Prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults

Carlos Estrela,Jesus Djalma Pécora,Cláudio Rodrigues Leles,Marcelo Sampaio Moura,Augusto César Braz Hollanda

doi:10.1590/s0103-64402008000100006

Carlos Estrela, Jesus Djalma Pécora + Show 3 more

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https://doi.org/10.1590/s0103-64402008000100006

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Abstract

The aim of this study was to assess the prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults. A total of 1,372 periapical radiographs of endodontically treated teeth were analyzed based on the quality of root filling, status of coronal restoration and presence of posts associated with apical periodontitis (AP). Data were analyzed statistically using odds ratio, confidence intervals and chi-square test. The prevalence of AP with adequate endodontic treatment was low (16.5%). This percentage dropped to 12.1% in cases with adequate root filling and adequate coronal restoration. Teeth with adequate endodontic treatment and poor coronal restoration had an AP prevalence of 27.9%. AP increased to 71.7% in teeth with poor endodontic treatment associated with poor coronal restoration. When poor endodontic treatment was combined with adequate coronal restoration, AP prevalence was 61.8%. The prevalence of AP was low when associated with high technical quality of root canal treatment. Poor coronal restoration increased the risk of AP even when endodontic treatment was adequate (OR=2.80; 95%CI=1.87-4.22). The presence of intracanal posts had no influence on AP prevalence.

Highlights

Apical periodontitis (AP) often appears as a response to intraradicular or extraradicular infection
Endodontic epidemiological studies conducted with different populations worldwide have shown that the periapical health status is related to factors like quality of root canal filling, coronal restoration and presence of intracanal post [1,2,3,4,5,8,9,10,11,12,13,14,15,16,17]
Root canal obturation represents an important phase of endodontic treatment, which is completed with the placement of an adequate coronal restoration

Summary

Introduction

Apical periodontitis (AP) often appears as a response to intraradicular or extraradicular infection. Ray and Trope [2] examined the radiographs of 1,010 endodontically treated teeth and observed absence of periapical pathology in 61.07% of the cases. These authors concluded that the technical quality of the coronal restoration was significantly more important than the technical quality of the endodontic treatment for apical periodontal health. Kirkevang et al [3] evaluated the radiographs of 773 root-filled teeth to investigate the quality of endodontic treatments and coronal restorations as well as its association with the periodontal status and reported an AP prevalence of 52.3%. Inadequate root canal filling and coronal restoration were associated with an increased

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