Endodontic treatment outcome: effect of the permanent restoration.
OBJECTIVE
To investigate the relationship between the presence of the coronal restoration and endodontic treatment success or failure.


METHODS
This study comprised 200 endodontically treated teeth with 441 roots. Follow-up examination was conducted 4 +/- 0.5 years after completion of endodontic treatment. Outcome criteria were modified from Strindberg.


RESULTS
Teeth/roots restored with permanent coronal restoration (casting or filling) had a higher success rate (80%) than teeth/roots not restored (60%; P < .01) in the analysis of aggregate data. However, the results of stratified analysis on key confounding factor (preoperative periapical diagnosis) showed that there is no significant association between the presence of permanent restoration and endodontic outcome. Teeth with preoperative apical periodontitis were less likely to be restored with a crown (23.9%) than teeth without apical periodontitis (76.1%; P < .01). Anterior teeth were more likely to be restored with a filling and sooner than the posterior teeth. These associations suggest a treatment selection bias.


CONCLUSIONS
Stratified analysis on the key confounding factor reveals that endodontic outcome is driven by the presence of preoperative root canal infection (apical periodontitis). Lack of stratification on key confounding factors inaccurately suggests that presence of permanent restoration contributes to the success of endodontic treatment in the aggregate analysis of grouped data. The choice to restore the tooth as well as the choice and timing of permanent restoration may be the result of a bias in treatment selection. Stratified analysis on key confounding factors is the key to valid analysis and accurate results.
Chugal
Nadia M
NM
Section of Endodontics, University of California-Los Angeles School of Dentistry, Los Angeles, CA 90095-1668, USA. nchugal@ucla.edu
Clive
Jonathan M
JM
Spångberg
Larz S W
LS
D000704:Analysis of Variance; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D010485:Periapical Periodontitis / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D012390:Root Canal Therapy; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome