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Retention of molars after root-resective therapy: a retrospective evaluation of up to 30 years

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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.

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References

  1. McGuire MK, Nunn ME (1996) Prognosis versus actual outcome. III. The effectiveness of clinical parameters in accurately predicting tooth survival. J Periodontol 67:666–74l

    Article  PubMed  Google Scholar 

  2. Dannewitz B, Krieger JK, Husing J, Eickholz P (2006) Loss of molars in periodontally treated patients: a retrospective analysis five years or more after active periodontal treatment. J Clin Periodontol 33:53–61l

    Article  PubMed  Google Scholar 

  3. Salvi GE, Mischler DC, Schmidlin K, Matuliene G, Pjetursson BE, Bragger U, Lang NP (2014) Risk factors associated with the longevity of multi-rooted teeth. Long-term outcomes after active and supportive periodontal therapy. J Clin Periodontol 41:701–77l

    Article  PubMed  Google Scholar 

  4. Graetz C, Schutzhold S, Plaumann A, Kahl M, Springer C, Salzer S, Holtfreter B, Kocher T, Dorfer CE, Schwendicke F (2015) Prognostic factors for the loss of molars—an 18-years retrospective cohort study. J Clin Periodontol 42:943–50l

    Article  PubMed  Google Scholar 

  5. Dannewitz B, Zeidler A, Husing J, Saure D, Pfefferle T, Eickholz P, Pretzl B (2016) Loss of molars in periodontally treated patients: results 10 years and more after active periodontal therapy. J Clin Periodontol 43:53–62l

    Article  PubMed  Google Scholar 

  6. Carnevale G, Pontoriero R, Hürzeler MB (1995) Management of furcation involvement. Periodontol 2000 9:69–89l

    Article  Google Scholar 

  7. DeSanctis M, Murphy KG (2000) The role of resective periodontal surgery in the treatment of furcation defects. Periodontol 22:154–68l

    Article  Google Scholar 

  8. Livada R, Fine N, Shiloah J (2014) Root amputation: a new look into an old procedure. The New York state dental journal 80:24–8l

    PubMed  Google Scholar 

  9. Huynh-Ba G, Kuonen P, Hofer D, Schmid J, Lang NP, Salvi GE (2009) The effect of periodontal therapy on the survival rate and incidence of complications of multirooted teeth with furcation involvement after an observation period of at least 5 years: a systematic review. J Clin Periodontol 36:164–76l

    Article  PubMed  Google Scholar 

  10. Orstavik D, Kerekes K, Eriksen HM (1986) The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol 2:20–34l

    Article  PubMed  Google Scholar 

  11. Liang YH, Li G, Wesselink PR, Wu MK (2011) Endodontic outcome predictors identified with periapical radiographs and cone-beam computed tomography scans. J Endod 37:326–31l

    Article  PubMed  Google Scholar 

  12. Miller PD Jr (1985) A classification of marginal tissue recession. Int J Periodontics Restorative Dent 5:8–13l

    PubMed  Google Scholar 

  13. Henderson R, Omar P (1999) Effect of frailty on marginal regression estimates in survival analysis. Journal of the Royal Statistical Society B61:367–379l

    Article  Google Scholar 

  14. Bergenholtz A (1972) Radectomy of multirooted teeth. J Am Dent Assoc 85:870–875

    Article  PubMed  Google Scholar 

  15. Klavan B (1975) Clinical observations following root amputation in maxillary molar teeth. J Periodontol 46:1–5

    Article  PubMed  Google Scholar 

  16. Hamp SE, Nyman S, Lindhe J (1975) Periodontal treatment of multirooted teeth. Results after 5 years. J Clin Periodontol 2:126–135

    Article  PubMed  Google Scholar 

  17. Langer B, Stein SD, Wagenberg B (1981) An evaluation of root resections. A ten-year study. J Periodontol 52:719–22l

    Article  PubMed  Google Scholar 

  18. Erpenstein H (1983) A 3-year study of hemisectioned molars. J Clin Periodontol 10:1–10l

    Article  PubMed  Google Scholar 

  19. Bühler H (1988) Evaluation of root-resected teeth. Results after 10 years. J Periodontol 59:805–10l

    Article  PubMed  Google Scholar 

  20. Carnevale G, Di Febo G, Tonelli MP, Marin C, Fuzzi M (1991) A retrospective analysis of the periodontal-prosthetic treatment of molars with interradicular lesions. Int J Periodontics Restorative 11:189–205

    Google Scholar 

  21. Basten CH, Ammons WF, Persson R (1996) Long-term evaluation of root-resected molars: a retrospective study. Int J Periodontics Restorative Dent 16:206–219

    PubMed  Google Scholar 

  22. Blomlöf L, Jansson L, Appelgren R, Ehnevid H, Lindskog S (1997) Prognosis and mortality of root-resected molars. Int J Periodontics Restorative Dent 17:190–201

    PubMed  Google Scholar 

  23. Carnevale G, Pontoriero R, di Febo G (1998) Long-term effects of root-resective therapy in furcation-involved molars. A 10-year longitudinal study. J Clin Periodontol 25:209–14l

    Article  PubMed  Google Scholar 

  24. Hou GL, Tsai CC, Weisgold AS (1999) Treatment of molar furcation involvement using root separation and a crown and sleeve-coping telescopic denture. A longitudinal study. J Periodontol 70:1098–1109

    Article  PubMed  Google Scholar 

  25. Svärdström G, Wennström JL (2000) Periodontal treatment decisions for molars: an analysis of influencing factors and long-term outcome. J Periodontol 71:579–585

    Article  PubMed  Google Scholar 

  26. Vire DE (1991) Failure of endodontically treated teeth: classification and evaluation. J Endod 17:338–42l

    Article  PubMed  Google Scholar 

  27. Alley BS, Kitchens GG, Alley LW, Eleazer PD (2004) A comparison of survival of teeth following endodontic treatment performed by general dentists or by specialists. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:115–18l

    Article  PubMed  Google Scholar 

  28. de Chevigny C, Dao TT, Basrani BR, Marquis V, Farzaneh M, Abitbol S, Friedman S (2008) Treatment outcome in endodontics: the Toronto study—phase 4: initial treatment. J Endod 34:258–63l

    Article  PubMed  Google Scholar 

  29. Lin PY, Huang SH, Chang HJ, Chi LY (2014) The effect of rubber dam usage on the survival rate of teeth receiving initial root canal treatment: a nationwide population-based study. J Endod 40:1733–177l

    Article  PubMed  Google Scholar 

  30. Burry JC, Stover S, Eichmiller F, Bhagavatula P (2016) Outcomes of primary endodontic therapy provided by endodontic specialists compared with other providers. J Endod 42:702–75l

    Article  PubMed  Google Scholar 

  31. Walter C, Weiger R, Dietrich T, Lang NP, Zitzmann NU (2012) Does three-dimensional imaging offer a financial benefit for treating maxillary molars with furcation involvement? A pilot clinical case series. Clin Oral Implants Res 23:351–38l

    Article  PubMed  Google Scholar 

  32. Walter C, Dagassan-Berndt DC, Kuhl S, Weiger R, Lang NP, Zitzmann NU (2014) Is furcation involvement in maxillary molars a predictor for subsequent bone augmentation prior to implant placement? A pilot study. Clin Oral Implants Res 25:1352–138l

    Article  PubMed  Google Scholar 

  33. Albrektsson T, Donos N, Working G (2012) Implant survival and complications. The Third EAO consensus conference 2012. Clin Oral Implants Res 23(Suppl 6):63–5l

    Article  PubMed  Google Scholar 

  34. Corbella S, Taschieri S, Del Fabbro M (2015) Long-term outcomes for the treatment of atrophic posterior maxilla: a systematic review of literature. Clin Implant Dent Relat Res 17:120–32l

    Article  PubMed  Google Scholar 

  35. Sousa V, Mardas N, Farias B, Petrie A, Needleman I, Spratt D, Donos N (2016) A systematic review of implant outcomes in treated periodontitis patients. Clin Oral Implants Res 27:787–844l

    Article  PubMed  Google Scholar 

  36. Fugazzotto PA (2001) A comparison of the success of root resected molars and molar position implants in function in a private practice: results of up to 15-plus years. J Periodontol 72:1113–123l

    Article  PubMed  Google Scholar 

  37. Micheelis W, Süßlin W (2012) Einstellung und Bewertung der Bevölkerung zur zahnärztlichen Versorgung in Deutschland. Ergebnisse einer bundesweiten Umfrage 2011. Book title. Institut der Deutschen Zahnärzte, Köln

    Google Scholar 

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Private Dental Practice, 46446, Emmerich am Rhein, Germany

    Hermann Derks

  2. Private Dental Practice, 24576, Bad Bramstedt, Germany

    Derk Westheide

  3. Section of Endodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, 69120, Heidelberg, Germany

    Thorsten Pfefferle

  4. Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany

    Peter Eickholz & Bettina Dannewitz

  5. Private Dental Practice, 35781, Weilburg, Germany

    Bettina Dannewitz

Authors
  1. Hermann Derks
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  2. Derk Westheide
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  3. Thorsten Pfefferle
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  4. Peter Eickholz
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  5. Bettina Dannewitz
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Corresponding author

Correspondence to Bettina Dannewitz.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study formal consent was not required.

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Derks, H., Westheide, D., Pfefferle, T. et al. Retention of molars after root-resective therapy: a retrospective evaluation of up to 30 years. Clin Oral Invest 22, 1327–1335 (2018). https://doi.org/10.1007/s00784-017-2220-1

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  • DOI: https://doi.org/10.1007/s00784-017-2220-1

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