Periapical Health of Endodontically Treated Teeth in Relation to the Quality of the Endodontic Treatment in a Sudanese Population.

Introduction: Apical periodontitis is a chronic inflammatory disorder of periradicular tissues caused by a etiological agents of endodontic origin. Leakage of bacterial elements from the oral environment along the root filling to the periapical region has recently been proposed as an important contributing factor to the persistence or development of periapical lesions in root-filled teeth. Objectives: In this study we investigated the quality of root fillings and coronal restorations and their association with periapical status in an adult Sudanese population. Methods: Periapical radiographs were taken of 70 root-filled teeth selected from patients attending the Department of Conservative Dentistry, Faculty of Dentistry, and University of Khartoum. The coronal status of the teeth was scored according to a modification of Ryge’s criteria for marginal adaptation. The quality of the root filling was assessed radiographically for length and homogeneity. The periapical status was categorized on the basis of presence or absence of signs of apical periodontitis (AP). The relationship between coronal status, quality of root filling and periapical health was determined statistically using Χ2 test. Results: Thirty-four teeth (48.57%) showed signs of AP. The combination of adequate coronal restoration and adequate root filling resulted in significantly reduced incidence of AP of 12.5% compared to 76.47% presence of AP when both parameters scored as inadequate. When adequate coronal restoration and poor root filling was combined together AP was present in 40.9% of the teeth, while the combination of   poor coronal restoration and good root filling associated with 40% presence of the disease. There’s statistically significant relation between the quality of the treatment and the periapical status (P = 0.001). Conclusion: The incidence of AP in root-filled teeth was high. The importance of a good coronal restoration and an adequate root filling should be stressed as they both influence the periapical health.