Three-year outcomes of root canal treatment: Mining an insurance database.

Objectives: There is doubt whether success rates of root canal treatments reported from clinical trials are achievable outside of standardized study populations. The aim of this study was to analyse the outcome of a large number of root canal treatments conducted in general practice.

Methods: The data was collected from the digital database of a major German national health insurance company. All teeth with complete treatment data were included. Only patients who had been insurance members for the whole 3-year period from 2010 to 2012 were eligible. Kaplan-Meier survival analyses were conducted based on completed root canal treatments. Target events were re-interventions as (1) retreatment of the root canal treatment, (2) apical root resection (apicoectomy) and (3) extraction. The influences of vitality status and root numbers on survival were tested with the log-rank test.

Results: A total of 556,067 root canal treatments were included. The cumulative overall survival rate for all target events combined was 84.3% for 3 years. The survival rate for nonvital teeth (82.6%) was significantly lower than for vital teeth (85.6%; p<0.001). The survival rate for single rooted teeth (83.4%) was significantly lower than for multi-rooted teeth (85.5%; p<0.001). The most frequent target event was extraction followed by apical root resection and retreatment.

Conclusions: Based on these 3-year outcomes, root canal treatment is considered a reliable treatment in practice routine under the conditions of the German national health insurance system.

Clinical Significance: Root canal treatment can be considered as a reliable treatment option suitable to salvage most of the affected teeth. This statement applies to treatments that in the vast majority of cases were delivered by general practitioners under the terms and conditions of a nationwide health insurance system.