Abstract

Objective: This study aimed to evaluate the prevalence of apical periodontitis in endodontically treated teeth and to assess the effects of coronal restorations and root canal filling quality on periapical status in a Turkish population.

Material-Method: A total of 901 adult patients and 1,709 endodontically treated teeth were assessed. Their digital panoramic radiographs were examined by three independent observers. The quality of the coronal restorations and root canal fillings was classified by radiographic examination, and the teeth were classified as healthy / success or diseased according to periapical status. The Cohen kappa calculated to assess inter-observer agreement for the quality of the restorations and root canal fillings and for periapical status. The results were analyzed using a chi-squared test and Fisher’s exact test.

Results: According to the periapical index scoring system (PAI), 750 (43.9%) teeth were classified as healthy, and 959 (56.1%) teeth were classified as diseased. The adequate coronal restoration and adequate root canal filling group showed the highest success rate. The adequate root canal filling and inadequate coronal restoration group had a significantly higher success rate than the inadequate root canal filling and adequate coronal restoration group (p<0.001). The inadequate coronal restoration and inadequate root canal filling group had the lowest success rate. The most frequently treated teeth were maxillary premolars, mandibular molars and maxillary molars, respectively. The Cohen’s kappa values were 0.82, 0.83 and 0.89 in the categories of periapical status, root canal filling and coronal restoration, respectively, thus test results showed that the inter-observers were in close agreement.

Conclusion: The quality of coronal restorations influenced the periapical health. The quality of root canal fillings may be the most effective factor in periapical health.

Keywords: Apical Periodontitis, Coronal Restoration, Endodontic Treatment, Periapical Status, Radiographic Evaluation.