Page 108 - Demo

Chapter 6106interappointment emergencies is not related to the patient’s sex, age, possibility of compromised healing due to medical conditions, or whether it concerned a maxillary or mandibular molar; though it is related to the (pre-operative) diagnosis of the tooth, and to the presence of pre-operative pain or an abscess [1,2,5,25,29]. The relation between the incidence of interappointment emergencies and the usage of antibiotics found in the present study should be interpreted cautiously. Information on the reasons for prescription of antibiotics was not always available in our sample. The reason might have been preoperative abscess, severe pain or swelling, and all these factors are related to the incidence of interappointment emergencies themselves [5,29]. In undergraduate clinics, it is more likely that the root canal treatment will be completed when no interappointment emergency visit becomes necessary [23]. This was also found in the present study (Table 2), and this might suggest that an interappointment emergency would be a reason for a patient to refuse further treatment. The results of the present study, however, did not confirm the presence of such an association; the decision to quit during the course of the root canal treatment – and have incomplete treatment for the endodontic pathology – appeared unrelated to interappointment emergencies (Table 2). The results of the present study did suggest, however, that an interappointment emergency might be a reason to have the tooth extracted, instead of having the root canal treatment completed. The incidence of interappointment emergencies in the group of patients who had the tooth extracted was four times higher than that in the group of patients who had the root canal treatment completed (Table 2). The percentage of patients who had the tooth extracted following initial treatment was distributed similarly over both cohorts (Table 1). Hence, omitting the use of an intracanal medicament seems not to affect the decision to have the tooth extracted midway the root canal treatment. However, the percentage of patients who had the root canal treatment completed was higher in the cohort that received intracanal medicament (Table 1). Interestingly, the number of root canal treatments started in the period 2010-2011 (representing the cohort receiving intracanal medicament) was two times higher than the number of treatments started in the period 2012-2013 or 2013-2014 (representing the cohort that received no intracanal medicament). Both the reason for the decrease in the number of root canal treatments started and the reason for the increase in the number of incomplete treatments is uncertain. One might speculate that changes in financial circumstances over the years can be a reason, and if that would be Annemarie Baaij.indd 106 28-06-2023 12:26