What are key Predictors of Early Endodontic Treatment Failure after imary root canal treatment?

A recent study explored the predictors of early endodontic treatment failure which helps in enhancing the ability of clinicians to forecast outcomes and improve patient care. The key findings of this study were published in the recent edition of BMC Oral Health.

This retrospective cohort analysis by Young-Eun Jang and team from South Korea included the cases of 1262 patients who underwent endodontic treatment at dentistry department. After meticulous examination, 175 cases were deemed suitable for thorough analysis. Various factors potentially contributing to treatment failure were scrutinized, including the quality of obturation, coronal status, presence of additional untreated canals, anatomical complexity, instrument separation, iatrogenic perforation, cracks and endodontic-periodontal lesions.

The investigation into the influence of time since initial treatment was found to be of paramount importance. The patients were categorized into "short-term" (less than 5 years since treatment) and "long-term" (over 10 years since treatment) groups. This temporal distinction provided critical insights into the dynamics of treatment outcomes over time.

The findings revealed a significant association between the presence of untreated additional canals and short-term treatment failure. Also, untreated additional canals were prevalent in 36.9% of short-term failure cases when compared to the 6.4% in long-term failure cases. Further analysis demonstrated that these additional canals posed a substantial risk of failure within the first four years following treatment.

The outcomes urge clinicians to prioritize thoroughness during initial root canal procedures. The detection and treatment of all root canals at the outset significantly improved the long-term prognosis for the patients who underwent endodontic treatment. In conclusion, this emphasis on the meticulous treatment enhance the individual patient outcome and also contribute to the overall advancement of endodontic practice.

Source:

Jang, Y.-E., Kim, Y., Kim, S.-Y., & Kim, B. S. (2024). Predicting early endodontic treatment failure following primary root canal treatment. In BMC Oral Health (Vol. 24, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12903-024-03974-8