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ePaper created 2016-01-20, 13:53:08 | version 1.38.0
06 I I studies _ comparison of three methods of therapy _Abstract The endodontic treatment of 1,720 non-vital an- terior teeth and premolars was observed in the au- thor’s general practice during 1985–1999 until De- cember2005.Theanalysisincludedsuccessorfailure and survival after non-surgical root canal treatment, root end resection or trephination with regard to various criteria. The failure analysis distinguished between clinical failures (acute exacerbations) that occurred within the first nine months of treatment only and failures with a follow-up radiograph. Oper- ator,sexandageofpatient,numberofappointments, or initial or second treatment did not have a signifi- cant impact statistically. Regarding the results, the degree of root canal filling was of minor importance, only found to be of statistical significance regarding the development of an acute exacerbation after overfilling of conservatively treated teeth. Statisti- cally significant factors were apical periodontitis before endodontic treatment, the homogeneity of a root canal filling and the restoration type. Posts were found to impair the treatment results. An increased extraction rate was observed among the patients in the lowest socio-economic group compared with thoseinthehighersocio-economicgroups.Tenyears post-endodontictreatment,15.6%ofthenon-surgi- cally treated cases, 23.8% of the cases treated with root end resection and 23.7% of the trephination cases were available for analysis without preceding re-intervention. _Introduction Primarily conservative therapy is recommended for therapy of non-vital teeth,1 as the endodontic lit- erature reports a high success rate. Another therapy is root end resection (RER); however, this indication has been limited in the course of time. In connection with apical periodontitis (AP), root canal filling (RCF) isperformedbeforeorduringtreatmentwithorwith- out retrograde RCF. During the last 15 years, RER studies have only dealt with RER in connection with retrograde RCF. However, RER guidelines emphasise that an RER is not an alternative to an exact RCF and itisregrettedthattherearenoepidemiologicalstud- ies on RER, although, based on accounting data from healthinsuranceprovidersinwesternGermany,pay- ments for RER increased nearly threefold from 19842 to20113.PaymentsforSchröderaeration(synonyms: apical aeration, artificial fistulation, trephination [TR]), a possible alternative therapy for conservative non-surgical root canal treatment (nsRCT) and RER, Fig. 1_Success depending on root filling length of nsRCT. The influence of RCF length in nsRCT on survival. In the case of Failure 2 only, no statistically significant differences (p = 0.56) were found. Thus, a survival difference among the three therapy types was only based on a different Failure 1 rate. roots1_2015 Aretrospective comparison of the effectiveness of three methods of endodontic therapy of non-vital teeth Author_ Dr Robert Teeuwen, Germany Fig. 1