The aim of this study was to compare the quality of root canal treatment in two Danish subpopulations.
Group 1 (358 patients) was examined 1974-75 and group 2 (244 patients) 1997-98. All patients were more than 20 years old. All had undergone a full-mouth radiographic survey. In root-filled teeth the following parameters were assessed: the quality of the coronal restoration or crown, the lateral seal of the root filling, the length of the root filling, and the periapical status. Chi-squared tests were used for the evaluation of differences between the groups.
In group 1 there were 975 endodontically treated teeth, in group 2 there were 753. In group 1 the majority of root-filled teeth were premolars, in group 2 the majority were molars (P
AIM: The aim of this study was to investigate the prevalence of endodontically treated teeth and apical periodontitis (AP) in a Danish population. METHODOLOGY: From Aarhus County 614 individuals were radiographically examined, and the frequency of endodontic treatment and periapical status of all teeth were assessed. The year of birth of the subjects ranged from 1935 to 1975. The chi-squared test was used to determine the significance of differences between males and females and amongst age and tooth groups for the following parameters: AP, the number of endodontically treated teeth, and the number of endodontically treated teeth with AP. RESULTS: A total of 15 984 teeth were examined; of these 538 (3.4%) had AP and 773 (4.8%) had been endodontically treated. Of the endodontically treated teeth, 404 (52.2%) had AP. Females had more endodontically treated teeth than males; otherwise, no effect of gender was observed. Significantly more molars (P
Department of Dental Pathology, Operative Dentistry and Endodontics, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark. lise-lotte.kirkevang@odontologi.au.dk
The aim was to describe the incidence of caries lesions in a randomly selected adult population, and to identify risk factors related to the incidence of caries lesions in approximal surfaces. In 1997, 616 adults participated in a study including a radiographic survey. In 2003 these individuals were contacted again and offered a second radiographic survey; 473 consented and attended this examination. In approximal surfaces, presence/absence of caries lesions and presence and type of coronal fillings were recorded. The incidence of caries lesions in surfaces with no caries lesions in 1997 was studied. Potential risk factors included information at three levels: (1) person, (2) tooth, and (3) surface. The analysis was carried out by multilevel logistic regression. For the analyses 23,701 approximal surfaces were eligible. In 23,243 approximal surfaces no caries lesions were detected in 1997, 17,007 of these were surfaces without fillings, and 6,236 were filled surfaces. In unfilled surfaces several factors affected the risk for development of a caries lesion: young age, high number of fillings, number of teeth and status of the adjacent surface. In filled surfaces few factors affected the incidence of caries lesions: status of the adjacent surface, smoking and distal surfaces. Differences in risk factor patterns for the incidence of caries lesions were found for unfilled and filled surfaces. The study emphasizes the importance of assessing factors related to the incidence of caries lesions in adults. Further it underlines the need to analyse the fate of filled surfaces separately, because once a surface has received a filling it needs continuous attendance.
Department of Oral Radiology, School of Dentistry, Royal Dental College, University of Aarhus, Vennelyst Boulevard, DK-8000 Aarhus C, Denmark. llkirkevang@odont.au.dk
To describe and discuss changes in periapical and endodontic status in a general Danish population.
In 1997, 616 randomly selected individuals had a full-mouth radiographic survey taken. In 2003, 77% of the participants attended for a new full-mouth radiographic examination. Information on endodontic treatment and periapical status was obtained. The periapical index (PAI) was used to assess apical periodontitis (AP).
More participants had root filling(s) and AP in 2003 than in 1997. More teeth had AP and/or root fillings in 2003. Fewer of the root-filled teeth (RFT) had AP in 2003. Less than 3% of the teeth without root fillings (NRFT) that in 1997 had no AP, developed AP and/or received a root filling. Of the NRFT which in 1997 had AP, more than 35% still had AP and no root filling in 2003. Approximately, 30% of the NRFT with AP in 1997 received a root filling. Of the teeth that received a root filling, 40% had healed, whereas 60% had not. Approximately, 25% of the NRFT that in 1997 had AP had been extracted. In 1997 there were 618 RFT, 314 of the RFT had no AP in 1997. Almost 20% of the RFT that in 1997 were periapically sound, developed AP. Of the 304 RFT with AP in 1997, approximately 30% had healed, in 60% AP persisted, and 10% were extracted.
The present study indicates that caution must be exercised when statements on the outcome of root canal treatment are made based on the cross-sectional studies.
The aim of this study was to investigate the quality of endodontic and coronal restorations and the association with periapical status in a Danish population.
A total of 614 randomly selected individuals (20-60+ years of age) from Aarhus County had a full-mouth radiographic examination. The quality of endodontic and coronal restorations and the periapical status of endodontically treated teeth were assessed by radiographic criteria. Root fillings were categorized as 'adequate' or 'inadequate' with regard to root filling length and lateral seal. Coronal restorations were categorized into 'adequate' and 'inadequate', defined by the absence or presence of radiographic signs of overhangs or open margins. Results were analysed statistically using the chi-squared test.
The total number of endodontically treated teeth was 773, and 52.3% had apical periodontitis (AP). Root-filled teeth with an adequate lateral seal had a lower incidence of AP than teeth with an inadequate seal (44.3% vs. 57.8%), and teeth with an adequate root filling length were associated with a better periapical status than teeth with inadequate length of the root filling (42.0% vs. 67.6%). Similarly, adequate coronal restorations were associated with better periapical status than inadequate restorations (48.0% vs. 63.9%). When both root filling and coronal restoration quality were assessed, the incidence of AP ranged from 31.2% (optimal quality) to 78.3% (all parameters scored as inadequate).
Inadequate root canal and coronal restorations were associated with an increased incidence of AP.
To evaluate whether the full-scale Periapical Index (PAI) can predict the periapical status over time in nonroot filled and root filled teeth.
Full-mouth radiographic surveys of a random sample from a general population were performed in 1997, 2003 and 2008. The present investigation included 330 persons who participated in all three examinations and 143 persons who participated in the first and second examination. At each examination, the presence or absence of a tooth and of a root filling was recorded, and a PAI score (1-5) was assigned to all teeth. Retreatment of a root filling was recorded for root filled teeth. Statistical analysis was carried out using ordinal logistic regression and logistic regression and computed as Wald's tests.
At baseline, nonroot filled teeth had lower PAI scores than root filled teeth (P
To describe changes in periapical and endodontic status in a general adult Danish population examined in 1997, 2003 and 2008.
The study provides longitudinal, observational information on endodontic status for 327 individuals who participated in three consecutive full-mouth radiographic examinations performed with an approximately 5-year interval. The collected data allow changes to be investigated within and between age-cohorts.
The median number of teeth declined slightly, but the number of individuals with apical periodontitis (AP) and with root filled teeth increased. The number of teeth with AP and of teeth with root fillings increased, whereas the number of root filled teeth with AP was almost stable. The proportion of individuals who had no AP and the proportion of individuals who had no root fillings decreased during the 10-year observation period. The proportion of teeth with AP/individual increased steadily with age, unaffected by the different time periods. Differences were found between the age groups for the proportion of root filled teeth/individual where the younger age-cohorts had root fillings performed later in life and at a slower rate. In the old age-cohort, the proportion of lost teeth/individual was much larger and showed a stronger increase with age, than in the younger age-cohorts.
The younger age-cohorts will probably never reach the proportion of root fillings or lost teeth seen in the oldest age-cohort. However, it is disturbing that the proportion of teeth with AP/individual increased steadily with age, completely unaffected by the different time periods.
To assess the long-term outcome of root filled teeth in a general adult population examined in 1997, 2003 and 2008.
The study provides longitudinal, observational information on endodontic status for 327 randomly selected individuals from a general Danish population receiving three consecutive full-mouth radiographic examinations. The association between root filling quality, periapical disease and the long-term outcome of the root filling and the root filled tooth was assessed using GEE methodology and tests for trend.
Overall 13% of the root filled teeth had been extracted, 12% had received a revision of the root filling and 42% of root filled teeth present in 2008 had apical periodontitis (AP) after the 10-year follow-up period. The probability of persistent AP was higher if the root filling was either short or long (P = 0.001), if there were voids (P
