Survival analysis of root-resected molars from 1 to 13.4 years: A retrospective cohort study

Se-Lim Oh; Jong Ryul Kim; Emmanuel Engermann; Harlan J Shiau

doi:10.1016/j.prosdent.2023.05.037

Survival analysis of root-resected molars from 1 to 13.4 years: A retrospective cohort study

J Prosthet Dent. 2023 Jul 17:S0022-3913(23)00409-2. doi: 10.1016/j.prosdent.2023.05.037. Online ahead of print.

Authors

Se-Lim Oh¹, Jong Ryul Kim², Emmanuel Engermann³, Harlan J Shiau⁴

Affiliations

¹ Clinical Associate Professor, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Md. Electronic address: soh@umaryland.edu.
² Associate Professor, Department of Endodontology, Kornberg School of Dentistry, Temple University, Philadelphia, Pa.
³ Undergraduate student, School of Dentistry, University of Maryland, Baltimore, Md.
⁴ Clinical Associate Professor, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Md.

PMID: 37468370
DOI: 10.1016/j.prosdent.2023.05.037

Abstract

Statement of problem: While root resective therapy may extend the longevity of a molar, data on patient selection and outcomes of root resection are scarce.

Purpose: The purpose of this retrospective cohort study was to analyze the survival of root-resected molars and investigate factors affecting the decision and outcomes of the therapy.

Material and methods: Patient- and tooth-related data from participants who had received root resection between 1999 and 2022 were collected. Cox regression was used to build predictive models for time-to-tooth loss based on predictors-initial diagnoses (carious, endodontic, periodontal, or endodontic-periodontal lesions), the presence of a complete-coverage crown, and the location of the tooth in the arch (P<.001).

Results: Of 60 teeth, all from different participants, 31 molars were resected because of endodontic lesions. The failure rate was 35% with 21 teeth extracted. At 5 years, the survival probability was 0.58, considering all predictors. The survival of molars resected because of carious or endodontic lesions was significantly lower than those because of periodontal or endodontic-periodontal lesions (P<.05). The hazard ratio for tooth loss in the resected teeth was 15.6, 95% confidence interval (CI) (3.7 to 83.2) without complete-coverage crowns and 8.6, 95% CI (2.2 to 43.2) at the most posterior location.

Conclusions: Root resection provided to manage a localized periodontal lesion had the highest prognosis. The absence of a crown and the location as the most posterior tooth in the arch were associated with poor survival following resection.