title: Impact of diabetes mellitus, hypertension, and coronary artery disease on tooth extraction after nonsurgical endodontic treatment.
abstract: BACKGROUND
  Limited prospective data are available on the long-term prognosis of teeth receiving nonsurgical root canal treatment (NSRCT) in patients with systemic diseases including diabetes mellitus (DM), hypertension (HT), and coronary artery disease (CAD). This prospective study aimed to elucidate the impact of systemic diseases on the risk of tooth extraction after NSRCT.
  
  
  METHODS
  A total of 49,334 NSRCT teeth were randomly selected from databank in October 2003 and were followed for 2 years for tooth extraction after NSRCT. Cox proportional hazards model was used to estimate the risk of tooth extraction after NSRCT.
  
  
  RESULTS
  Of the 49,334 teeth, 1592 (3.2%) were extracted during the 2-year follow-up period, yielding a 2-year tooth retention rate of 96.8%. We found that DM (hazard ratio [HR], 1.79), HT (HR, 1.75), and CAD (HR, 1.70) were significant risk factors for tooth extraction after NSRCT (all P values <.0001) in univariate Cox proportional analyses. After adjustment for age, gender, and tooth type in multivariate analyses, DM (HR, 1.29) and HT (HR, 1.18) remained as independent risk factors (both P values <.05). Simultaneous possession of 2 diseases of DM, HT, and CAD was a significant and robust predictor for an increased long-term risk of tooth extraction after NSRCT (P for trend <.001).
  
  
  CONCLUSIONS
  An increased risk of tooth extraction after NSRCT is significantly associated with DM, HT, and CAD individually. Moreover, the constellation of systemic disease burden also manifests the importance in addition to other potential confounders.
authors.affiliation: Department of Cardiology, Cardinal Tien Hospital, College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Wang
authors.forename: Ling-Huey
authors.initials: LH
authors.lastname: Chueh
authors.forename: Shih-Chung
authors.initials: SC
authors.lastname: Chen
authors.forename: Yen-Chen
authors.initials: YC
authors.lastname: Feng
authors.forename: Chuhsing K
authors.initials: CK
authors.lastname: Hsiao
authors.forename: Chun-Pin
authors.initials: CP
authors.lastname: Chiang
mesh_terms: D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease; D048909:Diabetes Complications; D003920:Diabetes Mellitus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016016:Proportional Hazards Models; D011446:Prospective Studies; D019233:Retreatment; D018570:Risk Assessment; D012390:Root Canal Therapy / Q000706:statistics & numerical data*; D013624:Taiwan; D014081:Tooth Extraction / Q000706:statistics & numerical data*; D019553:Tooth, Nonvital; D017211:Treatment Failure; D055815:Young Adult