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External cervical root resorption : determinants and treatment outcomes Irinakis, Eleni

Abstract

Objectives: The objectives of this study were to assess if any systemic condition could be a potential predisposing factor for external cervical root resorption (ECRR), and to assess the long-term ECRR treatment outcome and its determinants. Methods: This study contains data from 76 patients (98 teeth) diagnosed with ECRR at the UBC Graduate Endodontics clinic, from 2008 to 2018. Data regarding the medical and dental history were retrospectively collected from the charts of the ECRR group and an equivalent group of patients without ECRR (control group). Subsequently, the ECRR patients were approached for a follow-up appointment, during which a clinical examination was conducted and intraoral photos were taken. Periapical radiographs, and CBCT if indicated, were taken for the radiographic evaluation. Chi Square test or Fisher’s Exact test were used for statistical comparisons at two levels, patient-based and tooth-based level. The Kaplan Meier curves method was used in order to evaluate the overall ECRR survival/failure rates, and how various treatment-related and local predisposing determinants were associated with the ECRR treatment outcome. Results: Overall, 67 patients were evaluated. The mean follow-up was 3.9 years with the minimum follow-up being one year. The majority of the patients were older than 40 years old (72.4%). The most frequently affected teeth were the maxillary anteriors (31.7%) with the most common diagnosis being Class 2 (38.8%). Half of the cases survived for eight years. Twenty-four teeth failed (i.e. 19 extracted, 5 not functional). The only influencing factor that proved to be statistically significant among the systemic conditions was diabetes, and it was more frequently present in the ECRR group than in the control group. Determinants with statistically significant influence were: the root canal treatment (RCT) and the resorption repair combined with RCT as local determinants; and the tooth location and the Heithersay classification as treatment-related determinants. Conclusions: Diabetes may be a potential systemic predisposing factor for ECRR. RCT and the ECRR repair combined with RCT are associated with lower failure rates. Higher failure rates are associated with posterior teeth and higher classes in the Heithersay classification.

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