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. 2017 Dec 12;17(1):147.
doi: 10.1186/s12903-017-0429-7.

Apical periodontitis in southern Estonian population: prevalence and associations with quality of root canal fillings and coronal restorations

Veiko Vengerfeldt  1 , Reet Mändar  2   3 , Minh Son Nguyen  1   4 , Silvia Saukas  1 , Mare Saag  1
Affiliations

Apical periodontitis in southern Estonian population: prevalence and associations with quality of root canal fillings and coronal restorations

Veiko Vengerfeldt et al. BMC Oral Health. .

Abstract

Background: Apical periodontitis (AP) is an inflammatory disease around the apex of a tooth root. Reported prevalence of AP ranges from 27% to 83% while the data about most post-Soviet countries are still missing. Knowing the prevalence of AP within a certain population helps to plan the treatment need and evaluate the success of endodontic interventions. We aimed to collect data about prevalence and determining factors of AP for the first time in Estonia.

Methods: The cross-sectional study included 6552 patients (age 35.5±19.2 years). Radiographic examination was applied to investigate the prevalence of AP and quality of endodontic treatment.

Results: AP was diagnosed in 54.7% of subjects. Endodontically treated teeth were present in 58.2% of subjects. Periapical finding was present in 44.6% of endodontically treated and in 30.8% of untreated teeth. Out of 181,495 teeth, 52.7% were intact. AP was diagnosed in 6.3% of teeth, 6.9% of teeth were endodontically treated. Risk factors for AP included caries (OR = 2.30), male gender (OR = 1.44), too short (OR = 1.76) or too long root canal filling (OR = 2.51), root canal filling of low density (OR = 1.61) while not orthodontic appliance. Lower AP risk was associated with restoration of the tooth - filling (OR = 0.45), crown (OR = 0.34) and bridge (OR = 0.33).

Conclusions: AP is highly prevalent in Southern Estonian population. Most cases are associated with root canal-treated teeth. The overall quality of root canal fillings tends to be low, consistent with the mediocre outcome of treatment. Considerable efforts are required to improve the standards of endodontic treatment.

Keywords: Apical periodontitis; Epidemiology; Quality of restoration; Quality of root canal filling.

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Conflict of interest statement

Ethics approval and consent to participate

The study was conducted in compliance with the "Ethical principles for medical research involving human subjects" of Helsinki Declaration and approved by Ethics Review Committee (ERC) on Human Research of the University of Tartu (protocol no: 246/T-19). Written informed consent was obtained from the human subjects. All of the collected data were coded and isolated; personal data and measurements data were kept separately.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Overview of the study subjects. Altogether 3584 subjects with AP were investigated (of them 2021 had pAP at least in one tooth and 2920 had sAP at least in one tooth) as well as 2968 subjects without current AP. Legend: AP, apical periodontitis; pAP, primary AP; sAP, secondary AP; RCT, root canal treatment; hRCT, healthy RCT in other teeth; +, present; −, absent
See this image and copyright information in PMC

References

    1. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposure of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 1965;20:340–349. doi: 10.1016/0030-4220(65)90166-0. - DOI - PubMed
    1. Siqueira JF, Jr, Rocas IN. Bacterial pathogenesis and mediators in apical periodontitis. Braz Dent J. 2007;18:267–280. doi: 10.1590/S0103-64402007000400001. - DOI - PubMed
    1. Graunaite I, Lodiene G, Maciulskiene V. Pathogenesis of apical periodontitis: a literature review. J Oral Maxillofac Res. 2011;2:e1. doi: 10.5037/jomr.2011.2401. - DOI - PMC - PubMed
    1. Márton IJ, Kiss C. Overlapping protective and destructive regulatory pathways in apical periodontitis. J Endod. 2014;40:155–163. doi: 10.1016/j.joen.2013.10.036. - DOI - PubMed
    1. Gomes MS, Blattner TC, Sant'Ana Filho M, Grecca FS, Hugo FN, Fouad AF, et al. Can apical periodontitis modify systemic levels of inflammatory markers? A systematic review and meta-analysis. J Endod. 2013;39:1205–1217. doi: 10.1016/j.joen.2013.06.014. - DOI - PubMed

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