| 1. |
- Dawson, Victoria, et al.
(författare)
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Further interventions after root canal treatment in relation to type of coronal restoration and tooth group : a 10-year follow-up of a Swedish dental register
- 2023
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Ingår i: ESE Wladimir Adlivankine Research Prize, Education Prize and Original Research Abstracts.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To investigate the frequency of further interventions after root filling during a follow-up of 10 to 11 years, and to compare the outcomes with respect to type of coronal restoration and tooth group.Methods: Data from the Swedish Social Insurance Agency´s register of dental treatments were obtained to identify the teeth registered as root filled in Sweden 2009. Type of coronal restoration within 6 months after root filling, as well as the frequency of further interventions (nonsurgical retreatment, periradicular surgery, extraction, further direct and indirect restoration) were tracked in the data register until December 31, 2019. Descriptive statistics and Chi-square tests were used for statistical analysis.Results: Of the 215 611 teeth root filled in 2009, nonsurgical retreatment, periradicular surgery, and extraction were registered for 3.5%, 1.4% and 20%, respectively. The highest frequency of nonsurgical retreatment was registered for molars (4.2%), and periradicular surgery was most frequent in maxillary canines and incisors (2.3%). The highest frequency of extractions was registered for mandibular molars (25.1%). Directly restored teeth had higher frequency of nonsurgical retreatment (3.9%) and extraction (20.8%), compared to indirectly restored teeth (1.7% and 13.6%, respectively; P < 0.001). Of teeth restored with direct restoration within 6 months after root filling, 41.5% were registered with at least one further direct restoration and 14.7% with an indirect restoration. In the group of indirectly restored teeth, 9.3% and 7.1% underwent further restorative treatment with direct and indirect restoration, respectively. The differences registered between directly and indirectly restored root filled teeth were statistically significant (P < 0.001).Conclusions: The frequencies of nonsurgical retreatment and periradicular surgery were low 10 to 11 years after root filling, despite one in five root filled teeth being registered as extracted. Further interventions were significantly more common for directly restored teeth than for those indirectly restored.
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| 2. |
- Dawson, Victoria S., et al.
(författare)
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Further Interventions after Root Canal Treatment Are Most Common in Molars and Teeth Restored with Direct Restorations : A 10–11-Year Follow-Up of the Adult Swedish Population
- 2024
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 50:6, s. 766-773
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aims were to investigate 1) the frequency of nonsurgical retreatment, root-end surgery, extraction, and further restorative treatment during a follow-up of 10–11 years after root filling and compare the frequencies according to tooth group and type of coronal restoration and 2) the timing of nonsurgical retreatment, root-end surgery, and extraction. Methods: Data were collected from the Swedish Social Insurance Agency's register. A search for treatment codes identified teeth root filled in 2009 and the type of coronal restoration (direct, indirect, and unspecified) registered within 6 months of root filling. The root-filled teeth were followed 10–11 years, and further interventions were recorded. Descriptive statistics and chi-square tests were used for statistical analysis. Results: In 2009, root fillings were registered for 215,611 individuals/teeth. Nonsurgical retreatment, root-end surgery, and extraction were undertaken in 3.5%, 1.4%, and 20% teeth, respectively. The frequency of further interventions varied with respect to tooth group and type of coronal restoration, but only slightly for endodontic retreatments. Further interventions, except for root-end surgery, were registered more often for molars and directly restored teeth (P < .001). The majority of endodontic retreatments were undertaken within 4 years, while extractions were evenly distributed over 10–11 years. Conclusions: The frequency numbers of nonsurgical retreatment and root-end surgery were low, despite 1 in 5 root-filled teeth registered as extracted. Further interventions were most common in molars and directly restored teeth. Endodontic retreatments were performed more often during the first 4 years.
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| 3. |
- Fransson, Helena, et al.
(författare)
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EndoReCo banar väg för ökad kunskap och akademisk meritering
- 2022
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Ingår i: Tandläkartidningen. - : Sveriges tandläkarförbund. - 0039-6982. ; 114:12, s. 46-52
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- För att minska kunskapsluckorna inom odontologin krävs samarbete mellan lärosätena. Det ger även möjlighet till akademisk meritering, vilket är angeläget då antalet seniora forskare med behörighet för forskningshandledning i Sverige är färre än någonsin. EndoReCo (Endodontic Research Collaboration) är ett skandinaviskt forskningsnätverk i endodonti som kan ta del av just dessa fördelar.
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| 4. |
- Nagendrababu, Venkateshbabu, et al.
(författare)
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PROBE 2023 guidelines for reporting observational studies in Endodontics: A consensus‐based development study
- 2023
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Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 56:3, s. 308-317
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Tidskriftsartikel (refereegranskat)abstract
- Observational studies are non-interventional studies that establish the prevalence and incidence of conditions or diseases in populations or analyse the relationship between health status and other variables. They also facilitate the development of specific research questions for future randomized trials or to answer important scientific questions when trials are not possible to carry out. This article outlines the previously documented consensus-based approach by which the Preferred Reporting items for Observational studies in Endodontics (PROBE) 2023 guidelines were developed. A steering committee of nine members was formed, including the project leaders (PD, VN). The steering committee developed an initial checklist by combining and adapting items from the STrengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist and the Clinical and Laboratory Images in Publications (CLIP) principles, as well as adding several new items specifically for the specialty of Endodontics. The steering committee then established a PROBE Delphi Group (PDG) and a PROBE Online Meeting Group (POMG) to obtain expert input and feedback on the preliminary draft checklist. The PDG members participated in an online Delphi process to reach consensus on the clarity and suitability of the items present in the PROBE checklist. The POMG then held detailed discussions on the PROBE checklist generated through the online Delphi process. This online meeting was held via the Zoom platform on 7th October 2022. Following this meeting, the steering committee revised the PROBE checklist, which was piloted by several authors when preparing a manuscript describing an observational study for publication. The PROBE 2023 checklist consists of 11 sections and 58 items. Authors are now encouraged to adopt the PROBE 2023 guidelines, which will improve the overall reporting quality of observational studies in Endodontics. The PROBE 2023 checklist is freely available and can be downloaded from the PRIDE website (https://pride-endodonticguidelines.org/probe/).
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| 5. |
- Wigsten, Emma, et al.
(författare)
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Comparative analysis of general dental practitioners' fees and scheduled fees for root canal treatment and coronal restorations in the adult population of Sweden : a five-year follow-up of data from the Swedish Dental Register.
- 2018
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Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 51:2, s. 141-147
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate the fees charged by Swedish dentists for root fillings, coronal restorations and further dental interventions during a follow-up period of 5-6 years. METHODOLOGY: A total of 248,299 root fillings were linked with the tooth, the patient and the provider and entered into the Swedish Social Insurance Agency register in 2009. The data register also recorded the subsidy-based (scheduled) fee and the fee actually charged for the root fillings. Fees charged for direct or indirect coronal restorations and additional interventions during the follow-up period were also recorded. One-way ANOVA and T-test were used for statistical analysis. RESULTS: The mean overall fee charged for a root filling was approximately 332 Euro and differed only marginally (13 Euro) from the scheduled fee. The total mean fee for preservation of a root filled tooth was 717 Euro, which included the root canal treatment, the coronal restoration and any additional interventions during the follow-up period. The fees for indirectly restored root filled teeth were significantly higher (1,105 Euro) than for directly restored teeth (610 Euro), despite further additional treatment (P< 0.001). The mean fee for teeth which were subsequently extracted was higher (769 Euro) than for the retained teeth (711 Euro) (P< 0.001). CONCLUSIONS: Fees charged by Swedish dentists for root canal treatment were in accordance with the scheduled fees. The overall mean fee was significantly higher for root filled teeth with indirect restorations than for teeth with direct coronal restorations. However, prospective clinical cost-effectiveness studies are needed to analyse the total costs. This article is protected by copyright. All rights reserved.
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| 6. |
- Wigsten, Emma, 1984, et al.
(författare)
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Comparative analysis of general dental practitioners' fees and scheduled fees for root canal treatment and coronal restorations in the adult population of Sweden: a 5-year follow-up of data from the Swedish Dental Register
- 2018
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Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885. ; 51:2, s. 141-147
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Tidskriftsartikel (refereegranskat)abstract
- Aim To investigate the fees charged by Swedish dentists for root fillings, coronal restorations and further dental interventions during a follow-up period of 5-6 years. Methodology A total of 248299 root fillings were linked with the tooth, the patient and the provider and entered into the Swedish Social Insurance Agency register in 2009. The data register also recorded the subsidy-based (scheduled) fee and the fee actually charged for the root fillings. Fees charged for direct or indirect coronal restorations and additional interventions during the follow-up period were also recorded. One-way anova and t-test were used for statistical analysis. Results The mean overall fee charged for a root filling was approximately 332 Euro and differed only marginally (13 Euro) from the scheduled fee. The total mean fee for preservation of a root filled tooth was 717 Euro, which included the root canal treatment, the coronal restoration and any additional interventions during the follow-up period. The fees for indirectly restored root filled teeth were significantly higher (1105 Euro) than for directly restored teeth (610 Euro), despite further additional treatment (P < 0.001). The mean fee for teeth which were subsequently extracted was higher (769 Euro) than for the retained teeth (711 Euro) (P < 0.001). Conclusions Fees charged by Swedish dentists for root canal treatment were in accordance with the scheduled fees. The overall mean fee was significantly higher for root filled teeth with indirect restorations than for teeth with direct coronal restorations. However, prospective clinical cost-effectiveness studies are needed to analyse the total costs.
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| 7. |
- Wigsten, Emma, 1984, et al.
(författare)
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Comparing Quality of Life of Patients Undergoing Root Canal Treatment or Tooth Extraction
- 2020
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399 .- 1878-3554. ; 46:105, s. 19-28
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The knowledge of patient-centered outcomes concerning the consequences of root canal treatment in daily life is limited. The treatment option is often tooth extraction with possible prosthetic replacement. This study aimed to achieve a greater understanding of the patient perspective by evaluating the effect of root canal treatment in terms of quality of life and quality-adjusted life year (QALY) weights in comparison with patients who underwent tooth extraction. Methods: Patients with either root canal treatment or extraction were recruited from 6 clinics in the general public dental service during a predetermined period of 8 weeks. Three different instruments were used: the Oral Health Impact Profile evaluating the oral health related quality of life (OHRQOL), the EQ-5D-5L evaluating health-related quality of life (HRQOL) and QALY weights, and a disease-specific questionnaire evaluating satisfaction regarding the root canal treatment. The evaluation was assessed at the initiation of treatment and after 1 month. Patient-based and tooth-specific characteristics were obtained from the dental records. Results: Eighty-five patients were included. The distribution between sexes was even, with 43 women and 42 men. The mean age was 51.1 years. Forty-eight patients (56.5%) had a tooth extraction, and 37 patients (43.5%) initiated root canal treatment. The response rate for the questionnaire at baseline was 95.3%, and at the 1-month follow-up, it was 74.1%. Two relevant and comparable groups were obtained after exclusion of the extracted third molars (n = 20), resulting in 65 patients for further analyses. At follow-up, the patients who initiated root canal treatment registered a significant improvement in perceived HRQOL according to the QALY weights (P = .02 and P < .01, respectively). Patients initiating root canal treatment reported generally high satisfaction. Conclusions: A cohort of patients either initiating root canal treatment or tooth extraction as a control group was established. Initiating root canal treatment had a positive impact on perceived HRQOL. The included patients in general dental practice registered overall high satisfaction regarding root canal treatment.
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| 8. |
- Wigsten, Emma, 1984, et al.
(författare)
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Cost-effectiveness of root canal treatment compared with tooth extraction in a Swedish Public Dental Service: A prospective controlled cohort study
- 2023
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Ingår i: Clinical and Experimental Dental Research. - : WILEY. - 2057-4347. ; 9:4, s. 661-669
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo evaluate the cost-effectiveness of root canal treatment (RCT) compared with a tooth extraction in a general dental practice setting, with reference to cost per quality-adjusted life-year (QALY) gained over 1 year. Material and MethodsThis is a prospective controlled cohort study based on patients either starting RCT or undergoing extraction at one of six Public Dental Service clinics in the county of Vastra Gotaland, Sweden. From a total of 65 patients, 2 comparable groups were formed: 37 started RCT and 28 underwent extraction. A societal perspective was used for the cost calculations. QALYs were estimated, based on the EQ-5D-5L given to the patients at their first treatment appointment and then after 1, 6, and 12 months. ResultsThe total mean cost of RCT ($689.1) was higher than for extraction ($280.1). For those patients whose extracted tooth was replaced, the costs were even higher ($1245.5). There were no significant intergroup differences in QALYs, but a significant improvement in health state values in the tooth-preserving group. ConclusionsIn the short term, extraction was cost-effective compared with preserving a tooth with RCT. However, the potential need for future replacement of the extracted tooth, by an implant, fixed prosthesis, or removable partial dentures, may change the calculation in favor of RCT.
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| 9. |
- Wigsten, Emma, et al.
(författare)
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Fees for root canal treatment and further dental care in the adult population in sweden : a 10-year follow-up of data from the Swedish dental register
- 2023
-
Ingår i: ESE Wladimir Adlivankine Research Prize, Education Prize and Original Research Abstracts.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To investigate the fees for root filling and further dental care charged by Swedish dentists during a follow-up period of 10 to 11 years. Comparisons are made between type of restoration registered within 6 months of the root filling, the tooth group, and the root filled teeth that survived versus those that were extracted.Methods: A total of 215 611 teeth were registered as root filled in the Swedish Social Insurance Agency’s data register in 2009. For each identified tooth, the fees for the following interventions were tracked: initial root filling, coronal restorations, and further dental interventions registered during the follow-up period. The outcomes were analysed with descriptive and analytic statistics, using one-way ANOVA and t-tests. The fees are presented in Euro (€1 = SEK 8.94; 01/01/2012).Results: The total fee for the root fillings was 72 million euros, and the mean fee was €333.6 per root filling. The total mean fee for the preservation of a root filled tooth over 10 to 11 years was €923.4, which included root canal treatment, coronal restorations, and further interventions. The mean fee for indirectly restored root filled teeth was higher (€1 279.3) than for those directly restored (€829.4) and for teeth without specified restorations (€832.7; P < 0.001). Molars had a significantly higher mean fee (€966.4) compared to premolars (€882.8) and anterior teeth (€891.3; P < 0.001). The mean fee for teeth that were extracted was higher (€1 225.3) than for those that survived the follow-up (€848.0; P < 0.001). Conclusions: Fees for root filled teeth have accumulated over time probably due to further dental care needed. The total mean fee was significantly higher for indirectly restored root filled teeth than for directly restored. However, prospective clinical cost-effectiveness studies are needed to analyse the total costs.
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| 10. |
- Wigsten, Emma, 1984, et al.
(författare)
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General dental practitioners' fees for root canal treatment, coronal restorationand follow-on treatment in the adult population in Sweden: A 10-year follow-up of data from the Swedish Dental Register
- 2024
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Ingår i: Clinical and Experimental Dental Research. - : John Wiley & Sons. - 2057-4347. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To analyze the accumulated fees connected with root filling, permanent coronal restoration and follow-on treatment charged by Swedish dentists over a 10–11-year follow-up period. Furthermore, analyzing these fees with reference to the type of restoration, tooth group, and the root-filled teeth which survived compared to those requiring extraction. Material and Methods: In 2009, the data register of the Swedish Social Insurance Agency recorded a total of 215,611 teeth as root-filled. The accumulated fees for each tooth encompassed the following interventions: initial root filling, coronal restorations, and follow-up treatments during the designated period. The outcomes were analyzed using descriptive and analytic statistics, including ttests and one-way analysis of variance. The fees are presented in Euros (€1 = SEK 8.94). Results: The total accumulated fees for root fillings amounted to 72 million Euros: the mean fee per root filled tooth was €333.6. The total mean fee over a 10–11-year period, comprising root canal treatment, coronal restorations, and any follow-up treatments, was €923.4. Root-filled teeth with indirect restorations presented a higher mean fee (€1 279.3) compared to those with direct restorations (€829.4) or those without specified restorations (€832.7; p <.001). Moreover, molars presented a significantly higher mean fee (€966.4) compared to premolars (€882.8) and anterior teeth (€891.3; p <.001). Lastly, the mean fee for extracted teeth was €1225.3, which was higher compared to those who survived the follow-up period (€848.0; p <.001). Conclusions: Fees charged by general dental practitioners for root-filled teeth accumulate over time, probably due to the need for further treatment of the tooth. The total mean fee was significantly higher for molars and root-filled teeth with indirect restorations. However, an analysis of the total costs would require prospective clinical cost-effectiveness studies.
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| 11. |
- Wigsten, Emma, 1984, et al.
(författare)
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Indications for root canal treatment in a Swedish county dental service: patient- and tooth-specific characteristics.
- 2019
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Ingår i: International endodontic journal. - : Wiley. - 1365-2591 .- 0143-2885. ; 52:2, s. 158-168
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Tidskriftsartikel (refereegranskat)abstract
- To study patient- and tooth-specific characteristics of teeth indicated for root canal treatment, in the public dental service of the county of Västra Götaland, Sweden.During a designated 8-week period, general dental practitioners working at 20 different public dental clinics consecutively registered indications for undertaking root canal treatment. The patients' subjective level of pain was also registered (visual analogue scale) at the very first appointment. The following information was retrieved from computerized dental records and radiographs: gender, age, number of remaining teeth, tooth group, previous restoration, number of restored surfaces, dental caries and tooth substance loss. Gender and age were compared using both descriptive and analytical statistics.The material comprised 243 teeth in 243 patients: 128 (52.7%) women and 115 (47.3%) men, mean age 48.3years. Molar teeth predominated (47.7%). Most of the teeth (83.5%) had previously been restored and exhibited significant loss of tooth substance, more than a third of the crown (71.3%). Dental caries was present in 127 teeth (62.9%). Dental trauma was implicated in only seven cases (2.9%). Initial treatment was frequently undertaken at an emergency visit, for relief of symptoms (64.9%). The most commonly registered indication was pulpal necrosis with apical periodontitis (38.1%), followed by pulpitis (37.7%). Retreatment of a root filled tooth was reported in 18 teeth (7.4%).In the general Public Dental Service of Sweden, root canal treatment is most frequently undertaken in molars. The primary indication is relief of symptoms. Retreatment of root filled teeth is uncommon.
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| 12. |
- Wigsten, Emma, 1984, et al.
(författare)
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Patient record assessment of results and related resources spent during 1 year after initiation of root canal treatment in a Swedish public dental organization
- 2022
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Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 55:5, s. 453-466
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Tidskriftsartikel (refereegranskat)abstract
- Aim To document treatment outcomes and related resources, in patients undergoing root canal treatment (RCT) in county public dental clinics, by monitoring patient records for 12 months from treatment start. Methodology The subjects comprised 243 patients starting RCT at 20 public dental clinics in Vastra Gotaland county, Sweden. Their computerized dental records were monitored prospectively for a year after starting their endodontic treatment. Treatment was completed with either a root filling or extraction. The following treatment-specific variables were registered: number of appointments and days until treatment was completed, possible complications and prescriptions for antibiotics, and for the root filled teeth: type of coronal restoration and further procedures undertaken within the year. The treatment outcomes were compared with the preoperative variables and in a logistic regression analysis. Results Complete data were available for 240 patients (98.8%): 128 women and 112 men, with a mean age of 48.5 years (SD = 16.3). Molar teeth predominated (n = 113, 47.1%). Most cases were completed with a root filling (n = 169, 70.4%). The remainder were extracted (n = 32, 13.3%) or were still uncompleted (n = 39, 16.3%). On average, a root filling was completed in 2.4 (SD = 0.9) appointments, or extraction at the third appointment (SD = 1.6). The molars were less often completed and often predominant among the extracted teeth. The indication for extraction was often for endodontic or RCT-related reasons. Most complications were registered in the molars and antibiotics were prescribed in 20 cases. Most root filled teeth were restored with a direct restoration. Four root filled teeth (2.4%) were extracted within the time period. Conclusions Patient records, followed from the start of treatment, show that 12 months on, the root filling had not been completed in just under 30% of the teeth. Of these, about half were extracted. Of particular concern is the outcome for endodontic treatment of molar teeth. In the general practice setting, molar endodontics are not only technically challenging but also very demanding in terms of chairside resources. In the present study, a successful outcome was achieved in just over half the cases.
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| 13. |
- Wigsten, Emma, 1984, et al.
(författare)
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Patient satisfaction with root canal treatment and outcomes in the Swedish public dental health service: A prospective cohort study
- 2021
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Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 54:9, s. 1462-1472
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Tidskriftsartikel (refereegranskat)abstract
- Aim To document satisfaction with root canal treatment procedures and outcomes among patients treated at Swedish public dental clinics. Method The original material comprised 243 patients who began root canal treatment (RCT) at 20 public dental clinics in the county of Vastra Gotaland, Sweden. One to three years later, 236 (97.1%) were posted a questionnaire of eight items, rating patient perceptions of RCT completion, present pain intensity and satisfaction with the RCT. To evaluate the reliability of the original responses, the first 50 respondents were mailed a follow-up questionnaire. Both descriptive and analytical statistics were used to compare respondents and nonrespondents and tooth groups. Results One hundred and fifty-nine patients (67.4%) responded: 86 (54.1%) women and 73 (45.9%) men. The mean age 52.5 years, was higher than for nonrespondents (p < .001). A completed root filling was registered for the majority of the teeth (n = 112, 70.9%), but significantly fewer molars had been completed (n = 46, 59.7%, p = .02). Fifty per cent (n = 59) of the patients reported current pain, mostly mild in intensity (n = 45, 38.1%). One hundred and twenty-three patients (80.9%) recalled experiencing pain during RCT. The highest satisfaction was registered for the item 'chewing ability' (mean = 1.6, SD = 1.9). The majority of patients (n = 114, 75.0%) stated that in retrospect they would still have chosen RCT. However, these patients belonged to the group which either registered the tooth as still present or had not experienced much discomfort during or after RCT. Forty-four patients (88.0%) responded to the second questionnaire. The reliability of the responses was good. In summary, one to 3 years after beginning RCT at a public dental clinic, patient satisfaction was high, even though every fourth molar had been extracted or treatment had not been completed and half the patients reported persistent pain. The reliability of the patients' responses was considered to be good. Conclusions The results indicate a need for further clinical observational studies of RCTs undertaken in general dental practice, with special reference to patient-centred outcomes.
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| 14. |
- Wigsten, Emma, 1984
(författare)
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Root Canal Treatment in a Swedish Public Dental Service - Studies of indications and results
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Despite the marked overall improvement of oral health in Sweden, root canal treatment is still a common procedure in general dental practice. The reasons are unclear. Few studies of root canal treatment have been undertaken in general dental practice and there are no studies which monitor treatment from the initial appointment to completed root filling. There are moreover, few studies which take patients’ perspectives into account. The main objective of this thesis was to broaden overall understanding of factors which influence the outcomes of root canal treatment undertaken in general dental practice. The studies are based on three patient cohorts. In Study I (cohort 1) information was retrieved from the Swedish Social Insurance Agency’s data register, in order to estimate fees associated with root canal treatments. In 2009, root fillings were registered in approximately 250,000 teeth. The fees for all root fillings, including any further related treatment in the subsequent 5 to 6 years, were estimated to be approximately SEK 1,600 million (SEK 6,400/tooth). Studies II-IV (cohort 2) were based on a sample of 243 patients who started root canal treatment, during a recruitment period of 2 months, at 20 different public dental clinics in the Public Dental Service of the Region Västra Götaland. Study II revealed that most root canal treatments were initiated in symptomatic (65%), previously non-root filled teeth (93%). Almost half were molars (48%). In Study III, the status of these teeth, one year later, was registered from the patients’ dental records. In 70% of cases, the root filling had been completed. However, 13% of the teeth had been extracted and in 16% root canal treatment was not yet completed. The least favorable outcomes were for molar teeth: not only had more molars been extracted, but root canal treatment was as yet not completed in significantly more molars than in the other tooth groups. Study IV is based on a questionnaire 1-3 years after the start of treatment. Half the patients reported symptoms. Of the patients whose root filling had been completed, the majority (87%) responded that they did not regret their decision to choose root canal treatment. Study V (cohort 3) is based on 85 patients treated in 6 public dental clinics, who had either started root canal treatment or had a tooth extracted. The aim was to study quality of life and QALY weights (quality-adjusted life year). A questionnaire, comprising the instruments OHIP-14, EQ-5D-5L and questions about the root canal treatment, was issued at the initiation of treatment and again after one month. There was some improvement in the health-related quality of life of the patients who had started root canal treatment. Patient satisfaction was generally high. The results of these five studies confirm that root canal treatment was most often initiated because of toothache. In the 12 months since the initial appointment, the root filling had been completed in only 70% of cases. A large proportion of patients reported pain after 1 year. Although root canal treatment has a positive effect on quality of life, it is unclear whether it is cost-effective compared with the alternative (extraction), especially in molar teeth.
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