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CC BY 4.0 · Eur J Dent 2022; 16(02): 386-395
DOI: 10.1055/s-0041-1735909
Original Article

Is Coronal Restoration a Predictor of Posttreatment Apical Periodontitis?

Romana Persic Bukmir 
1   Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
,
Ema Paljevic
1   Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
,
Jelena Vidas
1   Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
,
Irena Glazar
2   Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
,
Sonja Pezelj-Ribaric
2   Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
3   Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
,
Ivana Brekalo Prso
1   Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
3   Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
› Author Affiliations Funding This work was supported by a funding grant from the University of Rijeka, Croatia (grant no. 818101218).
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Abstract

Objectives To investigate the posttreatment apical periodontitis (AP) in endodontically treated teeth through a multivariate approach and to analyze the relative importance of quality and type of coronal restoration as predictors of periapical disease.

Materials and Methods The present study sample was drawn within 2-year period from the 1,072 consecutive patients older than 18 years, first time attending the Dental Clinic of the Clinical Hospital Center Rijeka, Croatia. A total of 1,350 endodontically treated teeth were included in the study. For each tooth, the periapical status, root filling quality, intracanal post, separated file presence, marginal bone loss, and quality and type of coronal restoration were recorded.

Statistical Analysis Chi-square tests were used to analyze the variations in the periapical status, quality of root canal filling, and quality of coronal restoration in different tooth types. The effect of explanatory variables on periapical status was explored using univariate and multivariate logistic regression models. The outcome variable was set as the presence versus absence of AP in the tooth.

Results Multivariate logistic regression analysis revealed statistically significant associations and increased risk for AP presence in molars (odds ratio [OR] = 2.15; p < 0.001), teeth positioned in mandible (OR = 1.49; p = 0.007), teeth with short length of root filling (OR = 4.08; p < 0.001), overfilled teeth (OR = 2.99; p = 0.001), and teeth with inadequate density of root filling (OR = 4.14; p < 0.001). Considering variables related to coronal restoration, neither coronal restoration type nor quality was found to be predictive for posttreatment AP. Merely, the presence of intracanal post significantly increased the odds of AP presence (OR = 1.57; p = 0.009).

Conclusion The results of the present study did not indicate that type or quality of coronal restoration may be predictors of posttreatment AP. Periapical disease was significantly associated with molars, mandibular teeth, substandard quality of root fillings, and intracanal post presence.

Keywords

dental - digital periapical radiograph - apical periodontitis - permanent coronal restoration - root canal treatment


Publication History

Article published online:
09 November 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 American Association of Endodontists (AAE). Saving your natural teeth. American Association of Endodontists [serial online]. Accessed March 14, 2021 at: https://www.aae.org/patients/root-canal-treatment/saving-natural-tooth/
    Google Scholar
  • 2 Orstavik D. Endodontic treatment of apical periodontitis. In: Orstavik D. ed. Essential Endodontology. 3rd ed. Oxford, UK: Wiley Blackwell; 2020: 313-330
    Google Scholar
  • 3 Friedman S, Mor C. The success of endodontic therapy–healing and functionality. J Calif Dent Assoc 2004; 32 (06) 493-503
    PubMedGoogle Scholar
  • 4 Jiménez-Pinzón A, Segura-Egea JJ, Poyato-Ferrera M, Velasco-Ortega E, Ríos-Santos JV. Prevalence of apical periodontitis and frequency of root-filled teeth in an adult Spanish population. Int Endod J 2004; 37 (03) 167-173
    CrossrefPubMedGoogle Scholar
  • 5 Dugas NN, Lawrence HP, Teplitsky PE, Pharoah MJ, Friedman S. Periapical health and treatment quality assessment of root-filled teeth in two Canadian populations. Int Endod J 2003; 36 (03) 181-192
    CrossrefPubMedGoogle Scholar
  • 6 Al-Omari MA, Hazaa A, Haddad F. Frequency and distribution of root filled teeth and apical periodontitis in a Jordanian subpopulation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 111 (01) e59-e65
    CrossrefPubMedGoogle Scholar
  • 7 Tsuneishi M, Yamamoto T, Yamanaka R. et al. Radiographic evaluation of periapical status and prevalence of endodontic treatment in an adult Japanese population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100 (05) 631-635
    CrossrefPubMedGoogle Scholar
  • 8 Friedman S. Considerations and concepts of case selection in the management of post-treatment endodontic disease (treatment failure). Endod Topics 2002; 1 (01) 54-78
    CrossrefGoogle Scholar
  • 9 Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature – part 2. Influence of clinical factors. Int Endod J 2008; 41 (01) 6-31
    PubMedGoogle Scholar
  • 10 Imura N, Pinheiro ET, Gomes BP, Zaia AA, Ferraz CC, Souza-Filho FJ. The outcome of endodontic treatment: a retrospective study of 2000 cases performed by a specialist. J Endod 2007; 33 (11) 1278-1282
    CrossrefPubMedGoogle Scholar
  • 11 Ricucci D, Russo J, Rutberg M, Burleson JA, Spångberg LS. A prospective cohort study of endodontic treatments of 1,369 root canals: results after 5 years. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112 (06) 825-842
    CrossrefPubMedGoogle Scholar
  • 12 Pak JG, Fayazi S, White SN. Prevalence of periapical radiolucency and root canal treatment: a systematic review of cross-sectional studies. J Endod 2012; 38 (09) 1170-1176
    CrossrefPubMedGoogle Scholar
  • 13 Dawson V, Petersson K, Wolf E, Akerman S. Periapical status of non-root-filled teeth with resin composite, amalgam, or full crown restorations: a cross-sectional study of a Swedish adult population. J Endod 2014; 40 (09) 1303-1308
    CrossrefPubMedGoogle Scholar
  • 14 Frisk F, Hugosson A, Kvist T. Is apical periodontitis in root filled teeth associated with the type of restoration?. Acta Odontol Scand 2015; 73 (03) 169-175
    CrossrefPubMedGoogle Scholar
  • 15 Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J 1995; 28 (01) 12-18
    CrossrefPubMedGoogle Scholar
  • 16 Kirkevang LL, Ørstavik D, Hörsted-Bindslev P, Wenzel A. Periapical status and quality of root fillings and coronal restorations in a Danish population. Int Endod J 2000; 33 (06) 509-515
    CrossrefPubMedGoogle Scholar
  • 17 Thampibul P, Jantarat J, Arayasantiparb R. Post-treatment apical periodontitis related to the technical quality of root fillings and restorations in Thai population. Aust Endod J 2019; 45 (02) 163-170
    CrossrefPubMedGoogle Scholar
  • 18 Hommez GM, Coppens CR, De Moor RJ. Periapical health related to the quality of coronal restorations and root fillings. Int Endod J 2002; 35 (08) 680-689
    CrossrefPubMedGoogle Scholar
  • 19 Tronstad L, Asbjørnsen K, Døving L, Pedersen I, Eriksen HM. Influence of coronal restorations on the periapical health of endodontically treated teeth. Endod Dent Traumatol 2000; 16 (05) 218-221
    CrossrefPubMedGoogle Scholar
  • 20 Craveiro MA, Fontana CE, de Martin AS, Bueno CE. Influence of coronal restoration and root canal filling quality on periapical status: clinical and radiographic evaluation. J Endod 2015; 41 (06) 836-840
    CrossrefPubMedGoogle Scholar
  • 21 Dawson VS, Isberg PE, Kvist T, Fransson H. EndoReCo. Further treatments of root-filled teeth in the Swedish adult population: a comparison of teeth restored with direct and indirect coronal restorations. J Endod 2017; 43 (09) 1428-1432
    CrossrefPubMedGoogle Scholar
  • 22 Ørstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol 1986; 2 (01) 20-34
    CrossrefPubMedGoogle Scholar
  • 23 Merdad K, Sonbul H, Bukhary S, Reit C, Birkhed D. Caries susceptibility of endodontically versus nonendodontically treated teeth. J Endod 2011; 37 (02) 139-142
    CrossrefPubMedGoogle Scholar
  • 24 Segura-Egea JJ, Jiménez-Pinzón A, Poyato-Ferrera M, Velasco-Ortega E, Ríos-Santos JV. Periapical status and quality of root fillings and coronal restorations in an adult Spanish population. Int Endod J 2004; 37 (08) 525-530
    CrossrefPubMedGoogle Scholar
  • 25 World Health Organization. Oral Health Survey-Basic Methods. 4th ed. Geneva, Switzerland: World Health Organization; 1997: 13-15
    Google Scholar
  • 26 Aminoshariae A, Kulild JC. The impact of sealer extrusion on endodontic outcome: a systematic review with meta-analysis. Aust Endod J 2020; 46 (01) 123-129
    CrossrefPubMedGoogle Scholar
  • 27 Flanders DH. Endodontic patency. How to get it. How to keep it. Why it is so important. N Y State Dent J 2002; 68 (03) 30-32
    PubMedGoogle Scholar
  • 28 Fonseca B, Coelho MS, Bueno CEDS, Fontana CE, Martin AS, Rocha DGP. Assessment of extrusion and postoperative pain of a bioceramic and resin-based root canal sealer. Eur J Dent 2019; 13 (03) 343-348
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 McGuigan MB, Louca C, Duncan HF. The impact of fractured endodontic instruments on treatment outcome. Br Dent J 2013; 214 (06) 285-289
    CrossrefPubMedGoogle Scholar
  • 30 Panitvisai P, Parunnit P, Sathorn C, Messer HH. Impact of a retained instrument on treatment outcome: a systematic review and meta-analysis. J Endod 2010; 36 (05) 775-780
    CrossrefPubMedGoogle Scholar
  • 31 Spili P, Parashos P, Messer HH. The impact of instrument fracture on outcome of endodontic treatment. J Endod 2005; 31 (12) 845-850
    CrossrefPubMedGoogle Scholar
  • 32 Machado R, Cunha MMD, Comparin D, Cosme-Silva L, Back EDEE, Garcia LDFR. Incidence of periodontal compromise in teeth indicated for undergoing endodontic treatment: a clinical study. Eur J Dent 2018; 12 (03) 334-337
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Kirkevang LL, Vaeth M, Wenzel A. Tooth-specific risk indicators for apical periodontitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97 (06) 739-744
    CrossrefPubMedGoogle Scholar
  • 34 Gambarini G, Piasecki L, Miccoli G, Gaimari G, Nardo DD, Testarelli L. Cone-beam computed tomography in the assessment of periapical lesions in endodontically treated teeth. Eur J Dent 2018; 12 (01) 136-143
    Article in Thieme ConnectPubMedGoogle Scholar
  • 35 Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J 2011; 44 (07) 583-609
    CrossrefPubMedGoogle Scholar
  • 36 Rodríguez G, Abella F, Durán-Sindreu F, Patel S, Roig M. Influence of cone-beam computed tomography in clinical decision making among specialists. J Endod 2017; 43 (02) 194-199
    CrossrefPubMedGoogle Scholar
  • 37 Patel S, Brown J, Pimentel T, Kelly RD, Abella F, Durack C. Cone beam computed tomography in endodontics - a review of the literature. Int Endod J 2019; 52 (08) 1138-1152
    PubMedGoogle Scholar
  • 38 Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod 2008; 34 (03) 273-279
    CrossrefPubMedGoogle Scholar
  • 39 Kruse C, Spin-Neto R, Evar Kraft DC, Vaeth M, Kirkevang LL. Diagnostic accuracy of cone beam computed tomography used for assessment of apical periodontitis: an ex vivo histopathological study on human cadavers. Int Endod J 2019; 52 (04) 439-450
    CrossrefPubMedGoogle Scholar
  • 40 Patel S, Brown J, Semper M, Abella F, Mannocci F. European Society of Endodontology position statement: use of cone beam computed tomography in Endodontics: European Society of Endodontology (ESE) developed by. Int Endod J 2019; 52 (12) 1675-1678
    CrossrefPubMedGoogle Scholar