Quality Of Coronal Restoration Research Articles

Periapical status and quality of root canal fillings and coronal restorations in India

Aim: The aim of the study was to evaluate the periapical status and quality of root canal fillings and coronal restoration using postoperative radiographs. Materials and Methods: Postoperative periapical radiographs were collected from Swami Devi Dyal Hospital and Dental College and private clinics of district Panchkula. Final the sample consisted of 776 root-filled teeth with 1480 root canals. Radiographs, where the root canal treatment (RCT) was not completed or whose radiographic quality was poor, were excluded. Length, density and taper of root fillings, quality of coronal restoration, crown and periapical status of tooth were recorded. Length of root fillings was recorded as adequate, short or over- filled in relationship with radiographic apex. Density and taper of root fillings, coronal restoration and crown was recorded as adequate or inadequate. Periapical status was recorded according to periapical index (PAI). Results were evaluated statistically using one-way analysis of variable (ANOVA) and Chi-square analysis. Results: Total of 42.4%, 70.3%, and 81.1% of the root fillings had adequate length, density and taper respectively. Total of 57.8% and 69.7% of teeth had adequate coronal restoration and crown, respectively, whereas 50% of the root fillings and teeth fulfilled the above criteria at the same time. The relationship between length, density of root fillings and presence of canal curvature was not significant statistically whereas the relationship between taper of root filling and presence of canal curvature was statistically significant ( P Conclusion: In this study, half of the root filled teeth were not treated according to accepted endodontic guidelines. Apical periodontitis was uncommon in root-filled teeth.

Impact of the quality of coronal restoration and root canal filling on the periapical health in adult syrian subpopulation.

Background:The purpose of this study was to determine the status of periapical tissues of endodontically treated teeth according to coronal restorations and root canal fillings separately and in concomitant in adult Syrian subpopulation.Methods:784 endodontically treated teeth from two hundred randomly selected Syrian adult patients were radiographically evaluated. According to predetermined criteria, the quality of coronal restorations and root canal filling of each tooth was scored as adequate or inadequate. The status of periapical tissues was also classified as healthy or diseased. Results were analyzed using Chi-squared test.Results:Adequate coronal restorations were determined in 58.54% of cases which was accompanied with less periapical pathosis than that in teeth with inadequate restorations (P < 0.01). 14% of teeth were restored by posts which showed no significant impact on the periapical tissues health. 18.5% of endodontic treatments were evaluated as adequate with less number of periapical radiolucencies than that of inadequate root canal fillings (P < 0.01). Absence of periapical pathosis was 96.6% in cases with both adequate coronal restorations and root canals fillings. The rate was 88.5% in cases with only adequate root canals fillings, and about 70% in cases with only adequate coronal restorations. When the treatment was inadequate in both coronal and root canals fillings, success rate was only observed in 48.8%.Conclusion:The most important factor with regard to the periradicular tissue health is the quality of root canal filling without neglecting the influence of coronal restoration (regardless of its type). There is a high prevalence rate of periapical pathosis in Syrian subpopulation due to poor dental practice.

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.

Periapical Health Related to the Quality of Coronal Restorations and Root Fillings in a Turkish Population

800x600 Objectives: The aim of the present study was to evaluate the quality of root canal treatments and coronal restorations investigating their influence on the periapical status of endodontically-treated teeth in a Turkish population based on radiographic examination. Materials and Methods: The study included 583 patients referred for routine dental care. A total of 1125 endodontically treated teeth were examined with panoramic radiographs. The quality of root canal fillings and coronal restorations were evaluated according to the criteria determined by Gunduz et al., which were slightly modified from those described by De Moor et al. Apical status was assessed by the Periapical Index (PAI) scores. Results: Out of 1125 endodontically treated teeth, 539 were classified as healthy and 586 as displaying apical periodontitis. Of these 539 subjects, 389 teeth had received quality endodontic treatment. Of 586 teeth with apical periodontitis, 500 had poor endodontic treatment. Four hundred and seventy-five teeth had adequate root canal fillings. Of these teeth, 389 were classified as healthy. Of the 666 teeth with adequate restoration, apical region was classified as healthy for 410 subjects. For the 388 teeth with both adequate coronal restorations and root canal fillings, the success rate was 85.3%. For the 372 teeth with both inadequate coronal restorations and root canal fillings, the success rate was 18.8%. Conclusions: The quality of root fillings in the population living in the back country of Turkey is in general below the acceptable standard and requires substantial improvement. Normal 0 21 false false false TR X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:Normal Tablo; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:Calibri,sans-serif;}

The Effect of Preformed Metal Crowns on Primary Molars’ Exfoliation Time

Many factors contribute to the exfoliation of teeth. However, none of the local factors mentioned in the literature was the quality of coronal restorations. The aim of this research was to study the relation between restoring primary molars with preformed metal crowns and exfoliation process. Five hundred and fifty dental records of healthy children undergoing comprehensive dental treatment at the Faculty of Dentistry, King Abdulaziz University hospital in Jeddah were reviewed. Out of the 550 reviewed dental records, 140 records satisfied the inclusion criteria. Exfoliation time was recorded as on time, early or late. Undesirable exfoliation time was shown in 39 (27.9%) of the crowned primary molars (experimental) group compared to zero (0.00%) of primary molars in the control group. There was a statistically significant difference between both groups regarding the exfoliation time. However, within the experimental group, a relationship between crowned primary molars with pulp therapy or crowned primary molars without pulp therapy and exfoliation time was reported. This study showed no statistically significant difference between both groups, respectively. Our data suggest that preformed metal crowns might affect the exfoliation time of primary molars by either accelerating or delaying exfoliation.

Perawatan endodontik konvensional pada gigi molar pertama kanan rahang bawah dengan kista radikuler Conventional endodontic treatment in lower right first molar with radicular cyst

Abnormalities of the teeth that have had periapical endodontic treatment generally due to recurrent infections of root canal. Infection of the root canal is caused by leakage due to poor quality of coronal restoration and iatrogenicfactors. Root canal treatment of the tooth with periapical cyst generally do conventionally. Medication materialsused for healing of periapical lesions is calcium hydroxide, since it has properties not irritating, alkaline pH andantibacterial capabilities, so it is a biological stimulator for the formation of hard tissue in the area of damage andis expected to accelerate the healing process. It was reported the case of a 23-year-old student came to the Dentalclinic of Conservation Specialist RSGM Sekeloa with complaints lower right back teeth has restored with amalgam,no pain, but less comfortable when chewing. The results obtained after treatment with calcium hydroxide andmedikamen gutta percha filling with resin-based root canal cement. Approximately 4 months later, the periapicalradiolucent area had thinned. So it was concluded that conventional endodontic treatment proved to heal periapicallesions including cysts, as long as the treatment is taken adequately.

Root-filled teeth with adequate restorations and root canal treatment have better treatment outcomes

Medline, Embase, the Cochrane Library, the Wiley online database, four journals (Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology and Endodontics and Dental Traumatology) and the references of identified articles were searched manually. There was no language restriction. Clinical studies that provided sample size, and where success was based on radiographic and/or clinical criteria that evaluated quality of root filling, the quality of coronal restoration and periapical status at least one year after root canal treatment that provided an overall success rate or sufficient data to allow it to be calculated from the raw data were included. Data were collected based on predetermined criteria. Percentages of teeth without apical periodontitis were recorded for each category: adequate root canal treatment (AE); inadequate root canal treatment (IE); adequate restoration (AR); and inadequate restoration (IR). Data were analysed using meta-analysis for odds ratios (ORs). Nine article were included . After adjusting for significant covariates to reduce heterogeneity, the results were combined to obtain pooled estimates of the common OR for the comparison of AR/AE versus AR/IE:-AR/AE versus AR/IE (OR = 2.734; 95%CI, 2.61-2.88; P < .001)AR/AE versus IR/AE (OR = 2.808; 95% CI, 2.64-2.97; P < .001). On the basis of the current best available evidence, the odds for healing of apical periodontitis increase with both adequate root canal treatment and adequate restorative treatment. Although poorer clinical outcomes may be expected with adequate root filling-inadequate coronal restoration and inadequate root filling-adequate coronal restoration, there is no significant difference in the odds of healing between these two combinations.

Cross-sectional evaluation of the periapical status as related to quality of root canal fillings and coronal restorations in a rural adult male population of Turkey

BackgroundTo determine the prevalence of periapical lesions in root canal-treated teeth in a rural, male adult, Turkish population and to investigate the influence of the quality of root canal fillings on prevalence of periapical lesions.MethodsThe sample for this cross-sectional study consisted of 552 adult male patients, 18-32 years of age, presenting consecutively as new patients seeking routine dental care at the Dental Sciences of Gulhane Military Medicine, Ankara. The radiographs of the 1014 root canal-treated teeth were evaluated. The teeth were grouped according to the radiographic quality of the root canal filling and the coronal restoration. The criteria used for the examination were slightly modified from those described by De Moor. Periapical status was assessed by the Periapical Index scores (PAI) proposed by Orstavik.ResultsThe overall success rate of root canal treatment was 32.1%. The success rates of adequately root canal treatment were significantly higher than inadequately root canal treatment, regardless of the quality or presence of the coronal restoration (P < .001). In addition, the success rate of inadequate root canal treatment was also significantly affected by the quality of coronal restorations.ConclusionsOur results revealed a high prevalence of periapical lesions in root canal treatment, which is comparable to that reported in other methodologically compatible studies from diverse geographical locations. In addition, the results from the present study confirm the findings of other studies that found the quality of the root canal treatment to be a key factor for prognosis with or without adequate coronal restoration.

Endodontic Outcome Predictors Identified with Periapical Radiographs and Cone-beam Computed Tomography Scans

Introduction The outcome predictors identified with data from periapical radiographs (PA) and cone-beam computed tomography (CBCT) scans might not be the same. This retrospective study evaluated various factors that might affect the outcome of root canal therapy. Methods In total, 115 teeth (143 roots) with vital pulps were endodontically treated and followed up 2 years after treatment. Multivariate logistic regression was performed on the data from PA or CBCT to analyze outcome predictors. Results At recall, PA detected periapical lesions in 18 roots (12.6%), as compared with 37 on CBCT images (25.9%). The length and density of root filling determined by PA and CBCT were often different ( p < .001). Overall, 20 of the 25 short root fillings (80%) diagnosed by PA appeared as flush fillings on CBCT images. PA revealed 23 root fillings (16.1%) with voids, as compared with 66 on CBCT images (46.2%). When findings from PA were analyzed, density and apical extent of root filling were identified as predictors ( p < .05). When findings from CBCT were analyzed, density of root filling and quality of coronal restoration influenced the outcome significantly ( p ≤ .001), whereas gender, tooth type, root curvature, number of visits, CBCT-determined apical extent of root filling, and use as abutment did not ( p > .1). Conclusions Treatment outcome, length and density of root fillings, and outcome predictors as determined with CBCT scans might not be the same as corresponding values determined with PA.

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.

Cross‐sectional study of endodontic treatment in an Australian population

The quality and technical standard of Australian endodontic treatment is generally unknown. Two hundred and forty-three patients from a metropolitan dental hospital were radiographically assessed for quality of root canal therapy. Total teeth examined were 5647 with 499 teeth (8.84%) being root-filled. Teeth were scored using Ørstavik's Periapical Index. Periapical Index scores indicating a healthy periapical state were found in 392 root-filled teeth (78.56%) and those indicative of periapical disease in 107 root-filled teeth (21.43%). Of the 499 root-filled teeth, 149 (29.9%) were adequate in terms of length, with 120 teeth (80.5%) of these healthy. Three hundred and fifteen teeth (63.1%) were filled short with 271 (86.0%) classified as healthy. Thirty-five teeth (7.0%) were filled long with only one tooth (2.9%) in this category deemed healthy. Four hundred and fifty-nine teeth (92.0%) were adequate in density, with 365 teeth (79.5%) being healthy. Forty teeth (8.0%) showed inadequate density with 27 (67.5%) being healthy. One hundred and forty-five teeth (29.1%) were adequate in length and density with 117 teeth (80.7%) deemed healthy. A significant statistical correlation between root filling quality and periapical status was not found. Factors, such as the coronal restoration quality, should be further investigated.

Prevalence of Apical Periodontitis in Root Canal–Treated Teeth From an Urban French Population: Influence of the Quality of Root Canal Fillings and Coronal Restorations

This cross-sectional study determined the prevalence of apical periodontitis in 1035 root canal–treated teeth from adult French patients and investigated the influence of the quality of canal fillings and coronal restorations on the periradicular status. Periapical radiographs were used for analyses, and teeth were classified as healthy or diseased according to the periapical index scoring system. Overall, the prevalence of apical periodontitis in root canal–treated teeth was 33%. Only 19% of the teeth had endodontic treatments rated as adequate. The success rate (number of healthy teeth) for cases with adequate endodontic treatment was 91%, which was significantly higher when compared with teeth with inadequate treatment (61%). Teeth with adequate restorations had significantly decreased prevalence of apical periodontitis (29%) as compared with teeth with inadequate restorations (41%). The combination of adequate endodontic treatment and adequate restorations yielded the highest success rate (93.5%). The quality of the endodontic treatment was the most important factor for success, although the quality of the coronal restoration also influenced the treatment outcome.

Outcome of secondary root canal treatment: a systematic review of the literature

AIMS (I): To investigate the effects of study characteristics on the reported success rates of secondary root canal treatment (2 degrees RCT or root canal retreatment); and (ii) to investigate the effects of clinical factors on the success of 2 degrees RCT. Longitudinal human clinical studies investigating outcome of 2 degrees RCT which were published upto the end of 2006 were identified electronically (MEDLINE and Cochrane database 1966-2006 Dec, week 4). Four journals (Dental Traumatology, International Endodontic Journal, Journal of Endodontics, Oral Surgery Oral Medicine Oral Pathology Endodontics Radiology), bibliographies of all relevant papers and review articles were hand-searched. Two reviewers (Y-LN, KG) independently assessed and selected the studies based on specified inclusion criteria and extracted the data onto a pre-designed proforma, independently. The criteria were: (i) Clinical studies on 2 degrees RCT; (ii) Stratified analyses available for 2 degrees RCT where 1 degrees RCT data included; (iii) Sample size given and larger than 10; (iv) At least 6-month post-operative review; (v) Success based on clinical and/or radiographic criteria (strict = absence of apical radiolucency; loose = reduction in size of radiolucency); and (vi) Overall success rate given or could be calculated from the raw data. Three strands of evidence or analyses were used to triangulate a consensus view. The reported findings from individual studies, including those excluded for quantitative analysis, were utilized for the intuitive synthesis which constituted the first strand of evidence. Secondly, the pooled weighted success rates by each study characteristic and potential prognostic factor were estimated using the random effect model. Thirdly, the effects of study characteristics and prognostic factors (expressed as odds ratios) on success rates were estimated using fixed and random effects meta-analysis with DerSimonean and Laird's methods. Meta-regression models were used to explore potential sources of statistical heterogeneity. Study characteristics considered in the meta-regression analyses were: decade of publication, study-specific criteria for success (radiographic, combined radiographic & clinical), unit of outcome measure (tooth, root), duration after treatment when assessing success ('at least 4 years' or '<4 years'), geographic location of the study (North American, Scandinavian, other countries), and qualification of the operator (undergraduate students, postgraduate students, general dental practitioners, specialist or mixed group). Of the 40 papers identified, 17 studies published between 1961 and 2005 were included; none were published in 2006. The majority of studies were retrospective (n = 12) and only five prospective. The pooled weighted success rate of 2 degrees RCT judged by complete healing was 76.7% (95% CI 73.6%, 89.6%) and by incomplete healing, 77.2% (95% CI 61.1%, 88.1%). The success rates by 'decade of publication' and 'geographic location of study' were not significantly different at the 5% level. Eighteen clinical factors had been investigated in various combinations in previous studies. The most frequently and thoroughly investigated were 'periapical status' (n = 13), 'size of lesion' (n = 7), and 'apical extent of RF' (n = 5) which were found to be significant prognostic factors. The effect of different aspects of primary treatment history and re-treatment procedures has been poorly tested. The pooled estimated success rate of secondary root canal treatment was 77%. The presence of pre-operative periapical lesion, apical extent of root filling and quality of coronal restoration proved significant prognostic factors with concurrence between all three strands of evidence whilst the effects of 1 degrees RCT history and 2 degrees RCT protocol have been poorly investigated.

The relation between apical periodontitis and root‐filled teeth in patients with periodontal treatment need

To investigate a number of clinical and treatment variables that might have influenced the prevalence of apical periodontitis in root-filled teeth in a population of periodontally compromised patients. This investigation was a retrospective cross-sectional study on data collected from periodontal charts in addition to intra-oral full-mouth radiographs from patients attending the Department of Periodontology of the Dental School of the Ghent University Hospital. Periodontal parameters (clinical attachment loss and the lowest marginal bone level, the history of periodontal treatment), endodontic treatment (length, homogeneity and overall quality of the root filling) and the quality of coronal restorations were related to the prevalence of apical periodontitis. A total of 272 root-filled teeth in 94 patients were evaluated. The periapical condition was significantly influenced by the quality of the root filling and the coronal filling (P < 0.05). More apical periodontitis was seen when the coronal level of the root filling exceeded the marginal bone level (P < 0.005). The marginal periodontal condition seemed to influence the periapical status. Teeth with apical periodontitis were associated with significantly more extended marginal bone loss (P < 0.001). Significantly less apical periodontitis was seen in patients that had received marginal periodontal treatment (P < 0.005), compared with untreated periodontal patients. Signs of periodontal disease, as reflected by marginal bone loss, are of importance for the periapical condition of root-filled teeth. Efforts should be taken in preventing spread of infection through the periodontal-endodontic pathway by periodontal infection control and a high quality of root filling and coronal filling. Care should also be taken to seal the coronal cavity up to the level of the root filling, where it is advisable to reduce the coronal level of the root filling below or at least at the level of the surrounding marginal bone.

Periradicular status related to the quality of coronal restorations and root canal fillings in a Brazilian population

This cross-sectional study was undertaken to determine the prevalence of periradicular lesions in root-filled teeth from an urban adult Brazilian population, and to investigate the quality of root canal fillings and coronal restorations and their association with the periradicular status of these teeth. Root canal fillings from 2,051 teeth were categorized as adequate or inadequate on the basis of root canal filling length and homogeneity. Coronal restorations from the same teeth were categorized into adequate, inadequate, or absent. Results were analyzed statistically using the chi-squared test. The overall success rate of root-filled teeth was 49.7%. Cases with adequate endodontic treatment and adequate restorations had a success rate of 71%. When cases with adequate treatment and inadequate restoration were evaluated, the success rate was 65%. Cases with adequate treatment and absent restoration showed a success rate of 48%. Teeth with inadequate treatment combined with adequate restoration yielded a success rate of 38%, whereas the combination of inadequate treatment and inadequate restoration resulted in a success rate of 25%. Teeth with inadequate treatment and absent restoration showed the lowest success rate of this study (18%). Data analysis revealed that when the root canal filling appeared to be adequate, the quality of the restoration did not significantly influence the treatment outcome. However, when a coronal restoration was absent, the success rate of adequately treated canals was significantly reduced. The quality of the coronal restoration significantly affected the outcome of inadequately treated teeth. Our results revealed a high prevalence of periradicular lesions in root-filled teeth, which was comparable to that reported in other methodologically compatible studies from diverse geographical locations. In addition, even though the coronal restoration had a significant impact on the periradicular health, the quality of the root canal filling was found to be the most critical factor in this regard.

Investigation of the effect of the coronal restoration quality on the composition of the root canal microflora in teeth with apical periodontitis by means of T‐RFLP analysis

To investigate the effect of the radiographic and clinical quality of coronal restorations on the composition of the root canal flora of teeth with necrotic pulps and teeth with root fillings associated with apical periodontitis. Twenty-eight necrotic pulps and 35 root filled canals with signs of apical periodontitis were studied. Both the coronal filling (presence of radiographically or clinically deficient margins and/or secondary caries) and the root filling (homogeneity and length) were scored. Bacterial root canal samples were taken with sterile paper points under rubber dam and using measures to prevent contamination. A DNA-based nonculture bacterial identification technique was used, namely terminal restriction fragment length polymorphism (T-RFLP) analysis. Twelve samples were negative for bacterial DNA. A total of 33 different terminal restriction fragments (TRFs) were detected. The Fusobacterium nucleatum/Streptococcus mitis group was the most frequently encountered TRF. The mean number of TRFs per necrotic pulp was 6.2 and 5.8 for the groups with acceptable and unacceptable coronal restorations, respectively. This difference was not significant. In the root filled group, these values (respectively, 5.2 and 8.6) were statistically significantly different (P < 0.05). The following parameters in root filled teeth had no significant influence on the mean numbers of TRFs detected: the length and homogeneity of the root filling and the type of tooth (anterior-premolar-molar). T-RFLP allowed the rapid assessment of bacterial biodiversity in root canal samples. The technique revealed the presence of bacteria that have rarely been described in the root canals of teeth with apical periodontitis. Biodiversity in the root filled group was high, as compared with culture-dependent studies where monoinfections were more frequently reported. Only in root filled teeth did defective coronal restorations have a statistically significant influence on the mean numbers of detected TRFs per sample.

Periapical status and quality of root fillings and coronal restorations in an adult Spanish population.

To investigate the quality of root fillings and coronal restorations and their association with periapical status in an adult Spanish population. A total of 180 subjects, aged 37.1 +/- 15.7 years, who presented as new patients at the Faculty of Dentistry, Seville, Spain, were examined. All participants underwent a full-mouth radiographic survey incorporating 14 periapical radiographs. The periapical region of all root filled teeth, excluding third molars, were examined. The technical quality of root fillings was evaluated in terms of length in relation to the root apex and lateral adaptation to the canal wall. Radiographic signs of overhang or open margins associated with coronal restorations were also evaluated. Periapical status was assessed using the Periapical Index score. Statistical analyses were conducted using the Cohen's kappa test and logistic regression. The total number of root filled teeth was 93, and 60 (64.5%) had apical periodontitis (AP). Presence of AP in root filled teeth was associated with inadequate adaptation of the filling (OR = 2.29; P = 0.06), inadequate length of the root filling (OR = 2.44; P = 0.048), and with poor radiographic quality of the coronal restoration (OR = 2.38; P = 0.054). Only 34.4% of the root fillings were adequate from a technical perspective. When both root fillings and coronal restorations were adequate the incidence of AP decreased to 31.3% (OR = 5.50; P < 0.01). The incidence of AP in root filled teeth was high. Many root fillings were technically unsatisfactory. Adequate root fillings and coronal restorations were associated with a lower incidence of AP; an adequate root filling had a more substantial impact on the outcome of treatment than the quality of the coronal restoration.

Periapical health related to the quality of coronal restorations and root fillings.

To evaluate the impact of the quality of coronal restorations scored on a clinical and radiographic basis and the quality of root fillings on periapical health. Periapical radiographs were taken of 745 root-filled teeth, randomly selected from patients attending the Ghent University Dental School. The teeth had not received restorative treatment in the previous year. The coronal status was scored both clinically according to modified Ryge's criteria, and radiographically by evaluating the presence of signs of marginal leakage or decay. The quality of the root filling was scored according to criteria of length and homogeneity and the periapical status was categorized on the basis of presence or absence of radiographic signs of apical periodontitis. The relationship between coronal status, quality of root filling and periapical health was determined. The data were analyzed using Chi2 test, Odds ratio, Spearman's r(S) and logistic regression. Thirty-three percent of the teeth had apical periodontitis as diagnosed radiographically. Teeth with good and poor coronal restorations scored clinically had apical periodontitis in 31.1 and 36.8%, respectively; this difference was not statistically significant. The quality of the coronal restorations scored radiographically had a statistically significant influence on the periapical condition (P<0.001) with apical periodontitis in 23.8 and 49.1%, respectively, for acceptable and unacceptable restorations. Marginal decay did not influence the periapical status. Teeth restored without a base under the coronal filling had apical periodontitis in 41.3%, whereas teeth with a base had significantly less (P<0.005) apical periodontitis (25.9%). Composite-restored teeth exhibited apical periodontitis in 40.5% of cases whilst amalgam-restored teeth had apical periodontitis in 28.4% of cases; this difference was statistically significant (P<0.01). Root-canal posts had no influence on periapical health. The length and homogeneity of the root-canal fillings had a significant influence (P<0.01 and P<0.001, respectively) on the presence of apical periodontitis, as well as the quality of the coronal restoration scored radiographically (P<0.001). The importance of a good coronal restoration, as well as of a good root filling should be emphasized as the technical quality of both influencing the periapical status.

Periapical status and quality of root fillings and coronal restorations in a Danish population

The aim of this study was to investigate the quality of endodontic and coronal restorations and the association with periapical status in a Danish population. A total of 614 randomly selected individuals (20-60+ years of age) from Aarhus County had a full-mouth radiographic examination. The quality of endodontic and coronal restorations and the periapical status of endodontically treated teeth were assessed by radiographic criteria. Root fillings were categorized as 'adequate' or 'inadequate' with regard to root filling length and lateral seal. Coronal restorations were categorized into 'adequate' and 'inadequate', defined by the absence or presence of radiographic signs of overhangs or open margins. Results were analysed statistically using the chi-squared test. The total number of endodontically treated teeth was 773, and 52.3% had apical periodontitis (AP). Root-filled teeth with an adequate lateral seal had a lower incidence of AP than teeth with an inadequate seal (44.3% vs. 57.8%), and teeth with an adequate root filling length were associated with a better periapical status than teeth with inadequate length of the root filling (42.0% vs. 67.6%). Similarly, adequate coronal restorations were associated with better periapical status than inadequate restorations (48.0% vs. 63.9%). When both root filling and coronal restoration quality were assessed, the incidence of AP ranged from 31.2% (optimal quality) to 78.3% (all parameters scored as inadequate). Inadequate root canal and coronal restorations were associated with an increased incidence of AP.