Restor Dent Endod.  2024 May;49(2):e16. 10.5395/rde.2024.49.e16.

Prevalence of apical periodontitis and quality of root canal treatment in an adult Kuwaiti sub-population: a crosssectional study

Affiliations
  • 1Department of Restorative Dentistry, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
  • 2Farwania Dental Department, Ministry of Health, Kuwait City, Kuwait
  • 3Department of Restorative Dentistry – Endodontics, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
  • 4Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia

Abstract


Objectives
This cross-sectional study evaluated the prevalence of apical periodontitis (AP) and the technical quality of root canal fillings in an adult Kuwaiti subpopulation using conebeam computed tomography (CBCT) images.
Materials and Methods
Two experienced examiners analyzed 250 CBCT images obtained from Kuwaiti patients aged 15–65 years who attended government dental specialist clinics between January 2019 and September 2020. The assessment followed the radiographic scoring criteria proposed by De Moor for periapical status and the technical quality of root canal filling. Chi-square and Fisher’s exact tests were used for statistical analysis, with significance level set at p < 0.05.
Results
Among the 2,762 examined teeth, 191 (6.91%) exhibited radiographic signs of AP, and 176 (6.37%) had undergone root canal filling. AP prevalence in root canal-treated teeth was 32.38%, with a significant difference between males and females. Most of the endodontically treated teeth exhibited adequate root canal filling (71.5%).
Conclusions
The study demonstrated a comparable prevalence of AP and satisfactory execution of root canal treatment compared to similar studies in different countries.

Keyword

Apical periodontitis; Cone-beam computed tomography; Endodontic outcome; Epidemiology; Root canal treatment

Reference

1. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 1965; 20:340–349. PMID: 14342926.
2. Sundqvist G, Figdor D, Persson S, Sjögren U. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85:86–93. PMID: 9474621.
3. Abbott PV. Classification, diagnosis and clinical manifestations of apical periodontitis. Endod Topics. 2004; 8:36–54.
4. Tibúrcio-Machado CS, Michelon C, Zanatta FB, Gomes MS, Marin JA, Bier CA. The global prevalence of apical periodontitis: a systematic review and meta-analysis. Int Endod J. 2021; 54:712–735. PMID: 33378579.
5. Seppänen L, Lemberg KK, Lauhio A, Lindqvist C, Rautemaa R. Is dental treatment of an infected tooth a risk factor for locally invasive spread of infection? J Oral Maxillofac Surg. 2011; 69:986–993. PMID: 20950917.
6. Ørstavik D, Qvist V, Stoltze K. A multivariate analysis of the outcome of endodontic treatment. Eur J Oral Sci. 2004; 112:224–230. PMID: 15154919.
7. Kojima K, Inamoto K, Nagamatsu K, Hara A, Nakata K, Morita I, et al. Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97:95–99. PMID: 14716263.
8. 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; 41:6–31. PMID: 17931388.
9. 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; 34:273–279. PMID: 18291274.
10. Al-Nazhan SA, Alsaeed SA, Al-Attas HA, Dohaithem AJ, Al-Serhan MS, Al-Maflehi NS. Prevalence of apical periodontitis and quality of root canal treatment in an adult Saudi population. Saudi Med J. 2017; 38:413–421. PMID: 28397949.
11. Halse A, Molven O, Fristad I. Diagnosing periapical lesions--disagreement and borderline cases. Int Endod J. 2002; 35:703–709. PMID: 12196224.
12. Nair MK, Nair UP. Digital and advanced imaging in endodontics: a review. J Endod. 2007; 33:1–6. PMID: 17185117.
13. Zaatar EI, al-Kandari AM, Alhomaidah S, al-Yasin IM. Frequency of endodontic treatment in Kuwait: radiographic evaluation of 846 endodontically treated teeth. J Endod. 1997; 23:453–456. PMID: 9587301.
14. Maslamani M, Behbahani J, Mitra AK. Radiographic evaluation and predictors of periapical lesions in patients with root-filled and nonroot-filled teeth in Kuwait. Indian J Dent Sci. 2017a; 9:237–240.
15. Maslamani M, Khalaf M, Mitra AK. Association of quality of coronal filling with the outcome of endodontic treatment: a follow-up study. Dent J (Basel). 2017; 5:5. PMID: 29563411.
16. McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012; 22:276–282. PMID: 23092060.
17. De Moor RJ, Hommez GM, De Boever JG, Delmé KI, Martens GE. Periapical health related to the quality of root canal treatment in a Belgian population. Int Endod J. 2000; 33:113–120. PMID: 11307451.
18. Lupi-Pegurier L, Bertrand MF, Muller-Bolla M, Rocca JP, Bolla M. Periapical status, prevalence and quality of endodontic treatment in an adult French population. Int Endod J. 2002; 35:690–697. PMID: 12196222.
19. Kabak Y, Abbott PV. Prevalence of apical periodontitis and the quality of endodontic treatment in an adult Belarusian population. Int Endod J. 2005; 38:238–245. PMID: 15810974.
20. Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pécora JD. A new periapical index based on cone beam computed tomography. J Endod. 2008; 34:1325–1331. PMID: 18928840.
21. Loftus JJ, Keating AP, McCartan BE. Periapical status and quality of endodontic treatment in an adult Irish population. Int Endod J. 2005; 38:81–86. PMID: 15667629.
22. 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; 37:167–173. PMID: 15009405.
23. Alfouzan K, Baskaradoss JK, Geevarghese A, Alzahrani M, Alhezaimi K. Radiographic diagnosis of periapical status and quality of root canal fillings in a Saudi Arabian subpopulation. Oral Health Prev Dent. 2016; 14:241–248. PMID: 26669654.
24. Petersson K, Lewin B, Hakansson J, Olsson B, Wennberg A. Endodontic status and suggested treatment in a population requiring substantial dental care. Endod Dent Traumatol. 1989; 5:153–158. PMID: 2635106.
25. Mukhaimer R, Hussein E, Orafi I. Prevalence of apical periodontitis and quality of root canal treatment in an adult Palestinian sub-population. Saudi Dent J. 2012; 24:149–155. PMID: 23960544.
26. Alrahabi M, Younes HB. A cross-sectional study of the quality of root canal treatment in Al-Madinah Al-Munawwarah. Saudi Endod J. 2016; 6:31–35.
27. Georgopoulou MK, Spanaki-Voreadi AP, Pantazis N, Kontakiotis EG. Frequency and distribution of root filled teeth and apical periodontitis in a Greek population. Int Endod J. 2005; 38:105–111. PMID: 15667632.
28. Ørstavik D. Time-course and risk analyses of the development and healing of chronic apical periodontitis in man. Int Endod J. 1996; 29:150–155. PMID: 9206419.
29. Petersson K, Håkansson R, Håkansson J, Olsson B, Wennberg A. Follow-up study of endodontic status in an adult Swedish population. Endod Dent Traumatol. 1991; 7:221–225. PMID: 1810716.
30. Ariga J, Al-Mutawa S, Nazar H. School oral health program in Kuwait. Med Princ Pract. 2014; 23(Supplement 1):43–46. PMID: 24335161.
31. Kerekes K, Tronstad L. Long-term results of endodontic treatment performed with a standardized technique. J Endod. 1979; 5:83–90. PMID: 296248.
32. Weiger R, Hitzler S, Hermle G, Löst C. Periapical status, quality of root canal fillings and estimated endodontic treatment needs in an urban German population. Endod Dent Traumatol. 1997; 13:69–74. PMID: 9550033.
33. Sjögren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod. 1990; 16:498–504. PMID: 2084204.
34. Schaeffer MA, White RR, Walton RE. Determining the optimal obturation length: a meta-analysis of literature. J Endod. 2005; 31:271–274. PMID: 15793382.
35. Nair PN, Sjögren U, Krey G, Sundqvist G. Therapy-resistant foreign body giant cell granuloma at the periapex of a root-filled human tooth. J Endod. 1990; 16:589–595. PMID: 2094762.
36. Sidaravicius B, Aleksejuniene J, Eriksen HM. Endodontic treatment and prevalence of apical periodontitis in an adult population of Vilnius, Lithuania. Endod Dent Traumatol. 1999; 15:210–215. PMID: 10825828.
37. 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; 16:218–221. PMID: 11202885.
38. 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; 28:12–18. PMID: 7642323.
39. 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; 37:525–530. PMID: 15230905.
40. Hoskinson SE, Ng YL, Hoskinson AE, Moles DR, Gulabivala K. A retrospective comparison of outcome of root canal treatment using two different protocols. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 93:705–715. PMID: 12142878.
Full Text Links
  • RDE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr