LIMITED EVIDENCE SUGGESTED THAT UNFINISHED ROOT CANAL TREATMENTS MAY INCREASE THE RISK OF CARDIOVASCULAR DISEASE

Subjects The study used the records of the Longitudinal Health Insurance Database 2005, which includes the registration data and medical claims of a random sample of the Taiwan National Health Insurance beneficiaries in 2005. A total of 283,590 participants aged 20 years or older, who received at least 1 root canal treatment (RCT) and had no cardiovascular disease (CVD) history before 2005, were recruited and followed until the end of 2011. Females constituted 56.3% of the study sample. Key Risk/Study Factor The key risk factor was unfinished RCT, defined as a tooth on which RCT was started but with no completion code. Teeth extracted before CVD hospitalization or RCT after CVD hospitalization were excluded. Main Outcome Measure The main outcome measure was incidence rate of CVD hospitalization. CVD hospitalization events were identified from the database by using the International Classification of Diseases, Ninth Revision, Clinical Modification codes for acute myocardial infarction, ischemic stroke, and coronary heart disease. Main Results A total of 3626 participants underwent CVD hospitalization during an average observation period of 6.01 years, thus yielding an overall incidence rate of 0.21% per person-year. The incidence rate of CVD hospitalization for the participants with 3 or more unfinished RCTs (0.58% per person-year) was significantly higher than that for participants without unfinished RCTs (0.21%) and with 1 or 2 unfinished RCTs (0.28%). Compared with the participants without unfinished RCTs, the hazard ratio for CVD hospitalization for those with 1 or 2 unfinished RCTs was 1.22 (95% confidence interval [CI] 1.11-1.35) and for those with 3 or more unfinished RCTs was 3.61 (95% CI 2.36-5.51). These results were adjusted for age, sex, number of RCTs, annual scaling frequency after RCT, periodontal disease, and systemic diseases. Conclusions The authors concluded that participants with unfinished RCTs were associated with a higher risk of future CVD hospitalization.