Treatment outcome in endodontics: the Toronto study. Phases I and II: Orthograde retreatment.
The 4- to 6-year outcome of orthograde retreatment was assessed for Phases I and II of the Toronto Study. In total, 523 teeth in 444 patients were retreated. With 395 teeth lost to follow-up and 25 extracted, 103 teeth (34% recall) were examined by two independent, blinded, calibrated examiners for outcome: "healed" (absence of apical periodontitis, signs, or symptoms) or "diseased" (presence of apical periodontitis, signs, or symptoms). The "healed" rate (81%) differed significantly for preoperative apical periodontitis (absent, 97%; present, 78%) and perforation (absent, 89%; present, 42%). Logistic regression revealed an increased risk of disease for preoperative perforation and adequate root filling quality, and postoperative lack of definitive restoration (odds ratios = 26.5, 6.6, and 14.0, respectively). Without perforation, inadequate intraoperative root filling length was also identified (odds ratio = 6.8). This study suggested that apical periodontitis, although a strong predictor, was secondary to preoperative perforation and root filling quality, and to postoperative restoration, in predicting the outcome of retreatment.
Farzaneh
Mahsa
M
Discipline of Endodtics, Faculty of Dentistry, University of Toronto, Toronto, Ontario M5G 1G6, Canada.
Abitbol
Sarah
S
Friedman
Shimon
S
D000328:Adult; D002170:Canada; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010485:Periapical Periodontitis / Q000628:therapy*; D011446:Prospective Studies; D019233:Retreatment / Q000706:statistics & numerical data; D012390:Root Canal Therapy / Q000706:statistics & numerical data*; D016896:Treatment Outcome