IMPACT OF THE QUALITY OF ROOT CANAL FILLING ON THE PERIAPICAL STATUS
Keywords:
endodontics, endodontic outcome, periapical lesions, periapical radiography root canal treatment qualityAbstract
The relationship between the quality of endodontic treatment and the prevalence of apical periodontitis has been demonstrated in a number of epidemiological studies. In addition to providing insight into the oral health status of the population, epidemiological studies are a relevant source of data for health care policy and further planning directions. The aim of the study was to obtain detailed data on the quality of root canal treatments performed through radiological examination, the frequency of periapical changes in treated teeth and their relationship with the quality of endodontic treatments. Methods: The material required for the realization of the set goal was 1300 orthopantomographic images taken over a period of two years in 1300 patients at the University Dental Clinical Center "St. Panteleimon" in Skopje. The subjects were divided into six groups according to age. To be included in the study, patients had to be older than 18 years; have at least 10 remaining teeth and at least one tooth where endodontic therapy was performed. The following were monitored: 1. the quality of the performed endodontic therapy monitored through the condition of the canal filling and 2. the condition of the apical periodontium, classified according to the modification of the periapical index (PAI). Results: This paper is a cross
sectional/translational study, based on retrospective follow up of radiographic data, a study in which we included 1300 subjects after exclusion selection, in which 3273 endodontically treated teeth and over 5000 roots were evaluated. The quality of the performed endodontic therapies was mostly unsatisfactory. The most common finding was too short or inhomogeneous fillings, confirmed in 37.36% of cases, clinically acceptable fillings were determined in 31.92% of teeth, and excellent endodontics in 24.11% of cases. Overfilled canals and canals with a visible fragment of a fractured instrument were rarely observed. According to the results of the periapical index, the majority of this group of analyzed roots had normal periapical structures 3122(60.83%). Small changes in bone structure were found in 1551 (30.22%) roots, changes in bone structure with some mineral loss in 339 (6.61%), periodontitis with a well defined radiolucent area. was shown in a small part of the treated roots 70 (1.36%) and 50 (0.97%), respectively. The most common finding of normal periodontium and was statistically confirmed as significant, (p<0.0001) The quality of filling the root canals and the value of the periapical index significantly correlate with each other (p < 0.0001). The correlation is of a negative, indirect type (R = 0.376), and shows that with an increase in the value of the periapical index, the quality of filling the root canals decreases. Conclusion: Endodontic therapy is generally unsuccessful in the studied material. Inadequate therapy is correlated with the presence of apical periodontitis. Efforts are needed to improve the quality of endodontic therapy in order to reduce the incidence and prevalence of apical periodontitis
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