The Effect of Cuspal Coverage on Endodontic Treatment Outcome

Abstract

Abstract Aim A retrospective analysis was undertaken to determine the effect of cuspal coverage restoration on the outcome of primary and secondary root canal treatments determined using cone-beam computed tomography (CBCT) as well as periapical radiographs. A pooled data analysis was gathered from three prospective clinical outcome trials. Methodology The analysis merged data from the 1-year results for 402 teeth which included 151 primary endodontic treatments and 251 retreatments. All the root canals were instrumented with rotary instruments and obturated with continuous wave of condensation of gutta-percha and sealer. The effect of cuspal coverage and other dental variables on the outcome of the treatments was assessed using simple binary logistic regression models. Multi-level logistic regression using generalized estimation equations (GEE) was conducted to assess the risk of failure (unfavourable outcome) in a tooth by cuspal coverage and other factors. Results The outcome of the treatment in posterior teeth was the primary variable of the research with an overall distribution of 77.3% favourable and 22.7% unfavourable outcome. There were no differences in the failure rate between teeth with cuspal coverage and teeth without (p=0.468). The tooth type was not relevant factor on treatment outcome (p=0.104). There was no significant difference between primary and secondary treatment outcomes (p=0.347. The failure rate was significantly higher in teeth with preoperative periapical radiolucencies (OR=2.41; p=0.019) Conclusions The presence of cuspal coverage did not affect the treatment outcome. The presence of a preoperative periapical radiolucency was the main negative prognostic factor.