Statement of problem
Teeth are weakened after endodontic treatment and should, ideally, be crowned, especially
posterior teeth. However, this is not always possible. Information about the longevity
of endodontically treated teeth without crown coverage may assist in selecting appropriate
treatment modalities.
Purpose
The aims of this cohort study were to evaluate the survival rate for endodontically
treated molars without crown coverage and to identify possible related factors.
Material and methods
A total of 220 endodontically treated permanent molar teeth in 203 subjects on a waiting
list for fixed prosthodontic treatment at the Faculty of Dentistry-Mahidol University,
Thailand, were included. Follow-up data were derived from a clinical examination and
review of the dental record and radiographs. Subjects were not included in the study
if teeth had provisional crowns, definitive restorations with cuspal coverage, or
with dowel and core and/or crown restorations. The outcome evaluated was defined as
a failure if there were negative findings in the condition of a tooth that required
a restoration, tooth repair, or extraction. Tooth loss due to endodontic and periodontal
reasons was excluded. The independent variables assessed were patient age, gender,
location (maxilla or mandible), the existence of an opposing dentition and adjacent
teeth, remaining tooth structure, and types of restorative material. Kaplan-Meier
analysis with a 95% confidence level was used to calculate the survival probability,
and a log-rank test was used to determine whether significant differences existed.
Results
Overall survival rates of endodontically treated molars without crowns at 1, 2, and
5 years were 96%, 88%, and 36%, respectively. With greater amounts of coronal tooth
structure remaining, the survival probability increased. Molar teeth with maximum
tooth structure remaining after endodontic treatment had a survival rate of 78% at
5 years. Restorations with direct composite had a better survival rate than conventional
amalgam and reinforced zinc oxide and eugenol with polymethacrylate restorations.
Conclusion
Within the limitations of this study, the amount of remaining tooth structure and
types of restorative material have significant association with the longevity of endodontically
treated molars without crown coverage.
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Article info
Publication history
Faculty of Dentistry, Mahidol University, Bangkok, Thailand
Identification
Copyright
© 2005 The Editorial Council of The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
