Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Friedman S, Mor C (2004) The success of endodontic therapy—healing and functionality. J Calif Dent Assoc 32:493–503

    PubMed  Google Scholar 

  2. Ørstavik D (1996) Time–course and risk analyses of the development and healing of chronic apical periodontitis in man. Int Endod J 29:150–155

    Article  PubMed  Google Scholar 

  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 91:342–352

    Article  PubMed  Google Scholar 

  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 97:95–99

    Article  PubMed  Google Scholar 

  5. Strindberg LZ (1956) The dependence of the results of pulp therapy on certain factors. Acta Odontol Scand 14(Suppl 21):1–175

    Google Scholar 

  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 35:784–790

    Article  PubMed  Google Scholar 

  7. Fristad I, Molven O, Halse A (2004) Nonsurgically retreated root filled teeth-radiographic findings after 20–27 years. Int Endod J 37:12–18

    Article  PubMed  Google Scholar 

  8. European Society of Endodontology (2006) Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J 39:921–930

    Article  Google Scholar 

  9. Ørstavik D, Kerekes K, Eriksen HM (1987) Clinical performance of three endodontic sealers. Endod Dent Traumatol 3:178–186

    Article  PubMed  Google Scholar 

  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 24:1–7

    Article  PubMed  Google Scholar 

  11. Ørstavik D, Hørsted-Bindslev P (1993) A comparison of endodontic treatment results at two dental schools. Int End J 26:348–354

    Article  Google Scholar 

  12. Kerosuo E, Ørstavik D (1997) Application of computerized image analysis to monitoring endodontic therapy: reproducibility and comparison with visual assessment. Dentomaxillofac Radiol 26:79–84

    Article  PubMed  Google Scholar 

  13. Trope M, Delano EO, Ørstavik D (1999) Endodontic treatment of teeth with apical periodontitis: single vs. multivisit treatment. J Endod 25:345–350

    Article  PubMed  Google Scholar 

  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 92:89–92

    Article  PubMed  Google Scholar 

  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 36:296–301

    Article  PubMed  Google Scholar 

  16. Ørstavik D, Kerekes K, Eriksen HM (1986) The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol 2:20–34

    Article  PubMed  Google Scholar 

  17. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–175

    Article  PubMed  Google Scholar 

  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 3:58–63

    Article  PubMed  Google Scholar 

  19. Kerekes K, Tronstad L (1979) Long-term results of endodontic treatment performed with a standardized technique. J Endod 5:83–90

    Article  PubMed  Google Scholar 

  20. Reit C (1987) Decision strategies in endodontics: on the design of a recall program. Endod Dent Traumatol 3:233–239

    Article  PubMed  Google Scholar 

  21. Eriksen HM, Orstavik D, Kerekes K (1988) Healing of apical periodontitis after endodontic treatment using three different root canal sealers. Endod Dent Traumatol 4:114–117

    Article  PubMed  Google Scholar 

  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 7:221–225

    Article  PubMed  Google Scholar 

  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 21:243–250

    Article  PubMed  Google Scholar 

  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 54:566–574

    Article  PubMed  Google Scholar 

  25. Adenubi JO, Rule DC (1976) Success rate for root fillings in young patients. A retrospective analysis of treated cases. Br Dent J 19:237–241

    Article  Google Scholar 

  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 6:485–489

    Article  PubMed  Google Scholar 

  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 21:384–390

    Article  PubMed  Google Scholar 

  28. Hamasha A, Alomari Q (2004) Prevalence of dens invaginatus in Jordanian adults. Int Endod J 37:307–310

    Article  PubMed  Google Scholar 

  29. Hűlsmann M (1997) Dens invaginatus; aetiology, classification, prevalence, diagnosis and treatment considerations. Int Endod J 30:79–90

    PubMed  Google Scholar 

  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 99:119–124

    Article  PubMed  Google Scholar 

  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 25:97–105

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

The authors deny any conflicts of interest.

We have no financial affiliation for this paper.

Author information

Authors and Affiliations

  1. Institute of Dentistry, Faculty of Medicine, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland

    Sisko Huumonen

  2. Department of diagnostic imaging, Turku University Hospital, Turku, Finland

    Sisko Huumonen

  3. NIOM—Nordic Institute of Dental Materials, Oslo, Norway

    Sisko Huumonen & Dag Ørstavik

  4. Department of Endodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway

    Dag Ørstavik

Authors
  1. Sisko Huumonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dag Ørstavik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sisko Huumonen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Huumonen, S., Ørstavik, D. Radiographic follow-up of periapical status after endodontic treatment of teeth with and without apical periodontitis. Clin Oral Invest 17, 2099–2104 (2013). https://doi.org/10.1007/s00784-013-0926-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-013-0926-2

Keywords

Search

Navigation