The effect of endodontics and crown restoration techniques on the prognosis of treatment non-vital teeth

Introduction: It is generally accepted that the prognosis of endodontic treatment positively correlates with the technical quality of root filling. This seems logical in the sense that the root filling is intended to create a bacterial tight seal on the root canal, so oral bacteria cannot reach the periapical tissues and cause disease. The materials that are available to seal the root canal system are not flawed, and a number of studies using different methods have suggested that even seeming adequate root fillers may not be effective over time. The aim of the study was to evaluate the possible relationship between the quality of restorative crown of the tooth, obturation of the root canal and the periapical status of the teeth that were subjected to endodontic treatment. Materials and methods: A series of X-ray images of randomly selected outpatient cards from patients in the dental department of the Dnipropetrovsk State Medical Academy clinic were investigated. A total of 1001 teeth that were subjected to endodontic treatment, restored by permanent restoration, were evaluated independently by two experts. According to the predetermined set of radiological criteria, the quality of filling the root canals of the tooth was assessed as good (GE), or poor (PE). In turn, the quality of the tooth crown restoration was also evaluated and recognized as good (GR) or poor (PR). Subsequently, the roots of the teeth and surrounding tissues were investigated, and according to existing or present abnormalities, the outcome of treatment was determined to be either successful or unsuccessful. Results: The successful outcome of endodontic treatment among all the teeth tested was found at 66.4% (n = 1001). The positive result of treatment of teeth with root posts reached 72.7% (n = 527), the success of treatment of teeth without pins was 64.6% (n = 472). The effectiveness of dental treatment, where the technically satisfactory endodontics was found to be the highest. Thus, in combination with technically satisfactory restorations, the success rate reached 82% (GE + GR), and when the restoration was technically unsatisfactory, positive results of treatment were observed in 72% of cases (GE + PR). At the same time, in those groups where endodontics was considered technically unsatisfactory, the positive result of treatment was observed significantly less often, in combination with unsatisfactory restoration, only 55% (PE + GR). If restorations were satisfactory, then somewhat more often, in 57% of the examined teeth (PE + PR). Conclusions: Thus, according to the results of the X-ray assessment of non-vital teeth, it became clear that in order to achieve a positive result, technically qualitative endodontics is more important, with the same characteristic of restoration of the crown of the tooth