Evaluating the Association Between Periapical Index and Root Canal Treated Teeth: A Comprehensive Retrospective Cross-Sectional Study
DOI:
https://doi.org/10.48047/Keywords:
Endodontic treatment, root canal treatment, periapical index, obturation quality, restoration failure, radiographic evaluation.Abstract
Abstract
Background/Objectives
Root canal treatment aims to eliminate infection, preserve tooth function, and prevent extraction. The long-term success of endodontic treatment depends on multiple factors, including obturation quality, coronal restoration, and periapical status. This study evaluates the association between periapical index and obturation quality in endodontically treated teeth, identifying key failure reasons through radiographic assessment.
Methods
A retrospective cross-sectional study was conducted at Islamic International Dental Hospital, Islamabad, involving 203 endodontically treated teeth from 92 orthopantomograms (OPGs). Teeth with a minimum one-year post-obturation history were included. Radiographs were independently assessed by three examiners using a periapical index scoring system to evaluate periapical health, obturation quality, and failure reasons. Statistical analysis was performed using SPSS v26, applying Cohen’s Kappa, logistic regression, and chi-square tests.
Results
Significant correlations were found between age, gender, and periapical index scores. Tooth fracture (40.6%) was the most common failure reason, followed by absence of a Prosthetic crown (28.7%) and recurrent caries (14.9%). Gender-based analysis showed that females had a higher prevalence of recurrent caries (30%), while males exhibited more restoration failures (23.6%). While obturation quality did not significantly correlate with periapical index, a notable association was observed between obturation and failure reasons (p = 0.107), approaching statistical significance.
Discussion
The findings highlight the importance of periapical status in the success of root canal treatment. Structural failures, such as tooth fractures and lack of coronal coverage, were major contributors to treatment failure. The results emphasize the need for high-quality obturation techniques, post-endodontic restorations, and preventive strategies to enhance long-term treatment success.
Keywords
Endodontic treatment, root canal treatment, periapical index, obturation quality, restoration failure, radiographic evaluation.
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Copyright (c) 2025 Romeysah Adnan, Zarnab Rizwan, Haleema Tariq, Youhamna Rehan, Sabaiyna Suhail, Nawal Altaf, Ujala Anjum, Maryam Sarwar, Syeda Amtul Razeeqa (Author)
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