How Long Do Teeth Survive After Complex Treatment?

Orthodontics - April 30, 2014 - Vol. 28 - No. 5

After clinical crown lengthening, endodontic therapy, and prosthodontic treatment, teeth have a survival rate of 96% at 5 years and 83% at 10 years.

Article Reviewed: Long-Term Survival Rate of Teeth Receiving Multidisciplinary Endodontic, Periodontal and Prosthodontic Treatments. Moghaddam AS, Radafshar G, et al: J Oral Rehabil; 2014;41 (March): 236-242.

Background: With larger numbers of adult patients now seeking orthodontic treatment, orthodontists are frequently involved in interdisciplinary treatment planning regarding compromised teeth.

Objective: To evaluate the long-term survival rate of teeth undergoing endodontic, periodontic, and prosthodontic treatment.

Design: Retrospective study.

Participants/Methods: 87 patients (81% female; age range, 21 to 70 years) who underwent crown lengthening, endodontic treatment, and prosthodontic work on at least 1 tooth between 1996 and 2009 at the Guilan University of Medical Sciences were included. A total of 245 teeth were treated. Teeth with furcation involvement, considerable mobility prior to crown lengthening, or a crown-to-root (C/R) ratio <1 were excluded. All crown lengthening procedures were done by a single periodontist whose records were used to select the sample. Patients were recalled for a clinical and radiographic exam to record bleeding points index (BPI), position of the restorative margin relative to the gingival margin, pocket depth, mobility, C/R ratio, and reasons for any lost teeth. Teeth with severe caries requiring addition crown lengthening, extensive periodontal lesions, pocket depths >7 mm, or severe furcation involvement were deemed hopeless.

Results: 18 teeth (13 maxillary, 5 mandibular were lost or deemed hopeless during the recall exam. The survival rate was 98% for 3 years, 96% for 5 years, 83% for 10 years, and an estimated 52% for 13 years (using the Kaplan-Meier estimator). Survival rate was not influenced by patient sex, history of smoking, or the presence of a post. Teeth that had survived >10 years showed increased pocket depths and C/R ratios. When examining factors to predict failure, the major determinates were found to be C/R ratio and the position of the crown margin relative to the gingival margin.

Conclusions: The survival rate of teeth receiving complex prosthodontic, endodontic, and periodontic treatment was 83% at 10 years.

Reviewer's Comments: The authors highlight the fact that these survival rates reflect good interdisciplinary treatment planning, and did not attempt complex treatment if the tooth was overly compromised. It also was unclear what the response rate was for patients being recalled, which could alter the strength of these findings.(Reviewer–Brent E. Larson, DDS, MS).

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