Teeth treated with apicOectomies had acceptable 3-year survival rates, based on insurance claims data

Subjects This retrospective data analysis was based on the claims data of a major German national health insurance company (BARMER GEK) that represent about 8.6 million persons. The study data included about 93,797 apicoectomies performed in 77,636 patients (26,640 men), with a mean age of 50.58 years (standard deviation of 15.59; range, 8-99 years). Key Exposure/Study factor The intervention analyzed was apicoectomy. Diagnosis and tooth condition were unknown. The observation period was up to 3 years. Most of the apicoectomies were delivered in anterior teeth (n 5 32,353) and premolars (n 5 32,340) as compared to molar teeth (n 5 29,104). Main Outcome Measure The main outcome measure was tooth survival as evaluated 1, 2, and 3 years after surgery. Main Results The principal finding was that cumulative survival rates for all teeth were 91.4% at 1 year, 85.7% at 2 years, and 81.6% at 3 years. The 3-year survival rate was highest in anterior teeth (84.0%) and similar in premolars (80.4%) and molars (80.2%). The difference between anterior teeth and posterior teeth was highly significant (P ,.0001). The survival rate was higher in men than in women (83.5% vs 80.6%). This difference was highly significant (P ,.0001). Analyzing survival by age, significant differences among the age groups were found (P , .0001). Analysis of survival by age revealed continuously declining survival rates with age (93.3% for subjects under age 18 years to 75.6% for subjects over age 84 years). Conclusions The authors concluded that the survival rates for teeth treated with apicoectomies are acceptable for an intervention that is primarily conducted as a retreatment after failure of root canal treatment. The study underlined that the rate of failures as evaluated each year potentially indicates a minor tendency toward more early failures.