatments, apical surgeries, and extractions was 3% and occurred mostly within 3 yr from completion of treatment. Analysis of the extracted teeth revealed that 85% had no full coronal coverage. A significant difference was found between covered and noncovered teeth for all tooth groups tested (p < 0.001). In conclusion, it appears that initial nonsurgical endodontic treatment is a predictable procedure with high incidence of tooth retention after 8 yr.

Section snippets

MATERIALS AND METHODS

Data for this study were obtained from the Delta Dental Insurance Data Center located in Seattle, WA. This company insures approximately 14 million individuals in 50 states across the USA. It has maintained a computerized database of its claims since 1993.

The protocols and guidelines of evidence-based medicine for prognosis and outcome analysis as suggested by Sackett et al. were followed (7). These included analysis of a large patient population, common point for analysis initiation, long

RESULTS

A total of 1,462,936 teeth were evaluated in this study and included 309,979 anterior teeth (21%), 390,343 premolars (27%), and 762,614 molars (52%). At the end of the 8-yr observation period, a total of 1,420,963 teeth (97.1%) were retained in the oral cavity.

DISCUSSION

Endodontic treatment outcomes are related to treatment expectations (1). Often, the many endodontic outcome studies published in the literature vary in their results regarding the incidence of success and failure of initial endodontic therapy. While in several studies treatment success is measured by radiographic and clinical normalcy, others refer only to clinical normalcy (2, 3).

In this study, we attempted to analyze the outcomes of initial endodontic treatment from an epidemiological

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    The authors thank Dr. Michael Del Aguila from Delta Dental data center for assisting in data collection, Dr. Michael Melnick for the statistical analysis and the USC Endodontic Innovation and Development Fund.

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