Factors Influencing Quality of Life after Surgical and Nonsurgical Interventions of Persistent Endodontic Disease

Nonsurgical endodontic retreatment and apical surgery are predictable procedures for the management of endodontically treated teeth with persistent disease. However, there is no information available that compares these treatment modalities based on patients’ oral health–related quality of life (OHRQOL). The aims of this study were to compare the OHRQOL of patients who received nonsurgical endodontic retreatment versus those who received apical surgery and to identify correlations between OHRQOL, clinician-assessed healing outcome, and other factors. Patients who received treatment at 2 dental hospitals with a recall period of 6–24 months were invited to participate. They underwent follow-up examination and were surveyed with the Oral Health Impact Profile (OHIP-14). Healing outcomes were determined by clinical and radiographic evaluation. Potential influencing factors for OHIP-14 scores were investigated. One hundred fifty patients (75 patients from each group) participated in the study. There were no differences in OHIP-14 scores between both groups at the follow-up. The overall adverse impact on OHRQOL was low, with patients experiencing greater impact in the domains of “physical pain” and “psychological discomfort.” Women and patients who had preoperative pain reported a greater impact. There was an overall high healed and healing rate for both groups. No correlation was found between OHIP-14 scores and healing outcome. Patients who received nonsurgical endodontic retreatment and apical surgery reported comparable OHRQOL, with women and patients with preoperative pain reporting greater impact. Both treatments are viable options for the management of persistent endodontic disease based on clinician- and patient-reported outcome assessments.