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ePaper created 2016-01-20, 13:53:08 | version 1.38.0
I 11 studies _ comparison of three methods of therapy I roots1_2015 female sexes approached significance regarding acute exacerbations (p = 0.075). Of the 149 Failure 2 cases,89(59.7%)wereattributedtothemalesexand 60 (40.3%) to the female sex. The difference was not statistically significant. Table1 No statistically significant differences in failure rate were found between operators (author vs assis- tantdoctor),orfornumberofappointments(1vs>1; 40.5% of cases had > 1 appointment), age (< 30; 30–50; > 50), or primary vs secondary RCT (20.8%). TheEXdataindicatedastatisticallysignificantdiffer- ence (p = 0.029) related to therapy type. After five (ten;15)years,88.9%(72.2%;57.1%)ofnsRCTcases, 88.7% (76.8%; 69.9%) of RER cases and 90.5% (80.6%; 70.6%) of TR cases had survived without EX. The highest EX rate was observed for maxillary pre- molars (20.6%) and the lowest for maxillary anterior teeth(12.3%),and36.0%ofEXwereduetoanon-re- storablenaturalcrown(cariesorfracture),26.4%due to periodontal disease and 30.2% due to endodontic failure. Social stratification was noted in connection withEX.Thelowestsocio-economicgroupwasrepre- sented by 59.2% of the patients and EX amounted to 65.5% in this group. Higher socio-economic groups, such as employees and private patients, were repre- sentedby28.8%and10.7%,respectively,andEXwas 24.8% and 9.7%, respectively. nsRCTshowedthemostacuteexacerbations(Fail- ure 1) compared with RER and TR, indicating statisti- cal significance (p = 0.029).The development of Fail- ure 2 was independent from pain anamnesis. Table2 DependingontheinitialdiagnosisofnoAP(Diag- nosis1or2)orwithAP(Diagnosis3,4or5),follow-up radiographic diagnosis and Failure 2 rate were com- binedinTable2.BeforeRCT,theteethwithAPwereas follows: n = 222 (42.4%) for nsRCT, n = 524 (69.6%) for RER and n = 217 (47.9%) for TR. These AP teeth were evaluated radiographically as successful (fol- low-up radiographic Diagnosis 1) as follows: 60.8% of nsRCT cases, 73.9% of RER cases and 76.4% of TR cases. If the initial diagnosis was no AP, the results were better: 81.5% of nsRCT cases, 83.1% of RER cases and 88.5% of TR cases. During the first four years after RCT, 38.0% of the follow-up radiographs were performed: 39.0% of nsRCT cases, 37.8% of RER cases and 37.6% of TR cases. Radiographically, the TR cases represented the highest success and lowest failure rates (81.1% and 9.3%). Furthermore, it was considered whether a ra- diographicDiagnosis3afteraperiodoflessthanfour years provided similar results to a diagnosis more thanfouryearsafterRCT.Theradiographsofthelater period found a worse result regarding Diagnosis 3 (9.7% vs 13.4%) and Diagnosis 1 (79.3% vs 74.6%), whereas Diagnosis 2 remained nearly unchanged (11.0% vs 12.0%). Intheanalysisofsingle-toothpositions,mandibu- larincisorswerefoundtobethetoothgroupwiththe most frequent Diagnosis 3 (17 of 78 = 21.8%). The maxillary lateral incisors had the second most fre- quent Diagnosis 3 (34 of 215 = 15.8%). This tooth lo- cation showed a significantly shorter survival rate compared with all other locations regarding the cri- teriaforFailures1and2.Thesurvivalratesofthemax- illary lateral incisors after ten years were as follows: 46.5% (p = 0.001) for those treated with RCT, 81.9% (p = 0.027) for RER and 87.8% (p = 0.949, i.e. not sig- nificant)forTR.Themandibularpremolarsweremost rarely given Diagnosis 3 (14 of 199 = 7.0%), followed by the maxillary central incisors (22 of 216 = 10.2%). Follow-up radiographic Diagnosis 3 was not the onlycriterionforrecordingFailure2.Failure2withan accompanying radiograph accounted for 138 cases proved by radiographic Diagnosis 3 and a further eleven cases (7.4% of the 149 failed cases), resulting inaradiographicDiagnosis1fornineandDiagnosis2 for two. The diagnosis of six of the cases as having AP was found to be incorrect after EX. Four cases under- wentRER.Onecaseofpainremainedwithouttherapy. The149Failure2caseswereallottedtothethreether- apy types as follows, with the percentage of follow- up radiographs: 44 (12.5%) to nsRCT, 70 (14.4%) to RERand35(10.9%)toTR.TheFailure2ratedecreased linearlyuntil216monthsafterRCT.Themostcommon localisation for Failure 2 after RER and TR was in the Fig. 3_Success according to initial Diagnosis 1, 2 (no lesion n = 500); 3, 4, 5 (lesion n = 662: ns-RCT 41.9%, RER 73.3%, TR 48.8%). The Failure 2 rate for cases with initial diagnosis of AP was more than double thatofcaseswithnoAP:18.2%vs8.3% fornsRCT,16.3%vs7.7%forRER,and 15.9% vs 6.1% for TR. The differ- ences were statistically significant. Fig. 3