Tooth-specific risk indicators for apical periodontitis.

Abstract

The present study aimed at identifying tooth-specific risk indicators for apical periodontitis (AP) and to investigate their interrelations in order to identify those teeth that would benefit from a radiographic examination. The study included 311 males and 302 females who gave written informed consent and attended a full-mouth radiographic examination. All teeth were assessed individually. AP was scored by the periapical index (PAI); other variables were root fillings, coronal fillings and crowns, pulpal posts, and caries. A conditional logistic regression analysis was used to assess the effect of tooth-specific risk indicators on the presence of apical periodontitis. The dependent variable was presence of AP versus absence of AP in the tooth. A total of 536 teeth with AP were identified. A highly increased risk for AP was seen in teeth with root fillings, particularly for technically inadequate ones. Presence of coronal fillings also increased the risk for AP, and inadequate fillings were associated with a slightly higher risk than adequate fillings. A similar pattern was seen for crowns. Teeth with caries also had an increased risk of AP, but the difference was only statistically significant for primary caries. Compared to first incisors, second incisors and canines had a significantly reduced risk, and molars, especially first maxillary molars, had a significantly increased risk for having AP.