Nihad El Sayed1, Raluca Cosgarea2,3, Sonja Rahim4, Natalia Giess4, Johannes Krisam5, Ti-Sun Kim4. 1. Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld, 400 69120, Heidelberg, Germany. nihad.elsayed@med.uni-heidelberg.de. 2. Department of Periodontology, Philipps University Marburg, Marburg, Germany. 3. Department of Prosthetic Dentistry, University Iuliu Hatieganu, Cluj-Napoca, Romania. 4. Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld, 400 69120, Heidelberg, Germany. 5. Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Heidelberg, Germany.
Abstract
OBJECTIVES: The aim of this study was to evaluate long-term (≥5 years) tooth survival after resective therapy of multi-rooted, periodontally treated teeth and investigate the influence of patient-, tooth-, and dentist-related risk factors on tooth loss. MATERIALS AND METHODS: A total of 128 patients with root-resected molars were reexamined. Patient-, tooth-, and dentist-related factors were assessed. Tooth survival times were estimated using the Kaplan-Meier method in addition to a Cox proportional hazard frailty model with survival as the dependent outcome to assess an association with predictor variables. RESULTS: Overall, 100 patients with 130 molars were included. The average postoperative reevaluation period was a 9.62 ± 3.08 year showing an overall survival rate of 56.9% after resective therapy. A cumulative survival rate of 69% (95% CI (61%; 77%)) after 5 years decreasing to 48% (95% CI (35%; 61%)) after 15 years was detected. The median survival time of resected molars was 13.83 years (95% CI (8.75; ∞)). Adherence, smoking, and insurance status were detected to significantly influence the risk for loss of molars after resective therapy. CONCLUSIONS: Resective periodontal procedures can still be considered an option to retain periodontally compromised molars. In contrast to dentist- and tooth-related factors, patient-related factors impacted significantly upon tooth survival. CLINICAL RELEVANCE: Periodontally compromised molars could be retained in more than 50% of the cases thus prolonging their life span significantly. This information shall be valuable for clinicians in decision-making, treatment planning, and postoperative management. The weighting of resective therapy to implants especially with regards to the risk of peri-implantitis should be considered.
OBJECTIVES: The aim of this study was to evaluate long-term (≥5 years) tooth survival after resective therapy of multi-rooted, periodontally treated teeth and investigate the influence of patient-, tooth-, and dentist-related risk factors on tooth loss. MATERIALS AND METHODS: A total of 128 patients with root-resected molars were reexamined. Patient-, tooth-, and dentist-related factors were assessed. Tooth survival times were estimated using the Kaplan-Meier method in addition to a Cox proportional hazard frailty model with survival as the dependent outcome to assess an association with predictor variables. RESULTS: Overall, 100 patients with 130 molars were included. The average postoperative reevaluation period was a 9.62 ± 3.08 year showing an overall survival rate of 56.9% after resective therapy. A cumulative survival rate of 69% (95% CI (61%; 77%)) after 5 years decreasing to 48% (95% CI (35%; 61%)) after 15 years was detected. The median survival time of resected molars was 13.83 years (95% CI (8.75; ∞)). Adherence, smoking, and insurance status were detected to significantly influence the risk for loss of molars after resective therapy. CONCLUSIONS: Resective periodontal procedures can still be considered an option to retain periodontally compromised molars. In contrast to dentist- and tooth-related factors, patient-related factors impacted significantly upon tooth survival. CLINICAL RELEVANCE: Periodontally compromised molars could be retained in more than 50% of the cases thus prolonging their life span significantly. This information shall be valuable for clinicians in decision-making, treatment planning, and postoperative management. The weighting of resective therapy to implants especially with regards to the risk of peri-implantitis should be considered.