Date of Award

Spring 2021

Document Type


Degree Name

Master of Science (MS)



First Advisor

Bhagavatula, Pradeep

Second Advisor

Ibrahim, Mohamad

Third Advisor

Szabo, Aniko


INTRODUCTION: The impact of orthodontic treatment on anterior teeth specifically in relation to root canal therapy and extraction has not been previously described. The objective of this study was to evaluate the incidence of root canal therapy and extraction after orthodontic treatment in the anterior permanent dentition.Methods: We analyzed insurance claims and enrollment data for individuals enrolled with Delta Dental of Wisconsin from 2008 to 2017. A total of 63,720 teeth from 5310 patients who had Delta Dental insurance at age 10 were included in the study. The Cox Regression model was used to analyze the effect of the predictor variables, including orthodontic treatment on the survival of anterior teeth. The survival time was defined as the time from when patients turned ten years old to when extraction/root canal occurred. Teeth without an adverse event were censored at the end of continuous insurance coverage. All dental treatment procedures were identified using CDT codes (Code on Dental Procedures and Nomenclature).Results: Out of 63,720 teeth, only 1910 (2.9%) teeth of 1184 unique subjects had a root canal and 54 (.08%) had an extraction. The majority of root canals and extractions occurred in the maxillary teeth, specifically the central incisors. In addition, males were more at risk of extraction or root canal therapy than females (Female vs Male HR =0.650 p <0.05). Cox regression showed that there is no added risk of extraction or root canal after the start of orthodontic treatment compared to before orthodontic treatment (after vs before orthodontics HR 1.105 p>0.05).Conclusions: Orthodontic therapy is a safe and effective treatment modality for malocclusion and may not be directly associated with an increased risk of root canal therapy or extraction. The risk of endodontic treatment or extraction is considerably higher in males compared to females and is more likely to occur on the permanent maxillary central incisors compared to other anterior teeth.

Included in

Dentistry Commons