A Retrospective, Radiographic Outcomes Assessment of 1960 Initial Posterior Root Canal Treatments Performed by Endodontists and Dentists
Introduction
The
Air Force Dental Service has established evidence-based treatment
standards for endodontics, including 3-dimensional filling of the canal
system, cuspal coverage restoration of endodontically treated posterior
teeth, and use of rubber dam. The purpose of this retrospective study
was to determine the effect of these standards on outcomes of initial
posterior root canal treatments (RCTs) completed by Air Force (AF) and
civilian dentists with and without accredited postgraduate training.
Methods
Treatment
and follow-up radiographs of AF members who had an initial posterior
RCT completed in 2011 were evaluated. A survey of all radiographs was
performed to determine the (1) RCT obturation quality, (2) healing of
periapical pathosis, and (3) presence and quality of cuspal coverage
restorations.
Results
A
total of 2262 RCTs were examined, with 1960 RCTs meeting inclusion
criteria for at least 1 evaluation category. For RCT obturation quality,
1810 RCTs were evaluated, and 96.0% were considered adequate. For
cuspal coverage restorations, 1856 RCTs were evaluated, and of these
2.7% were inadequately restored. Healing of periapical pathosis was
91.5% and 85.7% for AF and referred civilian providers, respectively.
Survivability was 94.4% for endodontists, 95.3% for AF general dentists
with additional training, 87.9% for AF general dentists without
additional training, and 78.4% for civilian general dentists. Overall,
survivability was 94.1% for a follow-up period ranging up to 47 months,
with a mean of 27 months.
Conclusions
In
this retrospective, radiographic analysis, evidence-based practices as
followed in the Air Force Dental Service and accredited postgraduate
training resulted in improved treatment outcomes.
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