A Retrospective Study on Endodontic Treatment Outcomes in Patients with Special Needs

INTRODUCTION

Outcomes of endodontic treatment in patients with special needs are not fully understood, leading to reluctance in performing endodontic treatment.

METHODS

This retrospective cohort study evaluated the periapical healing and tooth survival in patients with special needs who had permanent teeth endodontically treated in a hospital setting between 1998 to 2019. Data characterization was performed using univariate analyses. Logistic and Cox regression analyses (P<0.05) were performed to identify the odds ratio (OR) and hazard ratio (HR) of the potential prognostic factors, respectively. These predictors were chosen from previous outcome studies in the general population and patients with special needs.

RESULTS

61 patients (108 teeth) met the inclusion criteria. Most common treatment modality was initial therapy with 81.5% of cases being managed without a need for general anesthesia. Healing rate for initial endodontic treatment was 89.9% and was affected by no restoration at follow-up (OR=0.15, 95%CI:0.12, 0.71, P=0.02). After a mean follow up of 79.36±59.6 months, the survival rate was 73% and was correlated with gender (HR for males = 0.3; 95% CI, 0.1-0.6; P <0.05) and age (HR for patients >45 years = 3.7; 95% CI, 1.7-8.2; P<0.05). The most common reason for tooth extraction was unrestorable tooth fracture.

CONCLUSIONS

Endodontic therapy without a need for general anesthesia is a viable treatment option for patients with special needs. If the overall patient condition permits, then treatment can be administered by community dentists rather than waiting for a patient to be seen in a hospital setting.