A multivariate analysis of the outcome of endodontic treatment

Abstract

In the present study, multivariate analyses were performed on clinical and treatment variables that may influence the outcome of endodontic treatment. Data collected in a previous clinical-radiographic follow-up study were used. Of 810 treated, 675 roots in 498 teeth were followed for 6 months to 4 yr. Of these, 192 (the CAP group) had pre-existing, chronic apical periodontitis and 483 (the NAP group) had not. Root canal treatment followed a standard procedure with one of three sealers chosen at random. Demographic, clinical and radiographic variables were recorded at the start of, and during treatment. The periapical index (PAI) score was used to record the outcome of treatment, and applied in two different endpoint modes (END1 and END2) as the dependent variable for multivariate statistical analyses using logistic regression and the general model. The modes reflected increasing PAI scores (END1) and conventional success/failure assessment (END2). Dropouts were largely similar to the cases followed up. A total of 10 preoperative and peroperative variables were found to be significantly associated with treatment outcome by the multivariate analyses of either the total material or the NAP or CAP subgroups. Several of these were not significant in univariate analyses (e.g. the effect of sealer). Conventional success/failure analyses (END2) identified fewer of the influential variables and had low explanatory power, whereas PAI scores on an ordinal scale (END1) were most sensitive in identifying variables of influence on the treatment outcome.

Influence of Hero Apical instruments on cleaning ovoid-shaped root canals

“…Although there are contradictory findings in the literature regarding the effects of apical enlargement on the outcome of treatment, [17][18][19][20][21] instrumentation to larger file sizes can also result in increased penetration of the irrigating needle and facilitate better irrigant exchange in the apical third of the root canal. [22][23][24] Previous studies report that the Hero 642 instruments are not able to clean the root canals completely, when used alone.…”

Periapical Healing of Endodontically Treated Teeth Filled Only in the Apical Third: A Randomized Controlled Trial

“…Notably, this study has only included mandibular teeth. It has been reported that a better outcome is usually observed in mandibular than in maxillary teeth (34). We do not promote stopping cleaning and shaping of the root canals or filling routinely only the api-cal third.…”

“…We excluded cases with presence of sinus tracts or periapical radiolucency was larger than 4 mm. A better prognosis has been reported in teeth with periapical lesions with diameter less than 5 mm compared to larger lesions (33,34). In addition, as we only included single rooted (one canal) teeth and distal roots of mo- lars, some clear complexi-ties of the treatment of multi-rooted teeth were eliminated.…”

Evaluation of coronal leakage and pathway of dye leakage after obturation with various materials for open apical foramina

“…Gutta-percha and sealer are usually used for obturation 2) . However, obturation with gutta-percha and sealer is not suitable for open apical foramina because of the risk of extrusion of root-filling materials 3) and deterioration of the long-term treatment outcome 4) . Because of this risk, open apical foramina, such as those in immature teeth, and overenlargement of root canal ends are treated by apexification with calcium hydroxide 5) .…”