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A Retrospective Analysis of Initial Posterior Root Canal Therapy on United States Air Force Personnel
Uniformed Services University of the Health Sciences Bethesda United States
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Introduction The Air Force Dental Service AFDS has established evidence-based treatment standards for endodontics, including use of rubber dam, cuspal coverage restoration of endodontically treated posterior teeth, and three-dimensional filling of the canal system regarding length, taper, and density. The purpose of this retrospective study was to determine the effect of these standards on treatment outcomes of initial posterior root canal therapy RCT completed by Air Force AF dentists and to compare these outcomes with treatment referred to civilian providers. Methods Treatment and follow-up radiographs of AF members who had an initial posterior RCT completed in 2011 were evaluated. A survey of all radiographs was done to determine the 1 RCT obturation quality, 2 presence of pre- and postoperative periapical pathosis, and 3 presence and quality of cuspal coverage restorations. Results A total of 2,262 RCTs were examined with 1,960 RCTs meeting inclusion criteria for at least one evaluation category. For RCT obturation quality, 1,810 RCTs were evaluated and 96.0 were considered adequate. For cuspal coverage restorations, 1,856 RCTs were evaluated and of these 2.7 were inadequately restored. Incomplete and complete healing of preoperative lesions was 91.5 and 85.7 for AF and referred civilian providers, respectively. Survivability was 94.7 for AF endodontists, 94.4 for AF general dentists, 93.9 for civilian endodontists, and 78.4 for civilian general dentists. Overall, survivability was 94.1 mean of 27 months.Conclusions In this radiographic analysis, evidence-based practices as followed in the AFDS and additional training resulted in improved treatment outcomes.
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