Prevalence of Apical Periodontitis and Its Associated Factors in Endodontically Treated Teeth: A CBCT Study

The aim of this study was to investigate the prevalence of apical periodontitis and some associated factors in endodontically treated teeth among an Iranian population using Cone-Beam Computed Tomography (CBCT).

In this cross-sectional study, 470 CBCT scans (including 1287 root-filled teeth) were randomly selected from patients referred to a maxillofacial radiology center in Shiraz. Iran, during 2017-2020. Cone-Beam Computed Tomography Periapical Index (CBCTPAI) was used to assess the presence of apical periodontitis. In root-filled teeth with apical periodontitis, the length of the root filling and the presence of missed canals were investigated. Chi-square analysis was used to assess the relationship between apical periodontitis, age, gender of the patients, tooth type, and tooth location. A p value < 0.05 was considered significant.

Apical periodontitis was observed in 23.5% of the root-filled teeth. The prevalence of apical periodontitis in males (26.3%) was significantly higher than females (21.2%) (p value = 0.035). Also, the prevalence of apical periodontitis in root-filled teeth in patients under 50 years old (26.2%) was significantly higher than patients over 50 years old (20.3%) (p value = 0.012). The most common teeth with apical periodontitis were maxillary and mandibular first molars. Among the root-filled teeth with apical periodontitis, under-filling, over-filling and missed canals were observed in 37.6%, 16.2% and 13.9% of cases, respectively.

The prevalence of apical periodontitis in root-treated teeth is relatively high (23.5%). Patients’ age, gender, and type of tooth are among the factors that affect the prevalence of apical periodontitis in endodontically treated teeth.