High Prevalence Of Apical Periodontitis Research Articles

Predictors of apical periodontitis in root canal treated teeth from an adult Nepalese subpopulation: a cross-sectional study

BackgroundEndodontic literature search revealed that no study has been conducted to evaluate the prevalence of apical periodontitis (AP) in root canal treated teeth from an adult Nepalese population of Madhesh Province. Consequently, little is known about the extent and risk factors associated with it. This study aimed to determine AP prevalence in root canal treated teeth from an adult Nepalese subpopulation and to analyze the related risk factors including age, sex, tooth type, type of coronal restoration and quality of root canal treatment and coronal restoration as predictors of AP.MethodsDigital panoramic radiographs were evaluated. Periapical status of 300 root canal-treated teeth was scored by using the periapical index. The quality of root canal treatment and coronal restorations were categorized as adequate or inadequate through radiographic and clinical evaluation. The data were analyzed using univariate and multivariate logistic regression models.ResultsPrevalence of AP in the present study was 31.7%. In 45.7% of the treated teeth, quality of root canal treatment was adequate whereas 46% of the cases had adequate coronal restorations. Multivariate logistic regression analysis revealed statistically significant associations and remarkably increased risk for AP in teeth with inadequate root canal treatment (odds ratio [OR] = 7.92; 95% CI: 3.96–15.82; p < 0.001) whereas lower risk for AP was found in females (OR = 0.51; 95% CI: 0.28–0.90; p = 0.021) and in teeth restored with crown (OR = 0.22; 95% CI: 0.09–0.51; p < 0.001) and filling (OR = 0.18; 95% CI: 0.08–0.42; p < 0.001). Quality of coronal restoration, tooth type and age of the patient were not found to be the predictors of AP.ConclusionsWithin the limits of this study, a high prevalence of AP and poor overall quality of root canal treatment and coronal restoration was found in the subpopulation studied. Quality of root canal treatment, type of coronal restoration and sex of the patient are significant predictors of possible AP development in root canal treated teeth. Substantial efforts are needed to improve the endodontic treatment standards.

Apical periodontitis and autoimmune diseases-should we be screening patients prior to therapy?

A single-centre retrospective case-control study from 2012-2020 comparing the prevalence of apical periodontitis (AP) in patients with autoimmune disorders (AD) against a control group of those without. The different medication groups commonly used for treatment of AD were included for comparison. This study utilised patients' electronic records. These were anonymous. Patient sociodemographic variables were collected and compared. Two cases were removed from selection as they were being treated with dual biologic therapy. Both the control group and AP group contained 89 patients. Various additional variables were considered, such as DMFT and a logistical regression analysis was used to correlate between AD and AP. For the autoimmune disease conditions within this study, the authors found a higher prevalence of apical periodontitis than in the control group, 89.9% versus 74.2%, respectively (p = 0.015). Furthermore, those taking conventional disease-modifying drugs such as methotrexate had a lower prevalence than those on biologics. These results were of statistical significance. Individuals with autoimmune disorders may have increased prevalence of apical periodontitis irrespective of their treatment with biologics or not. A DMFT score can be used to predict the occurrence of AP.

Prevalence of Apical Periodontitis in Patients with Autoimmune Diseases under Immunomodulators: A Retrospective Cohort Study

IntroductionThe aim of this retrospective cohort study was to investigate the prevalence of apical periodontitis (AP) in patients affected by autoimmune diseases (ADs) taking biologic medications (BMs). MethodsNinety-nine patients (2440 teeth) with ADs referred to the university clinic for dental evaluation were investigated. The controls included 99 patients (2655 teeth) with no systemic diseases and taking no medications. The patients underwent a complete oral, dental, and radiographic examination for the presence of AP. The periapical index and the status of endodontic and restorative treatments were obtained. Statistics were based on descriptive analysis and continuous variables for the total sample and by subgroups. Adjusted odds ratios and 95% confidence intervals were calculated. ResultsThe prevalence of AP was 65.7% in the autoimmune diseases group (AI) and 46.5% in the controls (P ≤ .05). The association between smoking and AP was significant (P ≤ .05). Among the AI subgroups, rheumatoid arthritis patients at the tooth level had a lower probability of developing AP than patients with inflammatory bowel disease (P ≤ .05). Furthermore, each additional year of age implied a +1% risk of AP; women had a lower periapical index than men in both groups (P ≤ .05), and tocilizumab was associated with a reduced risk of AP compared with infliximab (P ≤ .05). ConclusionsPatients with ADs taking BMs had a higher prevalence of AP. These results indicate that the status of the patients' immune system may have an effect on the development and prevalence of AP.

Factors related to apical periodontitis in a southern Brazilian population: a multilevel analysis.

The aim of this cross-sectional study was to evaluate the effects of individual-level and tooth-level factors on apical periodontitis (AP) in an urban population in southern Brazil. A random sample of digital panoramic radiographs (n = 545) from a dental school database was evaluated. The diagnosis of AP was determined by using a dichotomous scale (yes/no). AP was assessed according to gender, age, presence and quality of endodontic treatment (ET), presence of an intracanal post, coronal condition, and dental group. Data were analyzed descriptively and through multilevel Poisson regression analysis, considering teeth characteristics (level 1) nested in individuals (level 2). In this sample of 545 participants, the prevalence of AP was 49.5% (n =2 70) and ET was 43.5% (n = 237). Considering 13,595 teeth, AP was identified in 596 (4.4%) and ET in 617 (4.5%). Of the teeth with ET, 153 (24.8%) presented AP. Among individual-level factors, the disease was not significantly associated with gender or age. For tooth-level factors, AP was significantly associated with ET quality: teeth with short fillings (< 3 mm) and teeth with over-fillings had 2.77 (CI: 1.95-3.94, p < 0.001) and 1.08 (CI: 0.39-2.98, p < 0.001) higher prevalence of AP, respectively. There was no association between AP and age, gender, dental group, coronal condition, or the presence of an intracanal post. AP was highly prevalent in this population, and multilevel analysis indicated a significant association with ET quality.

Associação entre a periodontite apical e as doenças cardiovasculares: uma revisão da literatura

Aim: The present study aims to review the data available in the literature to verify whether apical periodontitis (AP) is a risk factor for cardiovascular diseases (CVDs). Materials and Methods: a search was carried out in the databases of Pubmed and Google Scholar about a possible association of AP with the development of cardiovascular problems. After the selection criteria, 8 scientific articles were included to be analyzed in detail. Literature Review: although BP is a local inflammatory process, its pathogenesis can result in the development of systemic complications. Assuming that a localized inflammatory response is capable of causing the release and activation of systemic pro-inflammatory mediators, such as interleukin cytokines and tumor necrosis factors, some automatic effects are a possible association between a chronic AP and CVDs, due to the potential for the emergence of endothelial damage and atheroma. Discussion: although the correlation between periapical inflammatory lesions and systemic diseases is still questionable, mainly due to the discredit in which the subject was treated in the past and the limited amount of conclusive information currently available, the data reviewed in this paper propose that there is a positive association between AP and CVDs, with a higher prevalence of AP in patients with cardiovascular problems. Conclusion: a limited amount of findings are scientifically available. Therefore, it is suggested to carry out more research on the subject, aiming the search for relevant and well-grounded evidence on this association.

Prevalence of apical periodontitis between root canal-treated and non-treated teeth and between genders: A cross-sectional CBCT study.

Apical periodontitis (AP) is one of the most important prognostic factors in almost all endodontic outcome studies. The high prevalence of AP has been reported in different populations. The aim of the present study was to investigate (a) the overall prevalence of AP among all permanent teeth, (b) the differences between root canal-treated (RCT) and non-treated teeth in association with AP, and (c) the influence of gender on AP in a Saudi Arabian population using cone-beam computed tomography (CBCT). A total of 208 CBCT radiographs (including 5,504 permanent teeth) were investigated. The CBCT machine used in this study was a 3D Accuitomo 170 (Morita, Japan) with the following features: 90 kV, 5-8 mA, 17.5 s exposure time, and 0.25 mm voxel size. The radiographs of the axial, coronal, and sagittal segments of each tooth were acquired to evaluate the presence or absence of RCT teeth and AP. The data were presented as frequencies and percentages. Z test was used to analyze the differences in proportions at the significance level of P < 0.05. The overall prevalence of AP was 4.5% (264 out of 5,504 permanent teeth). AP had the highest frequencies in the mandibular and maxillary first molars (18.4 and 9.3%, respectively) with a higher prevalence in the maxillary teeth. AP was associated with endodontically treated teeth more than the untreated ones (66.3% compared with 33.7%) with a highly significant difference (P < 0.001). AP was more prevalent in females than in males but with no statistically significant difference (P > 0.05). AP had a low prevalence (4.5%) in all permanent teeth and was highly associated with RCT teeth (66.3%). First molars had the highest prevalence of AP. Care must be taken when examining patient radiographs to avoid missing AP, particularly in RCT teeth.

Smokers may have a higher prevalence of apical periodontitis and root canal treatment than nonsmokers, but this is not evidence that smoking is a risk factor for these outcomes

Pinto KP, Ferreira CM, Maia LC, Sassone LM, Fidalgo TKS, Silva EJNL. Does tobacco smoking predispose to apical periodontitis and endodontic treatment need? A systematic review and meta-analysis [published online ahead of print April 28, 2020]. Int Endod J. https://doi.org/10.1111/iej.13316.

High Prevalence of Apical Periodontitis in Patients With Inflammatory Bowel Disease: An Age- and Gender- matched Case-control Study.

Deep carious lesions cause pulpitis, pulpal necrosis and, finally, apical periodontitis (AP). Root canal treatment (RCT) is the treatment of choice for AP, changing the tooth into a root-filled tooth (RFT). Several studies have linked AP and RFT to systemic diseases. Likewise, previous studies have also found an association among inflammatory bowel disease (IBD) and periodontal disease. This study aims to analyze the frequency of AP and RCT in IBD patients and healthy control subjects. An age- and gender-matched case-control study design was used. The study group (SG) included 54 IBD patients (28 with Crohn´s disease, 26 with ulcerative colitis). Another 54 healthy subjects without IBD and age- and gender-matched were included in the control group (CG). The radiographic records were analyzed, and periapical radiolucencies were diagnosed as AP, using the periapical index (PAI). The statistical analysis was carried out using the Student t test, χ 2 test, and multivariate logistic regression. The presence of 1 or more teeth with radiolucent periapical lesions (RPLs) was found in 19 patients (35.2%) in the study group and in 9 subjects (16.7%) in the control group (P = 0.03). No differences were found among the 2 groups neither in the amount of teeth with AP nor in the number of RFTs (P > 0.05). However, multivariate logistic regression analysis adjusting for number of teeth and number of RFTs showed that patients with IBD have RPLs with higher likelihood than control patients (odds ratio, 5.7; confidence interval 95%, 1.7-19.1; P = 0.0048). Subjects with inflammatory bowel disease have higher prevalence of apical periodontitis. An oral health protocol should be established to address the higher prevalence of inflammatory oral processes.

Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review.

Biologic medications (BMs) are increasingly used for the management of systemic chronic inflammatory diseases. These diseases are often associated with a higher prevalence of apical periodontitis (AP) and periodontitis (P). The purpose of this systematic review was to ascertain the interactions between AP and/or P and BMs. The review was registered in the PROSPERO database (CRD42017054756). Electronic searches were performed on Pubmed Medline, Scopus and The Web of Science from their inception through to 20 March 2018. The references of the articles selected were checked. The keywords were chosen based on a pilot search, which aimed to find the most frequently prescribed BMs. The included studies were appraised qualitatively using appropriate tools. Thirty-five articles met the inclusion criteria, comprising 16 non-randomized clinical studies, 12 invivo animal studies and 7 case reports. Quality of information was assessed as high in 18 articles, moderate in 16 articles and low in 1 article. BMs in patients suffering from chronic inflammatory diseases seems to inhibit the progression of AP and P, and to enhance the healing response to periodontal and endodontic treatment. A healthier condition of the periodontal tissues seems to be associated with a better response of the patient to BMs therapy.

Prevalence of Apical Periodontitis in Patients with Inflammatory Bowel Diseases: A Retrospective Clinical Study

AimWe evaluated the prevalence of apical periodontitis (AP) and the oral health status in patients with inflammatory bowel diseases (IBDs) treated with immunomodulators, with particular attention to biologic medications (BMs). MethodsOne hundred ten patients, 49 men and 61 women (average age, 46 ± 13.8 years), from the Gastroenterology Unit of the University Hospital with IBDs who were treated with BMs or corticosteroids were included in the study. One hundred ten patients who registered for a dental check-up at the Dental Clinic were matched for age, sex, and physical characteristics with the study group without systemic diseases and not taking medications who were the control. Patients underwent a complete oral, dental, and radiographic examination. Decayed, missing, and filled teeth and periapical index score indexes were recorded. Student t test, χ2, and Mann-Whitney U test were used as appropriate. ResultsThe prevalence of AP was 64% in IBD patients and 59% in the control; according to the gender-stratified analysis, the difference was not significant among the male groups, whereas the number of teeth with AP was significantly higher in female patients with IBDs than in the controls (P ≤ .05). The prevalence of AP in patients treated with BMs was 65%; women showed 69% higher risk for AP and presented a significantly higher number of teeth with AP (P ≤ .05). Decayed, missing, and filled teeth index was similar in both groups, whereas patients with IBDs had a higher periapical index score than the controls. ConclusionsWomen with IBDs and taking immunomodulators had a higher prevalence of AP. All patients with IBDs had larger lesions than healthy subjects. These data emphasize the influence of the status of the immune system in the onset of AP and the need for further studies to confirm these findings.

Radiographic evaluation and predictors of periapical lesions in patients with root-filled and nonroot-filled teeth in Kuwait

Objective: The objective of this study was to determine the association between periapical health status with the quality of the root filling and was the coronal restoration and identify the predictors of periapical lesion. Subjects and Methods: It was conducted among 197 adult patients who visited Kuwait University. Periapical status was measured by periapical index. The presence or absence of periapical lesions was evaluated using panoramic radiographs. Statistical Analysis: Data were analyzed using the Statistical Package for Social Sciences. Chi-square tests were performed to assess associations between categorical variables. Results: Of the 4,841 teeth examined, 2.7% were root-filled (n = 130). Thirty-four percent of the root-filled teeth (n = 44), and 3% of the nonroot-filled teeth (n = 141 of 4711) exhibited periapical radiolucency. Of the root filled teeth, 49% were judged to be inadequate (n = 64) and 91% of the inadequate ones had short root filling (n = 58). The presence of periapical lesion was significantly predicted by inadequate coronal restoration, dental caries, periodontal bone loss, and the presence of post crown. Conclusion: This study demonstrated a large number of untreated teeth with periapical pathology. The quality of root fillings in this population appeared to be poor and was significantly associated with a high prevalence of apical periodontitis.

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.

Apical periodontitis and the technical quality of root canal treatment in an adult sub-population in London.

To assess the prevalence of apical periodontitis (AP) and the technical quality of root canal treatment in an adult sub-population in London. Panoramic radiographs of 136 patients who attended a dental hospital were collected. The periapical health of teeth present was assessed radiographically and the presence or absence of AP noted. The technical quality of the root canal treatment was scored as adequate or inadequate, based on the European Society of Endodontology (2006) guidelines. A total of 3,396 teeth were assessed; AP was detected in 4.1% of the teeth. Forty-nine percent of patients had at least one tooth with radiographic evidence of AP. The percentage of root filled teeth with AP was 38.3%. AP was significantly more frequently found in root treated, compared with non-root treated, teeth (p <0.001). In 44.3% of the cases, the technical quality of the root canal filling was inadequate. AP was detected in 14% of adequately, compared with 68.6% of inadequately, root filled teeth. There is a significant negative correlation between the technical quality of root canal treatment and the presence of AP (p <0.001). There was a high prevalence of AP and poor technical quality root canal treatment; a strong association between AP and root filled teeth, and between the periapical health and the technical quality of the root canal treatment. The results are consistent with previous studies using similar methodology and re-confirmed that high technical quality root canal treatment is crucial to ensure a favourable treatment outcome.

Summary of: Apical periodontitis and the technical quality of root canal treatment in an adult sub-population in London.

Aim To assess the prevalence of apical periodontitis (AP) and the technical quality of root canal treatment in an adult sub-population in London. Methodology Panoramic radiographs of 136 patients who attended a dental hospital were collected. The periapical health of teeth present was assessed radiographically and the presence or absence of AP noted. The technical quality of the root canal treatment was scored as adequate or inadequate, based on the European Society of Endodontology (2006) guidelines. Results A total of 3,396 teeth were assessed; AP was detected in 4.1% of the teeth. Forty-nine percent of patients had at least one tooth with radiographic evidence of AP. The percentage of root filled teeth with AP was 38.3%. AP was significantly more frequently found in root treated, compared with non-root treated, teeth (p <0.001). In 44.3% of the cases, the technical quality of the root canal filling was inadequate. AP was detected in 14% of adequately, compared with 68.6% of inadequately, root filled teeth. There is a significant negative correlation between the technical quality of root canal treatment and the presence of AP (p <0.001). Conclusions There was a high prevalence of AP and poor technical quality root canal treatment; a strong association between AP and root filled teeth, and between the periapical health and the technical quality of the root canal treatment. The results are consistent with previous studies using similar methodology and re-confirmed that high technical quality root canal treatment is crucial to ensure a favourable treatment outcome.

Periapical Status Related to the Quality of Coronal Restorations and Root Fillings in a Korean Population

IntroductionThe purpose of this study was to assess the prevalence of apical periodontitis in root canal–treated teeth from the Korean population and to evaluate the relationship between the quality of root canal fillings and coronal restorations and the periapical status of these teeth. MethodsFull-mouth periapical radiographs at the Dental Hospital of Yonsei University, Seoul, South Korea, were examined. A total of 1030 endodontically treated teeth restored with full veneer crown–type restorations were evaluated by 2 independent examiners. Teeth were classified as healthy or diseased according to the periapical status. The quality of endodontic treatment and coronal restorations were also classified via radiographic and clinical evaluation. The data were analyzed using the chi-square test and logistic regression. ResultsForty-one percent of all endodontically treated teeth were classified as diseased. Approximately 35.6% of the teeth had endodontic treatments that were rated as adequate. The diseased teeth rate for cases with adequate endodontic treatment was 24.5%, which was significantly lower when compared with teeth with inadequate endodontic treatment (49.9%). The number of teeth with adequate coronal restorations was 706 (68.5%). Teeth with adequate coronal restorations had a significantly decreased prevalence of diseased teeth (34.7%) compared with teeth with inadequate coronal restorations (54.3%). Teeth with both adequate root fillings and restorations showed a significantly better outcome (82.3%) than the others, and teeth with both inadequate root fillings and restorations showed a significantly worse outcome (41.2%) than the others. ConclusionsData from this Korean population showed a relatively high prevalence of apical periodontitis. The quality of endodontic treatment and coronal restorations were of equal importance and were strong independent predictors of the periapical status.

Periradicular Status and Quality of Root Canal Fillings and Coronal Restorations in an Urban Colombian Population

IntroductionThis cross-sectional study determined the prevalence of apical periodontitis in 1086 root canal–treated teeth from an urban Colombian population and evaluated the association of several factors with the periradicular status. MethodsPeriapical radiographs were used for analyses, and teeth were classified as healthy or diseased according to the periradicular status. Other factors were also evaluated for their association with the periradicular conditions, including gender, quality of both endodontic treatment and coronal restoration, apical level of filling, and presence of post restoration. ResultsFifty-one percent of the treated teeth were classified as healthy. Only 33% of the teeth had endodontic treatment rated as adequate. The quality of both endodontic treatment and coronal restoration significantly influenced the periradicular conditions (P < .001). Combined data revealed that teeth with both adequate endodontic treatment and adequate restorations showed significantly better periradicular status than the other combinations (P < .01), except for teeth with adequate treatment and inadequate restoration (P = .08). Canals filled up to 0–2 mm short of the apex had a significantly higher number of teeth rated as healthy than overfilled or underfilled cases (P = .02). Regression analysis showed that the quality of endodontic treatment was the most significant factor influencing the periradicular status (P < .001). Gender and presence of post restoration had no association with the periradicular conditions. ConclusionsData from this Colombian population showed a relatively high prevalence of apical periodontitis in root canal–treated teeth. This was largely due to an equally high prevalence of treatments performed under substandard technical quality. The quality of the endodontic treatment was the most determinant factor for healthy periradicular status.

Frequency and distribution of root filled teeth and apical periodontitis in a Jordanian subpopulation

The aim of this study was to evaluate the prevalence and distribution of apical periodontitis and endodontic treatment in a Jordanian subpopulation. Digital panoramic radiographs of 294 patients who were assessed at Caritas Association between January and September 2008 were evaluated. The coronal and periapical status of all visible teeth were evaluated according to the criteria proposed by de Moor et al. Of the 294 subjects assessed, 83.7% had apical periodontitis and 63.3% had endodontically treated teeth. Of the 7,390 teeth assessed, 11.6% had apical periodontitis and 5.7% were endodontically treated. A correlation was found between apical periodontal lesions and endodontically treated teeth. Endodontic treatment was inadequate in 72.4% of the endodontically treated teeth, of which 87.0% had apical periodontitis. No difference in the number of endodontically treated teeth or the presence of apical periodontitis was found between male and female subjects (P > .05). The results of this study indicate that there is a relatively higher prevalence of apical periodontitis compared with those of many other countries. High percentage of endodontically treated teeth was inadequate and associated with periapical pathosis, indicating a poor quality of endodontic treatment.

Periapical Status and Quality of Root Fillings and Coronal Restorations in an Adult Turkish Subpopulation

To investigate the quality of root fillings and coronal restorations and their association with periapical status in an adult Turkish subpopulation. A total of 400 subjects were examined. Panoramic radiographs of all participants and additional periapical radiographs of affected teeth were processed. The frequency of root canal treatment and the periapical status of all root filled teeth were evaluated. The relationship between the radiographic quality of root fillings and coronal restorations was examined by chi-squared statistical analysis. A total of 9460 teeth were examined. The total number of root filled teeth was 890 (9.39%), and 658 (73.9%) had apical periodontitis (AP). There was a significant correlation between the presence of periapical pathology and inadequate root canal fillings (P<.05). Presence of AP in root filled teeth was associated with inadequate adaptation of the filling (OR=1.097; P=0.54), and with poor radiographic quality of the coronal restoration (OR=0.91; P=0.70), and with poor radiographic quality of the filling restoration (OR=0.97; P=0.92). Only 24.5% of the root fillings were adequate. The highest percentage of root fillings was found in maxillary right first molars (6.9%). The results demonstrate a low prevalence of root-filled teeth and poor quality of coronal restorations and root fillings consistent with a high prevalence of apical periodontitis in a Turkish subpopulation.

High prevalence of apical periodontitis amongst smokers in a sample of Spanish adults

To study the prevalence of apical periodontitis in smoker and nonsmoker patients. In a cross-sectional study, the records of 180 subjects, 109 smokers and 71 nonsmokers, were examined. All participants underwent a full-mouth radiographic survey incorporating 14 periapical radiographs. The periapical region of all teeth, excluding third molars, was examined. Periapical status was assessed using the Periapical Index score. Statistical analyses were conducted using the Cohen's Kappa test, analysis of variance and logistic regression. Apical periodontitis in at least one tooth was found in 74% of smokers and in 41% of nonsmokers (P < 0.01; odds ratio = 4.2; 95% C. I. = 2.2-7.9). Amongst smoker patients 5% of the teeth had apical periodontitis, whereas in nonsmoker subjects 3% of teeth were affected (P = 0.008; odds ratio = 1.5; 95% C. I. = 1.1-2.1). The percentage of root filled teeth in smoker and nonsmoker patients was 2.5% and 1.5%, respectively (P < 0.05; odds ratio = 1.7; C. I. 95% = 1.0-2.6). In this study population, smoking was significantly associated with a greater frequency of root canal treatment and with an increased prevalence of apical periodontitis.

Periapical status and quality of endodontic treatment in an adult Irish population

To determine the prevalence of apical periodontitis and the quality of root fillings in an adult Irish population using a retrospective analysis of orthopantomograms (OPGs). A systematic sample of clinical records and OPGs of 302 adult patients attending the Dublin Dental Hospital, Ireland, were screened by two examiners to determine the quality of root canal treatment and the prevalence of apical periodontitis. The operators who carried out the treatment were unknown. Two examiners inspected OPGs after inter-examiner correlation. European Society of Endodontology (ESE) guidelines were used to determine adequacy of root treatment. Of the 7427 teeth examined 2% had root fillings. Apical periodontitis was evident in 1.6% of all nonroot filled teeth whilst 33.1% of the subjects had at least one tooth with apical periodontitis. Of the root filled teeth, 25% had apical periodontitis and 52.6% were considered technically inadequate by ESE guidelines. There was a statistically significant (P < 0.05) negative correlation between the quality of the root fillings and the prevalence of apical periodontitis. Posterior root filled teeth (premolars and molars) had a greater prevalence of apical periodontitis than anterior root filled teeth. The technical quality of root fillings in an adult Irish population was poor and was consistent with a high prevalence of apical periodontitis.