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non-surgical treatment study | 27 roots 3 2016 tal teeth at 3,951 patients remained for analysis. The non-vital cases had been applied to a former study8 withshorterfollow-up-time,exclusionofmolarsand X-ray-rating of three reviewers. The observation pe- riodendedinSeptember2006.Arecallofthepatients did not take place. Considering extractions and re- maining cases after 5, 10, 15 and 20 years, drop-out rates amounted to 40.6, 58.5, 72.2 and 81.7 %. RCTs were carried out according to the N2- method of Sargenti.9 This method includes the use of the paraformaldehyde-containing zinc oxide root canal cement N2 and canal preparation without ca- nal rinsing. Canal preparation was solely done man- ually by reamer: using step-back technique in vital teeth, crown-down technique in non-vital teeth. The creamyN2compositionwasappliedtotherootcanal by lentulo instruments. A gutta percha point was addedinwidecanalsonly.TheRF-sittingwerealways finished by a definite filling as well as a provisional crown, if needed. The adequate length of the RF was considered to end in the area of the radiological apex up to –2 mm, an RF level of < –2 was determined as underfilling, an RF level of > 0 as overfilling. RF-qual- ity was judged according to its homogeneity. X-rays were taken and diagnostics were performed by the authorhimself.Follow-upX-rayswereonlyevaluated oneyearormoreafterRCT.AccordingtotheEuropean Society of Endodontology (ESE) quality guidelines10 , the ‘follow-up’ diagnoses were classified into three criteria: · · Diagnosis 1 (success): Regular periodontal gap in X-ray, no symptoms, no fistula, no swelling; · · Diagnosis 2 (uncertain result): AP after < 4 years, incompletehealing,nottobeevaluated,scartissue, remaining shadow around overfilled root-canal; · · Diagnosis 3 (failure): AP still existing > 4 years, newly developed AP, clinical symptoms. In multi-canal teeth, the root canal with the poor- est prognosis was selected as being relevant for the analysis. The present study contains an analysis of success/failure and survival of root-filled teeth with reference to re-intervention: extraction, retreatment (RTR), root-end-resection (RER), trephination (TR), hemisection (HEM). Failures were divided into: · · Clinical failure: no follow-up X-ray accompanying acute exacerbation, pain, swelling, fistula; · · Failure with follow-up X-ray. The statistic evaluation was executed with pro- gram R: R Core Team.11 The survival rates were esti- mated by nonparametric estimation according to Kaplan & Meier.12 Group comparison was done by Origin Follow- Variable Sub-group Teeth up at Risk Survival at Risk Survival n (%) Year n % (CI) p n % (CI) p Operator T 5071 (58,7) 10 1648 73,9 (80,7-72,3) 0.927 1558 90,0 (88,9-91,1) <0.0001 Operator A 3573 (41,3) 10 1011 72,2 (70,2-74,3) 0.927 952 86,4 (84,8-87,9) <0.0001 Gender Male 4440 (51,4) 10 1397 71,7 (69,9-73,4) 0.0015 1332 88,9 (87,6-90,1) 0.417 Gender Female 4204 (48,6) 10 1262 75,1 (73,3-76,9) 0.0015 1188 88,3 (86,9-89,6) 0.417 Age < 30 3370 (39,0) 10 809 81,2 (79,1-82,2) <0.0001 754 86,2 (84,4-87,9) 0.0007 Age 30 - 50 3355 (38,8) 10 1217 73,5 (71,6-75,5) <0.0001 1143 89,1 (87,8-90,5) 0.0007 Age > 50 1919 (22,2) 10 633 62,9 (60,2-65,6) <0.0001 613 90,8 (89,1-92,5) 0.0007 Health-insurance RVO (worker) 5100 (60,0) 10 1465 69,5 (67,7-71,2) <0.0001 1384 88,5 (87,3-89,7) 0.629 Health-insurance VDAK (employer) 2300 (27,1) 10 818 78,2 (76,0-80,4) <0.0001 774 88,8 (87,2-90,5) 0.629 Health-insurance Private patients 1093 (12,9) 10 352 79,0 (75,9-82,1) <0.0001 330 88,5 (86,0-91,1) 0.629 Tooth-type Front 2736 (31,6) 10 856 74,3 (72,2-76,6) 0.0314 807 91.9 (90,5-93,2) <0.0001 Tooth-type Premolars 3275 (37,9) 10 1069 73,6 (71,6-75,6) 0.0314 1007 91,2 (89,9-92,5) <0.0001 Tooth-type Molars 2633 (30,5) 10 734 71,6 (69,3-74,0) 0.0314 696 81,8 (79,8-83,8) <0.0001 Visits 1 289 (52,9) 10 79 69,3 (62,6-76,6) 0.0672 62 69,0 (62,6-76,0) 0.0496 Visits >1 257 (47,1) 10 67 73,8 (66,9-81,4) 0.0672 53 73,7 (66,6-81,5) 0.0496 Sympt. preoperative yes 79 (22,4) 10 28 80,8 (70,7-92,4) 0.116 22 71,4 (60,2-84,6) 0.575 Sympt. preoperative no 273 (77,6) 10 71 69,7 (62,7-77,4) 0.116 54 66,9 (59,7-74,9) 0.575 Pulp preoperative vital 8098 (93,7) 10 2513 73,4 (72,1-74,7) 0.186 2395 89,7 (88,8-90,7) <0.001 Pulp preoperative non-vital 546 (6,3) 10 146 71,4 (66,6-76,6) 0.186 115 71,3 (66,5-76,4) <0.001 Periapex preoperative lesion 256 (46,9) 10 63 65,5 (58,1-73,8) 0.0577 56 65,1 (58,2-72,9) 0.0028 Periapex preoperative no lesion 290 (53,1) 10 83 76,3 (70,1-83,0) 0.0577 69 76,6 (70,3-83,5) 0.0028 RC-filling length short 4553 (52,7) 10 1438 71,3 (69,6-73,1) 0.0001 1354 86,7 (85,3-88,0) <0.0001 RC-filling length flush 3326 (38,5) 10 1008 76,2 (74,3-78,2) 0.0001 972 93,4 (92,3-94,5) <0.0001 RC-filling length long 765 (8,85) 10 213 72,3 (68,0-76,8) 0.0001 184 79,5 (75,8-83,3) <0.0001 RC-filling quality homogen 5788 (67,0) 10 1803 75,4 (73,9-76,9) <0.0001 1723 92,1 (91,2-93,0) <0.0001 RC-filling quality inhomogen 2856 (33,0) 10 856 68,9 (66,7-71,2) <0.0001 787 81,5 (79,5-83,5) <0.0001 Restoration filling 5576 (64,5) 10 1199 63,8 (62,0-65,7) <0.0001 1134 84,9 (83,5-86,3) <0.0001 Restoration crown 2482 (28,7) 10 1157 86,8 (85,2-88,5) <0.0001 1111 94,4 (93,3-95,5) <0.0001 Restoration crown+post 529 (6,1) 10 290 86,6 (83,2-90,1) <0.0001 265 89,8 (86,7-92,9) <0.0001 Restoration filling+post 57 (0,7) 10 13 56,5 (41,2-77,7) <0.0001 Breakage RC-instrum. yes 382 (4,4) 10 100 64,2 (58,3-70,7) <0.0001 93 74,2 (68,6-80,2) <0.0001 Breakage RC-instrum. no 8262 (95,6) 10 2559 73,7 (72,4-75,0) <0.0001 2417 89,2 (88,3-90,2) <0.0001 Via falsa yes 32 (0,37) 10 7 26,2 (12,6-54,4) <0.0001 2 8,25 (1,30-52,3) <0.0001 Via falsa no 8612 (99,6) 10 2652 73,4 (72,2-74,7) <0.0001 2508 88,9 (88,0-89,8) <0.0001 Extraction Failure Table 1: Survival probability related to extraction and failure with confident intervals (CI). 32016 Operator T 5071 (58,7) 10164873,9 (80,7-72,3) 0.927155890,0 (88,9-91,1) <0.0001 Operator A 3573 (41,3) 10101172,2 (70,2-74,3) 0.92795286,4 (84,8-87,9) <0.0001 Gender Male 4440 (51,4) 10139771,7 (69,9-73,4) 0.0015133288,9 (87,6-90,1) 0.417 Gender Female 4204 (48,6) 10126275,1 (73,3-76,9) 0.0015118888,3 (86,9-89,6) 0.417 Age < 303370 (39,0) 1080981,2 (79,1-82,2) <0.000175486,2 (84,4-87,9) 0.0007 Age 30 - 503355 (38,8) 10121773,5 (71,6-75,5) <0.0001114389,1 (87,8-90,5) 0.0007 Age > 501919 (22,2) 1063362,9 (60,2-65,6) <0.000161390,8 (89,1-92,5) 0.0007 Health-insurance RVO (worker) 5100 (60,0) 10146569,5 (67,7-71,2) <0.0001138488,5 (87,3-89,7) 0.629 Health-insurance VDAK (employer) 2300 (27,1) 1081878,2 (76,0-80,4) <0.000177488,8 (87,2-90,5) 0.629 Health-insurance Private patients 1093 (12,9) 1035279,0 (75,9-82,1) <0.000133088,5 (86,0-91,1) 0.629 Tooth-type Front 2736 (31,6) 1085674,3 (72,2-76,6) 0.031480791.9 (90,5-93,2) <0.0001 Tooth-type Premolars 3275 (37,9) 10106973,6 (71,6-75,6) 0.0314100791,2 (89,9-92,5) <0.0001 Tooth-type Molars 2633 (30,5) 1073471,6 (69,3-74,0) 0.031469681,8 (79,8-83,8) <0.0001 Visits 1289 (52,9) 107969,3 (62,6-76,6) 0.06726269,0 (62,6-76,0) 0.0496 Visits >1257 (47,1) 106773,8 (66,9-81,4) 0.06725373,7 (66,6-81,5) 0.0496 Sympt. preoperative yes 79 (22,4) 102880,8 (70,7-92,4) 0.1162271,4 (60,2-84,6) 0.575 Sympt. preoperative no 273 (77,6) 107169,7 (62,7-77,4) 0.1165466,9 (59,7-74,9) 0.575 Pulp preoperative vital 8098 (93,7) 10251373,4 (72,1-74,7) 0.186239589,7 (88,8-90,7) <0.001 Pulp preoperative non-vital 546 (6,3) 1014671,4 (66,6-76,6) 0.18611571,3 (66,5-76,4) <0.001 Periapex preoperative lesion 256 (46,9) 106365,5 (58,1-73,8) 0.05775665,1 (58,2-72,9) 0.0028 Periapex preoperative no lesion 290 (53,1) 108376,3 (70,1-83,0) 0.05776976,6 (70,3-83,5) 0.0028 RC-filling length short 4553 (52,7) 10143871,3 (69,6-73,1) 0.0001135486,7 (85,3-88,0) <0.0001 RC-filling length flush 3326 (38,5) 10100876,2 (74,3-78,2) 0.000197293,4 (92,3-94,5) <0.0001 RC-filling length long 765 (8,85) 1021372,3 (68,0-76,8) 0.000118479,5 (75,8-83,3) <0.0001 RC-filling quality homogen 5788 (67,0) 10180375,4 (73,9-76,9) <0.0001172392,1 (91,2-93,0) <0.0001 RC-filling quality inhomogen 2856 (33,0) 1085668,9 (66,7-71,2) <0.000178781,5 (79,5-83,5) <0.0001 Restoration filling 5576 (64,5) 10119963,8 (62,0-65,7) <0.0001113484,9 (83,5-86,3) <0.0001 Restoration crown 2482 (28,7) 10115786,8 (85,2-88,5) <0.0001111194,4 (93,3-95,5) <0.0001 Restoration crown+post 529 (6,1) 1029086,6 (83,2-90,1) <0.000126589,8 (86,7-92,9) <0.0001 Restoration filling+post 57 (0,7) 101356,5 (41,2-77,7) <0.0001 Breakage RC-instrum. yes 382 (4,4) 1010064,2 (58,3-70,7) <0.00019374,2 (68,6-80,2) <0.0001 Breakage RC-instrum. no 8262 (95,6) 10255973,7 (72,4-75,0) <0.0001241789,2 (88,3-90,2) <0.0001 Via falsa yes 32 (0,37) 10726,2 (12,6-54,4) <0.000128,25 (1,30-52,3) <0.0001 Via falsa no 8612 (99,6) 10265273,4 (72,2-74,7) <0.0001250888,9 (88,0-89,8) <0.0001