Periapical status, quality of root canal fillings and estimated endodontic treatment needs in an urban German population

Etiologies of non-surgical root canal treatment and its association with risk factors in a selected Thai population

BACKGROUND

The aim of this study was to investigate the etiologies of non-surgical root canal treatment (NS-RCT) in a Thai population and examine their association with risk factors.

METHODS

A cross-sectional observational study was performed to examine the etiologies of NS-RCT and risk factors among Thai-nationality patients treated at a tertiary care dental hospital in Thailand from 2019-2023. Treatment records and radiographs were retrospectively reviewed to identify NS-RCT etiologies, and associated contributing factors were analyzed. Statistical analysis used univariate logistic regression followed by multivariate logistic regression, with a significance level set at P < 0.05.

RESULTS

The data from 1500 teeth were analyzed, comprising 59.1% females and 40.9% males, with ages ranging from 7-91 years (mean = 48.56 years). The most prevalent age group was 61-70 years-old. Among the treated teeth, the mandibular first molar was the most frequently involved (13.9%), followed by the maxillary first molar (9.9%) and mandibular second premolar (9.7%). The primary etiologies of NS-RCT were dental caries (53.7%), old and large restorations (7.9%), and attrition (5.9%). Analysis of etiology of NS-RCT due to caries revealed that the most commonly affected sites were the occlusal (32.6%), distal (31.6%), and mesial (17.2%) surfaces. In immature teeth requiring NS-RCT, the predominant etiologies were dens evaginatus (32.1%), dental caries (28.6%), and traumatic injury (21.4%). The association between the etiology of NS-RCT and investigated associated factors were identified.

CONCLUSIONS

The etiologies of NS-RCT in the selected Thai population were mainly attributed to dental caries, with additional factors being old and large restorations and attrition. Notably, due to the aging society, the elderly population experiences a higher demand for NS-RCT, particularly due to attrition, non-carious cervical lesions, and erosion. In contrast, in immature teeth, the most common etiologies leading to NS-RCT comprise dens evaginatus, dental caries, and traumatic injuries. The distinct etiological patterns observed in different age groups emphasize the importance of specific oral health prevention programs to address individual needs.

Prevalence of apical periodontitis and quality of root canal treatment in an adult Kuwaiti sub-population: a cross-sectional study

Objectives

This cross-sectional study evaluated the prevalence of apical periodontitis (AP) and the technical quality of root canal fillings in an adult Kuwaiti subpopulation using cone-beam computed tomography (CBCT) images.

Materials and Methods

Two experienced examiners analyzed 250 CBCT images obtained from Kuwaiti patients aged 15-65 years who attended government dental specialist clinics between January 2019 and September 2020. The assessment followed the radiographic scoring criteria proposed by De Moor for periapical status and the technical quality of root canal filling. Chi-square and Fisher's exact tests were used for statistical analysis, with significance level set at p < 0.05.

Results

Among the 2,762 examined teeth, 191 (6.91%) exhibited radiographic signs of AP, and 176 (6.37%) had undergone root canal filling. AP prevalence in root canal-treated teeth was 32.38%, with a significant difference between males and females. Most of the endodontically treated teeth exhibited adequate root canal filling (71.5%).

Conclusions

The study demonstrated a comparable prevalence of AP and satisfactory execution of root canal treatment compared to similar studies in different countries.

Retreatment Strategies for Cases Containing Calcium Silicate-Based Root Canal Sealers: A Comprehensive Review

This review explores the field of retreatment strategies for cases filled with calcium silicate-based root canal sealers. Since the introduction of calcium silicate-based materials in dentistry, calcium silicate-based root canal sealers have become popular among dentists because of their biocompatibility, bioactivity, and sealing ability. Therefore, effective retreatment strategies are indispensable. This article aims to identify the challenges associated with the removal of calcium silicate-based sealers themselves and removal of gutta-percha with the sealers during retreatment, evaluate current techniques and materials, and provide future directions for research in this field. Regarding the strategies of removal of root canal sealers, calcium silicate-based sealers are still relatively new materials for clinicians compared with traditional sealers such as epoxy- or eugenol-based sealers. First, no clinically established solvents have been reported. Second, calcium silicate-based sealers are currently utilized by clinicians in either the cold sealer-based technique or the warm vertical condensation technique. Third, the setting process of calcium silicate-based sealers generates byproducts, primarily calcium hydroxide and secondarily hydroxyapatite, that could interact with dentine. Lastly, there is a lack of clinical studies evaluating the efficacy of retreatment protocols for teeth filled with calcium silicate-based sealers. Therefore, it is important to investigate the chemo-mechanical properties of calcium silicate-based sealers themselves and their reactions to solvents and/or mechanical instruments and identify the interfacial properties of calcium silicate-based sealers with respect to dentine and gutta-percha. In addition, researchers in the clinical field need to actively gather and report data on retreatments of teeth filled with calcium silicate-based sealers.

Detecting high-risk neighborhoods and socioeconomic determinants for common oral diseases in Germany

BACKGROUND

Ideally, health services and interventions to improve dental health should be tailored to local target populations. But this is not the standard. Little is known about risk clusters in dental health care and their evaluation based on small-scale, spatial data, particularly among under-represented groups in health surveys. Our study aims to investigate the incidence rates of major oral diseases among privately insured and self-paying individuals in Germany, explore the spatial clustering of these diseases, and evaluate the influence of social determinants on oral disease risk clusters using advanced data analysis techniques, i.e. machine learning.

METHODS

A retrospective cohort study was performed to calculate the age- and sex-standardized incidence rate of oral diseases in a study population of privately insured and self-pay patients in Germany who received dental treatment between 2016 and 2021. This was based on anonymized claims data from BFS health finance, Bertelsmann, Dortmund, Germany. The disease history of individuals was recorded and aggregated at the ZIP code 5 level (n = 8871).

RESULTS

Statistically significant, spatially compact clusters and relative risks (RR) of incidence rates were identified. By linking disease and socioeconomic databases on the ZIP-5 level, local risk models for each disease were estimated based on spatial-neighborhood variables using different machine learning models. We found that dental diseases were spatially clustered among privately insured and self-payer patients in Germany. Incidence rates within clusters were significantly elevated compared to incidence rates outside clusters. The relative risks (RR) for a new dental disease in primary risk clusters were min = 1.3 (irreversible pulpitis; 95%-CI = 1.3-1.3) and max = 2.7 (periodontitis; 95%-CI = 2.6-2.8), depending on the disease. Despite some similarity in the importance of variables from machine learning models across different clusters, each cluster is unique and must be treated as such when addressing oral public health threats.

CONCLUSIONS

Our study analyzed the incidence of major oral diseases in Germany and employed spatial methods to identify and characterize high-risk clusters for targeted interventions. We found that private claims data, combined with a network-based, data-driven approach, can effectively pinpoint areas and factors relevant to oral healthcare, including socioeconomic determinants like income and occupational status. The methodology presented here enables the identification of disease clusters of greatest demand, which would allow implementing more targeted approaches and improve access to quality care where they can have the most impact.

Prevalence of Periapical Radiolucency and Conventional Root Canal Treatment in Adults: A Systematic Review of Cross-Sectional Studies

Cross-sectional studies assess a population's health state and the prevalence of diseases or treatments. Few systematic reviews regarding the prevalence of periapical radiolucency (PARL) and nonsurgical root canal treatment (NSRCT) were conducted in the last decade. The goal of this study was to collect and review all updated and available cross-sectional studies that focus on the prevalence of both PARL and NSRCT in adult populations. It involves a systematic literature review of cross-sectional studies on the prevalence of PARL and NSRCT published from 1987 to 2022 in PubMed, Google Scholar, Web of Science, and Scopus with specific keywords used in the search process. A total of 52 articles were included in this systematic review. The majority of the included articles were from different populations. The overall prevalence of teeth with PARL was 43,522 (6.40%), while the prevalence of NSRCT teeth was 52,149 (7.67%). On the other hand, the overall prevalence of PARL in teeth that have received endodontic treatment and teeth that have not received endodontic treatment were 22,110 (3.25%) and 21,412 (3.15%), respectively. A meta-analysis was not performed due to underreporting of publication bias and the high degree of heterogeneity between studies. The overall risk of bias assessment revealed a low risk of bias in 25 (48%) of the included studies. The prevalence of NSRCT was higher at 7.67%, followed by PARL at approximately 6.40%. However, future studies are recommended to investigate the prevalence of both PARL and NSRCT in different patient populations.

The Significance of Oral Inflammation in Elite Sports: A Narrative Review

Recently, there has been intense discussion about sports dentistry and potential interactions between oral health and athletes' performance. This narrative review aims to provide a comprehensive overview of the available literature about oral inflammation in sports. For this purpose, it presents the most common types of oral inflammation (gingivitis, periodontitis, pericoronitis, apical periodontitis), and their prevalence in athletes. Both the impact of oral inflammation on performance and causes for oral inflammation in athletes are discussed by presenting current literature. Finally, international recommendations for dental care in sports are presented. Several studies stated a high prevalence of oral inflammation in athletes, especially of gingivitis (58-97%) and periodontitis (41%). Also, many athletes report oral pain (17-30%) and a negative impact of oral health on training (3-9%). Besides this, a systemic impact of oral inflammation is discussed: In periodontitis patients, blood parameters and physical fitness are changed. In athletes, associations between muscle injuries and poor oral health are reported. There are deficits in oral health behavior. Furthermore, systemic changes due to physical stress could influence oral tissues. Overall, complex bidirectional interactions between competitive sports and oral inflammation are possible. Regular dental examinations and prevention strategies should be implemented in sports.

A Pilot Feasibility Study to Establish Full Pulpotomy in Mature Permanent Teeth with Symptomatic Irreversible Pulpitis as a Routine Treatment in Mexican Public Healthcare Services

Symptomatic irreversible pulpitis is a common dental disease for which root canal treatment (RCT) has been the standard treatment. However, in many countries, RCT is considered a high-cost treatment that is not covered by public healthcare services; this forces patients to have dental extraction as their only option to relieve pain. In the last decade, several investigations have provided evidence that an alternative treatment known as full pulpotomy (FP) could be an alternative for patients who could not afford the cost of an RCT. Nevertheless, evidence is lacking on the success rate that could be obtained if it is performed in a public dental care clinic (PDCC). The present investigation has two main objectives. To be the first approach of a multicentric feasibility study to find out whether an FP performed by a general practice dentist (GPD) in a PDCC could be suitable and establish its success rate and patient satisfaction. Patients attending a PDCC with symptoms of irreversible pulpitis were invited to participate. FP was performed and followed up at 1, 3, 6, 9, and 12 months. The treatment success was assessed by combining three variables, patient satisfaction, clinical, and radiographic outcomes. Forty-one patients from 17 to 78 years old received the intervention. In total, 97.5% were completely satisfied with the treatment and were considered successful since none of the clinical or radiographic variables were present in any of the follow-ups. An FP performed by a GPD in a PDCC could be suitable as a routine treatment for symptomatic irreversible pulpitis due to the excellent success rate and patient satisfaction.

Prevalence of root canal treatment worldwide: A systematic review and meta-analysis

BACKGROUND

The prevalence of root filled teeth (RFT) worldwide will inform about the amount of clinical activity of dentists dedicated to treat endodontic disease.

OBJECTIVES

To carry out a systematic review with meta-analysis answering the following question: What is the prevalence of RFT around the world? The percentage of people with at least one RFT was also investigated.

METHODS

A systematic review including population-based studies using the following databases: PubMed, EMBASE and Scielo. Studies related to prevalence of RFT were included. The outcome of interest of the study was the prevalence of RFT. The meta-analyses were calculated with the Open Meta Analyst software to determine the global prevalence of RFT. Subgroups analyses were performed comparing geographical distribution, radiographic method and year of the study (classified in 20th or 21th century). The prevalence of people with at least one RFT was also analysed.

RESULTS

Seventy-four population-based studies fulfilled the inclusion criteria. Twenty-eight, forty-four and two studies reported high, moderate and low risk of bias, respectively. No obvious publication bias was observed. Prevalence of RFT was estimated with 1 201 255 teeth and 32 162 patients. The calculated worldwide prevalence of RFT was 8.2% (95% CI = 7.3%-9.1%; p < .001). The global prevalence of people with at least one RFT was 55.7% (95% CI = 49.6%-61.8%; p < .001). In 20th century, the prevalence of RFT was 10.2% (95% CI = 7.9%-12.5%; p < .001), whereas in the 21st century the overall calculated prevalence of RFT was 7.5% (95% CI = 6.5%-8.6%; p < .001). Brazilian people (12%) and the European population (9.3%) showed the highest prevalence of RFT. In Europe, 59.6% (95% CI = 52.4%-66.8%) of people has at least one RFT.

CONCLUSIONS

This review showed that root canal treatment is a very common therapy throughout the world. More than half of the studied population have at least one RFT. A limitation of the present study is that most of the studies did not consider random sampling for population selection.

REGISTRATION

PROSPERO Systematic review registration number: (CRD42022329053).

In Vitro Evaluation of Five Newly Isolated Bacteriophages against E. faecalis Biofilm for Their Potential Use against Post-Treatment Apical Periodontitis

State-of-the-art treatment of root canal infection includes the use of mechanical debridement and chemical agents. This disinfection method is limited, and microorganisms can remain in the canal system. Enterococcus faecalis appears with a high prevalence in secondary and persistent root canal infections and can be linked to endodontic treatment failure due to its various resistance mechanisms. Here, we evaluated the activity of newly isolated bacteriophages against clinical isolates of E. faecalis (including one vancomycin- and gentamicin-resistant strain) as a single treatment or in combination with gentamicin and vancomycin. For the resistant strain, daptomycin and fosfomycin were tested. Sixteen E. faecalis strains were used to screen for the presence of bacteriophages in sewage. Five different bacteriophages were characterized in terms of virion morphology, host range and killing-kinetics against each E. faecalis host strain. To investigate the antibiofilm effect of antibiotic and phages, E. faecalis biofilm was grown on porous glass beads and treated with different antibiotic concentrations and with isolated bacteriophages alone or in staggered combinations. A strong biofilm reduction was observed when phages were combined with antibiotic, where combinations with gentamicin showed a better outcome compared to vancomycin. Regarding the resistant strain, daptomycin had a superior antibiofilm effect than fosfomycin.

An Umbrella Review of Systematic Reviews and Meta-Analyses Evaluating the Success Rate of Prosthetic Restorations on Endodontically Treated Teeth

Materials and Methods

The electronic search was conducted in the MEDLINE/PubMed, Cochrane, and Google Scholar databases until November 2020, regardless of language limitations. The inclusion criterion was as follows: S/M-R regarding prosthetic restorations in endodontically treated teeth. Three qualified researchers evaluated the inclusion criteria and bias risk. The fourth investigator was referred to when facing any doubtfulness.

Results

From 43 achieved S/M-R, 14 studies were selected for this inquiry. Primary extracted information included success rate, survival rate, and postendodontic failure rate. Five S/M-R had a moderate risk of bias, and nine S/M-R had a low risk of bias and were considered strong clinical evidence in this examination. According to the low-risk reports, the success rate of fiber posts was higher than that of metal posts; the rate of root fracture in metallic and fiber posts was alike; the failure rate for fiber posts was comparable to fixed partial dentures or single crowns; the construction of endocrowns was likely to perform better than intracanal posts, composite resin, or inlay/onlay restorations.

Conclusion

It appears that with practice and experience, deciding which type of restoration to choose changes. In dental restorations associated with root canal therapy, the single crowns are likely to be a proper option. Nevertheless, due to the heterogeneity of the studies, more clinical assessments are required to achieve more specific findings in this field.

A retrospective three-dimensional assessment of the prevalence of apical periodontitis and quality of root canal treatment in Mid-West Indian population

Introduction

This study aims to report a retrospective observation of the prevalence of apical periodontitis (AP) and quality of root canal treatment in cone-beam computed tomography (CBCT) scans among the Mid-West Indian population.

Materials and Methods

A total of 1229 CBCT scans were obtained across different CBCT centers in western India. After the exclusion criteria, those that were included were divided into broadly two groups - those that were filled and those that were unfilled. Various parameters were taken into account such as AP, length of the root canal filled, and coronal filling.

Results

There were a significantly higher percentage of nonfilled canals. Poor filling quality, inadequate coronal restoration, and also missed extra canal were significantly associated with AP. Both males and females showed higher presence of AP in the nonfilled teeth than filled ones (X2 - Chi square value M = 612.156, P < 0.00001, X² F = 1032.9092, P < 0.00001).

Conclusion

(1) The inadequacy of the filling of the root length was a contributory factor to the higher prevalence of AP among the study population. (2) The density of the filling and the quality of the coronal filling also significantly affected the successful outcome of the root canal treatment.

Prevalence of Lateral Radiolucency, Apical Root Resorption and Periapical Lesions in Portuguese Patients: A CBCT Cross-Sectional Study with a Worldwide Overview

Objective:

Apical periodontitis develops when bacteria, or their by products, migrate from the infected root canal system space to the surrounding apical tissues. The objective of the present multi-center cross-sectional study was to analyze the prevalence of lateral radiolucency, apical root resorption and periapical lesions in 7 districts of Portugal using cone-beam computed tomographic (CBCT) assessment.

Methods:

A total of 1,249 CBCT scans, from 11 dental clinics, were screened. Data regarding 22,899 teeth was included. For each tooth the recorded data was the presence of lateral radiolucency, apical root resorption, periapical lesions, previous root canal treatment, missed root canals, length of root canal filling (short, good or overfilling) and type of coronal restoration (intact tooth, non-restored, filling or crown). Differences between districts were tested using chi-squared. A P<0.05 was considered significant.

Results:

The proportion of lateral radiolucency ranged between 0.0% (Aveiro, Braga and Coimbra) and 0.9% (Lisbon), while the prevalence of apical root resorption ranged from 0.0% (Braga and Coimbra) to 3.0% in Setubal. The nationwide proportion of lateral radiolucency was 0.4%, while for apical root resorption was 1.1%. The prevalence of periapical lesions varied from 4.1% (Braga) and 13.0% (Lisbon) with a nationwide proportion of 10.0%. Significant differences were noted between districts (P<0.05).

Conclusion:

The prevalence of lateral radiolucency and apical root resorption were low in all districts. Root canal filled teeth were associated with higher periapical lesions proportions than non-treated teeth. Independently of the assessed district, the periapical status may be influenced by both quality of the endodontic treatment and coronal restoration.

Frequency of different indications for endodontic treatment among patients from Pancevo, Serbia

Introduction: Different types of irreversible pulp diseases are the most commonly stated reasons for conducting root canal treatment. Data obtained from epidemiological studies are of great importance for a better understanding of endodontic pathology and for evaluating the need for this kind of treatment. Aim: The aim of this epidemiological study was to evaluate the structure of endodontic pathology among selected adult population of municipality of Pancevo, Serbia, indicated for endodontic treatment. Material and methods: Investigations were conducted on a sample of patients who referred for dental examination and treatment, at the Department of Restorative Dentistry and Endodontics, Faculty of Dentistry in Pancevo, during 2018. The study included 229 male and female subjects, aged over 18, who had at least one tooth indicated for endodontic treatment. Subjects were clinically examined by a standardized procedure, using visual and tactile inspection, percussion and palpation tests, periodontal evaluation and pulp vitality tests. Panoramic and retroalveolar radiographs were also analyzed. Data were statistically analyzed using Chi-Square test. Results: Endodontic treatment was indicated on 322 teeth from total number of 4911 (6.6%). Largest frequency of teeth indicated for treatment was recorded among subjects aged over 60 years (7.5%) and on frontal teeth (36.6%). The most commonly registered indications were asymptomatic irreversible pulpitis (32.3%) and symptomatic irreversible pulpitis (19.9%). Irreversible pulpitis was the most common indication for endodontic treatment between all age groups of subjects, between both genders and between all three teeth functional groups (p < 0.001). Conclusion: Percentage of teeth indicated for endodontic treatment was higher than presented in other studies. Irreversible pulpitis was the most common indication for endodontic treatment. After conducting the study, it is clear that dental care and caries preventive programs should be strengthened and expanded, especially among people with less education and awareness regarding dental health.

Prevalence of Apical Periodontitis and Conventional Nonsurgical Root Canal Treatment in General Adult Population: An Updated Systematic Review and Meta-analysis of Cross-sectional Studies Published between 2012 and 2020

INTRODUCTION

This study aimed to summarize data on apical periodontitis (AP) and nonsurgical root canal treatment (NSRCT) prevalence and risk factors related to age, gender, and quality of restorative and endodontic treatment in the general population from cross-sectional studies published between 2012 and 2020.

METHODS

An electronic search was performed in the following databases: Web of Science, Scopus, and PubMed. The conducted literature search covered studies published between 2012 and 2020, without restrictions on language. The STROBE and NOS tools were used for quality assessment of the included studies.

RESULTS

Sixteen articles were included in the review. In total, 200,041 teeth were examined. On average, 6.3% of teeth had AP, and 7.4% had NSRCT. Forty-one percent of RCT teeth had AP, and 3.5% of untreated teeth had AP. Female patients were less prone to AP in endodontically treated teeth only, compared with male patients (P < .001). Variable stratification of age subgroups among included studies prevented us from conducting a meta-analysis. An increase in AP frequency was found in teeth with inadequate restorative and endodontic treatment (P < .001 and P < .001, respectively). Because of high heterogeneity, these results should be taken with caution.

CONCLUSIONS

There is an increased AP prevalence in the adult general population compared with data from 2012 (6.3% versus 5.4%) in both endodontically treated (41.3% versus 35.9%) and untreated teeth (3.5% versus 2.1%). In addition, AP developed less frequently in female patients with endodontically treated teeth and in teeth with inadequate compared with adequate restorative and endodontic treatment.

Assessment of the quality of endodontic re-treatment and changes in periapical status on a postgraduate endodontic clinic

OBJECTIVE

The aim of this study was to assess endodontic retreatment outcomes based on quality of obturation and healing.

MATERIALS AND METHODS

A total number of 223 radiographs of patients who had received endodontic retreatment during the period (2008-2015) at a postgraduate teaching clinic were selected. Unreadable radiographs were all excluded. From the original sample of 223 in total 24 radiographs were discarded. The final sample thus consisted of 199 root canal fillings. All radiographs were individually evaluated for the density of the root filling as well as the distance between the end of the root canal filling and radiographic apex based on a six-point scoring system. Subsequently, patients were reviewed and follow up periapical radiographs were exposed. The outcome of healing was assessed using the Periapical Index (PAI) scoring system. The data were analysed using Chi Square test (p < 0.05).

RESULTS

The study revealed that 78.9 % of the endodontic retreatments were both homogeneity and length acceptable. The corresponding figure was only 13.1 % before endodontic retreatment. Conversely, homogeneity and length unacceptable before endodontic retreatment was 47.2 % reducing to a mere 2.5 % after retreatment. The results were statistically significant (P < 0.001). There was over 80 % improvement in periapical healing following endodontic retreatment and this was also statistically significant (P < 0.001).

CONCLUSION

There was a significant improvement in outcome after endodontic retreatment on the postgraduate endodontic clinic. The success rate of endodontic retreatment was over 70 % which is in line with the endodontic literature. Radiographic follow up confirmed some 81 % improvement in healing rate following endodontic retreatment.

CLINICAL SIGNIFICANCE

Endodontic re-treatment cases are normally categorised as high complexity and as such referral to specialist settings should be considered to help improve treatment outcomes.

Factors influencing the long-term prognosis of root tip resected teeth

Introduction: The aim of the study was to investigate possible predictive factors influencing the long-term success of root tip resection. Methods: The retrospective study included 216 patients (♂ 111, ♀ 106, median age 43.3 years). A total of 261 root tip resections were performed on these patients between 1989 and 2012. In addition to determining the success rates 5 and 10 years postoperatively, the factors gender, age, tooth type, use of bone replacement material and preoperative periodontal tooth status were examined with regard to their significance for the long-term prognosis of root tip resected teeth. Results: The evaluation showed an average success rate of 63.6% for all included teeth over the entire observation period (tooth at least one year postoperatively still in situ). The 5-year success rate was 78.2%, the 10-year success rate 63.1%. A dependence of the success rates on the tooth type could not be evaluated. However, the examination showed a clear dependence of the success on the age of the patients. Root tip resections in patients in the age group 60 years and older had significantly worse success rates compared to the age groups 20 to 39 years and 40 to 59 years. The prognosis was also significantly better for patients in the age group 20 to 39 years than for patients in the age group 40 to 59 years. Periodontally compromised teeth showed only a tendency for a poorer prognosis than periodontally healthy teeth. With regard to sex and intraoperative filling of the resection defect with bone replacement material, no differences in the success rates were found. Conclusions: A root tip resection is a good option, largely independent of the type of tooth, to preserve a tooth in the medium to long term after unsuccessful endodontic treatment. However, a revision of the endodontic treatment or even an extraction with subsequent implantation should always be considered as an alternative, especially with increasing age.

Impact of orthodontic treatment on the integrity of endodontically treated teeth

AIM

The purpose of this study was to evaluate the periapical status of endodontically treated teeth and the integrity of endodontic treatment before and after orthodontic treatment.

MATERIALS AND METHODS

This retrospective study was conducted by evaluating 128 teeth with root canal treatment (RCT). The teeth were obtained from 72 patients (23 males, 49 females) who had undergone fixed orthodontic treatment. Panoramic radiographs were taken and were evaluated before the start and after the completion of orthodontic treatment. Apical periodontitis (AP) was evaluated by the periapical index (PAI) and the probability index (PRI) of periapical bone destruction. Other variables related to the quality of root canal fillings were included, such as RCT quality index, length, and homogeneity, and coronal restoration.

RESULTS

According to the PRI, the proportion of teeth with periapical bone destruction was significantly higher after orthodontic treatment. Overall, there was no significant change in the PAI scores after orthodontic treatment. However, the quality of the endodontic treatment moderated the change in the PAI score, as well as the change in the PRI. There was no significant increase in PAI and PRI scores after orthodontic treatment for adequately treated teeth. However, the risk for periapical lesions and bone destruction after orthodontic treatment was significantly increased for teeth receiving inadequate endodontic treatment compared with those receiving adequate endodontic treatment.

CONCLUSION

Increased PAI and PRI after orthodontic treatment correlated with the quality of endodontic treatment.

Comparison of Two-Dimensional and Three-Dimensional Radiographs Using Clinically Relevant Parameters

This work compared the assessment of clinically relevant parameters by two-dimensional, that is, full-mouth intraoral radiograph (I-O) and panoramic radiograph (OPT), and three-dimensional, that is, cone beam computed tomography (CBCT), imaging methods. Different radiographic images (CBCT, I-O and OPT) were available for a 53-year-old female patient with dental and periodontal problems. A total of 14 dental and periodontal parameters were assessed by two independent examiners and compared among the three radiographic imaging modalities. For 10 parameters (71%), the CBCT images were superior to both I-O and OPT images. In contrast, CBCT demonstrated an inferior performance compared to I-O and OPT in the assessment of caries and dental restorations. Compared to OPT, I-O provided more clinically relevant findings for 10 out of 14 parameters (71%). Agreement between I-O and OPT was found with respect to dehiscence, fenestration, the number of bone walls and the root canal cross-section. Differences between the radiographic images were more likely to be detected when maxillary teeth rather than mandibular teeth were assessed with regard to furcation involvement, root proximity and root fusion.

Changes in periapical status, quality of root fillings and estimated endodontic treatment need in a similar urban German population 20 years later

OBJECTIVES

The study aimed at assessing, as primary objective, the periapical status and quality of root fillings, and, as secondary objective, the endodontic treatment need of a German urban population in a cross-sectional study 20 years after the first one.

MATERIALS AND METHODS

Clinical and radiographic data of 353 patients were evaluated. Descriptive and regression analyses were performed and the endodontic treatment need was calculated. Results were compared with data from the year 1993.

RESULTS

A total of 9269 teeth were examined (26.2 teeth per patient; 1993, 24.4), of which 337 teeth were root filled (3.6%; 1993, 2.7%). Prevalence of apical periodontitis in root-filled teeth was 34% (1993, 61%). Quality of root fillings was adequate in 117 cases (35%; 1993, 14%). Minimum endodontic treatment need was estimated with 1.6% (1993, 2.3%), including teeth with clinical symptoms. Considering symptomless teeth with apical periodontitis and poor quality of root filling, the treatment need was 2.9% (1993, 3.7%). Regression analysis identified quality of root filling as a significant factor for periapical health (p = 0.01, odds ratio 3.4×, 95% CI 1.9-6.3×), likewise the type of instrumentation. Teeth treated with rotary files had a significantly better outcome (p = 0.02, odds ratio 2.0×, 95% CI 1.1-3.7×).

CONCLUSIONS

Quality of root fillings and the periapical status have improved over the last 20 years in Germany. However, there is still a need for an increase in quality of root canal treatment.

Apical periodontitis in southern Estonian population: prevalence and associations with quality of root canal fillings and coronal restorations

Background

Apical periodontitis (AP) is an inflammatory disease around the apex of a tooth root. Reported prevalence of AP ranges from 27% to 83% while the data about most post-Soviet countries are still missing. Knowing the prevalence of AP within a certain population helps to plan the treatment need and evaluate the success of endodontic interventions. We aimed to collect data about prevalence and determining factors of AP for the first time in Estonia.

Methods

The cross-sectional study included 6552 patients (age 35.5±19.2 years). Radiographic examination was applied to investigate the prevalence of AP and quality of endodontic treatment.

Results

AP was diagnosed in 54.7% of subjects. Endodontically treated teeth were present in 58.2% of subjects. Periapical finding was present in 44.6% of endodontically treated and in 30.8% of untreated teeth.

Out of 181,495 teeth, 52.7% were intact. AP was diagnosed in 6.3% of teeth, 6.9% of teeth were endodontically treated.

Risk factors for AP included caries (OR = 2.30), male gender (OR = 1.44), too short (OR = 1.76) or too long root canal filling (OR = 2.51), root canal filling of low density (OR = 1.61) while not orthodontic appliance. Lower AP risk was associated with restoration of the tooth – filling (OR = 0.45), crown (OR = 0.34) and bridge (OR = 0.33).

Conclusions

AP is highly prevalent in Southern Estonian population. Most cases are associated with root canal-treated teeth. The overall quality of root canal fillings tends to be low, consistent with the mediocre outcome of treatment. Considerable efforts are required to improve the standards of endodontic treatment.

Electronic supplementary material

The online version of this article (10.1186/s12903-017-0429-7) contains supplementary material, which is available to authorized users.

Periapical Status and Quality of Root Canal Fillings in a Moroccan Subpopulation

AIM

The aim of the study was to assess the prevalence of apical periodontitis (AP) and quality of root canal fillings in an adult Moroccan subpopulation.

METHODS

In the study 508 patients were included, attending the Conservative Dentistry Clinic at the Faculty of Dentistry of Casablanca. 508 panoramic and 709 periapical radiographs were observed. The periapical status of all teeth (with the exception of third molars) was examined according to Ørstavik's periapical index. The statistical analysis was performed with the software Epi Info Version 6.04dfr, April 2001.

RESULTS

A total of 12719 teeth were examined. 45.3% of patients had apical periodontitis. 4.2% of teeth were treated endodontically and 70.4% of these treatments were inadequate. 91,5% with inadequate endodontic treatment presented apical periodontitis, while only 8,2% with adequate endodontic treatment had apical periodontitis. The lower molars and the upper premolars were the most affected teeth. The presence of apical periodontitis was correlated significantly with insufficient root canal fillings (p < 0.05).

CONCLUSIONS

The present study found a high prevalence of apical periodontitis in this Moroccan population. Inadequate root canal fillings were associated with an increased prevalence of apical periodontitis.

Radiologic assessment of quality of root canal fillings and periapical status in an Austrian subpopulation - An observational study

Background/Objective

Progress in endodontic techniques and methodological advances have altered root canal therapy over the last decades. These techniques and methods need periodical documentation. This observational study determined the current prevalence of endodontic treatments, and investigated the relationship of various factors with the periapical status in a Lower Austrian subpopulation.

Methodology

One thousand orthopantomograms of first-time university adult patients radiographed at an outpatient clinic were evaluated. For each tooth, the presence of periradicular pathosis and/or endodontic treatment was recorded, as was the quality of (post-)endodontic treatment (homogeneity and length of root canal fillings; preparation failures; posts/screws; apicoectomies; coronal restorations). Two evaluators, blinded to each other, scored all teeth. In cases of disagreement, they joined for a consensus score.

Results

In all, 22,586 teeth were counted. Of these, 2,907 teeth (12.9%) had periapical pathosis, while 2,504 teeth had undergone root canal treatment. Of the endodontically treated teeth, 52% showed no radiographic signs of apical periodontitis, while 44.9% had overt apical lesions, and 3,1% revealed widened periodontal ligament space. The majority of the root canal fillings was inhomogeneous (70.4%); 75.4% were rated too short, and 3.8% too long. The presence of apical pathosis was significantly correlated (odds ratio (OR) 2.556 [confidence interval (CI) 2.076–3.146]; P<0.0001) with poor root canal fillings (length and homogeneity). Posts or screws positively affected periapical status (OR 1.853 [CI 1.219–2.819]; P = 0.004), but endodontically treated posterior teeth were infrequently restored (posts, 7.5%; screws, 2.7%). Best results were found for teeth with both appropriate endodontic treatment and adequate coronal restoration.

Conclusion

A high prevalence of periradicular radiolucencies was observed with root canal filled teeth, along with high numbers of unmet treatment needs. Periapical health was associated with adequate root canal obturation and high-grade postendodontic restorations, and quality regarding these latter aspects is considered mandatory to promote periapical health.

Apical Periodontitis and Endodontic Treatment in Patients with Type II Diabetes Mellitus: Comparative Cross-sectional Survey

AIMS

The aims of this study were to investigate the prevalence of apical periodontitis (AP) in diabetes mellitus (DM) patients compared with nondiabetic patients and to examine the effect of glycemic control on the prevalence of AP.

MATERIALS AND METHODS

Radiographs of a group of DM patients were compared with those of a matched nondiabetic group to identify AP. The diabetic group was subdivided according to the level of glycemic control into two subgroups: A well-controlled DM and a poorly controlled DM. The periapical index score was used to assess the periapical status. All groups were compared in regard to the presence of AP lesions, the number of end-odontically treated teeth (ET), and the percentage of failure of endodontically treated teeth (AP/ET ratio). Statistical Package for the Social Sciences (SPSS version 20.0, Chicago, Illinois, USA) was used for all the analyses; p ≤ 0.05 was considered as statistically significant.

RESULTS

The prevalence of AP was higher in diabetic group than in the nondiabetic group (13.5 vs 11.9% respectively). Diabetic group had more teeth with endodontic treatment ET compared with nondiabetic group (4.18 vs 1.82% respectively); this difference was statistically significant (p = 0.001) along with higher AP/ET ratio (27.7 vs 19.3 respectively). The poorly controlled DM group had a higher prevalence of AP lesions compared with the well-controlled DM group (18.29 vs 9.21 respectively). This difference was statistically significant (p = 0.001); they also had a higher percentage of ET (5.55 vs 3.13% respectively) and AP/ ET ratio (32.0 vs 21.8% respectively).

CONCLUSION

This survey demonstrates a higher prevalence of AP in DM patients compared with nondiabetic group, with an increased prevalence of persistent chronic AP. Compared with a well-controlled diabetic group, a poor glycemic control may be associated with a higher prevalence of AP and increased rate of endodontic failures.

CLINICAL SIGNIFICANCE

Counseling diabetic patients, particularly those with poor glycemic control, about the risk of failure of endodontic treatment can be part of planning management, which could include refereeing diabetic patients who need endodontic treatment for consultant care.

Presence of root canal treatment has no influence on periodontal bone loss

AIM

The aim of this study was to compare the interproximal bone level at root canal-filled teeth and non-root canal-filled teeth.

MATERIALS AND METHODS

The records of patients from the department were consecutively screened from January 2009 to October 2011. The distance between the coronal reference point to the alveolar bone crest (AC) was assessed at the mesial and distal aspects of root canal-filled teeth (RCF+) and their contralateral non-root canal-filled teeth (RCF-) on periapical radiographs. Generalised linear mixed-effects models were applied.

RESULTS

The sample consisted of 128 pairs of teeth comprising data from 72 patients. The results for AC revealed a median distance of 3.2 mm for RCF+ and 3.4 mm for RCF- (p = 0.61). Using the maximal distance on either the distal or the mesial tooth surface, a median distance of 3.6 mm was detected for RCF+ and 3.8 mm for RCF-, respectively (p = 0.42). Even after taking several tooth- and subject-specific variables into account, the differences between AC on RCF+ and RCF- were statistically not significant (p > 0.05).

CONCLUSION

The interproximal bone loss did not differ statistically significant between root canal-filled teeth and non-root canal-filled teeth.

CLINICAL RELEVANCE

Existence of appropriately done root canal fillings in periodontitis patients has no effect on the prognosis of periodontal disease.

Preclinical endodontic teaching. A survey of Saudi dental schools

Objectives:

To provide an overview of the general curricula in preclinical endodontic training from 6 established dental schools in Saudi Arabia.

Methods:

This study was conducted in January 2014 including only schools that had more than 2 groups of student graduates prior to the study. We included 2 dental schools from the Central region, one from Qassim region, one from the Makkah region (west), one from Abha region (south west), and one from the eastern region. An internet-based questionnaire was sent to the course directors of preclinical endodontics department of the 6 schools. The survey comprised 20 questions that examined various aspects of preclinical endodontics.

Results:

It was demonstrated that a significant number of faculty members had Doctor of Philosophy (PhD) degrees (n=21), Master’s degrees (n=15), and Saudi board certifications (n=8). We determined that the faculty to student ratio varied from 2:1 to 8: 1 among the colleges. The participating dental schools were found to teach the Step Back, as well as the Step Down techniques for root canal preparation. Five of the 6 schools implemented the use of nickel titanium rotary instruments. All dental schools predominantly used radiographs as the means of the working length determination.

Conclusion:

The curriculum for preclinical endodontics in Saudi Arabia is comparable to that followed in most European countries. A more comprehensive survey is needed that would involve more schools to formulate generalized guidelines for preclinical endodontic training in Saudi Arabia.

Technical quality assessment of root canal treatment performed by preclinical dental students at Taibah University, KSA

Objectives

The aim of this study was to evaluate the technical quality of root canal treatment (RCT) performed by preclinical undergraduate dental students at the Dental College of Taibah University KSA.

Methods

In this study, 259 extracted teeth were treated endodontically by preclinical students of the College of Dentistry, Taibah University, KSA, from 2013 to 2015. The evaluation criteria were root canal obturation length, root canal obturation density (homogeneity), and root canal obturation taper. A specific score (0, 1, or 2) was assigned to each parameter.

Results

Of 259 endodontically extracted teeth, 138 (53.3%) had RCT of unacceptable technical quality, 42 (16.2%) had treatment of slightly acceptable technical quality, 50 (19.3%) had treatment of acceptable technical quality, and 29 (11.2%) teeth had RCT of perfectly acceptable technical quality. There were no significant differences (p > 0.05) in the technical quality of root canal obturation among types of teeth.

Conclusion

The results of this study showed that there were varied levels of technical quality of root canal treatment performed by preclinical undergraduate dental students, and the outcome varied between unacceptable, slightly acceptable, acceptable, and perfectly acceptable. The unacceptable cases were the most common, representing more than half of all cases, and the perfectly acceptable cases were the least common. There is an urgent need to improve the endodontics teaching programmes in the College of Dentistry of Taibah University. This research should be repeated in the future to evaluate improvement in the performance of RCT by undergraduate dental students in Taibah University.

Technical quality of a matching-taper single-cone filling technique following rotary instrumentation compared with lateral compaction after manual preparation: a retrospective study

OBJECTIVES

The objectives of the study were to evaluate the radiographic technical quality of root canal treatment before and after the implementation of a nickel-titanium rotary (NiTiR) preparation followed by a matching-taper single-cone (mSC) obturation and to detect the procedural errors associated with this technique.

MATERIALS AND METHODS

A random sample of 535 patients received root canal treatment at the Department of Conservative Dentistry and Periodontology at the University of Würzburg: 254 teeth were treated in 2002-2003 by using stainless steel instruments (SSI) for preparation and a lateral compaction (LC) technique (classic group (CG)). Two hundred eighty-one teeth were root filled in 2012-2013 employing NiTiR instruments for the root canal shaping and a mSC technique (advanced group (AG)). The quality assessments were based on the radiographic criteria of the European Society of Endodontology. The presence of voids was recorded separately for the apical, central and cervical thirds of the root canals. Procedural errors, such as ledges, apical transportations, perforations and fractured instruments, were detected. The root canal fillings in the CG and AG were compared using chi-squared and Fisher's exact tests. Multivariable logistic regression was performed to investigate the association between the independent variables (patient age, tooth type and type of treatment) and the dependent variables (density and length).

RESULTS

Adequate length was achieved significantly more often in the AG compared to the CG for molars (p = 0.017), mandibular teeth (p = 0.013) and primary root canal treatments (p = 0.024). No significant difference was detected between the AG and CG regarding adequate length in general (p = 0.051) or adequate overall quality of root canal filling (p = 0.1). In the AG, a significant decrease in procedural errors was evident (p = 0.019) and decreases in the densities of the root canal fillings in the cervical (p = 0.01) and central (p = 0.01) thirds of the root canals were also observed. Moreover, root canals in elderly patients exhibited fewer voids (p = 0.009).

CONCLUSIONS

Rotary root canal preparation followed by a matching-taper single-cone filling technique provides a reliable shaping of the root canal, with fewer procedural errors and a more acceptable filling quality in terms of length and homogeneity in the apical third. Less favourable results were achieved in the central and cervical parts of the root canals.

CLINICAL RELEVANCE

The matching-taper single-cone technique seems to effectively obturate well-tapered root canals after adequate rotary instrumentation. Irregularly shaped canals require additional lateral or warm vertical condensation to avoid voids.

The Factors Responsible for Endodontic Treatment Failure in the Permanent Dentitions of the Patients Reported to the College of Dentistry, the University of Aljouf, Kingdom of Saudi Arabia

INTRODUCTION

The endodontic failure is a common problem in dentistry. The success of endodontic and re-endodontic treatment depends on many factors. These includes periodontal disease, root fractures, residual necrotic pulp tissue, presence of peri-radicular infection, broken instruments, mechanical perforations, root canal underfillings, root canal overfillings, missed canals or unfilled canals.

AIM

The present research was aimed at evaluating the different factors responsible for endodontic treatment failure in permanent dentitions of the patients.

MATERIALS AND METHODS

In the present in vivo cross-sectional study, 90 patients, who reported in endodontic section of Department of Conservative Dentistry, with post endodontic treatment pain, tenderness to percussion, swelling and sinus tract in their permanent dentitions were considered as endodontic failure cases, and were considered for endodontic re-treatment. The teeth with vertical root fracture and badly broken down unrestorable teeth were excluded from the present study. The study subjects were divided into three groups on the basis of their age. Informed consent was taken from the study subjects and the approval was taken for this study from the college ethical committee.

RESULTS

The results were obtained as frequencies and percentages after analysing the collected informations by using SPSS version 10 computer soft ware. The majority of the endodontic failures were noted in the age group III (41.11%) and minimum endodontic failures were found in the age group I (24.44%). According to the tooth type, the majority of the endodontic failures were noted in maxillary molars (44.4%), mandibular molars (20%) and maxillary premolars (15.5%). The endodontic treatment performed by the general dental practitioners (GDPs) showed the most failure rate (78.8%). The factors which were most responsible for endodontic failures were underfilled canals (33.3%), unfilled and missed canals (17.7%).

CONCLUSION

This study concluded that endodontic failures are more related with the lack of knowledge on the part of the operator, complex anatomy of the teeth involved and lack of referral of such patients to the specialists.

Prevalence and distribution of endodontic treatments and apical periodontitis in an Italian population sample

This study was undertaken to investigate for the first time the distribution and prevalence of apical periodontitis and its determinants in an Italian population. A total of 312 participants (191 women, 121 men) received free clinical examination and full-mouth digital X-ray. Data regarding the oral health status of the patients were collected such as the reason for the visit and the incidence of lesions. We examined 8101 teeth, 6.59% of which had been submitted to endodontic treatment and 15.02% of which were lower molars. Lower molars were reported missing more frequently, in detail 16.24%. Moreover 3.89% of the lower molars had developed an apical lesion, whereas only 0.08% of the lower incisors. Periapical lesions were present in 0.29% of not endodontically treated teeth, while in endodontically treated teeth lesions were present in 17.04%. Additionally, 15.65% of the endodontically treated teeth showed incongruous (long or short) seals. A prevalence of women (61.21%) over men (38.78%) was reported indicating that women attend to their oral health more. Endodontic treatment success and failure in over- or under-filled teeth was evaluated with success being verified in 97% of appropriately treated teeth; the success rate decreases in inappropriately treated teeth (by 72.73% in over-filled and 77.71% under-filled teeth). The prevalence of teeth with periapical lesions amounted to 1.35%. Finally, endodontically treated teeth with periapical lesions amounted to 17.04%. Successful treatment can be achieved when disease is intercepted at an early stage while prevention still remains better than cure.

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT

OBJECTIVE

This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation.

MATERIAL AND METHODS

The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test.

RESULTS

The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth].

CONCLUSIONS

The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics.

Is apical periodontitis in root filled teeth associated with the type of restoration?

OBJECTIVE

To study the association between type of restoration and apical periodontitis (AP) in root filled teeth.

MATERIALS AND METHODS

The present study used data from surveys conducted in 1983, 1993 and 2003. In 1983, 130 randomly selected subjects aged 3-80 years in the city of Jönköping, Sweden, were invited for a clinical and radiological examination. The study was repeated in 1993 and 2003. New participants were, thus, recruited with the same sampling criteria and sample size in the same geographical area in 1993 and 2003, respectively. In the present study, only dentate individuals aged 20-70 years with ≥1 root filled tooth were included, yielding a sample of 788 subjects with 2634 root filled teeth. Apical periodontitis on the tooth level was the dependent variable. Periapical status was assessed according to Periapical Index (PAI). Independent variables were root filling quality, recurrent caries, type of restoration, number of teeth with apical periodontitis, age and gender. Root fillings appearing homogenous and ending within 2 mm from radiographic apex were regarded as adequate, otherwise inadequate. All radiographs were re-studied by one observer regarding periapical status and root filling quality. Risk was analyzed by means of a GEE model.

RESULTS

Type of restoration, root filling quality, number of teeth with apical periodontitis within the individual and age were found to be predictors of AP in root filled teeth. Presence of recurrent caries and gender were not found to be associated with AP.

CONCLUSIONS

According to the present study, root filling quality and type of restoration may be predictive of AP in root filled teeth.

Periradicular lesions in HIV-infected patients attending the faculty of dentistry: clinical findings, socio-demographics status, habits and laboratory data - seeking an association

OBJECTIVE

The purpose of this study was to estimate the prevalence of periradicular lesions in HIV-infected Brazilian patients and to assess the correlation of several factors with the periradicular status.

METHOD

One hundred full-mouth periapical radiographs were evaluated. A total of 2,214 teeth were evaluated for the presence of periradicular lesions, caries lesions, coronal restorations, pulp cavity exposure and endodontic treatment.

RESULTS

The prevalence of periradicular lesions was 46%. There were no significant differences between individuals with or without periradicular lesions with respect to their socio-demographic status, habits, laboratory data and route of HIV infection. However, the presence of a periradicular lesion was statistically correlated with the number of teeth with endodontic treatment (p = 0.018), inadequate endodontic treatment (p = 0.025), images suggesting pulp cavity exposure (p = 0.002) and caries lesions (p = 0.001).

CONCLUSIONS

The prevalence of periradicular lesions in HIV-infected individuals was 46% and was not related to HIV infection.

A survey report on effect of root canal fillings and coronal restorations on the periapical status of endodontically treated teeth in a selected group of population

AIM

A cross-sectional radiographic orthopantomogram (OPG) survey was done to determine the prevalence of apical periodontitis (AP) in root canal-treated teeth in a selected population, and to evaluate the influence of the coronal restorations (CR) and root canal fillings on the periapical status.

MATERIALS AND METHODS

A total of 250 OPGs were evaluated out of which root canal treatment (RCT) had been performed in 438 teeth which was taken as the sample size.

STATISTICAL ANALYSIS USED

Chi-square test, odds ratio and p-values were recorded.

RESULTS

The results showed that 53.1% of the endodontically treated teeth presented with AP radiographically. Incidence of AP among teeth with acceptable RCT (32.3%) was significantly lower than those suffering from unacceptable RCT (92.7%). Moreover, adequate CR demonstrated a significantly better periapical status (83.2%) compared to teeth with inadequate CR (37.2%). Also, the combination of adequate CR and adequate root filling resulted in significantly reduced incidence of AP (21.6%) compared to the presence of AP (97%) when both parameters scored as inadequate.

CONCLUSION

RESULTS hence demonstrated that a well-performed RCT and well-sealing CR are both essential for the overall success of endodontic treatment. Therefore, a considerable improvement in the quality of RCT and CR in general dental practice is required to promote oral/periapical health. How to cite this article: Khullar P, Raisingani D, Gupta S, Khatri RK. A Survey Report on Effect of Root Canal Fillings and Coronal Restorations on the Periapical Status of Endodontically Treated Teeth in a Selected Group of Population. Int J Clin Pediatr Dent 2013;6(2):89-94.

Radiographic assessment of the technical quality and periapical health of root-filled teeth performed by general practitioners in a Turkish subpopulation

Aim. The aim of this study was to evaluate by means of radiographs the technical quality of root fillings performed by dental practitioners. Methods and Material. Standardized periapical radiographs were made on 484 patients who received endodontic treatment in private practice. A total of 831 endodontically treated teeth with 1448 roots were evaluated for technical quality of the root canal filling and the periapical status of the teeth. Also, the apical status of each root-filled tooth was assessed according to the length, density, and taper of root fillings, and the presence of apical transportation, broken root instruments, and overfilled sealer or gutta-percha material was recorded for each root canal. Results. Of the endodontically treated teeth 26.6% had healthy periapical tissues, while technically good endodontic treatment constituted 12.8%. Based on the treatment success, there was no significant difference between the tooth groups. Statistical analysis of the data did not demonstrate statistically significant differences between the various parameters that were evaluated (P < 0.05). Conclusions. Technical quality of root fillings in a population who received treatment in private practice was poor and was consistent with a low prevalence of apical health. The probable reasons for this failure are multifactorial and may be improved if the operators improve their skills with continuing postgraduate education programs.