success Flashcards
TORONTO STUDIES
Initial treatment: Phase IV • Healed rate 88% in phase IV. • 87% phase II, 86% phase III. • Overall functional retention 95% • overall heal rate 86%
Significant Outcome predictors:
1. multi root tooth - diff heal rate 11%
• multi 84% single 93%
2. presence of preop AP- diff heal rate 11%.
• absent 93% present 82%
3. Mid tx complication - lower heal rate by 15%
4. root filling technique- diff heal rate 10%
• LC 77%
• VC 87%
TORONTO STUDIES
Retreatment/apical surgery
Phase III, IV, V
Retreatment/apical surgery. Phase III, IV, V
74% healed after apical surgery (4-10years)
• 94% functional
• 84% healed or diminished lesion.
BIOPSY:
- 75% periapical granuloma
- 15% cyst
- 4.6%scar- tooth-bone-p
OUTCOME PREDICTORS: 1. short/long RF • short/long RF 84% heal rate vs adequate RF of 68% heal rate 2. <45 years • 84% >45 • 68% <45 3. crypt size <10mm • <10mm 80% heal rate • >10mm 53% heal rate
NG et al 2010
Tooth survival 2–10 years after root canal treatment to range from 86% to 93%.
PROGNOSTIC FACTOR FOR SURVIVAL OF RCT
- teeth restored with a crown after treatment
- teeth with mesial and distal proximal contacts
- teeth not functioning as abutment for removable or fixed prosthesis
- non-molar teeth
most failures were noted w/in 24 mo
Seltzer & Bender 1967
• Guidelines for clinical assessment of success are outlined.
• Failures become apparent 6 mo to 2 yrs after tx.
• Only 2% of the teeth looked at histologically had scar tissue, so it is a pretty rare occurrence.
Definition of clinical success:
1. Absence of pain/swelling.
2. Disappearance of fistula.
3. No loss of function.
4. No evidence of tissue destruction.
5. Rdx evidence of an eliminated or arrested area of rarefaction 6 months to 2 years post-op
Seltzer & Bender 1966
86% success rate in teeth with AP
96% success rate in teeth w/o AP
Re-treatment- success rate 62% in teeth with AP
Re-treatment- success rate 90% if can instrument to full length of canal
Sjogren et al 1990
Coronal seal more important than RCT itself. Good endo with good resto: success rate 91%
Trope 1995
The 4-year survival rate of root-treated teeth after 1°RCT or 2°RCTx was 95%
Prognostic factors:
Conditions found to improve tooth survival following 1°RCT or 2°RCTx were:
1. patients not suffering from diabetes or receiving systemic steroid therapy;
2. absence of pre-operative deep periodontal probing defects,
3. pain and sinus tract;
4. absence of pre- and intra-operative tooth perforation;
5. achievement of patency at canal terminus;
6. absence of root filling extrusion;
7. teeth with cast restoration after treatment;
8. teeth with both mesial and distal adjacent teeth present;
9. teeth not requiring cast post and core for support and retention of restoration.
Ng et al 2011
81% of short root fillings are able to be improved upon retreatment
Hoen & Pink, 2002
42% of retreatment cases had previously untreated anatomy
Bergenholtz et al 1979
In teeth where the natural root canal morphology has been preserved by prior RCT, 86% success rates for retreatment were found. 41% success rate if procedural errors present.
Gorni and Gagliani 2003
The survival rate of retreatment cases at 5 years is reported to be 89%
Salehrabi & Rotstein 2010
According to 2 recent meta-analyses, the pooled weighted success rate for nonsurgical retreatment was 76.6% and 78%, with a range of 62%–86% in the reported literature
Ng et al 2011
Torabinejad et al 2009
74% of endodontic failures were successfully managed by re-treatment
Infection at the time of root filling and size of the periapical lesion were factors that had a negative influence on the prognosis.
Sundqvist et al 1998
Endodontic surgery offered higher initial success, but non-surgical retreatment offered a more favorable long-term outcome Endo surgery- success • 2-4 years 77.8% • 4-6 years 71.8% • >6 years 62.9% Non-surgical retreatment- success • 2.4 years 70.9% • 4-6 years 83%
Torabinejad et al 2009
