Status Of Restorations Research Articles

Silver diamine fluoride modified atraumatic restorative treatment compared to conventional restorative technique on carious primary molars–A randomized controlled trial

ObjectiveTo compare the success of silver diamine fluoride-modified atraumatic restorative technique (SMART) with that of the conventional drill and fill method in restoring carious lesions in primary molars. MethodChildren (4–8years old) reporting to a tertiary care hospital setting with asymptomatic cavitated dentinal carious lesions in primary molars were randomly allocated to two groups; SMART and Conventional; and subsequently restored with Glass Ionomer Cement (GIC). Follow-up evaluations were carried out by blinded independent evaluator at 6-months intervals to assess the status of restorations. Primary outcome was the success of restorations at 24 months and the secondary outcome was the child's behaviour and acceptance of the treatment at the time of interventions. Two sample Z-test of proportion, logistic regression analysis and Chi-square test were used to compare the outcomes in two groups. ResultsA total of 226 children (SMART group, 112 and conventional, 114) were included with 280 and 282 GIC restorations placed by the SMART and the conventional method respectively. At 24-months, 459 (81.6 %) primary molars were available for evaluation. Success rates of restorations was 38.4 % and 45.8 % % in SMART and conventional groups respectively (p = 0.105). The rate of acceptability of treatment in the SMART and conventional group was 79 % and 56 % (p<0.001) respectively. ConclusionThere was no significant difference in the success rates of GIC restorations by SMART and conventional technique in carious primary molars at 24 months. SMART was better accepted by children as compared to the conventional restorative technique. Clinical significanceSMART can be an alternative option to treat the asymptomatic carious lesions in primary molars and is well accepted by children than the conventional drill and fill technique thus implying that it has a useful role in un-cooperative children.

Indirect restorations: an update

Indirect restorative procedures are integral to clinical dentistry. Over the past 50 years however, minimally invasive, direct adhesive restorative techniques have gradually replaced many of the indications for traditional indirect restorations. While numerous indirect procedures are still carried out every year, multiple studies have demonstrated that these restorations have limited longevity and are subject to a wide range of clinical complications, including the reduction in lifespan of the restored teeth and an increased risk of dento-legal problems. This article provides an update on the current status of indirect restorations and presents a comprehensive step-by-step guide to optimising all clinical stages, including case selection, patient assessment, diagnosis, aesthetic considerations, treatment planning, tooth preparation design, impression techniques, temporization, cementation and maintenance. CPD/Clinical Relevance: In contemporary dental practice there is a reduced need for indirect restorations. When indicated however, all clinical stages must be optimised to maximize longevity and minimise complications.

Evaluation of the marginal adaptation and gingival status of full-crown restorations using an intraoral camera

ObjectiveThe purpose of this study was to compare the usefulness of intraoral photographs, acquired with a household intraoral camera operating in conventional, calibrated, and polarized modes, with clinical examinations for assessing the marginal adaptation and gingival status of full-crown restorations.MethodsClinical examinations were performed by a prosthodontist who classified the marginal adaptation of full-crown restorations according to FDI World Dental Federation criteria, and a periodontal expert who classified gingival status according to the Modified Gingival Index (MGI). The margins and gingival status of the conventional, calibration, and polarization groups of full-crown restorations were independently assessed by three evaluators who obtained photographs using an intraoral camera. Cases where at least two of three assessors were in agreement were analyzed using Cohen’s kappa coefficient and the chi-square test, and the sensitivity and specificity were calculated.ResultsThe conventional, calibration, and polarization groups differed significantly in marginal and gingival status of full-crown restorations. In the calibration group, there was good agreement between the camera-based and oral clinical examinations in terms of the gingival status of full-crown restorations (kappa = 0.945), with 100% sensitivity and 91.67% specificity; this was also the case in the polarization group with respect to the margins of full-crown restorations (kappa = 0.917, sensitivity = 97.22%, specificity = 94.44%).ConclusionsAn intraoral camera with black and white calibrated images is useful to assess the gingival status of full-crown restorations. Polarization mode can be used to assess the marginal adaptation of full-crown restorations. The camera is a feasible and valid diagnostic aid.

Associations between Oral Health and Cannabis Use among Adolescents and Young Adults: Implications for Orthodontists.

Cannabis use is prevalent among adolescents and young adults in the US. Virtually all modes of cannabis consumption involve the oral cavity, and previous studies have linked cannabis use with poorer oral health. We sought to identify associations between cannabis use and various oral health outcomes and behaviors among individuals 12-25 years of age, and to discuss implications for orthodontists who largely interact with this age group over an extended period of treatment time. We examined data from patient electronic health records (N = 14,657) obtained between 2015 and 2021. Associations between lifetime and current self-reported cannabis use and several oral health outcomes or related behaviors that reflect periodontal health, caries status, oral lesions, and physical integrity of tooth structure and restorations were examined in a bivariable and multivariable manner, controlling for patient age, sex, and self-reported tobacco and alcohol use. Reporting lifetime cannabis use was associated with higher risk for having oral lesions (aPR = 1.41, 95% CI: 1.07-1.85), bruxism (aPR = 1.31, 95% CI: 1.09-1.58), and frequent consumption of sugary beverages and snacks (aPR = 1.27, 95% CI: 1.12-1.41). Reporting current cannabis use was associated with higher risk for oral lesions (aPR = 1.45, 95% CI: 1.03-2.06) and frequent consumption of sugary beverages and snacks (aPR = 1.26, 95% CI: 1.07-1.48). Cannabis users aged 12-25 are at increased risk for bruxism, oral lesions, and frequent consumption of sugary beverages and snacks. Orthodontists and other dental professionals should probe for drug use and be cognizant of increased risk for oral health problems in patients that report actively using cannabis.

Follow-up of first permanent molar restorative treatment with and without Molar Hypomineralization.

Hypomineralization (MH) are controversial. The aim of this study was to compare need for treatment and status of restorations performed on first permanent molars in patients with and without MH. Retrospective design based on the clinical records of 153 patients who had received comprehensive care in 2014 at the Clinic of the Children's Comprehensive Dentistry Department (FOUBA) by 3 pediatric dentists (Kappa MH 0.94), and who attended periodical follow-up visits for at least 24 months. Need for treatment in first molars, and type and longevity of treatment were recorded (modified Ryge criteria /USPHS, Kappa 0.78). Results were compared between patients with MH and without MH. The Kruskal Wallis test was used to compare follow-up time, the asymptotic test was performed to compare proportions, and relative risk (RR) was calculated to compare need for treatment. Mean follow-up times for the 595 teeth analyzed were 61.7±20.1 months for Group without MH, and 57.5±23.9 months for Group with MH (p=0.0504). The percentages of teeth requiring at least one treatment were 7.2% in Group without MH and 27.5% in Group with MH (RR = 3.80, p <0.001). Of the teeth treated in Group with MH 23.1% required retreatment, while none of the teeth in Group without MH did. The need for treatment was approximately 4 times higher in molars affected with MH, with greater probability of retreatment.

Comparison of Short-Term Restorative Effects and Periodontal Health Status of Restorations Made of Different Materials in Full-Crown Restoration of Mandibular Premolar Tooth Defects.

Purpose To compare the short-term restorative effect and periodontal health status of restorations with different materials in full-crown restoration of mandibular premolar tooth defects. Methods A total of 105 cases (123 affected teeth) of mandibular premolar tooth defects who visited the Department of Stomatology between January 2019 and January 2020 were selected, of which 58 cases (68 affected teeth) restored with cobalt-chromium alloy porcelain crowns were included in the metal-ceramic crown (MCC) group and 47 cases (55 affected teeth) repaired by zirconium dioxide all-ceramic crowns were assigned to the zirconia crown (ZC) group. The restorative effect, inflammatory factors (high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α)) and periodontal health indicators (human cartilage glycoprotein-39 (YKL-40), resistin, aspartate aminotransferase (AST), and alkaline phosphatase (ALP)) after treatment, and the occurrence of adverse reactions were compared between the two groups. Results The ZC group outperformed the MCC group in terms of margin fitness, restoration fracture, gingival condition, and color matching. After restoration, hs-CRP and TNF-α were statistically decreased in both groups, while YKL-40, resistin, AST, and ALP were significantly increased; and compared with the MCC group, hs-CRP, TNF-α, YKL-40, resistin, AST, and ALP were lower in the ZC group. The ZC group also scored statistically higher in retention effect, aesthetic effect, masticatory function, voice function, and comfort. Moreover, the ZC group had a higher total effective rate and a lower incidence of adverse reactions than the MCC group, with statistical significance. Conclusions Zirconia dioxide all-ceramic crowns contribute to a better short-term restorative effect in the full-crown restoration of mandibular premolar tooth defects, with little impact on periodontal health and high patient satisfaction, which deserves popularization and application.

Endodontic retreatment due to secondary periapical injury: case report

Endodontic retreatment due to secondary periapical injury: case report

Reliability of Caries Assessment Spectrum and Treatment Tool in the Indian Subcontinent.

ABSTRACTBackground:Accurate diagnosis, reporting of caries and its consequences, is absolute mandate for planning an efficient, effective community health-care program. Literature reports indicate shortcomings of existing caries assessment tools. Caries assessment spectrum and treatment (CAST) is novice caries quantification tool, which quantifies the entire spectrum of carious lesions. This tool records give an insight into the status of restorations along with various progressive developmental stages of dental caries. This instrument has been validated for face, content, and construct by an expert group, and currently, its usage is on the rise.Aim:The aim of this study was to report the reliability of this assessment tool with regard to the primary and permanent dentition of school children and adults belonging to a south Indian district.Materials and Methods:A cross-sectional study was carried out by two trained and calibrated examiners by examining 192 school children in the age-group between 4 and 6 years and 262 adults between 19 and 69 years. The study sample was reexamined by the same examiners after a gap of 4 weeks. The κ coefficient values and percent of agreement were calculated for the data recorded from the study subjects.Results:The analyzed data showed moderate intra-examiner and inter-examiner reproducibility for either of the dentition as revealed by κ coefficient values (0.80–0.89). Inter- or intra-examiner agreement was found to be substantial to almost perfect (percent agreement above 90%) with respect to both the age-groups.Conclusion:The CAST tool seems quite promising to be the future for quantifying caries spectrum for a community or an individual.

COMPARATIVE CHARACTERISTICS OF THE EFFECTIVENESS OF DIRECT AND INDIRECT RESTORATIONS ON TEETH WITH DISCOLORATION

COMPARATIVE CHARACTERISTICS OF THE EFFECTIVENESS OF DIRECT AND INDIRECT RESTORATIONS ON TEETH WITH DISCOLORATION

An RCT of atraumatic restorative treatment for older adults: 5 year results

Objectivesto compare the survival of ART and a conventional restorative technique (CT) for restoring carious lesions in older adults after 5 years. MethodsIn this parallel randomised controlled clinical trial, 219 independently-living adults were recruited from a dental hospital/community and a geriatric day hospital. Ninety-nine patients who met the inclusion criteria and presented with carious lesions were randomly allocated to receive either ART or conventional restorations (anaesthesia, rotary instruments and resin-modified glass ionomer). The status of restorations was assessed 6 months, 1, 2 and 5 years after restoration placement. Estimates of cumulative survival were calculated for each interval between assessments and a Cox Proportional Hazards (PH) model was fitted to the interval-censored survival time. ResultsThree hundred restorations (ART n=142; CT n=158) were placed on 99 patients, 46 males and 53 females, with a mean age of 73.2, SD: 6.8 (65–90 yrs). After 5 years, ART and CT presented cumulative probability of survival of 85% and 79% (p=0.8095), respectively. Conclusions: ART presents survival rates comparable to a conventional technique, when treating older adults after 5 years. The ART approach could be a useful tool to provide dental care for older adults particularly in the nonclinical setting. (Trial Registration number: ISRCTN 76299321). Clinical RelevanceThis study shows that ART presents survival rates comparable to conventional techniques to treat carious lesions in older patients after 5 years. It is well accepted by this age cohort, and therefore could be an alternative to treat the elderly, especially those who are homebound or cannot attend the dentist.

Клінічна оцінка реставрацій із композитних матеріалів з урахуванням гігієни порожнини рота

The article describes the clinical effectiveness of restorations performed by composite materials for the restoration of hard tissues of teeth. Evaluated the status of restorations in children with different levels of oral hygiene. Influence of hygiene on the state of seals in 3,6,12 months. The aim of the study. Clinically assess the quality of restorations of chewing teeth made of composite materials with regard to oral hygiene. Material and methods of investigation. A total of 92 children aged 12-17 years were examined in whom 128 teeth with Cari I defects in Black were reconstructed with composite materials. To repair the defects, composite materials Charisma, Dipol and Esta-3 light curing were used. Results of the study and their discussion. In children with poor oral hygiene, the quality of the seals is deteriorated for all materials compared to children with good and satisfactory oral hygiene. Especially the number of teeth with violation of marginal adaptation, discrepancy of color, discomfort and marginal pigmentation increases. It should be noted that the disruption of the anatomical form of the restorations (6.9%), the appearance of roughness (8.6%), color disturbance (10.6%) and the appearance of pigmentation (17.7%) were detected more often in caries defects, Dipol. With poor oral hygiene, the violation of the anatomical structure of the restorations from the Charisma composite (2.3%) and the Esta-3 material (5.9%) is more often compared with children with good and satisfactory oral hygiene. Conclusions: Thus, the evaluation of the quality of restorations of the chewing group of teeth with composite materials showed that the level of oral hygiene significantly affects the quality of the fillings.

The association between dental proximal restorations and periodontal disease: A retrospective 10-18 years longitudinal study.

Dental restorations may be plaque retentive. The aim of this study was to evaluate the long-term association between proximal restorations and the incidence and progression of periodontal disease in well-maintained patients. Probing pocket depths (PPD), bleeding on probing (BOP), and radiographic status of proximal restorations were retrospectively retrieved from files of patients attending a specialist periodontal office. Ill-fitting margins were recorded. The association between these parameters was evaluated at baseline examination (T0), after cause-related therapy (T1) and after ≥ 10 years from T0 (T2), during which supportive periodontal therapy (SPT) was administered, using descriptive statistics, ANOVA-Bonferroni, and chi-square analyses. 1,301 teeth were examined. Mean PPD in unrestored surfaces was 3.7 ± 1.7 mm, 3.1 ± 1.3 mm, and 2.8 ± 1 mm at T0, T1, and T2, respectively. Deeper pockets were found in restored surfaces at those time points with PPD values of 4.4 ± 1.8 mm, 3.6 ± 1.4 mm, and 3.2 ± 1.1 mm, respectively (P < .001). Higher PPD values were found in restored surfaces exhibiting inadequate restorations when compared to restored surfaces with adequate restorations at all time points. These values were 4.9 ± 1.9 mm, 4.1 ± 1.5 mm, and 4 ± 1.7 mm vs 4.3 ± 1.8 mm, 3.6 ± 1.4 mm, and 3.1 ± 1.1 mm, respectively (P < .001). The present study confirmed that restorations might be detrimental to periodontal health. A significant association between the presence of proximal restorations and the incidence of periodontal disease was observed. This association was more pronounced for inadequate restorations while becoming less significant over time in patients receiving routine SPT.

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.

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.

Comprehensive Periodontal Therapy: A Statement by the American Academy of Periodontology

Comprehensive Periodontal Therapy: A Statement by the American Academy of Periodontology

Periapical Status and Quality of Root canal Fillings and Coronal Restorations in Iranian Population.

This cross-sectional survey determined the dental prevalence of apical periodontitis (AP) in selected Iranian population, and evaluated the influence of the quality of root canal treatment (RCT) and their coronal restorations (CR) on the periapical status. A total of 1064 panoramic radiographies were evaluated by two observers during 2009. The quality of RCT i.e. length/density of root fillings and CR in addition to periapical status of endodontically treated teeth were recorded. Their interrelationship was analyzed by Chi-squared, logistic regression and Spearman's rho statistics. Hosmer and Lemeshow tests were used for assessing fitness of logistic regression model and one sample k-s test was used for evaluating of normality of the data. Our results showed that 527 teeth (52%) of the endodontically treated teeth presented with AP radiographically. The percentages of teeth which fulfilled the criteria of an acceptable RCT or CR radiographically were 42.3 and 62.5 respectively. Incidence of AP among teeth with acceptable RCT (29.1%) was significantly lower than those suffering from unacceptable RCT (68.8%) (P<0.001). Moreover, adequate CR demonstrated a significantly better periapical status (58.6%) compared to teeth with inadequate CR (30.3%) (P<0.001). The incidence of AP ranged from 25.6% (good qualities) to 79.5% (bad qualities) (P<0.001). Cases with both unacceptable RCT/CR were 11 times more likely to have AP than cases with acceptable RCT/CR. The quality of RCT and CR were found to impact the periapical health of endodontically treated teeth. There are a significant high number of technically unacceptable endodontic and restorative treatments in Iran; therefore considerable efforts are needed to improve the standards of endodontic and restorative treatments.

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.

Multilevel modelling of clustered grouped survival data using Cox regression model: an application to ART dental restorations

In some controlled clinical trials in dental research, multiple failure time data from the same patient are frequently observed that result in clustered multiple failure time. Moreover, the treatments are often delivered by more than one operator and thus the multiple failure times are clustered according to a multilevel structure when the operator effects are assumed to be random. In practice, it is often too expensive or even impossible to monitor the study subjects continuously, but they are examined periodically at some regular pre-scheduled visits. Hence, discrete or grouped clustered failure time data are collected. The aim of this paper is to illustrate the use of the Monte Carlo Markov chain (MCMC) approach and non-informative prior in a Bayesian framework to mimic the maximum likelihood (ML) estimation in a frequentist approach in multilevel modelling of clustered grouped survival data. A three-level model with additive variance components model for the random effects is considered in this paper. Both the grouped proportional hazards model and the dynamic logistic regression model are used. The approximate intra-cluster correlation of the log failure times can be estimated when the grouped proportional hazards model is used. The statistical package WinBUGS is adopted to estimate the parameter of interest based on the MCMC method. The models and method are applied to a data set obtained from a prospective clinical study on a cohort of Chinese school children that atraumatic restorative treatment (ART) restorations were placed on permanent teeth with carious lesions. Altogether 284 ART restorations were placed by five dentists and clinical status of the ART restorations was evaluated annually for 6 years after placement, thus clustered grouped failure times of the restorations were recorded. Results based on the grouped proportional hazards model revealed that clustering effect among the log failure times of the different restorations from the same child was fairly strong (corr(child)=0.55) but the effects attributed to the dentists could be regarded as negligible (corr(dentist)=0.03). Gender and the location of the restoration were found to have no effects on the failure times and no difference in failure times was found between small restorations placed on molars and non-molars. Large restorations placed on molars were found to have shorter failure times compared to small restorations. The estimates of the baseline parameters were increasing indicating increasing hazard rates from interval 1 to 6. Results based on the logistic regression models were similar. In conclusion, the use of the MCMC approach and non-informative prior in a Bayesian framework to mimic the ML estimation in a frequentist approach in multilevel modelling of clustered grouped survival data can be easily applied with the use of the software WinBUGS.

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 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.