Post-treatment periapical status related to the quality of root canal fillings in adults living in Vojvodina

Background/Aim. Apical periodontitis (AP) is an acute or chronic inflammation of the periradicular tissue, usually caused by the presence of microbial irritants in the root canal system. The aim of the present study was to radiographically investigate the AP prevalence in root-filled teeth in adults from an urban area of Vojvodina. Methods. Randomly selected digital ortopantomographs of 616 subjects attending the Clinic of Dentistry of Vojvodina, Serbia, were examined. Periapical status, root canal filling (RCF) quality, type of coronal restorations, and their relationships were evaluated. The chi-square test was used for statistical analysis. Results. The total number of endodontically treated teeth was 965, 44.2% of them received an adequate RCF score, and 34.9% had AP, which was diagnosed in 57.4% of inadequately scored root-filled teeth. Posterior teeth had significantly worse RCF quality than anterior teeth (p < 0.001). The direct logistic regression results indicate that a technically well-performed RCF reduced the risk of AP almost 21-fold. The prevalence of AP in our cohort was not influenced by the type of restoration (direct or indirect), but statistically significantly, the highest prevalence of AP was found in rootfilled teeth without any coronal restoration. Conclusion. The results of this study reaffirm that technically high-quality root canal treatment is crucial to ensure a more predictable root canal treatment outcome.