Analysis of factors influencing root canal therapy failure in patients with misdiagnosed residual pulpitis

SONG Tianjiao; LIU Aili

doi:10.3969/j.issn.1002-3429.2026.04.004

Abstract：Objective To analyze the influencing factors and predictive value of root canal therapy(RCT)failure in patients with misdiagnosed residual pulpitis.Methods Clinical data of 97 patients with misdiagnosed residual pulpitis who underwent RCT from March 2022 to February 2024 were retrospectively analyzed.According to the results of RCT outcomes,the patients were divided into the successful treatment group(n=79)and the failure group(n=18).The general data of the two groups were compared.The statistically significant indicators were included in the multivariate logistic regression model to analyze the influencing factors and predictive value of RCT failure.Results There were significant differences in the location of the affected tooth,crown restoration after RCT,pulp condition,apical lesion,tight root canal filling,and cracked root canal between the two groups(P＜0.05).Further multivariate Logistic regression analysis showed that the location of the affected tooth and the condition of the pulp were the main factors affecting RCT failure in patients with misdiagnosed residual pulpitis(P＜0.05).According to the combined data fitted by multivariate Logistic regression coefficients,the receiver operating characteristic(ROC)curve analysis for predicting treatment failure showed that the area under the ROC curve was 0.893,with the sensitivity and specificity of 83.3％and 91.1％,respectively,the prediction accuracy of 68.2％,the recall rate of 83.3％,and the predicted probability of 0.820.Conclusion Tooth location and pulp status are key factors affecting RCT outcomes in patients with misdiagnosed residual pulpitis,warranting heightened clinical attention.The risk prediction model developed from this study demonstrates high predictive value for RCT failure.