Follow-Up After Urgent Endodontic Care: A Retrospective Exploratory Study in a University Clinic

TL;DR

This study explores how often patients return for full root canal treatment after urgent dental care, finding that some conditions and treatments are linked to lower follow-up rates.

Contribution

The study identifies specific diagnostic and treatment factors associated with follow-up behavior after urgent endodontic care in a university clinic.

Findings

Approximately 50.2% of visits involved urgent endodontic care, with SIP/SAP being the most common diagnosis.

Patients with AIP/SAP and those treated with CD/OD were less likely to return for RCT completion.

Mandibular teeth had higher odds of follow-up compared to maxillary teeth.

Abstract

Background and Objectives: Many patients present with urgent endodontic conditions characterized by pain and swelling, requiring prompt intervention. Failure to return for definitive root canal treatment (RCT) after urgent care can compromise tooth prognosis. This study examined the frequency and diagnostic patterns of urgent endodontic visits at a university dental college and evaluated predictors of follow-up after urgent treatment, considering demographic, anatomical, and clinical factors. Materials and Methods: A retrospective cohort analysis of 1619 patient records (August 2023–May 2025) was conducted. Data on urgency type, pulpal/periapical diagnosis, tooth characteristics, urgent treatment modality, and follow-up attendance were collected. Descriptive statistics and chi-square tests were used to assess bivariate associations. Multivariable logistic regression was performed to evaluate factors associated with completing follow-up after urgent care. Results: Approximately 50.2% of visits involved urgent endodontic care, most commonly symptomatic irreversible pulpitis (SIP) with symptomatic apical periodontitis (SAP), particularly in posterior teeth. Pulpectomy was the most frequently provided urgent treatment. Overall, 72.8% of urgent-care patients returned for completion of RCT (overall OR = 2.67). While urgency incidence and follow-up rates did not differ by gender, arch, or region, gender-stratified comparisons within urgent cases showed significant differences by arch and region. In multivariate analysis, mandibular teeth demonstrated higher odds of follow-up than maxillary teeth, whereas gender and region showed no association. Patients diagnosed with asymptomatic irreversible pulpitis (AIP)/SAP had lower odds of returning, and those treated with canal debridement with occlusal reduction (CD/OD) were also less likely to complete treatment. No other diagnostic or treatment categories showed significant associations. Conclusions: In this university-based cohort, urgent endodontic visits were common and primarily involved SIP/SAP. While the overall follow-up rate was high, certain diagnostic and treatment scenarios, specifically AIP/SAP and CD/OD, were associated with a reduced likelihood of returning for completion of RCT. Given the study’s limitations, these findings should be interpreted with caution.

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