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Patient-, tooth-, and dentist-related factors influencing long-term tooth retention after resective therapy in an academic setting—a retrospective study

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Abstract

Objectives

The aim of this study was to evaluate long-term (≥5 years) tooth survival after resective therapy of multi-rooted, periodontally treated teeth and investigate the influence of patient-, tooth-, and dentist-related risk factors on tooth loss.

Materials and methods

A total of 128 patients with root-resected molars were reexamined. Patient-, tooth-, and dentist-related factors were assessed. Tooth survival times were estimated using the Kaplan-Meier method in addition to a Cox proportional hazard frailty model with survival as the dependent outcome to assess an association with predictor variables.

Results

Overall, 100 patients with 130 molars were included. The average postoperative reevaluation period was a 9.62 ± 3.08 year showing an overall survival rate of 56.9% after resective therapy. A cumulative survival rate of 69% (95% CI (61%; 77%)) after 5 years decreasing to 48% (95% CI (35%; 61%)) after 15 years was detected. The median survival time of resected molars was 13.83 years (95% CI (8.75; ∞)). Adherence, smoking, and insurance status were detected to significantly influence the risk for loss of molars after resective therapy.

Conclusions

Resective periodontal procedures can still be considered an option to retain periodontally compromised molars. In contrast to dentist- and tooth-related factors, patient-related factors impacted significantly upon tooth survival.

Clinical relevance

Periodontally compromised molars could be retained in more than 50% of the cases thus prolonging their life span significantly. This information shall be valuable for clinicians in decision-making, treatment planning, and postoperative management. The weighting of resective therapy to implants especially with regards to the risk of peri-implantitis should be considered.

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Funding

The work was supported by the Department of Operative Dentistry of the University Hospital Heidelberg.

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Authors and Affiliations

  1. Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld, 400 69120, Heidelberg, Germany

    Nihad El Sayed, Sonja Rahim, Natalia Giess & Ti-Sun Kim

  2. Department of Periodontology, Philipps University Marburg, Marburg, Germany

    Raluca Cosgarea

  3. Department of Prosthetic Dentistry, University Iuliu Hatieganu, Cluj-Napoca, Romania

    Raluca Cosgarea

  4. Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Heidelberg, Germany

    Johannes Krisam

Authors
  1. Nihad El Sayed
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  2. Raluca Cosgarea
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Correspondence to Nihad El Sayed.

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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 national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board for Human Studies of the Medical Faculty of Heidelberg University (Application# S-132/2009).

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Informed consent was obtained from all individual participants included in the study.

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El Sayed, N., Cosgarea, R., Rahim, S. et al. Patient-, tooth-, and dentist-related factors influencing long-term tooth retention after resective therapy in an academic setting—a retrospective study. Clin Oral Invest 24, 2341–2349 (2020). https://doi.org/10.1007/s00784-019-03091-9

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  • DOI: https://doi.org/10.1007/s00784-019-03091-9

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