Changes in periapical status, quality of root fillings and estimated endodontic treatment need in a similar urban German population 20 years later

Abstract

Objectives: The study aimed at assessing, as primary objective, the periapical status and quality of root fillings, and, as secondary objective, the endodontic treatment need of a German urban population in a cross-sectional study 20 years after the first one.

Materials and methods: Clinical and radiographic data of 353 patients were evaluated. Descriptive and regression analyses were performed and the endodontic treatment need was calculated. Results were compared with data from the year 1993.

Results: A total of 9269 teeth were examined (26.2 teeth per patient; 1993, 24.4), of which 337 teeth were root filled (3.6%; 1993, 2.7%). Prevalence of apical periodontitis in root-filled teeth was 34% (1993, 61%). Quality of root fillings was adequate in 117 cases (35%; 1993, 14%). Minimum endodontic treatment need was estimated with 1.6% (1993, 2.3%), including teeth with clinical symptoms. Considering symptomless teeth with apical periodontitis and poor quality of root filling, the treatment need was 2.9% (1993, 3.7%). Regression analysis identified quality of root filling as a significant factor for periapical health (p = 0.01, odds ratio 3.4×, 95% CI 1.9-6.3×), likewise the type of instrumentation. Teeth treated with rotary files had a significantly better outcome (p = 0.02, odds ratio 2.0×, 95% CI 1.1-3.7×).

Conclusions: Quality of root fillings and the periapical status have improved over the last 20 years in Germany. However, there is still a need for an increase in quality of root canal treatment.

Keywords: Apical periodontitis; Endodontic treatment need; Endodontics; Epidemiology; Periapical status; Repeated cross-sectional study.