Have you ever wondered about how the outcomes of root canal treatments performed by endodontists versus those performed by general dentists (or non-endodontists) differ? Well, researchers at the Marquette University School of Dentistry and Delta Dental of Wisconsin recently tackled this topic.
Their study evaluated the outcomes of 487,476 initial nonsurgical root canal treatments performed by endodontists versus other providers (mostly general dentists). They followed the cases for up to 10 years and until an untoward procedure such as retreatment, apical surgery, or extraction was required.
It was reassuring to see this extensive study find that the combined “survival rate” for root canal treated teeth (or the absence of untoward events) was 98% at one year, 92% at 5 years, and 86% at 10 years. There was a significantly higher success rate for root canals performed by endodontists versus general dentists at the 10-year mark. However, this increased success rate was just 5%.
The root canal procedures studied were performed between 2000 and 2013. So, while there was a difference in success rates between endodontists and other providers, one may wonder if the difference nowadays would be less.
Endodontic armamentaria, intra-canal medications and disinfections, and even endodontic education tailored for general dentists all have improved a great deal in recent years—especially since 2000. And these advances all are readily available and, in many ways, have been tailored for general dentists.
More and more general dentists are incorporating new procedures into their endodontic routines, which surely helps improve their endodontic outcomes. These services include enhanced magnification (ie, loupes and/or dental microscopes), better engineered and simplified NiTi mechanized files, intra-canal disinfection (ie, chlorhexidine-based irrigants and ethylenediaminetetraacetic acid, as well as sonics or ultrasonic medicament activation), and enhanced obturation systems.
Also, there seem to be many more comprehensive endodontic lectures and workshops available for general dentists, as many practitioners strive to improve their endodontic capabilities and ultimately their success rates.
One look at the July edition of Dentistry Today and its “Top 100 Products” demonstrates the cutting edge of endodontic armamentaria that is now so readily available to general dentists and not just to endodontists. At the start of this study in 2000, these advances certainly weren’t present or as readily available to non-endodontist providers who performed root canal treatments.
So in this age of dental implants, the take home message from this study of nearly 500,000 initial root canal treatments is that root canal therapy has a very good long-term success rate. This is so even in cases performed well over a decade ago and before the availability of today’s improved armamentaria and continuing dental education tailored to general dentists.
Dr. Manor Haas is a certified specialist in endodontics in Toronto, Canada. He is extensively involved in continuing education to dentists and has presented internationally. He is a Fellow of the Royal College of Dentists of Canada and is on staff at the University of Toronto Faculty of Dentistry and the Hospital for Sick Children. He maintains a full-time private practice limited to endodontics and microsurgery in Toronto. He has no disclosures to make and may be reached at HaasEndoEducation.com.
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