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ePaper created 2016-09-05, 09:33:59 | version 1.38.0
non-surgical treatment study | 33 roots 3 2016 tic studies come up with another variability making comparability more complicated. Thecasesofthepresentstudyweretreatedintheau- thors office and evaluated by the author himself. Whereas extraction and thus the relevant survival rep- resentahard,non-discussiblefact,success/failureeval- uationsaresubjecttobias.Accordingtoliterature6, 7 the survivalrateregardingtoothextractionsishigherthan thefailurerate.Analysisofthepracticedatashowedthe opposite: after 20 years, 51.5 % of the teeth were still insituand82 %werestillsavedfromfailure. Comparison with some studies can partly not be made,assurvivaldatarefertotheinitialcasenumbers and are not in reference to the remaining cases get- tinglessovertheyears.Sothesurvivaldatesreferring to extractions gained from the insurance registers have to be seen critically. Lazarski et al.15 indicated that94.4 %remainedinthemouthfunctionallyafter an average of 3.5 years. Salehrabi and Rotstein16 cal- culated a remaining in situ of 97.1 % after 8 years and Chen et al.17 a remaining in situ of 93.3 % after 5 years. Drop-outs are not mentioned in these stud- ies. The fact is that only data known to the insurance areevaluatedinthosestudies,whichisratherunlikely in non-treated pathology, non-treated radiographi- cal failure or goodwill treatments. In 914 cases, Stoll et al.18 noticed 105 (11.5 %) losses (extractions, RER, RTR) after 106 months, which can be interpreted as a cumulative survival rate of 74 %. De Chevigny et al.19 report about 70–73 % of drop-outs. They judged the remaining cases as being in function (95 %) and as healed radiographically (86 %). The present study includes a drop-out rate of 40.6 % after 5 years, of 58.5 % after 10 years. As a recall never took place it can be supposed that the drop-out rates would have been more favorable in case of recall management. Thelongobservationperiodofupto25yearsmay have supported the low failure rate. The later lower failureratecanbeledbacktothefactthattheradio- graphical failure diagnosis averaged from 9.9 % to 8.3 % after the fourth year. It has to be mentioned that 9.5 % of the failures accompanied by X-ray could not have been verified radiographically. This maybeduetothefactthattheapicalosteitishasnot yet rounded the corticalis with sufficient mineral loss what is, according to Bender20 , the pre-condi- tion for a radiographical AP presentation. Also anatomic features may superimpose an AP. The de- clining development of apical lesions over time Table 6: Extraction reason and failure. Case 2 Fig.8: Initial situation X-ray (1987). Fig.9: Control X-ray (2002). Fig.10: Permatex-Anker inserted with N2 (2002). Fig.11: Control X-ray (2011). n % n % 866 46 55 6.4 441 23.4 24 5.4 167 8.9 10 6 222 11.8 222 100 78 4.1 4 5.1 109 5.8 97 89 Total 1883 412 Caries, Fracture Extraction Reason Extraction Failure Parodontopathy Prosthetics Endodontic Failure Unknown Reason Pain Fig.8 Fig.10 Fig.9 Fig.11 32016 86646556.4 44123.4245.4 1678.9106 22211.8222100 784.145.1 1095.89789 Total 1883412