Local, Systemic, and Genetic Considerations of Endodontic Treatment Prognosis
The outcome of nonsurgical endodontic treatment/re-treatment and the survival of the endodontically treated tooth depend on many known and possibly unknown factors. Among the ones that have been identified in the literature, 21 factors will be discussed i
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Matthew Malek and Louis M. Lin
Abstract
The outcome of nonsurgical endodontic treatment/re-treatment and the survival of the endodontically treated tooth depend on many known and possibly unknown factors. Among the ones that have been identified in the literature, 21 factors will be discussed in this chapter. These factors are classified under local (including anatomical, preoperative, intraoperative, and postoperative) and systemic (including demographic, genetic, systemic disease and medications, and geriatric) factors. Each factor is reviewed, and its effect on the outcome of the endodontic treatment and/or survival of the treated tooth is discussed based on the highest available evidence. Among the factors discussed in this chapter, the ones that are believed to be strongly associated with the outcome of the root canal treatment/re-treatment are periapical status, apical extent of root canal filling, quality of the root canal filling, and quality of the restoration.
Many studies have been performed on the outcome of endodontic treatment. However, the results of these studies are not always consistent with one another. These inconsistencies may be due to different factors, such as adopting different definitions of success and failure [1–3], varied follow-up periods [2, 3], different sample sizes [1, 2], different geographical locations of study [3], different study methodologies [3], etc. In order to reconcile these inconsistencies and identify the most commonly accepted predictors, the base of this chapter will be focused on systematic reviews that have been done in those areas. Regarding the factors that have not been fully
M. Malek • L.M. Lin (*) Department of Endodontics, New York University College of Dentistry, New York, NY, USA e-mail: [email protected]; [email protected] © Springer International Publishing Switzerland 2017 N. Chugal, L.M. Lin (eds.), Endodontic Prognosis, DOI 10.1007/978-3-319-42412-5_11
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developed in systematic reviews, or if the reviews failed to satisfactorily identify the factors, an overview of the most important studies regarding those factors would be presented. For the sake of this chapter, the factors involved in the prognosis of root canal treatment are categorized under local and systemic factors listed below: Local Factors: • Anatomic factors • Preoperative factors • Intra- (inter)operative factors • Postoperative factors Systemic Factors: • Demographic factors • Genetic factors • Systemic diseases and medications • Geriatric patients
11.1 Local Factors 11.1.1 Anatomical Factors 11.1.1.1 Tooth Type Many studies have assessed the outcome of initial root canal treatment in relation to the tooth type, but the findings differ from one another. Kerekes and Tronstad [4] found that specific teeth (maxillary canines, second premolars, and mandibular canines) might have a better prognosis than others. Few other studies [5–7] found that mandibular molars had significantly lower success rates than other tooth types. In contrast, one study [8] o
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