Two-year Treatment Outcomes of Teeth With Apical Periodontitis Based on Cone-beam Computed Tomography and Estimated by Means of Periapical and Endodontic Status Scale

Study sample The study participants were adult patients, admitted for general oral rehabilitation to Vilnius Implantology Center, Lithuania, and referred for treatment to a specialist in endodontics during the period December 2016 - December 2019. A total of 140 patients, with 200 teeth with AP, were invited to participate in the study. Ten patients were excluded according to the inclusion criteria, and 2 patients declined to participate. Finally, 128 patients with 176 teeth with AP, agreed to participate in this study. The mean age of the participants was 46 years, range 18-70 years, (SD =12.3).

The inclusion criteria were as follows:

• no systemic diseases present;
• at least one tooth with the diagnosis of AP (necrotic pulp and/or filled root canals) present;
• sufficient periodontal support (absence of clinical periodontal inflammation on an anatomically intact or, on a reduced periodontium of the teeth indicated for treatment);
• baseline CBCT images available (performed for general oral rehabilitation planning purposes, no earlier than one month prior to endodontic procedures).

The diagnosis of apical periodontitis was based on the clinical tests of pulp vitality (sensitivity to heat and cold), percussion, palpation, presence of abnormal bite, swelling, caries, sinus tracts, of unstimulated/stimulated pain, and on the radiological findings. A total of 176 teeth (403 root canals) were subjected to endodontic treatment.

Pregnant women, immunosuppressed patients, and patients presenting with un-restorable teeth (e.g., deep root caries lesion, coronal cracks, root fracture) or, with the probing depths >5 mm around the marginal bone were excluded.