Abstract

The aim of this study was to assess the preoperative, intraoperative, and postoperative factors that influenced complete periapical healing in teeth that underwent primary root canal treatment (RCT), in patients treated by postgraduate students in endodontics. Factors were retrieved and compared with the periapical status during the follow-up visit. Healing was considered as the absence of clinical and radiological symptoms. Variables significantly associated by the chi-squared test were included in a logistic regression model (LRM). Preoperative factors associated with healing were: American Society of Anesthesiology (ASA) status (p = 0.01); the absence of preoperative pain (p = 0.04); positive response to pulp tests; when the RCT cause was caries, pain, abscess, or sinus tract; probing depth <4 mm; the absence of mobility; absence or <4 mm periapical lesion (p < 0.01). In the LRM, the factors included were: absence or <4 mm periapical lesion; probing depths <4 mm; RCT caused by caries, pain, abscess, or sinus tract; the tooth was not a bridge abutment. Postoperative factors were: teeth with direct restoration; teeth that did not act as a support for a fixed prosthetic restoration; the favorable condition of the coronal restoration (p < 0.01). In the LRM, only the status of the coronal restoration was included. Preoperative conditions and the adequate fit of the coronal restoration influenced the outcome of RCT.

Highlights

  • Apical periodontitis is an acute or chronic inflammatory process of polymicrobial origin which reaches the periodontium through the root canal system [1]

  • In the logistic regression model (LRM), the factors included were: absence or

  • The objective of the present retrospective study was to assess the factors that influenced periapical lesion healing in teeth that underwent primary RCTs, after follow-up periods of 1–6 years, in patients treated by postgraduate students in endodontics

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Summary

Introduction

Apical periodontitis is an acute or chronic inflammatory process of polymicrobial origin which reaches the periodontium through the root canal system [1] It is characterized by exhibiting high cytokine and inflammatory mediator levels, which trigger a periapical inflammatory response through the activation of the innate immune system [2]. The process of apical periodontitis healing will result in a complete disappearance of any radiological alterations in the periradicular tissues. This reparative process involves the neoformation of connective tissue at the lesion site, which will be substituted by bone tissue [3]. The underlying local and/or systemic conditions of the patients may affect the outcome of root canal treatment (RCT) [4]

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