Retention of molars after root-resective therapy: a retrospective evaluation of up to 30 years.

Clin Oral Investig

Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany.

Published: April 2018

Objectives: Long-term retention of teeth and especially molars in function is the ultimate goal of periodontal therapy. Root-resective therapy is a treatment option for molars with advanced furcation involvement, which has been questioned because of the heterogenous success rates published in literature. This study aimed to evaluate long-term results of root-resective treatment over a period of up to 30 years.

Methods: In this retrospective cohort, 90 root-resected molars in 69 patients were examined for 4-30 years (14.7 ± 6.8 years). The complete treatment sequence was performed by one of the authors in a general dental practice.

Results: Overall cumulative survival rate was 90.6% after 10 years, but then decreased considerably. Molars after root resection had a median survival time of 20 years. The incidence of endodontic complications leading to tooth extraction was only 26.7%, 50% were lost due to periodontal problems, and 16.7% because of caries. Mandibular molars had a significantly lower relative risk of loss than molars in the maxilla (HR 0.31, 95% CI 0.1-0.91, p = 0.033). Mandibular molars showed a survival probability of almost 80% even 20 years after root resection.

Conclusion: Root-resective therapy is a predictable treatment option, when care is administered at each phase of therapy.

Clinical Relevance: This study provides important information about what is possible in daily practice under the outlines of public health care, when care is administered at each phase of resective therapy.

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Source
http://dx.doi.org/10.1007/s00784-017-2220-1DOI Listing

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