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Clinical Oral Investigations

, Volume 17, Issue 9, pp 2099–2104 | Cite as

Radiographic follow-up of periapical status after endodontic treatment of teeth with and without apical periodontitis

  • Sisko HuumonenEmail author
  • Dag Ørstavik
Original Article

Abstract

Objectives

The aim was to assess objectively the rate of changes in periapical status after endodontic treatment in relation to preoperative radiographic status (Periapical Index Score, PAI) and to tooth type.

Material and methods

Radiographic data from a total of 1,410 teeth in seven prospective clinical studies was pooled. The periapical status was evaluated blindly using the PAI scoring system. The longest follow-up period was 4 years; intervals between controls varied from 3 months to 1 year.

Results

Teeth with preoperative PAI score 1 maintained excellent periapical health throughout. Teeth with preoperative PAI score 2 showed some impairment in health over the first 6 months, but improved to approach 95 % healthy teeth at 2 years of observation. Teeth with PAI 3–5 at the start showed significant improvement at 3 months; 27 % were considered healthy (PAI 1 or 2) increasing to 41 % after 1 year. Improvement of periapical status was slower in PAI groups 4 and 5 compared with PAI 3 during the first year. After 2 years, improvement continued similarly in all preoperative PAI 3–5 groups of teeth. Upper lateral incisors showed the poorest healing rate.

Conclusions

Healing of pre-existing periapical lesions is most pronounced from 3 months to 2 years. Teeth with initially healthy periapical structures predictably maintain good periapical health. Maxillary teeth, especially lateral incisors, showed poorer healing rates than mandibular teeth.

Clinical relevance

Radiographic healing rates may vary among tooth groups within the dentition. Periapically healthy teeth that are root filled may not need postoperative controls.

Keywords

Apical periodontitis Developing Healing Tooth type 

Notes

Acknowledgment

The authors deny any conflicts of interest.

We have no financial affiliation for this paper.

References

  1. 1.
    Friedman S, Mor C (2004) The success of endodontic therapy—healing and functionality. J Calif Dent Assoc 32:493–503PubMedGoogle Scholar
  2. 2.
    Ørstavik D (1996) Time–course and risk analyses of the development and healing of chronic apical periodontitis in man. Int Endod J 29:150–155PubMedCrossRefGoogle Scholar
  3. 3.
    Chugal NM, Clive JM, Spånberg LS (2001) A prognostic model for assessment of the outcome of endodontic treatment: effect of biologic and treatment variables. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 91:342–352PubMedCrossRefGoogle Scholar
  4. 4.
    Kojima K, Inamoto K, Nagamatsu K, Hara A, Nakata K, Morita I et al (2004) Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 97:95–99PubMedCrossRefGoogle Scholar
  5. 5.
    Strindberg LZ (1956) The dependence of the results of pulp therapy on certain factors. Acta Odontol Scand 14(Suppl 21):1–175Google Scholar
  6. 6.
    Molven O, Halse A, Fristad I, MacDonald-Jankowski D (2002) Periapical changes following root-canal treatment observed 20–27 years postoperatively. Int Endod J 35:784–790PubMedCrossRefGoogle Scholar
  7. 7.
    Fristad I, Molven O, Halse A (2004) Nonsurgically retreated root filled teeth-radiographic findings after 20–27 years. Int Endod J 37:12–18PubMedCrossRefGoogle Scholar
  8. 8.
    European Society of Endodontology (2006) Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J 39:921–930CrossRefGoogle Scholar
  9. 9.
    Ørstavik D, Kerekes K, Eriksen HM (1987) Clinical performance of three endodontic sealers. Endod Dent Traumatol 3:178–186PubMedCrossRefGoogle Scholar
  10. 10.
    Ørstavik D, Kerekes K, Molven O (1991) Effects of extensive apical reaming and calcium hydroxide dressing on bacterial infection during treatment of apical periodontitis: a pilot study. Int Endod J 24:1–7PubMedCrossRefGoogle Scholar
  11. 11.
    Ørstavik D, Hørsted-Bindslev P (1993) A comparison of endodontic treatment results at two dental schools. Int End J 26:348–354CrossRefGoogle Scholar
  12. 12.
    Kerosuo E, Ørstavik D (1997) Application of computerized image analysis to monitoring endodontic therapy: reproducibility and comparison with visual assessment. Dentomaxillofac Radiol 26:79–84PubMedCrossRefGoogle Scholar
  13. 13.
    Trope M, Delano EO, Ørstavik D (1999) Endodontic treatment of teeth with apical periodontitis: single vs. multivisit treatment. J Endod 25:345–350PubMedCrossRefGoogle Scholar
  14. 14.
    Waltimo TM, Boiesen J, Eriksen HM, Ørstavik D (2001) Clinical performance of 3 endodontic sealers. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 92:89–92PubMedCrossRefGoogle Scholar
  15. 15.
    Huumonen S, Lenander-Lumikari M, Sigurdsson A, Ørstavik D (2003) Healing of apical periodontitis after endodontic treatment: a comparison between a silicone-based and a zinc-oxide eugenol-based sealer. Int Endod J 36:296–301PubMedCrossRefGoogle Scholar
  16. 16.
    Ørstavik D, Kerekes K, Eriksen HM (1986) The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol 2:20–34PubMedCrossRefGoogle Scholar
  17. 17.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–175PubMedCrossRefGoogle Scholar
  18. 18.
    Byström A, Happonen RP, Sjögren U, Sundqvist G (1987) Healing of periapical lesions of pulpless teeth after endodontic treatment with controlled asepsis. Endod Dent Traumatol 3:58–63PubMedCrossRefGoogle Scholar
  19. 19.
    Kerekes K, Tronstad L (1979) Long-term results of endodontic treatment performed with a standardized technique. J Endod 5:83–90PubMedCrossRefGoogle Scholar
  20. 20.
    Reit C (1987) Decision strategies in endodontics: on the design of a recall program. Endod Dent Traumatol 3:233–239PubMedCrossRefGoogle Scholar
  21. 21.
    Eriksen HM, Orstavik D, Kerekes K (1988) Healing of apical periodontitis after endodontic treatment using three different root canal sealers. Endod Dent Traumatol 4:114–117PubMedCrossRefGoogle Scholar
  22. 22.
    Petersson K, Håkansson R, Håkansson J, Olsson B, Wennberg A (1991) Follow-up study of endodontic status in an adult Swedish population. Endod Dent Traumatol 7:221–225PubMedCrossRefGoogle Scholar
  23. 23.
    Molven O, Halse A (1988) Success rates for gutta-percha and Kloroperka N-0 root fillings made by undergraduate students: radiographic findings after 10–17 years. Int Endod J 21:243–250PubMedCrossRefGoogle Scholar
  24. 24.
    Yusuf H (1982) The significance of the presence of foreign material periapically as a cause of failure of root treatment. Oral Surg Oral Med Oral Pathol 54:566–574PubMedCrossRefGoogle Scholar
  25. 25.
    Adenubi JO, Rule DC (1976) Success rate for root fillings in young patients. A retrospective analysis of treated cases. Br Dent J 19:237–241CrossRefGoogle Scholar
  26. 26.
    Barbakow FH, Cleaton-Jones P, Friedman D (1980) An evaluation of 566 cases of root canal therapy in general dental practice. 2. Postoperative observations. J Endod 6:485–489PubMedCrossRefGoogle Scholar
  27. 27.
    Friedman S, Lost C, Zarrabian M, Trope M (1995) Evaluation of success and failure after endodontic therapy using a glass ionomer cement sealer. J Endod 21:384–390PubMedCrossRefGoogle Scholar
  28. 28.
    Hamasha A, Alomari Q (2004) Prevalence of dens invaginatus in Jordanian adults. Int Endod J 37:307–310PubMedCrossRefGoogle Scholar
  29. 29.
    Hűlsmann M (1997) Dens invaginatus; aetiology, classification, prevalence, diagnosis and treatment considerations. Int Endod J 30:79–90PubMedGoogle Scholar
  30. 30.
    Marending M, Peters OA, Zehnder M (2005) Factors affecting the outcome of orthograde root canal therapy in a general dentistry hospital practice. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:119–124PubMedCrossRefGoogle Scholar
  31. 31.
    Valderhaug J, Jokstad A, Ambjørnsen E, Norheim PW (1997) Assessment of the periapical and clinical status of crowned teeth over 25 years. J Dent 25:97–105PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Institute of Dentistry, Faculty of MedicineUniversity of TurkuTurkuFinland
  2. 2.Department of diagnostic imagingTurku University HospitalTurkuFinland
  3. 3.NIOM—Nordic Institute of Dental MaterialsOsloNorway
  4. 4.Department of Endodontics, Institute of Clinical DentistryUniversity of OsloOsloNorway

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