Factors Affecting the Periapical Status of Root-Filled Canals: A Cross-Sectional Study at the Undergraduate Level

Abstract

Objective The aim was to evaluate the influence of multiple factors on the periapical status of endodontically treated (ET) teeth. Methods The patients were clinically and radiographically reevaluated after root canal therapy. The quality of the root-filled canals, coronal restorations, intraradicular posts, dental caries, and periodontal parameters were associated with the teeth's periapical status. Results The 122 patients provided 154 ET teeth; 97.4% teeth were asymptomatic, and 75.5% had a normal periapical status. The percentage of perfect, satisfactory, and deficient root-filled canals was of the order of 41.6%, 46.1%, and 12.3%, respectively. The percentage of adequate and inadequate coronal restorations was 31.2% and 68.8%, respectively. A total of 14.9% teeth had intraradicular posts, and 29.2% had cavitated carious lesions in the dentin. Gingival bleeding was observed in 31.8% of teeth, and dental biofilm was visible in 58.4%. A total of 11.7% showed pathologic tooth mobility, and 22.1% teeth were diagnosed with periodontal disease. Conclusions Carious lesions, gingival bleeding, and tooth mobility were significantly associated with the occurrence of periapical lesions in root-filled canals.

Prevalence and risk factors of Apical periodontitis in endodontically treated teeth: cross-sectional study in an Adult Moroccan subpopulation

“…The present study revealed that inadequate coronal restorations especially those with large proximal margins (CL II cavity design), and gingival inflammation increased the risk of AP in endodontically treated teeth. Costa et al reported that gingival bleeding on probing was significantly associated to periapical status, however periodontal bone loss didn't influence periapical health [18] and this is in accordance with the present study results. In similar context, Skupien et al and Khalighinejad et al confirmed in two recent studies the high predictable survival rate of endodontically treated teeth after Table 5 Multivariate logistic Regression for the association of the dependent variable "apical periodontitis" with a number of explanatory variables (coronal restoration quality, coronal restoration type, gingival status, CL II cavity design, root canal filling quality) root canal treatment in cases with a healthy periodontium [15,36].…”

“…Epidemiological studies also revealed that apical periodontitis in ETT has been associated with periodontal health status [17,18] and with tooth structure loss. In a prospective study assessing the effect of coronal tooth structure loss on the outcome of root canal treatment, Al Nuaimi et al [19], concluded that less tooth structure increased likelihood of endodontic failure after one year.…”

Apical Periodontitis in Endodontically Treated Teeth: Cross-sectional Study of New Investigated Risk Factors

“…(Figure A) The present study revealed that inadequate coronal restorations especially those with large proximal margins (CL II cavity design), and gingival in ammation increased the risk of AP in endodontically treated teeth. Only few studies have linked gingival disease to periapical status, Costa et al (2017) reported that gingival bleeding on probing was signi cantly associated to periapical status, however periodontal bone loss didn't in uence periapical health [33]. This is in agreement with the present study results.…”

Predicting the outcome of initial non-surgical endodontic procedures by periapical status and quality of root canal filling: a cohort study

“…Authors such as Fernández et al [11] (OR 9.09 IC 95% 3.25-25.44, p = 0,000), Moreno et al [12] (OR 1.43 IC 95% 1.01-2.04, p = 0.05), and Song et al [21] (OR 2.13; IC 95% 1.621-2.815, p = 0.001) associated the quality of the restoration (a postoperative factor) with the success of the initial non-surgical EP. On the other hand, Craveiro et al and Costa et al determined that the quality of the root filling has a greater influence on the outcomes when compared to the quality of the restoration [32,33]. Controlling the confounding factors, the present investigation included teeth with definitive restoration, an additional reason to associate treatment failure with the quality of root filling.…”