TY - JOUR

T1 - Periradicular surgery

T2 - A longitudinal registry study of 10-year outcomes and factors predictive of post-surgical extraction

AU - de Almeida, Fernando José Mota

AU - Dawson, Victoria S.

AU - Kvist, Thomas

AU - Frisk, Fredrik

AU - Bjørndal, Lars

AU - Isberg, Per-Erik

AU - Fransson, Helena

AU - EndoReCo

A2 - Markvart, M.

N1 - Publisher Copyright: © 2023 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society.

PY - 2023

Y1 - 2023

N2 - Aim: This historical prospective cohort study of the adult population of Sweden is based on data from a national registry: the primary aim was to evaluate the long-term survival of teeth after periradicular surgery. A secondary aim was to identify factors predictive of extraction within 10 years of registration of periradicular surgery. Methodology: The cohort consisted of all individuals who had undergone periradicular surgery to treat apical periodontitis, as reported to the Swedish Social Insurance Agency (SSIA) in 2009. The cohort was followed until 31 December 2020. Subsequent registrations of extractions were collected for Kaplan–Meier survival analyses and survival tables. The patients' sex, age, dental service provider and tooth group were also retrieved from SSIA. Only one tooth per individual was included in the analyses. Multivariable regression analysis was used and p <.05 was considered statistically significant. The reporting guidelines STROBE and PROBE were followed. Results: After data cleaning, and exclusion of 157 teeth, 5622 teeth/individuals remained for analysis. The mean age of the individuals at the time of the periradicular surgery was 60.5 years (range 20–97, standard deviation 13.31); 55% were women. At the end of the follow-up, that is, up to 12 years, a total of 34.1% of the teeth had been reported as extracted. The multivariate logistic regression analysis, based on follow-up data at 10 years after registration of the periradicular surgery, included 5548 teeth, of which 1461 (26.3%) had been extracted. Significant associations between the independent variables tooth group and dental care setting (both p <.001) and the dependent variable extraction were found. The highest odds ratio (OR) for extraction applied to tooth group: compared to maxillary incisors and canines, mandibular molars were at greatest risk of extraction (OR 2.429, confidence interval 1.975–2.987, p <.001). Conclusions: After periradicular surgery in predominantly elderly people in Sweden, approximately three-quarters of the teeth are retained over a 10-year period. The type of tooth is associated with extraction: mandibular molars are at greater risk of extraction than maxillary incisors and canines.

AB - Aim: This historical prospective cohort study of the adult population of Sweden is based on data from a national registry: the primary aim was to evaluate the long-term survival of teeth after periradicular surgery. A secondary aim was to identify factors predictive of extraction within 10 years of registration of periradicular surgery. Methodology: The cohort consisted of all individuals who had undergone periradicular surgery to treat apical periodontitis, as reported to the Swedish Social Insurance Agency (SSIA) in 2009. The cohort was followed until 31 December 2020. Subsequent registrations of extractions were collected for Kaplan–Meier survival analyses and survival tables. The patients' sex, age, dental service provider and tooth group were also retrieved from SSIA. Only one tooth per individual was included in the analyses. Multivariable regression analysis was used and p <.05 was considered statistically significant. The reporting guidelines STROBE and PROBE were followed. Results: After data cleaning, and exclusion of 157 teeth, 5622 teeth/individuals remained for analysis. The mean age of the individuals at the time of the periradicular surgery was 60.5 years (range 20–97, standard deviation 13.31); 55% were women. At the end of the follow-up, that is, up to 12 years, a total of 34.1% of the teeth had been reported as extracted. The multivariate logistic regression analysis, based on follow-up data at 10 years after registration of the periradicular surgery, included 5548 teeth, of which 1461 (26.3%) had been extracted. Significant associations between the independent variables tooth group and dental care setting (both p <.001) and the dependent variable extraction were found. The highest odds ratio (OR) for extraction applied to tooth group: compared to maxillary incisors and canines, mandibular molars were at greatest risk of extraction (OR 2.429, confidence interval 1.975–2.987, p <.001). Conclusions: After periradicular surgery in predominantly elderly people in Sweden, approximately three-quarters of the teeth are retained over a 10-year period. The type of tooth is associated with extraction: mandibular molars are at greater risk of extraction than maxillary incisors and canines.

KW - apicoectomy

KW - endodontics

KW - epidemiology

KW - public health

KW - survival analysis

KW - treatment outcome

U2 - 10.1111/iej.13952

DO - 10.1111/iej.13952

M3 - Journal article

C2 - 37403305

AN - SCOPUS:85165583770

VL - 56

SP - 1212

EP - 1221

JO - International Endodontic Journal

JF - International Endodontic Journal

SN - 0143-2885

IS - 10

ER -