Clinical Parameter-based Evaluation of Restorative Treatment Difficulty in Endodontically Treated Teeth

Area of Science:

• Dental Restorations
• Endodontics
• Restorative Dentistry

Background:

• Restoring endodontically treated teeth presents unique challenges.
• Accurate pre-operative assessment is crucial for successful treatment outcomes.
• Existing methods may not fully capture the multidimensional nature of restorative difficulty.

Purpose of the Study:

• To evaluate restorative difficulty levels for endodontically treated teeth across the entire dental arch.
• To utilize a comprehensive, multidimensional scoring system for difficulty assessment.
• To identify key factors influencing restorative difficulty.

Main Methods:

• A total of 1000 teeth from 654 patients were assessed clinically and radiographically.
• The Restorative Difficulty Evaluation System (RDES), an 8-parameter index, was used for scoring.
• Data were analyzed using various statistical tests (Kruskal-Wallis, Dunn, Chi-square, Fisher-Freeman-Halton).

Main Results:

• Nearly 50% of evaluated teeth were categorized as high difficulty.
• Significant differences in difficulty parameters were found among incisors, premolars, and molars.
• Endodontic complexity and marginal seal were primary determinants of restorative difficulty.

Conclusions:

• Restorative difficulty is influenced by multiple clinical factors, not just tooth anatomy.
• Molars present higher technical risks, while incisors have distinct esthetic and wear demands.
• The RDES is a standardized tool for pre-operative assessment, improving treatment predictability.