Hermann Derks1, Derk Westheide2, Thorsten Pfefferle3, Peter Eickholz4, Bettina Dannewitz5,6. 1. Private Dental Practice, 46446, Emmerich am Rhein, Germany. 2. Private Dental Practice, 24576, Bad Bramstedt, Germany. 3. Section of Endodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, 69120, Heidelberg, Germany. 4. Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany. 5. Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany. dannewitz@med.uni-frankfurt.de. 6. Private Dental Practice, 35781, Weilburg, Germany. dannewitz@med.uni-frankfurt.de.
Abstract
OBJECTIVES: Long-term retention of teeth and especially molars in function is the ultimate goal of periodontal therapy. Root-resective therapy is a treatment option for molars with advanced furcation involvement, which has been questioned because of the heterogenous success rates published in literature. This study aimed to evaluate long-term results of root-resective treatment over a period of up to 30 years. METHODS: In this retrospective cohort, 90 root-resected molars in 69 patients were examined for 4-30 years (14.7 ± 6.8 years). The complete treatment sequence was performed by one of the authors in a general dental practice. RESULTS: Overall cumulative survival rate was 90.6% after 10 years, but then decreased considerably. Molars after root resection had a median survival time of 20 years. The incidence of endodontic complications leading to tooth extraction was only 26.7%, 50% were lost due to periodontal problems, and 16.7% because of caries. Mandibular molars had a significantly lower relative risk of loss than molars in the maxilla (HR 0.31, 95% CI 0.1-0.91, p = 0.033). Mandibular molars showed a survival probability of almost 80% even 20 years after root resection. CONCLUSION: Root-resective therapy is a predictable treatment option, when care is administered at each phase of therapy. CLINICAL RELEVANCE: This study provides important information about what is possible in daily practice under the outlines of public health care, when care is administered at each phase of resective therapy.
OBJECTIVES: Long-term retention of teeth and especially molars in function is the ultimate goal of periodontal therapy. Root-resective therapy is a treatment option for molars with advanced furcation involvement, which has been questioned because of the heterogenous success rates published in literature. This study aimed to evaluate long-term results of root-resective treatment over a period of up to 30 years. METHODS: In this retrospective cohort, 90 root-resected molars in 69 patients were examined for 4-30 years (14.7 ± 6.8 years). The complete treatment sequence was performed by one of the authors in a general dental practice. RESULTS: Overall cumulative survival rate was 90.6% after 10 years, but then decreased considerably. Molars after root resection had a median survival time of 20 years. The incidence of endodontic complications leading to tooth extraction was only 26.7%, 50% were lost due to periodontal problems, and 16.7% because of caries. Mandibular molars had a significantly lower relative risk of loss than molars in the maxilla (HR 0.31, 95% CI 0.1-0.91, p = 0.033). Mandibular molars showed a survival probability of almost 80% even 20 years after root resection. CONCLUSION: Root-resective therapy is a predictable treatment option, when care is administered at each phase of therapy. CLINICAL RELEVANCE: This study provides important information about what is possible in daily practice under the outlines of public health care, when care is administered at each phase of resective therapy.
Authors: Clemens Walter; Roland Weiger; Thomas Dietrich; Niklaus P Lang; Nicola U Zitzmann Journal: Clin Oral Implants Res Date: 2011-10-21 Impact factor: 5.977
Authors: Guy Huynh-Ba; Patrick Kuonen; Dominik Hofer; Jürg Schmid; Niklaus P Lang; Giovanni E Salvi Journal: J Clin Periodontol Date: 2009-02 Impact factor: 8.728