Impacto do tabagismo no prognóstico do tratamento endodôntico: dados preliminares de estudo de coorte retrospectivo

Abstract

Smoking is a risk factor for systemic and oral health. Scientific evidence supports the negative influence of tobacco smoking on periodontal tissues. Current studies suggest harmful effects on periapical tissues of endodontically compromised teeth. This retrospective cohort study aimed to investigate the impact of tobacco smoking on the endodontic treatment prognosis. Other predictive factors' impacts, such as the presence of coronal restoration, operatory accidents, sealer extrusion, apical limit, quality of root filling, and patient’s systemic condition, were also evaluated. This study consisted of all those who were submitted to endodontic treatment in the year 2016 at the Endodontics Department of the Rio de Janeiro Military Police (n=518) (ethics committee approval n.2.849.580). The inclusion criteria were ASA I and ASA II patients with a permanent tooth submitted to endodontic treatment. The exclusion criteria were patients undergoing orthodontic treatment and with severe bone loss (probing depth > 6mm). Patients were evaluated through clinical and radiographic examinations. Pre- and post-operative and follow-up periapical radiographs were assessed, and the periapical status was rated according to the Periapical Index score by two independent examiners (Kappa=0.87). The success or failure of endodontic treatment after at least five years of follow-up was based on clinical symptoms and radiographic evaluation of periapical tissues. The data were analysed in SPSS 23® using descriptive statistics and multiple logistic regression. A hundred and three patients (11 smokers and 92 non-smokers) were examined in this preliminary phase of the study. Treatment failed in two of the 11 smokers and in 22 of the 92 non-smokers (OR=1.4; 95% CI 0.2-7.4). No association of other predictive factors with endodontic treatment prognosis was observed (p<0.05). Thus, with our prelimary results, no association was found between tobacco smoking and other evaluated variables and the prognosis of endodontic treatment.