Validation of the effectiveness of the Dental Practicality Index in predicting the outcome of root canal retreatments

Abstract

Aim To assess the effectiveness of the Dental Practicality Index (DPI) in predicting the outcome of root canal retreatment in posterior teeth. Methodology One hundred and thirty‐seven posterior teeth with symptoms and/or signs of post‐treatment endodontic disease requiring root canal retreatment and previously included in a clinical trial were selected. Clinical and radiographic examinations including digital periapical and cone beam computed tomography (CBCT) were obtained pre‐treatment and 1‐year postoperatively from a previous study. Two calibrated and trained assessors who were unaware of the treatment outcome assessed the pre‐treatment clinical records of these cases using the DPI. The DPI score was then compared to the outcome of the root canal retreatment. A Chi‐square/Fisher’s exact test was used to establish a relationship between categorical variables, the total score of DPI vs outcome. Results Retreated teeth with DPI scores equal to 6 or above had an unfavourable outcome of 50% vs 14% of teeth with DPI below 6. Teeth with DPI score equal to 3 or above had an unfavourable outcome of 23% versus 2%, for teeth below 3. Molar teeth with a DPI score below 3 had a favourable outcome percentage of 96%. Conclusions This study highlighted that using the DPI gave a good outcome prediction for root canal retreatments. However, further research, including the prospective assessment of a wider range of cases undertaken by a larger group of examiners is needed to further validate the DPI.

Perspectives of General Dental Practitioners on Restoring Endodontically Treated Molars: A UK-Based Vignette Study.

“…Tifooni et al assessed the effectiveness of the Dental Practicality Index (DPI) in predicting the outcome of root canal retreatment in posterior teeth. 49 The results of the study highlighted that using the index gave a good outcome prediction for root canal retreatments. This shows although restorability indexes can be complex, they can be effective.…”

Comparing endocrown restorations on permanent molars and premolars: a systematic review and meta-analysis

“…37 The description of the amount of remaining tooth structure varied across the studies. Hence, a recognized index (Dental Practicality Index or DPI) 31,47 was used to standardise the manner in which the residual tooth structure was classified. The amount of tooth structure in all the included studies conformed to Level 2 structural integrity of DPI.…”

Shared Decision Making in Endodontics

“…A recent study found that utilising the DPI gave a good prediction for the outcome of endodontic retreatments although further validation is required. 38 Although not specifically an aid for SDM, this would help dentists to be able to decide predictably what treatment options need to be offered to the patient, thereby reducing the variations in clinical decision making. In a similar way, when the clinician has an up to date awareness of what the evidence base tells us about treatment outcomes, this will also support SDM.…”