The Effect of Apical Periodontitis on Tooth Loss: A Retrospective Study

Abstract

Aim: This study aimed to establish the association between apical periodontitis and tooth loss over an average interval of six years. Material and Methods: A total of 149 patients were included in this study, and they were examined at two different time points using panoramic radiographs, with an average interval of six years. The study also analysed different examination parameters such as age, gender, tooth group, and presence of apical lesion. Descriptive statistical analysis was conducted, including absolute and relative frequencies, and continuous variables such as mean, standard deviation, range, median, and IQR. Survival rates were compared within subjects for root canal treatment status and tooth position (anterior/premolar/molar) at the patient level using the Wilcoxon's test. The significance level used in the analysis was set at 5%. Results: At patient level There was a significantly higher loss of teeth with apical radiolucency (65.2%) compared to those without at baseline. (4.7%) (p<0.001). The loss of untreated anterior teeth with apical radiolucency (31.8%) was significantly higher than that of untreated anterior teeth without radiolucency (4.58%)(p=0.011). The loss of untreated premolars with apical radiolucency (72%) was significantly higher than of untreated premolars without radiolucency (4%) (p<0.001). The loss of untreated molars with apical radiolucency (82%) was significantly higher than that untreated molars without radiolucency (6.75%) (p<0.001). Similarly root canal treated Premolars and Molars with radiolucencies at baseline (65.4% and 82.0% respectively) were lost more than those with no radiolucency (17.6% I n premolars and 6.75% in molars) (P=0.029, and p<0.001 respectively). whereas there was no statistically significance difference in the number of root canal treated anterior teeth lost with (60%) and without radiolucency(8.33%) (P=0.216). At tooth level root canal treated molars were extracted significantly more (x4.84) than root canal treated premolars (x2.37) when compared to anterior teeth (p<0.001). Conclusion: Apical Radiolucency is an important prognostic factor of tooth loss.