{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:26:34Z","timestamp":1789133194417,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T00:00:00Z","timestamp":1559347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005634","name":"Suomen Hammasl\u00e4\u00e4k\u00e4riseura Apollonia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005634","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Endodontic J"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the impact of systemic health and tooth\u2010based factors on the outcome of root canal treatment (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>The target population consisted of all patients receiving <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content> at the Helsinki University Clinic in 2008\u20132011. The inclusion criteria were diagnosable pre\u2010 and postoperative (minimum 6\u00a0months after root filling) radiographs and adequate patient records of <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content> available. Teeth extracted for nonendodontic reasons were excluded. Patient documents including digital radiographs of 640 permanent teeth in 504 patients were scrutinized. The radiographs were assessed by two examiners under standardized conditions. The Periapical Index was used to define radiographically \u2018healthy\u2019 and \u2018healing\u2019 cases as successful. Data included systemic health, technical quality of root fillings, type of restoration and level of alveolar bone loss. Statistical evaluation of differences between groups included chi\u2010squared tests and Fisher's exact tests. Logistic regression modelling utilizing robust standard errors to allow for clustering within patients was applied to analyse factors related to the outcome of <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of patients was 51.5\u00a0years (standard deviation (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) 15.0; range 10\u201383), and 49% were female. In 41 cases (6%), the patient had diabetes mellitus (<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>), in 132 (21%) cardiovascular disease and in 284 (44%) no systemic disease. The follow\u2010up period was 6\u201371\u00a0months (mean 22.7). In the primary analyses, the success rate of <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content> was 73.2% in <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> patients and 85.6% in patients with no systemic disease (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.043); other systemic diseases had no impact on success. In the multifactorial analysis, the impact of <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> became nonsignificant and <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s were more likely to succeed in the absence of apical periodontitis (<jats:styled-content style=\"fixed-case\">AP<\/jats:styled-content>; odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>)\u00a0=\u00a04.4; <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001), in teeth with optimal root filling quality (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a02.5; <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001), in teeth restored with indirect restorations (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a03.7; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002) and in teeth with none\/mild alveolar bone loss (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a02.4; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>DM diminished the success of RCT, especially in teeth with apical periodontitis. However, tooth\u2010based factors had a more profound impact on the outcome of RCT. This should be considered in clinical decision\u2010making and in assessment of RCT prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iej.13143","type":"journal-article","created":{"date-parts":[[2019,5,10]],"date-time":"2019-05-10T14:53:56Z","timestamp":1557500036000},"page":"1417-1426","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Impact of systemic diseases and tooth\u2010based factors on outcome of root canal treatment"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8968-2981","authenticated-orcid":false,"given":"E.","family":"Laukkanen","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki Finland"},{"name":"Oral Health Care Department of Social Services and Health Care City of Helsinki, Helsinki Finland"},{"name":"Department of Oral and Maxillofacial Diseases Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6319-854X","authenticated-orcid":false,"given":"M. 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