Fifteen-year survival of root canal treated teeth in England and Wales

Lessani, Maria ORCID: 0009-0007-0941-142X (2025). Fifteen-year survival of root canal treated teeth in England and Wales. University of Birmingham. Ph.D.

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Abstract

Objective
Investigate the fifteen-year survival curve for root treated teeth in adult patients treated within the National Health Service General Dental Services (NHS GDS) in England and Wales by General Dental Practitioners (GDPs).

Methods
The data source was the age-stratified random sample of NHS GDS patients and the treatments they received over the period from 1990 to 2006 (SN7024 from https://ukdataservice.ac.uk). The survival was measured to reintervention which was categorised as re-root canal treatment, root-end surgery (apicectomy) or extraction after root canal treatment (RCT). Analysis was carried out using modified Kaplan- Meier methodology to establish survival curves extending to fifteen years and investigation of factors that can affect survival.

Results
The 15 years survival of root canal treated teeth by GDPs was 77% based on reintervention for 791,375 RCT teeth from over 2.5 million patients, whilst based on extraction the 15-year survival was 83%. The investigation of factors that affect survival were carried out and indicated that there were some dentist, patient and tooth factors of significance. The dentists in their 30s had the best survival outcome whilst the opposite was evident for dentists aged 60 and above, also dentists working in South Central England had markedly better results than those in Wales. The age of the patient and the full charge paying status of the patient were also significant factors.
The tooth factors investigated revealed better survival among posterior teeth, lower teeth, and those restored after RCT with a crown, bridge abutment and pin/screw. A previous history of RCT, post, crown and bridge abutment decreased the survival of the RCT teeth. Occlusal restorations also decreased the survival both before and after RCT.

Conclusion
The 15 years survival of root canal treated teeth carried out on 791,375 teeth by GDPs in England and Wales was 77% based on reintervention and 83% based on extraction. These findings are encouraging and appear to support the provision of RCT by GDPs working in the NHS GDS to save teeth. Two dentist factors, two patient factors plus tooth factors including the tooth position and nine types of restorations were found to be significant.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):

Supervisor(s)	Email	ORCID
Burke, Trevor	UNSPECIFIED	orcid.org/0009-0007-5112-0263
Lucarotti, Steve	UNSPECIFIED	orcid.org/0009-0000-6667-409X
Lumley, Philip	UNSPECIFIED	orcid.org/0009-0003-2852-0390