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Periradicular surgery : A longitudinal registry study of 10-year outcomes and factors predictive of post-surgical extraction

de Almeida, Fernando José Mota ; Dawson, Victoria S. ; Kvist, Thomas ; Frisk, Fredrik ; Bjørndal, Lars ; Isberg, Per Erik LU and Fransson, Helena (2023) In International Endodontic Journal 56(10). p.1212-1221
Abstract

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... (More)

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.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
apicoectomy, endodontics, epidemiology, public health, survival analysis, treatment outcome
in
International Endodontic Journal
volume
56
issue
10
pages
10 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:37403305
  • scopus:85165583770
ISSN
0143-2885
DOI
10.1111/iej.13952
language
English
LU publication?
yes
id
e251a16e-fdfc-4f0d-805f-07eb8403dc76
date added to LUP
2023-09-19 10:48:18
date last changed
2024-04-19 01:25:23
@article{e251a16e-fdfc-4f0d-805f-07eb8403dc76,
  abstract     = {{<p>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 &lt;.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 &lt;.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 &lt;.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.</p>}},
  author       = {{de Almeida, Fernando José Mota and Dawson, Victoria S. and Kvist, Thomas and Frisk, Fredrik and Bjørndal, Lars and Isberg, Per Erik and Fransson, Helena}},
  issn         = {{0143-2885}},
  keywords     = {{apicoectomy; endodontics; epidemiology; public health; survival analysis; treatment outcome}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1212--1221}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{International Endodontic Journal}},
  title        = {{Periradicular surgery : A longitudinal registry study of 10-year outcomes and factors predictive of post-surgical extraction}},
  url          = {{http://dx.doi.org/10.1111/iej.13952}},
  doi          = {{10.1111/iej.13952}},
  volume       = {{56}},
  year         = {{2023}},
}