PROMs Following Root Canal Treatment and Surgical Endodontic Treatment

Jasmine Wong; Gary Shun Pan Cheung; Angeline Hui Cheng Lee; Colman McGrath; Prasanna Neelakantan

doi:10.1016/j.identj.2022.06.015

PROMs Following Root Canal Treatment and Surgical Endodontic Treatment

Int Dent J. 2023 Feb;73(1):28-41. doi: 10.1016/j.identj.2022.06.015. Epub 2022 Jul 21.

Authors

Jasmine Wong¹, Gary Shun Pan Cheung², Angeline Hui Cheng Lee¹, Colman McGrath³, Prasanna Neelakantan⁴

Affiliations

¹ Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
² Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; Department of Dental Surgery, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
³ Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
⁴ Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China. Electronic address: prasanna@hku.hk.

Abstract

The FDI is currently working on developing a tool to encompass patient-reported outcome measures (PROMs) within the overall assessment of outcomes of endodontic treatment. The outcome of endodontic treatment has traditionally been determined by various clinical and radiographic criteria. However, these parameters do not address the impact of treatment on a patient's oral health-related quality of life (OHRQoL). OHRQoL, a crucial PROM, can be used to understand treatment outcome from a patient-centred perspective, thus improving clinician-patient communication whilst guiding decision-making. This focussed review aims to recount the OHRQoL of patients following nonsurgical root canal treatment and surgical endodontic treatment, with a specific focus on the minimal important difference (MID; the minimum score changes of an outcome instrument for a patient to register a clinically significant change in their OHRQoL and/or oral condition) and the methods used to determine it. The current evidence indicates that the OHRQoL of patients requiring root canal treatment is poorer than those without such need. Accordingly, the literature suggests that OHRQoL improves following nonsurgical or surgical endodontic treatment. However, study methodologies vary widely, and conclusions cannot be drawn with high confidence, nor can MID recommendations be provided. Well-designed clinical studies with baseline measurements and appropriate follow-up time frames are therefore needed. Despite that the literature is rife with outcome studies, research on PROMs is an area that deserves greater attention, particularly in relation to the MID. Determining the MID will facilitate the understanding of changes in outcome scores from the patients' perspective, thus allowing for more informed decision-making in clinical practice.

Keywords: Minimal important difference; Oral health–related quality of life; Patient-centered outcome; Root canal treatment; Surgical endodontics.

Publication types

Review

MeSH terms

Dental Care
Dental Pulp Cavity*
Endodontics
Humans
Patient Reported Outcome Measures
Patient-Centered Care
Quality of Life*
Root Canal Therapy* / methods
Treatment Outcome