A Naval Postgraduate Dental School Analysis of Initial Endodontic Treatment

Clinicians need to have the ability to predict the prognosis of endodontic treatment to make informed decisions on treatment options. The prognosis of initial endodontic treatment is reported to be very favorable with high healing rates; however, several variables have been identified as possible contributors to decrease healing in previous research. Objective: To determine the outcome of initial endodontic treatment completed by Navy Endodontists and Residents at the Naval Postgraduate Dental School (NPDS) as well as to identify variables that affect the outcome of initial endodontic treatment. Materials and Methods: To assess healing, this study used both clinical and radiographic data gathered from a cohort of 112 subjects who received endodontic treatment at NPDS or from a Navy Endodontist and follow-up examination at least 12 months following treatment. Further analysis of the data were performed using Fisher's Exact Chi-squared, logistic regression and odds ratio analysis to evaluate the variables that potentially influence healing. Results: Of the 112 subjects enrolled in this study, a 66%healed rate was noted, indicating the absence of a radiographic lesion and clinical signs and symptoms at follow-up. However, a 96% clinical success rate was achieved, indicating the absence of clinical signs and symptoms. Further analysis indicated an association between an immediate post-obturation radiographic lesion (p=0.002) and pre-operative diagnosis of a necrotic pulp (p=0.037) negatively affected healing. Utilizing logistic regression, no other factors analyzed were noted to affect healing. Odds ratio analysis indicated a greater likelihood for healing when a radiographic lesion was absent (6.2x) and a vital pulp was present (3.3x).Conclusion: Preliminary evaluation indicated a healing rate of 66% with a clinical success of 96%. The presence of either a necrotic pulp or an immediate post-operative radiographic lesion was determined to significantly