Root canal treatment Outcomes in Patients with Autoimmune Disease as Good as Controls, Suggests Study
South Korea: Researchers have found in a new study that the success rates of root canal treatment (RCT) in patients with autoimmune disease (AD) were comparable to those of controls. Outcomes were primarily determined by clinical factors rather than the presence of autoimmune disease, highlighting that high-quality treatment procedures are key to achieving favorable results.
The study, published in the International Endodontic Journal, was conducted by Seoyeon Lee and colleagues from the Veterans Health Service Medical Center. It aimed to assess whether autoimmune conditions influence the success of nonsurgical root canal treatment and to compare outcomes across specific disease subgroups, including inflammatory bowel disease (IBD), rheumatoid arthritis (RA), and psoriasis (Ps).
For this purpose, the researchers performed a retrospective case–control analysis using institutional data collected between 2010 and 2022. Patients diagnosed with autoimmune diseases who underwent primary RCT were identified and matched with controls without autoimmune conditions based on age, sex, tooth type, and dental arch. Radiographic assessments, including periapical, panoramic, and cone-beam computed tomography images, were used to evaluate treatment outcomes, with follow-up conducted at around one year and over a longer observation period.
The study led to the following findings:
- The study analysed 203 patients with autoimmune diseases (317 treated teeth) and 203 matched controls (312 teeth).
- At one-year follow-up, root canal treatment success rates were comparable between the two groups, with no statistically significant difference.
- Among autoimmune disease subtypes, patients with inflammatory bowel disease showed relatively lower success rates compared to those with rheumatoid arthritis and psoriasis.
- Only the inflammatory bowel disease subgroup showed a statistically significant difference in the initial analysis.
- Over a longer follow-up of approximately four years, success rates decreased slightly in both groups but remained similar overall.
- Multivariable regression analysis showed that autoimmune disease was not an independent predictor of treatment success.
- Clinical factors such as tooth type, dental arch, and the presence of preoperative periapical lesions were the primary determinants of treatment outcomes.
The study had some limitations. Data on patients’ medication use, including immunosuppressive and anti-inflammatory therapies, were unavailable and may have influenced healing outcomes. Differences in imaging modalities could have introduced bias, despite efforts to standardize assessments. Additionally, the single-center design with a specific patient population may limit generalizability.
Despite these constraints, the integrated medical and dental record system at the institution enabled comprehensive data collection and long-term follow-up, strengthening the reliability of the findings.
Overall, the study suggests that autoimmune disease status alone does not significantly impact the success of root canal treatment. Instead, adherence to high-quality endodontic practices and careful consideration of local clinical factors remain crucial in achieving optimal outcomes, even in patients with systemic inflammatory conditions.
Reference:
Lee, S., Kim, E., Jung, H., Kim, H., & Kim, S. Outcomes of Root Canal Treatment in Patients With Autoimmune Disease: A Retrospective Case–Control Study. International Endodontic Journal. https://doi.org/10.1111/iej.70174
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