Treatment Outcomes in Endodontics

Abstract

The success of endodontic treatment has been of great interest to practitioners for many years now. Endodontic failures, which are of particular interest to us, are due to either microbial or nonmicrobial reasons. It is often thought that procedural errors like ledging, perforation, overfilling, underfilling or instrument separation invariably result in failure. In reality, the fact is that such mishaps only impede the accomplishment of an ideal root canal treatment. It is often the concomitant presence of infection that ultimately results in failure.Numerous studies have evaluated the success or failure of endodontic therapy and reported a wide range of success rates from 40 to 93%. This wide range may be due to differences in clinical procedure, experimental design, criteria for evaluation and the length of the observation period. However, most authors conclude that the crucial factor influencing success is the preoperative status of the tooth. Teeth with an apical radiolucency show a 20% lower success rate than teeth without lesion.Till date, the main method of evaluating success is radiographic, using recall radiographs. This method, however, is not without its own limitations due to examiner bias and inconsistencies.The factors affecting treatment outcome include those related to diagnosis, preoperative condition of the patient and tooth, standard of care during treatment, postoperative factors and ongoing maintenance. This paper reviews the various factors influencing the outcome of endodontic treatment in light of modern thought.