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Purpose: To assess the opinions of dental professionals working within the Delta Dental insurance system regarding the predictability of initial endodontic treatment, expected long-term outcome and the importance of placing a coronal coverage after completion of treatment. Methods: An eight-item questionnaire was distributed among participants attending a continuing education course. The questionnaire included four items on practice profile and demographics and four multiple-choice questions regarding participants' opinions on endodontic treatment outcome. Results: 51% of participants responded that the expected retention rate of teeth 5-10 years after endodontic treatment was more than 90%. Sixty-eight percent of participants responded that the need for additional treatment was expected to occur within the first 3 years after initial endodontic treatment. 87% of participants responded that placing coronal coverage after completion of endodontic treatment was very important for long-term tooth retention. Ninety-three percent of participants responded that overall, endodontic treatment was a predictable procedure with long-term tooth retention rate. Statistically significant associations were found between (1) year of experience and expected rate of retention (P< 0.01 ); (2) participants' years of experience and their responses regarding the need for additional treatment (P< 0.05); and (3) their opinions that endodontic treatment was a predictable procedure with long-term tooth retention rate (P< 0.05 ). [ABSTRACT FROM AUTHOR]

Outcome assessment of endodontic treatment is critical for appropriate case selection and treatment planning. However, reports on outcomes of nonsurgical endodontic treatment vary considerably. Epidemiological studies done in a large patient population and over a long follow-up period can provide the clinician with useful tools for clinical decision-making and assessment of tooth prognosis. In this study, outcomes of initial endodontic treatment done in 1,462,936 teeth of 1,126,288 patients from 50 states across the USA was assessed over a period of 8 yr. Treatment was done by private general practitioners and endodontists participating in the Delta Dental Insurance plan that insures approximately 14 million individuals in the USA. Overall, 97% of teeth were retained in the oral cavity 8 yr after initial nonsurgical endodontic treatment. The combined incidence of untoward events such as retreatments, apical surgeries, and extractions was 3% and occurred mostly within 3 yr from completion of treatment. Analysis of the extracted teeth revealed that 85% had no full coronal coverage. A significant difference was found between covered and noncovered teeth for all tooth groups tested (p < 0.001). In conclusion, it appears that initial nonsurgical endodontic treatment is a predictable procedure with high incidence of tooth retention after 8 yr. [Copyright &y& Elsevier]

Aim: The aim of this study is to survey the opinion of endodontists in the United States regarding their approach to treatment of cracked teeth., Materials and Methods: A survey assessing the opinions of 3,500 endodontists in the United States was administered over a 4-week period. It consisted of a hypothetical clinical case and eight different treatment scenarios. Participants were asked to select one of the two treatment options: (A) informing the patient of the presence of a crack, reinforcing the tooth, and continuing with endodontic treatment; and (B) extraction of the tooth followed by replacement with an implant supported crown or fixed partial denture., Results: When the crack extended across the distal marginal ridge with no associated probing depths, 92.65% endodontists preferred to continue with endodontic treatment and reenforcing the tooth. When the crack extended across the distal marginal ridge and was associated with a probing depth of 6 mm, 80% preferred extraction of the tooth. When the crack extended across the mesial marginal ridge up to the orifice of the mesiolingual canal with no associated probing depth, 82.78% preferred to continue with the treatment. When the crack was associated with a 6-mm probing depth, 83.79% preferred tooth extraction. When the crack extended across the mesial marginal ridge and down into the mesiolingual canal with/without associated probing depth, 91.13% and 63.54% preferred tooth extraction, respectively. When the crack involved both mesial and distal marginal ridges and extended across the pulp chamber, 79.74% preferred tooth extraction. When a split tooth was presented, 98.48% preferred tooth extraction., Conclusion: It appears that the presence of a 6-mm periodontal pocket is considered an important factor by most American endodontists when deciding whether to preserve the cracked tooth or extract it., Clinical Significance: There is no consensus among dentists regarding the best approach to treat cracked teeth. Conclusive studies evaluating clinical approaches of endodontists regarding treatment of cracked teeth are lacking. Therefore, surveyed opinion of endodontists in the United States regarding their approach to treatment of cracked teeth was done to try to reach the best clinical decision regarding this dilemma.

Introduction: Teeth undergoing initial endodontic therapy have a very high survival rate. Some teeth that continue to show signs of pathosis after the initial therapy will require nonsurgical (orthograde) retreatment. Outcome assessment of endodontic retreatment is crucial for appropriate case selection and treatment planning. However, reports on outcomes of orthograde endodontic retreatment performed by endodontists are limited in number, and the reported data vary. In this study, outcomes of orthograde endodontic retreatment performed on 4744 teeth were assessed during a period of 5 years., Methods: Data were obtained from retreatments that were performed by endodontists participating in the Delta Dental Insurance plan that insures approximately 15 million individuals in the USA., Results: Overall, 89% of teeth were retained in the oral cavity 5 years after the endodontic retreatment. Four percent of all teeth underwent apical surgery that occurred mostly within 2 years from completion of orthograde retreatment. Eleven percent of teeth were extracted at the end of the 5-year observation period., Conclusions: It appears that orthograde endodontic retreatment yields high incidence of tooth retention after 5 years., (Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)