A prognostic model for assessment of the outcome of endodontic treatment: Effect of biologic and diagnostic variables

By Chugal N, Clive J,Spångberg L.

Summary: 

Purpose: to assess factors associated with outcome of endodontic treatment.

N= 200 teeth

Materials/Methods:

•Anatomic status, periodontal, pulpal, and periapical diagnosis, treatment history, treatment-associated factors including level of instrumentation and obturation, use of intracanal medication, and overall quality of endodontic treatment rendered were evaluated and recorded for each case retrospectively  (table 1 A).

•At follow up visit patient was assessed clinically and radiographically (Table B). Presence of PA lesion was assessed (strindberg, 1956).

Most highlighted Results:

  • Preoperative factors that affected the outcome: gender (higher in female) of the patient, pulp diagnosis, periapical diagnosis, size of periapical radiolucency, and presence of a sinus tract.
  • Treatment outcome (table IV).
  • No statistically significant difference in outcome between normal periapex and acute apical periodontitis.
  • Roots with chronic/exacerbating apical periodontitis had 3.67 risk of failure than normal periapex.
  • Cases with pulpitis and normal periapex had the highest success rate(87%), worst for necrotic with chronic/exacerbating apical periodontitis(61%). Retreatment cases with chronic or exacerbating apical periodontitis had a success rate of (69.8%)
  • Teeth with larger PA lesion had lower success rate than smaller PA lesion.
  • Strongest effect on postoperative healing was the presence and/or the extents of a preoperative periapical bone lesion .

Clinical significance

Developing a prognostic model  would certainly help in treatment planning