Tooth survival following non-surgical root canal treatment: a systematic review of the literature
- PMID: 20158529
- DOI: 10.1111/j.1365-2591.2009.01671.x
Tooth survival following non-surgical root canal treatment: a systematic review of the literature
Abstract
Aims: To investigate (i) the effect of study characteristics on reported tooth survival after root canal treatment (RCTx) and (ii) the effect of clinical factors on the proportion of root filled teeth surviving after RCTx.
Methodology: Longitudinal human clinical studies investigating tooth survival after RCTx which were published up to the end of 2007 were identified electronically (MEDLINE and Cochrane database 1966-2007 December, week 4). In addition, four journals (Dental Traumatology, International Endodontic Journal, Journal of Endodontics, Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics), bibliographies of all relevant articles and review articles were hand searched. Two reviewers (Y-LN, KG) assessed and selected the studies based on specified inclusion criteria and extracted the data onto a pre-designed proforma, independently. The criteria were as follows: (i) clinical study on RCTx; (ii) stratified analysis of primary and secondary RCTx available; (iii) sample size given and larger than 10; (iv) at least 6-month postoperative review; (v) success based on survival of tooth; and (vi) proportion of teeth surviving after treatment given or could be calculated from the raw data. Three strands of evidence or analyses were used to triangulate a consensus view. The reported findings from individual studies, including those excluded for quantitative analysis, were utilized for the intuitive synthesis, which constituted the first strand of evidence. Secondly, the pooled weighted proportion of teeth surviving and thirdly the combined effects of potential prognostic factors were estimated using the fixed and random effects meta-analyses on studies fulfilling all the inclusion criteria.
Results: Of the 31 articles identified, 14 studies published between 1993 and 2007 were included. The majority of studies were retrospective (n = 10) and only four prospective. The pooled percentages of reported tooth survival over 2-3, 4-5 and 8-10 years following RCTx were 86% (95% CI: 75%, 98%), 93% (95% CI: 92%, 94%) and 87% (95% CI: 82%, 92%), respectively. Substantial differences in study characteristics were found to hinder effective direct comparison of findings. Evidence for the effect of prognostic factors on tooth survival was weak. Based on the data available for meta-analyses, four conditions were found to significantly improve tooth survival. In descending order of influence, the conditions increasing observed proportion of survival were as follows: (i) a crown restoration after RCTx; (ii) tooth having both mesial and distal proximal contacts; (iii) tooth not functioning as an abutment for removable or fixed prosthesis; and (iv) tooth type or specifically non-molar teeth. Statistical heterogeneity was substantial in some cases but its source could not be investigated because of insufficient available information.
Conclusions: The pooled proportion of teeth surviving over 2-10 years following RCTx ranged between 86% and 93%. Four factors (listed above) were identified as significant prognostic factors with concurrence between all three strands of evidence.
Comment in
-
Tooth survival after root canal treatment.Evid Based Dent. 2011;12(1):10-1. doi: 10.1038/sj.ebd.6400772. Evid Based Dent. 2011. PMID: 21436855
Similar articles
-
Outcome of secondary root canal treatment: a systematic review of the literature.Int Endod J. 2008 Dec;41(12):1026-46. doi: 10.1111/j.1365-2591.2008.01484.x. Int Endod J. 2008. PMID: 19133093 Review.
-
Outcome of primary root canal treatment: systematic review of the literature - part 1. Effects of study characteristics on probability of success.Int Endod J. 2007 Dec;40(12):921-39. doi: 10.1111/j.1365-2591.2007.01322.x. Epub 2007 Oct 10. Int Endod J. 2007. PMID: 17931389 Review.
-
A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival.Int Endod J. 2011 Jul;44(7):610-25. doi: 10.1111/j.1365-2591.2011.01873.x. Epub 2011 Mar 2. Int Endod J. 2011. PMID: 21366627
-
Outcome of endodontic surgery: a meta-analysis of the literature--Part 2: Comparison of endodontic microsurgical techniques with and without the use of higher magnification.J Endod. 2012 Jan;38(1):1-10. doi: 10.1016/j.joen.2011.09.021. Epub 2011 Nov 21. J Endod. 2012. PMID: 22152611 Review.
-
A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health.Int Endod J. 2011 Jul;44(7):583-609. doi: 10.1111/j.1365-2591.2011.01872.x. Epub 2011 Mar 2. Int Endod J. 2011. PMID: 21366626
Cited by
-
Predicting early endodontic treatment failure following primary root canal treatment.BMC Oral Health. 2024 Mar 12;24(1):327. doi: 10.1186/s12903-024-03974-8. BMC Oral Health. 2024. PMID: 38475776 Free PMC article.
-
The incidence of dental fractures in the Italian population during the COVID-19 pandemic: An observational study.J Conserv Dent Endod. 2024 Feb;27(2):146-153. doi: 10.4103/JCDE.JCDE_241_23. Epub 2024 Feb 8. J Conserv Dent Endod. 2024. PMID: 38463480 Free PMC article.
-
Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth.Cureus. 2024 Jan 8;16(1):e51837. doi: 10.7759/cureus.51837. eCollection 2024 Jan. Cureus. 2024. PMID: 38327954 Free PMC article.
-
Attitudes regarding a warranty and the expected longevity of dental treatment amongst New Zealand dentists, dental students, and patients: a mixed methods survey.BMC Oral Health. 2024 Jan 13;24(1):74. doi: 10.1186/s12903-024-03860-3. BMC Oral Health. 2024. PMID: 38218853 Free PMC article.
-
Endodontic Retreatment of a Maxillary First Molar With Orthograde Retrieval of a Separated File by a Combination of Ultrasonic and File Braiding Techniques: A Case Report.Cureus. 2023 Dec 7;15(12):e50140. doi: 10.7759/cureus.50140. eCollection 2023 Dec. Cureus. 2023. PMID: 38186462 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources