Resident University of North Carolina Chapel Hill, North Carolina, United States
Aim: The primary aim of the study was to investigate the profile of root canal treated teeth that were replaced by implants at UNC School of Dentistry. The secondary aim was to identify the proportion of aforementioned teeth for which endodontic surgery could have been a valid treatment option to retain them (data was not yet available).
Methods: The UNC SOD’s database between 2004 and 2019 was searched for implant placement that replaced root canal treated teeth. Radiographs prior to extraction and clinical notes were examined to investigate factors that led to the decision to extract the tooth. The presence of periapical radiolucency was documented and classified into three categories (no lesion, periapical, halo or J-shaped). Radiographs and clinical findings of cases in which persisting apical periodontitis appeared to be the primary reason for the extraction were provided to two endodontists and requested to evaluate treatment options.
Results: Among the dental implants placed at UNC between 2004 and 2019 (11716), the total number of implants that replaced existing teeth was 5229. 24% of them were previously root canal treated (based on preliminary data collection). The primary reasons that led to a decision to extraction were, in descending order, extensive recurrent caries associated with unsatisfactory restoration (26.1%), fracture of coronal structure (23.9%), suspected/confirmed vertical root fracture (18.6%), compromised periodontal condition (16.0%), and persisting endodontic pathosis (3.3%).
Conclusion: Restoration failure was the most prevalent factor associated with the extraction of endodontically treated teeth, followed by vertical root fracture, periodontitis, and persisting apical periodontitis.
