Impact of diabetes mellitus, hypertension, and coronary artery disease on tooth extraction after nonsurgical endodontic treatment.

By Wang CH, Chueh LH, Chen SC, Feng YC, Hsiao CK, Chiang CP.

Date: 08/2012
Journal: JOE

Purpose: to assess the impact of systemic diseases (diabetes (DM), hypertension (HT) and coronary artery disease (CAD)) on the risk of tooth extraction after NSRCT.

  • N= 49,334 teeth treated with NSRCT. Excluded: Those with missing data or coding errors, deciduous teeth, and multiple teeth from 1 patient.


•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.

•DM was defined as having a fasting plasma glucose level ≥126 mg/ dL on 2 or more tests on different days, a random blood glucose level ≥ 200 mg/dL, hemoglobin A1c >6.5%  , or a history of treated DM.

•HT was defined as having repeated elevated blood pressure with systolic blood pressure ≥140 mm Hg and diastolic blood pressure ≥ 90 mm Hg, or history of treated HT.

Most highlighted 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%.
  • DM, HT, and CAD were significant risk factors for tooth extraction after NSRCT (all P values <.0001) (Hazard ratio HR: >1.7)
  • After adjustment for age, gender, and tooth type in multivariate analyses, DM (HR, 1.29) and HT (HR, 1.18) remained as independent significant risk factors (P values <.05).
  • Having 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<0.001). HR=1.53