To see the other types of publications on this topic, follow the link: Periapical Index.
Journal articles on the topic 'Periapical Index'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Periapical Index.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Sushma, Yadav, Garg Shalini, Joshi Sakshi, Gupta Anil, Srivastava Ankit, and Dogra Shikha. "Topographic Distribution of Carious Lesion on Young Permanent Mandibular Molars and Its Relation to Periapical Index Score of Apical Periodontitis: A Radiographic Analysis." International Healthcare Research Journal 4, no. 11 (2021): OR14—OR18. https://doi.org/10.26440/IHRJ/0411.02385.
Full textAbstract:
<strong>INTRODUCTION:</strong> Caries in young permanent teeth progress rapidly resulting in early pulp involvement which further progresses into loss of mineralized tissue and severe periapical pathologies. The Periapical Index scoring system (PAI) proposed by Ørstavik et al. in 1986 is an invaluable diagnostic tool used to evaluate periapical lesion extent and severity by 2D digital intraoral periapical radiographic analysis with minimal radiation exposure and hence treatment planning. <strong>AIM:</strong> To evaluate the relationship of the surface distribution of caries in young permanent molars, pulpal involvement and periapical index (PAI) score with respect to individual root forming young permanent mandibular molars. <strong>MATERIALS AND METHOD:</strong> In this retrospective single-centre study, 100 pulpally involved carious young permanent mandibular molars were included, selected from the departmental records between August 2018-2019. Topographic distribution of caries and radiographic analysis (using PAI) was evaluated to see the effect of anatomical site of caries, individual anatomical form of root, and extent & severity of apical periodontitis developed. <strong>RESULT:</strong> No significant correlation between the site of caries involvement and PAI score was observed. PAI score for distal roots was higher(PAI> 2) as compared to mesial root for pulpally involved carious young permanent first molars (p-value mesial root-0.576 , distal root-0.591) <strong>CONCLUSION:</strong> PAI score is independent of the topographic distribution of caries and no correlation was observed. Periapical radiolucency does not depend on caries distribution, either it is mesial, distal or occlusal.
2
Ridao-Sacie, C., J. J. Segura-Egea, A. Fernández-Palacín, P. Bullón-Fernández, and J. V. Ríos-Santos. "Radiological assessment of periapical status using the periapical index: comparison of periapical radiography and digital panoramic radiography." International Endodontic Journal 40, no. 6 (2007): 433–40. http://dx.doi.org/10.1111/j.1365-2591.2007.01233.x.
Full text
3
Rajasekhar, Reshma, Kailash Attur, Kamal Kumar Bagda, Sooraj Soman, and Anjana Anroop. "Volumetric correlation of periapical lesion with Orstavik’s periapical index: A retrospective cone-beam computed tomographic study." Journal of Conservative Dentistry and Endodontics 27, no. 10 (2024): 1054–58. http://dx.doi.org/10.4103/jcde.jcde_475_24.
Full textAbstract:
Abstract Aim: To assess the correlation among cone-beam computed tomographic periapical volume index (CBCTPAVI) and periapical lesion volume with Orstavik’s periapical index (PAI). Methodology: Seventy-six cone-beam computed tomographic (CBCT) and periapical radiographic images of single-rooted teeth presenting with apical periodontitis from 42 patients were obtained from a period of March 2023 to April 2024. Two observers evaluated the periapical radiographs and assigned PAI scores. CBCTPAVI was allocated based on the volume of the lesion, which was computed using ITK-SNAP software. Spearman’s correlation coefficient was employed to evaluate the association between CBCTPAVI and lesion volume with PAI. Results: A significant and moderate positive relationship between PAI and lesion volume (ρ = 0.553, P < 0.001) as well as between PAI and CBCTPAVI (ρ = 0.506; P < 0.001) was observed. Conclusion: The risk of under/overestimation of results on two-dimensional periapical radiographs exists, despite a favorable connection with volumetric assessment of CBCT images.
4
Sahara, Elvi, Rahmi Alma Farah, and Myrna Nurlatifah Zakaria. "Calcium Hydroxide as Intracanal Medicament in Pulp Necrosis with Periapical Lesion : A Case Report." Key Engineering Materials 829 (December 2019): 226–31. http://dx.doi.org/10.4028/www.scientific.net/kem.829.226.
Full textAbstract:
Calcium hydroxide [Ca(OH)2] has been widely used as an intracanal medicament especially in treatment of periapical lesion. This case report will discuss about calcium hydroxide as intracanal medicament in a periapical lesion of an upper left central incisor. This case describes about treatment of periapical lesion with suspect of infected cyst with symptoms and root resorption. Root canal preparation was done by crown down technique using protaper hands universal from S1/27mm until F5/27mm. Calcium hydroxide paste was continuously applicated every 2 weeks as intracanal medicament until the periapical index (PAI) of lesion decrease, in this case PAI decreased from scale 5 until scale 2 during three months recall. Calcium hydroxide supports tissue repair, stimulates fibroblast formation and damage the cytoplasmic membrane of bacteria, denature their proteins or damage the DNA by its alkaline property. As conclusion, the use of calcium hydroxide successfully decrease the periapical lesion index in the periapical radiograph examination and can be considered as a simple and effective medicament for endodontic infection.
5
ÖRSTAVIK, DAG. "Reliability of the periapical index scoring system." European Journal of Oral Sciences 96, no. 2 (1988): 108–11. http://dx.doi.org/10.1111/j.1600-0722.1988.tb01415.x.
Full text
6
Shafshak, Sanaa, Faiz Alsubaie, Faisal Alzamil, et al. "Use of the cone-beam computed tomography-endodontic radiolucency index for determination of lesion extension in periapical periodontitis." International Journal Of Community Medicine And Public Health 8, no. 9 (2021): 4268. http://dx.doi.org/10.18203/2394-6040.ijcmph20213188.
Full textAbstract:
Background: Periapical periodontitis is caused by extension of necrotic pulp tissue into the periodontal ligament area. cone-beam computed tomography (CBCT) facilitates better diagnosis for periapical periodontitis, especially in the absence of clinical symptoms. This study aims to use cone-beam computed tomography-endodontic radiolucency index (CBCT-ERI) to determine the extension of periapical periodontitis in post-graduate clinics of Riyadh Elm university (REU) and to record the extension of periapical periodontitis in the coronal direction along the root surface and evaluate the degree of cortical bone involvement associated with periapical radiolucency.Methods: CBCT images for patients treated at the endodontic clinics of REU were selected for this retrospective observational study. Images were examined after inter-examiner calibrations under the same magnification, slice thickness, and resolution and the measurements were analyzed statistically.Results: The first permanent molars were the most frequently affected by periapical periodontitis, followed by the second molars. The majority of lesions were graded with a score of 6 in length and width according to CBCT-ERI.Conclusions: The use of CBCT-ERI revealed extensive involvement of periodontal tissues around the apices of the roots of the examined teeth. Coronal extension of periapical periodontitis was observed along the root surface. The axial view accurately detected cortical bone involvement, including thinning of the cortical bone, which was the most common manifestation (11.76%). Apical radiolucency was observed most commonly in the first molars.
7
Yasa, I. Putu Gede Andyka, Haris Nasutianto, and Tomohiro Okano. "Diagnostic accuracy of periapical radiolucency using periapical radiography and cone-beam computed tomography." Jurnal Radiologi Dentomaksilofasial Indonesia (JRDI) 7, no. 1 (2023): 1. http://dx.doi.org/10.32793/jrdi.v7i1.934.
Full textAbstract:
Objectives: This research is aimed to compare the accuracy of periapical radiography in detecting periapical radiolucency with that of Cone-beam Computed Tomography (CBCT) and to assess the additional information that CBCT provides.
 Materials and Methods: 96 patients with a primary diagnosis of endodontic problem had been studied retrospectively. Each root was examined for the presence or absence of periapical lesions according to the Periapical Index (PAI) Score. Roots and root canals identified through perapical radiography and CBCT were recorded. Additional information from CBCT regarding effects of lesions in cortical bone and maxillary sinus was also noted. Sensitivity, specificity, positive predictive value, and negative predictive value were analyzed.
 Results: The result showed that accuracy of periapical radiography as expressed by its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) was 0.65, 0.90, 0.86, 0.75, respectively.
 Conclusion: Periapical radiography has a low sensitivity in detecting periapical lesions compared to CBCT. CBCT also provides more detailed information that is useful in endodontic treatment.
8
Kirkevang, L. L., D. Ørstavik, A. Wenzel, and M. Vaeth. "Prognostic value of the full-scale Periapical Index." International Endodontic Journal 48, no. 11 (2014): 1051–58. http://dx.doi.org/10.1111/iej.12402.
Full text
9
Yadav, Sushma, Shalini Garg, Sakshi Joshi, Anil Gupta, Ankit Srivastava, and Shikha Dogra. "Topographic Distribution of Carious Lesion on Young Permanent Mandibular Molars and Its Relation to Periapical Index Score of Apical Periodontitis: A Radiographic Analysis." International Healthcare Research Journal 4, no. 11 (2021): OR14—OR18. http://dx.doi.org/10.26440/ihrj/0411.02385.
Full textAbstract:
INTRODUCTION: Caries in young permanent teeth progress rapidly resulting in early pulp involvement which further progresses into loss of mineralized tissue and severe periapical pathologies. The Periapical Index scoring system (PAI) proposed by Ørstavik et al. in 1986 is an invaluable diagnostic tool used to evaluate periapical lesion extent and severity by 2D digital intraoral periapical radiographic analysis with minimal radiation exposure and hence treatment planning.AIM: To evaluate the relationship of the surface distribution of caries in young permanent molars, pulpal involvement and periapical index (PAI) score with respect to individual root forming young permanent mandibular molars. MATERIALS AND METHOD: In this retrospective single-centre study, 100 pulpally involved carious young permanent mandibular molars were included, selected from the departmental records between August 2018-2019. Topographic distribution of caries and radiographic analysis (using PAI) was evaluated to see the effect of anatomical site of caries, individual anatomical form of root, and extent & severity of apical periodontitis developed.RESULT: No significant correlation between the site of caries involvement and PAI score was observed. PAI score for distal roots was higher(PAI> 2) as compared to mesial root for pulpally involved carious young permanent first molars (p-value mesial root-0.576 , distal root-0.591)CONCLUSION: PAI score is independent of the topographic distribution of caries and no correlation was observed. Periapical radiolucency does not depend on caries distribution, either it is mesial, distal or occlusal.
10
Khetarpal, Ambica. "Radiological assessment of periapical healing using the cone beam computed tomography periapical index: case report." IOSR Journal of Dental and Medical Sciences 9, no. 5 (2013): 46–51. http://dx.doi.org/10.9790/0853-0954651.
Full text
11
Dumitrescu, Alexandra, Maria-Alexandra Martu, Alexandru Nemtoi, et al. "Association between Cone-Beam Computed Tomography and Histological and Immunohistochemical Features in Periapical Lesions Correlated with Thickened Maxillary Sinus Mucosa." Medicina 57, no. 8 (2021): 840. http://dx.doi.org/10.3390/medicina57080840.
Full textAbstract:
Background and Objectives: Odontogenic sinusitis is a frequently underestimated pathology with fewer symptoms in patients with periapical lesions, periodontal disease, or iatrogenic foreign bodies in the maxillary sinus. The aim of our study was to determine the correlation between maxillary sinusitis and periapical lesions using cone-beam computed tomography (CBCT) imaging and histological and immunohistochemical investigations. Materials and Methods: A total of 1450 initial patients diagnosed with maxillary sinusitis in the Ear-Nose-Throat (ENT) Department, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, Romania, were treated with anti-inflammatory drugs. Of these, 629 still had unresolved symptomatology and were later referred to the Dental Medicine departments for further investigations. Only 50 subjects with periapical lesions in the premolar/molar maxillary area were included in the present study. All the periapical lesions were observed on CBCT and classified using the Periapical Status Index (PSI) and the mean maxillary sinus mucosa thicknesses (MSMT). The enrolled patients underwent surgical procedures with the excision of periapical lesions. The excised samples were submitted to the histological and immunohistochemical investigations. Results: The 50 patients presented periapical lesions of their maxillary teeth in 328 dental units. There was a higher prevalence of periapical lesions in men than in women (chi-square test). We observed a significant difference between the mean MSMT of individuals with periapical lesions compared to those without (p < 0.01). Mean MSMT was 1.23 mm for teeth without periapical lesions and 3.95 mm for teeth with periapical lesions. The histopathological study identified 50% cases with periapical granulomas, 10% cases with periapical granulomas with cystic potential, and 40% cases as periapical cysts. Immunohistochemical stainings showed that CD4+ helper and CD8+ cytotoxic T lymphocytes, along with CD20+ B lymphocytes and CD68+ macrophages, were diffusely distributed in all periapical cysts and in some periapical granulomas, but CD79α+ plasma cells characterized especially periapical granulomas. Conclusions: The current study observed a significant correlation between CBCT maxillary mucosa thickness and type of periapical lesion. Chronic inflammatory lympho-histiocytic infiltrate predominates in periapical lesions, supporting the idea that lesion progression is determined by a humoral-type (CD20+ and CD79α+ B lymphocytes) but also by a cellular-type (CD4+ and CD8+ T lymphocyte population) immune mechanism.
12
Srinivasan, Shankar. "Prevalence and Recurrence of Multiple Periapical Cysts in Uncontrolled Diabetic Patients: A Retrospective Observational Study." International Journal of Clinicopathological Correlation 8, no. 2 (2024): 29–34. https://doi.org/10.56501/intjclinicopatholcorrel.v8i2.1183.
Full textAbstract:
Objective: This study aims to examine the prevalence and clinical characteristics of multiple periapical cysts in patients with uncontrolled diabetes, and to assess the association between poor glycemic control, oral hygiene, and cyst recurrence. Methods: A retrospective observational survey was conducted on 5000 diabetic patient records, identifying 2759 individuals with uncontrolled diabetes (HbA1c > 7%). Data were collected on patient demographics, oral hygiene status, presence and recurrence of periapical cysts, and relevant medical history. Oral hygiene was evaluated using DMFT and plaque index scores. Results: Among the 2759 uncontrolled diabetic patients, 2183 (79.1%) demonstrated poor oral hygiene, as indicated by low DMFT and high plaque index scores. Periapical cysts were identified in 983 patients (35.6%), with many exhibiting multiple cysts, particularly in posterior mandibular and maxillary regions. Additionally, 649 patients had a history of periapical cyst surgery, with 45.8% experiencing cyst recurrence, likely due to impaired healing associated with hyperglycemia. Patients also reported high rates of pain, swelling, and tooth mobility linked to cysts. Conclusion: Uncontrolled diabetes is strongly associated with poor oral hygiene, a higher prevalence of multiple periapical cysts, and an elevated rate of cyst recurrence post-surgery. These findings suggest that diabetic patients with poor glycemic control require targeted oral health interventions and close monitoring to prevent complications and improve outcomes. Further research on interventions to enhance wound healing and reduce recurrence in diabetic patients is warranted.
13
Salceanu, Mihaela, Cristina Dascalu, Cristi Giuroiu, et al. "EVALUATION OF PERIAPICAL AREA IN ROOT-FILLED TEETH WITH PERIAPICAL LESIONS: A CBCT STUDY." Romanian Journal of Oral Rehabilitation 16, no. 2 (2024): 353–62. https://doi.org/10.62610/rjor.2024.2.16.31.
Full textAbstract:
The aim of this study is to investigate the possibilities of diagnosis and post-treatment monitoring of chronic periapical lesions. Materials and method. The cross-sectional study included 151 patients (gender: 52 males, 99 females; mean age 48.36 15.708 yrs.) with 391 root-filled teeth (mean follow-up of 5.25 +/- 1.759 yrs.). Clinical examination and radiographic assessment of the root and its periapical area were performed to evaluate its status by PAI-CBCT score. Patients were included in the treatment within the Clinical Education Base “M. Kogălniceanu” of the Faculty of Dentistry, U.M.F. “Grigore T.Popa” Iaşi. CBCT images were obtained using PaX-Uni3D (TVAPANO04, VATECH). The dimensions of periapical lesions in coronal-apical, mesial-distal and buccal-oral sections were measured using the Ez3D 2009 Plus software application. CBCT parameters were set for 20 second exposure time, 85 kV, 5mA. The mean values of the CBCT-PAI index were recorded. Results. Apical periodontitis was diagnosed in 181 endodontically treated teeth, corresponding to a 46,3% prevalence of periapical lesions. The distribution of CBCT-PAI indices was as follows: CBCT-PAI 3 40%, followed by CBCT-PAI 2 40%, CBCT-PAI 4 20%, and CBCT-PAI 5 20%. Conclusion. The most frequent CBCT-PAI score was 3 recorded in 40% of the root-filled teeth. CBCT examination and CBCT-PAI index are precise, reliable and reproducible tools in the evaluation of the post-treatment evolution of the chronic periapical lesions.
14
Sălceanu, Mihaela, Cristina Dascălu, Adina Constantin, Tudor Hamburda, Claudiu Topoliceanu, and Anca Melian. "EVALUATION OF ROOT-FILLED TEETH BY PERIAPICAL AND ENDODONTIC STATUS SCALE (PESS): A CBCT STUDY." Romanian Journal of Oral Rehabilitation 16, no. 3 (2024): 90–99. https://doi.org/10.62610/rjor.2024.3.16.9.
Full textAbstract:
Aim. The aim of study was to assess the root-filled teeth with periapical lesions by using Periapical and Endodontic Status Scale (PEES) index. Materials and method. The study group included 166 filled root canals (70 molars and premolars) in 42 patients (gender: 12 males, 32 females; mean age 35.90 10.571 yrs.) treated in Clinical Base of Faculty of Dental Medicine, U.M.F. "Grigore T.Popa" Iasi. The evaluation of root canals and periapical areas was performed by using the two components of Periapical and Endodontic Status Scale (PEES) index, COPI and ETTI. Results. Distribution of COPI components in the study group was as follows: COPI D: 30,7% D1, 69,3% D3; COPI R: 27,1% R1, 70,5% R2, 2,4% R3; COPI S: S1 16,3%, S2 21,7%, S3 62%. Distribution of ETTI components in the study group was as follows: ETTI L: 42,2% L1, 43,4% L2, 5,4% L3, 5,4% L4, 3,6% L5; ETTI H: 36,7% H1, 63,3% H2; ETTI CS: 10,8% CS1, 89,2% CS2; ETTI CF: 3,6% CF1, 9% CF2, 5,4% CF3, 81,9% CF5. Conclusions. In endodontically treated teeth with apical periodontitis, PEES indices allowed to detect 62% of root canals with periapical lesions with diameter over 5 mm, while more than two thirds of teeth roots had periapical lesions extended in cortical bone (69,3%) affecting more than one root (70,2%). All teeth roots with apical radiolucency and non-treated root canals as well as roots with perforations or resorptions had apical lesions with diameter over 5 mm extended in cortical bone. The presence of apical radiolucency more than one root was associated to overfilling or root resorption.
15
Chaudhary, Sanjeeb, Harender Singh, Archana Gharti, Govind Kumar Chaudhary, and Abhishek Gupta. "Radiographic evaluation of preoperative periapical status in teeth with apical abscess." Journal of Kathmandu Medical College 12, no. 2 (2023): 87–95. http://dx.doi.org/10.3126/jkmc.v12i2.53545.
Full textAbstract:
Background: The presence of preoperative periapical lesion is a significant prognostic factor that influences the outcome of endodontic treatment. Radiographic evaluation of periapical status is important for diagnosis, treatment, and prognosis of periapical lesion. Objectives: To radiographically compare and evaluate the preoperative periapical status using periapical index (PAI) in teeth with acute and chronic apical abscess. Methods: An analytical cross-sectional study was conducted in Chitwan Medical College, between 2022 February to 2022 May using nonprobability convenience sampling technique. Forty-eight periapical radiographs with a diagnosis of apical abscess {24 acute apical abscess (AAA) = Group 1; 24 chronic apical abscess (CAA) = Group 2)} were included for evaluation. Four observers (Three endodontists and one oral radiologist) evaluated the periapical status on radiographs and scored them according to PAI scoring system. Statistical analysis was done using the Mann-Whitney U test and SPSS v.22. Results: The most common PAI score for teeth in Group 1 was three (13, 54.20%) with mean PAI score = 3.21 and in Group 2 the score was four (13, 54.20%) with mean PAI score = 3.79. Analysis of PAI scores found significant differences (p = 0.009, p <0.05) between groups. The distribution of PAI varied according to apical diagnosis (p <0.05). Intraobserver and Interobserver agreement values demonstrated good self-agreement and interobserver agreement. Conclusion: Teeth with CAA were more likely to have higher PAI scores and therefore, periapical radiograph and PAI scoring system can be used effectively for the evaluation of preoperative periapical status in teeth with apical abscess.
16
Manivasagam, Deepigaa, and Arvind Muthukrishnan. "A Comparative Study to Evaluate Periapical Pathology Using Mid Field of View CBCT and Direct Digital Radiography." Journal of Evolution of Medical and Dental Sciences 10, no. 43 (2021): 3659–64. http://dx.doi.org/10.14260/jemds/2021/742.
Full textAbstract:
BACKGROUND Local response of the bone surrounding the apex of the tooth as a result of pulp necrosis or destruction of the periapical tissues caused by significant periodontal disease is known as a periapical inflammatory lesion. Intraoral radiography is the most commonly used technique but has limitations in representing only 2- dimensional images. CBCT was created primarily to provide 3-dimensional maxillary skeletal images and a smaller and mid field of view (FOV) have a higher spatial resolution and improved diagnostic potential. The intention of this study was to compare and evaluate the results of limited view CBCT and DDI in the diagnosis of periapical pathology. METHODS In this study, a total of 25 patients who visited the oral medicine department with clinical and or radiographic findings were included. Periapical lesions were assessed using a cone-beam CT periapical index (CBCTPAI) scoring system in both direct digital imaging (DDI) radiographs and CBCT images. RESULTS Periapical lesions were found to be more prevalent in 30 - 39 years (40 %) with a male predilection (64 %) and maxillary anterior (36 %) more commonly affected. Wilcoxon signed-rank test performed to assess the mean difference between the two imaging modalities revealed a P < 0.001 and was statistically significant. CONCLUSIONS This study highlights the role of CBCT in diagnosing periapical lesions which can be missed or misdiagnosed on DDI. KEY WORDS Cone Beam Computed Tomography (CBCT); Direct Digital Imaging (DDI); Periapical Lesions
17
Spinelli, Andrea, Fausto Zamparini, Jacopo Lenzi, Maria Giovanna Gandolfi, and Carlo Prati. "Clinical Evaluation of a Novel Premixed Tricalcium Silicate Containing Bioceramic Sealer Used with Warm Carrier-Based Technique: A 12-Month Prospective Pilot Study." Applied Sciences 13, no. 21 (2023): 11835. http://dx.doi.org/10.3390/app132111835.
Full textAbstract:
Background: This pilot prospective study analysed the clinical use of a new bioceramic premixed CaSi-containing sealer in association with a warm carrier-based technique. Methodology: Healthy patients (n = 38) requiring 40 root canal treatments were enrolled. Periapical X-rays were taken preoperatively, after root canal filling and after 1, 6, and 12 months. Two evaluators assessed the Periapical Index (PAI) and the sealer extrusion. The healing rate and survival rate were also evaluated. Barnard test was used to assess the relationship of each potential prognostic factor with periapical index (PAI) at 12-month follow-up. The significance level was set at 0.05. Results: Root canal treatments (n = 38) were analysed at the end-line (12 months). The total drop-out was 5% (two patients; two teeth). A total of 31 teeth (82%) (PAI 1-2) showed complete healing, while 7 (18%) are still healing. Cumulative survival was 100%. Apical extrusion of the sealers was observed in 18 cases (47%). Of these extrusions, nine (50%) resulted radiographically undetectable after 12 months. Conclusions: The study supports the use of premixed CaSi-based bioceramic sealers in association with carrier-based techniques. Periapical extrusion of the sealer and its radiographic modification or disappearance are possible events reported in the first 12 months.
18
Boubaris, Matthew, Andrew B. Cameron, Robert Love, and Roy George. "Influence of periapical lesion volume on the radiodensity of surrounding bone: A CBCT study." Journal of Conservative Dentistry and Endodontics 27, no. 6 (2024): 626–33. http://dx.doi.org/10.4103/jcde.jcde_178_24.
Full textAbstract:
Abstract Aim: This study assesses if the size of periapical lesions has an effect on the bone immediately peripheral to an apical lesion. Methods: Cone-beam computed tomography (CBCT) images of 271 periapical lesions were analyzed using Mimics Research™ to determine the CBCT periapical lesion volume index (CBCTPAVI) score, along with the radiodensity of the lesion, lesion border, and surrounding bone in 0.5 mm increments up to 2.0 mm peripheral to the apical lesion. The one-way analysis of variance was used to assess for significant differences in the radiodensity of the lesion, border, and peripheral bone, as well as differences among CBCTPAVI scores. Results: The radiodensity of bone peripheral to the apical lesion increased significantly up to 1.0 mm around the lesion’s perimeter. In addition, lesions with higher CBCTPAVI scores showed a significantly greater difference in the radiodensity from the lesion to the lesion border and the peripheral bone, compared to lesions with smaller CBCTPAVI scores. Conclusions: This study for the first time shows the influence of periapical lesion size on the radiodensity of bone peripheral to an apical lesion. Variations in radiodensity at the perimeter of a periapical lesion can be influenced by the size of the lesion, possibly indicating differences in defense response. Knowledge of these phenomena may provide information on bone healing and enhance our understanding of bone peripheral to a periapical lesion.
19
Hadzic, Arnela, Martin Urschler, Jan-Niclas Aaron Press, et al. "Evaluating a Periapical Lesion Detection CNN on a Clinically Representative CBCT Dataset—A Validation Study." Journal of Clinical Medicine 13, no. 1 (2023): 197. http://dx.doi.org/10.3390/jcm13010197.
Full textAbstract:
The aim of this validation study was to comprehensively evaluate the performance and generalization capability of a deep learning-based periapical lesion detection algorithm on a clinically representative cone-beam computed tomography (CBCT) dataset and test for non-inferiority. The evaluation involved 195 CBCT images of adult upper and lower jaws, where sensitivity and specificity metrics were calculated for all teeth, stratified by jaw, and stratified by tooth type. Furthermore, each lesion was assigned a periapical index score based on its size to enable a score-based evaluation. Non-inferiority tests were conducted with proportions of 90% for sensitivity and 82% for specificity. The algorithm achieved an overall sensitivity of 86.7% and a specificity of 84.3%. The non-inferiority test indicated the rejection of the null hypothesis for specificity but not for sensitivity. However, when excluding lesions with a periapical index score of one (i.e., very small lesions), the sensitivity improved to 90.4%. Despite the challenges posed by the dataset, the algorithm demonstrated promising results. Nevertheless, further improvements are needed to enhance the algorithm’s robustness, particularly in detecting very small lesions and the handling of artifacts and outliers commonly encountered in real-world clinical scenarios.
20
Estrela, Carlos, Mike Reis Bueno, Bruno Correa Azevedo, José Ribamar Azevedo, and Jesus Djalma Pécora. "A New Periapical Index Based on Cone Beam Computed Tomography." Journal of Endodontics 34, no. 11 (2008): 1325–31. http://dx.doi.org/10.1016/j.joen.2008.08.013.
Full text
21
Noferesti, Maryam, Soheila Darmiani, and Homa Rastegar. "A 980 nm Diode Laser as an Adjunctive Therapy on the Healing of Apical Periodontitis Following Endodontic Retreatment: A Randomized Controlled Clinical Trial Study." Journal of Lasers in Medical Sciences 15 (August 5, 2024): e36. http://dx.doi.org/10.34172/jlms.2024.36.
Full textAbstract:
Introduction: Apical periodontitis is one of the common dental diseases. Microorganisms are the main reasons for these lesions; irrigations are used to remove them, but because of limited penetration, the rinsing agents may not always kill the microorganisms. Laser irradiation is effective in canal disinfection. The goal of this study was to compare the effect of calcium hydroxide (Ca(OH)2 ) and diode laser on the improvement of apical periodontitis following root canal retreatment (RCR). Methods: Twenty-four teeth of 19 patients with periapical lesions which needed RCR were divided into two groups (Ca(OH)2 and Ca(OH)2+laser irradiation [LI]). In the first session, after gutta-percha removal, cleaning, and shaping, Ca(OH)2 was used for 10 days. In the second session, in the Ca(OH)2+LI group, the irradiation utilizing a diode laser (using non-initiated 200-µm fiber, continuous wave (CW), power output of 1W) was done. The periapical radiographic healing was assessed before the retreatment and after 3-month and 6-month follow-ups by periapical index (PAI) Qrstavik. The quantitative data were analyzed (P<0.05). Results: The initial periapical lesion score was 3.75 and 3.88 in the Ca(OH)2 and Ca(OH)2+LI groups, respectively. In the Ca(OH)2 and Ca(OH)2+LI groups, 3 months after the RCR, the average periapical lesion score was 2.94 and 3.05, respectively. In the Ca(OH)2 and CA(OH)2+LI groups, 6 months after the RCR, the average periapical lesion score was 1.80 and 1.75, respectively. No significant differences were found at the 3 and 6 months between the experimental groups. Conclusion: The diode laser can reduce the periapical lesion, but there was no significant difference between CA(OH)2+LI and Ca(OH)2 at 3-month and 6-month follow-ups.
22
Neskovic, Jelena, Slavoljub Zivkovic, Milica Medojevic, and Milos Maksimovic. "Outcome of orthograde endodontic retreatment - a two-year follow-up." Srpski arhiv za celokupno lekarstvo 144, no. 3-4 (2016): 174–80. http://dx.doi.org/10.2298/sarh1604174n.
Full textAbstract:
Introduction. Endodontic retreatment is a complex intervention that requires detailed analysis of possible reasons for failure, and flawless practical execution of the procedure. Objective. The aim of the study was to assess the outcome of endodontic retreatment based on clinical and radiographic criteria after a two-year observation period. Methods. Clinical study included 49 teeth indicated for endodontic retreatment based on periapical index (PAI). All teeth were divided into two groups. Group I comprised teeth without any periapical lesion (PAI score of 1 and 2) while Group II consisted of teeth with visible periapical radiolucency (PAI score of 3, 4, and 5). Endodontic retreatment was completed in two visits with inter-appointment medication of 2% chlorhexidine and calcium hydroxide for two weeks. Outcome of endodontic retreatment was evaluated 12-24 months after final obturation. Results. Endodontic retreatment was successful in 93.3% in Group I after 24 months. In Group II, successful treatment and complete healing was found in 52.9% of teeth, whereas 14.7% of teeth showed only partial healing. However, clinical symptomatology was not present in any of the cases. Considering the absence of clinical signs and subjective symptoms, retreatment was successful in 67.6% of cases where chronic periapical inflammation was present. Conclusion. Endodontic retreatment was successful in high percentage in teeth with and without periapical lesions.
23
Jurado Patrón, Oscar David, Andrés Vargas López, Elma María Vega Lizama, Gabriel Alvarado Cárdenas, María Eugenia López Villanueva, and Marco Antonio Ramírez Salomón. "Radiographic characteristics in the periapical healing post endodontic treatment in patients of the Autonomous University of Yucatan, School of Dentistry." Nova Scientia 10, no. 21 (2018): 379–90. http://dx.doi.org/10.21640/ns.v10i21.1592.
Full textAbstract:
Introduction: The radiographic control of the root canal treatment can evaluate the healing of the periapical lesions. The objective of this study was to determinate the characteristics of the radiographic healing that was observed after one year, during follow-up sessions; so, the healing of the lesions according to the periapical pathology at the beginning of the treatment and the causes of failure of the endodontic treatments were recorded.Method: This is a prospective, observational, descriptive and longitudinal study, carried out in patients who attended control one year after endodontic treatment through the Periapical Index (PAI).Results: A total of 395 teeth of patients who underwent endodontic treatment one year prior to data collection, 87 presented radiogaphically observable periapical lesions; of these, 40 (45.97%) attended the control at one year. The frequency of cases in which some degree of radiographic healing was observed one year after treatment was 97.46%. The pathology with more cases of complete healing was periodontitis with sinus tract. In general, 84.61% of the cases decreased two levels in their PAI after one year. The 100% of the cases of failure presented vertical root fractures.Conclusion: The frequency of periapical healing after endodontic treatment is high. The main cause for the failure of the treatments documented in this study was the lack of coronal restoration that caused vertical fractures.
24
Parveen, Sultana, Mozammal Hossain, Md Abdul Hannan Sheikh, and Md Joynal Abdin. "Healing of periapical lesion with mineral trioxide aggregate apexification." Bangabandhu Sheikh Mujib Medical University Journal 11, no. 2 (2018): 122. http://dx.doi.org/10.3329/bsmmuj.v11i2.36448.
Full textAbstract:
<p class="Abstract">In the present study, the ability of mineral trioxide aggregate in the formation of apical plug for healing of large periapical lesion with open apex was assessed and evaluated the clinical outcome. Fifteen participants with periapical lesion at the upper anterior teeth with open apex were treated with mineral trioxide aggregate. The effect on healing of apical size was evaluated at 3, 6, and 12 months by radiological examinations in the form of periapical index criteria, diameter of the lesion size and the presence or absence of apical tissue barrier. The results found that neither pain nor any sinus was detected at 12 months. The mean size of the apical lesion was gradually reduced from 5.1 × 3.8 to 1.5 × 0.9 mm and mean PAI was reduced from 3.3 to 1.7 mm. The differences between mean size of periapical lesion at preoperative and 12 months observation period was also statistically significant (p&lt;0.05). The clinical success shown significant success rate of 93.3% analyzed with Z-test. In conclusion, tooth with open apex can be successfully treated with mineral trioxide aggregate apexification technique followed by root canal obturation.</p>
25
Kirkevang, Lise-Lotte, and Lotte Hein Sørensen. "Danish endodontic practice-based research network: follow-up data." Acta Odontologica Scandinavica 84 (June 10, 2025): 343–48. https://doi.org/10.2340/aos.v84.43857.
Full textAbstract:
Objective: The aim of this prospective, clinical study was to follow-up root canal treatments performed by dentists in the practice-based endodontic research network setting, to assess treatment outcome and factors related to treatment outcome. Material and methods: Baseline information from 536 teeth was included, follow-up information on 269 teeth (50%) was available. Treatments were performed by 12 dentists during 2017–2018. Follow-up period varied from 3.5 months to 3 years. Treatment outcome was assessed in periapical radiographs using the Periapical Index (PAI). Cases were classified as referred or not. Pre-, intra-, and post-operative variables were recorded by the dentists during treatment and analysed at follow-up in relation to treatment outcome. Results: Periapical status improved or remained healthy in 174 (66%) teeth. If PAI at baseline was 3, 4, or 5, the outcome was affected negatively (p = 0.049). The length and seal of the root filling was assessed adequate in 75% and 63% of the teeth, respectively. Adequate seal (p = 0.02) and length (p = 0.03) resulted in improved treatment outcome. Conclusions: When initial periapical status and/or quality of the root filling was good, there was a higher chance of a successful treatment outcome.
26
ÖZBAY, Yağız. "The outcome of single-visit nonsurgical retreatment and patients’ perception of retreatment: a retrospective cohort study with 1-year follow-up." Journal of Health Sciences and Medicine 5, no. 6 (2022): 1619–23. http://dx.doi.org/10.32322/jhsm.1169888.
Full textAbstract:
Aim: To evaluate the outcome of single visit nonsurgical retreatment by clinical examination and PAI (Periapical Index) and, patients’ feedback regarding the nonsurgical retreatment after 1 year.
 Material and Method: 115 patients who previously had nonsurgical retreatment were recalled after 1 year and after dropouts, 84 patients were examined clinically and radiographical examinations were completed pre-and postoperatively using Periapical Index. Patients were also asked if they would still choose nonsurgical retreatment for teeth with previously failed root canal treatment.
 Results: The healing rate after 1 year was 88%. The tooth type did not influence the outcome (p=0.756). While the failure rate was lower in males (3.3%) than in females (16.7%), gender did not affect the outcome (p=0.088). 97.6% of patients had a positive approach to nonsurgical retreatment. There was a statistically significant relationship between treatment outcome and patients' feedback (p=0.013). There is a statistically significant positive correlation between postoperative VAS (Visual Analogue Scale) pain score and postoperative PAI score (p=0.002).
 Conclusion: Single-visit nonsurgical retreatment is a viable option for teeth where certain periapical diseases such as symptomatic apical abscess are excluded. Patients, who experienced successful nonsurgical retreatment, are eager to preserve their tooth with failed primary root canal treatment when nonsurgical retreatment option is available.
27
Sarı, Ayşe Hanne, and Güldane Mağat. "Prevalence of Dens Invaginatus in Maxillary Lateral Teeth and Its Association with Periapical Lesions: A Cone‐Beam Computed Tomography." Journal of Endodontics and Restorative Dentistry 2, no. 2 (2024): 36–40. https://doi.org/10.5281/zenodo.13623834.
Full textAbstract:
<strong>Objectives:</strong> This study aimed to determine the prevalence of Dens Invaginatus (DI) and examine the association between factors such as age, gender, and DI type with the occurrence of periapical lesions.<strong>Materials and Methods:</strong> Cone beam computed tomography (CBCT) images of 250 patients were evaluated. The relationship between gender, tooth number, DI type according to Oehler classification, and periapical lesions (PL) was examined. PL were grouped using Estrela's CBCT Periapical Index (CBCT PAI). Periapical lesion incidence rates were statistically compared using chi-square tests and descriptive statistics. The statistical analysis was performed using SPSS v27.0 software.<strong>Results:</strong> 250 CBCT volumes were examined. The study involved 32 patients (average age 29.15 ± 11.50 years). DI was found in 10.0% of maxillary lateral teeth (11.6% right, 8.4% left) with no significant gender or age group differences (p>0.05). Type I DI was most common in the 15-20 age group. Most teeth had a CBCT PAI=0, with no significant differences across age groups (p>0.05). However, for the right lateral tooth, Type II DI was significantly associated with higher CBCT PAI scores (p<0.05), whereas no significant difference was found for the left lateral tooth (p=0.142).<strong>Conclusion:</strong> DI is a developmental dental anomaly that is relatively prevalent. The presence of associated periapical lesions and the proportion of maxillary lateral teeth impacted by DI should be meticulously assessed during the diagnosis and treatment planning process. Clinicians can more effectively plan and execute treatment by comprehending the prevalence of DI, its subtypes, and their relationship to periapical lesions.
28
Roi, Ciprian, Mircea Riviș, Alexandra Roi, et al. "CD34 and Ki-67 Immunoexpression in Periapical Granulomas: Implications for Angiogenesis and Cellular Proliferation." Diagnostics 14, no. 21 (2024): 2446. http://dx.doi.org/10.3390/diagnostics14212446.
Full textAbstract:
Background/Objectives: The main mechanism of the formation of granulation tissue is the progression of an infection from the tooth to the periapical bone. At this level, the immune system tries to localize and annihilate the microorganism’s injury. Ki-67 is a protein directly associated with the cell proliferation rate, while CD34 is a biomarker involved in angiogenesis, and studies suggest that they both have a positive correlation with the intensity of the local inflammatory infiltrate. This study will determine the immunoexpression of CD34 and Ki-67 in periapical granulomas and assess their impact on the growth and development of this tissue, as well as consider their roles in the proliferative process and aggressiveness of evolution. Methods: In the present study, 35 periapical granulomas obtained after a tooth extraction were included. The specimens were analyzed via histopathology and immunohistochemistry. Results: A positive reaction for the Ki-67 antibody was observed in 32 (86.5%) of the 35 periapical granuloma cases included in our study. We identified the overexpression of Ki-67 and CD34 and further calculated the Ki-67 index to evaluate and correlate the proliferation potential and angiogenesis with regard to the presence of an inflammatory infiltrate. Conclusions: These findings suggest that the persistence of an inflammatory environment directly influences Ki-67 and CD34 expression, sustaining the proliferative capacity of cells and abnormal angiogenesis. This study is the first to evaluate the presence of the CD34+ and Ki-67+ proliferating vessels in periapical granulomas.
29
Steiner, Sina R., Fabio Saccardin, Thomas Connert, and Andreas Filippi. "Changes in periapical status of root canal-treated teeth after head and neck IMRT: a retrospective study." SWISS DENTAL JOURNAL SSO – Science and Clinical Topics 134, no. 2 (2023): 35–52. http://dx.doi.org/10.61872/sdj-2024-09-01.
Full textAbstract:
The objective of this retrospective study was to analyze the effect of the intensity modulated radiotherapy (IMRT) of the head and neck region on root canal-treated teeth and their periapical changes due to radiation. Patients undergoing IMRT of the head and neck region were evaluated. Different types of teeth (molars, premolars, incisors and canines) were compared. Panoramic and dental radiographs were used to assess the periapical region of root canal-treated teeth using the periapical index (PAI) before and after radiotherapy (RT) and put in relation to the radiation dose per tooth. Further parameters (patient-, therapy- and tooth-related factors) were included in this study. One hundred and twenty-four root canal-treated teeth (maxilla and mandible) of 51 patients were observed. A radiolucency in the periapical region was seen in 34.7% of the samples before IMRT and an increasing number of 46% after IMRT (p-value 0.092). Clinical or radiological signs of osteoradionecrosis could not be determined. The only statistically significant difference was detected in regions irradiated with less than 40 Gy (p-value 0.045). In regions irradiated with higher doses (>40 Gy), comparable pathologies increased in non-significant numbers. A statistically significant increase of periapical pathologies was detected in premolars of the maxilla. The observations reported here suggest that a high radiation dose during IMRT has no significant consequences on root canal-treated teeth. To compare the success of endodontic treatment before versus after IMRT, further research needs to be done.
30
Alghamdi, Abdulwahed, Dana Mominkhan, Reem Sabano, et al. "Factors Associated with Postsurgical Pain and Swelling Following Endodontic Microsurgery: The Role of Radiographic Characteristics." Healthcare 13, no. 9 (2025): 995. https://doi.org/10.3390/healthcare13090995.
Full textAbstract:
Objectives: Endodontic microsurgery has become an integral part of daily endodontic practice. However, research on the correlation between the lesion characteristics observed via cone beam computed tomography (CBCT) and pain and swelling after endodontic microsurgery (EMS) is still lacking in the literature. The present study aims to examine the relationship between the radiographic characteristics of preoperative periapical lesions obtained from CBCT images and post-surgical symptoms such as pain and swelling. Materials and Methods: A total of 61 patients undergoing EMS utilizing modern techniques were asked to report their level of pain and swelling at 8, 24, 48, and 72 h after EMS using VAS. Independent variables such as age, gender, tooth location, CBCT periapical index, endodontic diagnosis, cortical bone perforation by the lesion, duration of the EMS, preoperative analgesic consumption, antibiotic prescription, and pre-/postoperative mouthwash were analyzed using the Fisher Exact test. Multivariate regression analysis was also conducted to determine the independent significant factors associated with pain and swelling. A p-value of ≤0.05 was considered statistically significant. Results: The maximum pain score was recorded at 8 h (4.26 ± 3.13), while peak swelling was measured after 24 h (6.46 ± 2.87). The risk of swelling was more likely to decrease by 75.7% for patients with a CBCT index score of >3 than those with a CBCT index score of ≤3 (AOR = 0.243; CI = 0.071–0.831; p = 0.024). The effects of all other factors on pain, including cortical bone perforation by the lesion (p = 0.290), swelling (p = 0.071), postoperative mouthwash use (p = 0.062), and swelling (p = 0.934), did not reach statistical significance. Conclusions: Patients with periapical lesions larger than 4 mm will likely experience less swelling after EMS, while pain is not affected by lesion size, cortical bone perforation, or mouthwash use. Clinical Relevance: This study identified a new predictor of swelling after EMS based on the size of the periapical lesion. These results will improve the management of post-surgical sequelae after EMS and support shared decision making.
31
Boțilă, Mihaela-Roxana, Mihaela Jana Țuculina, Oana Andreea Diaconu, et al. "Retrospective study on the evolution of teeth with endodontic treatment in a group of patients from Craiova – Romania." Romanian Journal of Oral Rehabilitation 16, no. 2 (2024): 225–43. https://doi.org/10.62610/rjor.2024.2.16.22.
Full textAbstract:
The importance of preserving dental tissues together with the evolution of dental techniques and materials has led to advances in the field of endodontics and new principles in tooth restoration. Endodontically treated teeth are more prone to fracture and endodontically treated abutment teeth have a lower survival rate compared to vital abutment teeth. The aim of this study was to establish the evolution of teeth with endodontic treatment in a group of patients from Craiova, the frequency of various forms of failure of endodontic treatment and to identify the factors that contributed to the failure or success of endodontic treatment. Materials and Methods: This study was carried out based on the clinical and radiological examination and the consultation of the treatment sheets of some patients who came for treatment in the Dental Prosthetics Clinic of the Faculty of Dental Medicine of the University of Medicine and Pharmacy Craiova. The general technical quality of the endodontic treatment was evaluated based on the guidelines published by the European Society of Endodontology, following the radiological appearance of the root canal obturation as well as the presence of periapical lesions. The periapical index (PAI) proposed by Orstavik et al. was used to assess the periapical condition of teeth with root canal fillings. Results: The most common indications for endodontic treatment were irreversible pulpitis (64.05%) and endodontic treatment for prosthetic purposes (23.72%). Periapical lesions were observed in 33.4% of all endodontically treated teeth. Periapical lesions were observed in 35.2% of endodontically treated abutment teeth compared to 7.1% of vital abutment teeth. Conclusions: The most common indications for endodontic treatment were irreversible pulpitis and endodontic treatment for prosthetic purposes. Endodontic treatments for prosthetic purpose were very frequent although there are clear recommendations against it. Periapical complications were recorded in a higher proportion in case of abutment teeth.
32
Tarcin, Bilge, Birsay Gumru, Emre Iriboz, Dilek Erbay Turkaydin, and Hesna Sazak Ovecoglu. "Radiologic Assessment of Periapical Health: Comparison of 3 Different Index Systems." Journal of Endodontics 41, no. 11 (2015): 1834–38. http://dx.doi.org/10.1016/j.joen.2015.08.010.
Full text
33
Hossain, Md Ismail, Md Nahid Khurram Choudhury, Md Shamsul Alam, Shahnaz Sultana Beauty, and Farid Uddin. "Evaluation of LSTR 3 Mix MP Therapy for Healing of Periapical Pathosis of Nonvital Teeth." TAJ: Journal of Teachers Association 33, no. 2 (2020): 76–84. http://dx.doi.org/10.3329/taj.v33i2.51343.
Full textAbstract:
Context: LSTR 3 Mix MP therapy is one of the procedures for the management of nonvital tooth with periapical lesion. The principle of this therapy is the complete sterilization of the total pulp canal space, thereby healing of the periradicular lesion. Objectives: To assess the clinical and radiological outcome of ‘Lesion sterilization and Tissue Repair’ (LSTR) for endodontic treatment of nonvital teeth with periapical lesion. Materials and Methods: This descriptive, observational study allocated 40 nonvital teeth with periapical lesion treated by LSTR 3 Mix MP Therapy. In study subjects, a mixture of Metronidazole, Ciprofloxacin and Minocycline (3 Mix) in a proportion of 1:1:1 in ointment (Macrogol mixed with propylene glycol: MP) was placed at the orifice of the root canal or the bottom of pulp chamber after gaining access in the pulp chamber and removal of necrotic pulp, then sealed with Glass Ionomer cement and further reinforced by composite resin. The protocols for follow up examination were 3, 6 and 12 months post operatively. At the time of follow up examination a standard follow up chart was maintained. Results: Out of 40 cases, in 29 cases had good responses both clinically and radiologically and 8 patients came back with some complications. Out of these 8 patients, 6 patients had uncertain outcome and in 2 patients it was unacceptable. Conclusion: LSTR 3 mix MP therapy reduced clinical signs and symptoms successfully in teeth with periapical lesion and radiological improvement of the periapical index was also noted.
 TAJ 2020; 33(2): 76-84
34
Jesus, Sidinéia Feitoza de, Nestor Cohenca, Priscilla Coutinho Romualdo, et al. "Radiographic and Immunohistochemical Evaluation of Root Canal Treatment Using Different Irrigation Systems." Brazilian Dental Journal 30, no. 2 (2019): 123–32. http://dx.doi.org/10.1590/0103-6440201901702.
Full textAbstract:
Abstract The aim of this study was to evaluate the radiographic periapical repair and the synthesis of inflammatory mediators after endodontic treatment in a single session, using different irrigation protocols, in teeth with apical periodontitis. Experimental apical periodontitis were induced in dog’s teeth randomly assigned into 4 groups: G1 - Irrigation by Negative Apical Pressure (n= 20); G2 - Passive Ultrasonic Irrigation (n= 20), G3 - Positive Pressure Irrigation (n= 20); G4 - apical periodontitis without treatment (n= 20). After 180 days, the animals were euthanized, the tissues removed and submitted to histotechnical processing for immunohistochemical analysis of osteopontin (OPN), tumor necrosis factor-a (TNF-a) and interleukin 1-a (IL-1a). Radiographic analysis was performed using the Periapical Index (PAI), obtained prior to and 180 days following endodontic treatment. Data were analyzed using Wilcoxon signed-rank test, Fisher’s Exact test or Kruskal-Wallis test and Dunn’s post-test (a = 5%). Radiographically, after endodontic treatment, apical periodontitis persisted in 35% of G1 specimens, 40% of G2 and 40% of G3 (p>0.05), although a PAI reduction was observed (p<0.05). By immunohistochemical evaluation, endodontic treatment resulted in lower synthesis of TNF-a and OPN in periapical region, compared to apical periodontitis without treatment (p<0.05). Production of IL-1 was not modulated by endodontic treatment (p>0.05). Periapical healing was observed in approximately 60% of the cases after endodontic treatment performed in a single session with lower synthesis of TNF-a and OPN in the periapical region, regardless of the irrigation protocol used.
35
Pandey, Ruchika, Nitin Kararia, Deepak Kumar Sharma, Vishal Rathod, Anand Vilas Bansod, and Dhaval Desai. "Comparative evaluation of postoperative pain and periapical healing after root canal treatment using three different endodontic sealers: A randomized controlled clinical trial." Journal of Conservative Dentistry and Endodontics 27, no. 9 (2024): 962–69. http://dx.doi.org/10.4103/jcde.jcde_334_24.
Full textAbstract:
Aims: A randomized controlled clinical trial to evaluate postoperative pain and investigate periapical healing after root canal treatment using eugenol, resin-based, and calcium silicate-based sealers (CSBSs) sealers. Materials and Methods: Sixty-three individuals diagnosed with apical periodontitis confirmed using cold test and electronic pulp tester, periapical pathology with periapical index score of 2 or more, previous endodontic treatment failure exhibiting a visual analog scale pain score of 3 or above, were enrolled in this investigation. The patients were randomly allocated into three groups and following biomechanical preparation, the canals were obturated using Meta CeraSeal, AH plus, and eugenol-based sealers. Postprocedural pain intensity was assessed at 24 h, 48 h, and 7 days, while periapical healing was evaluated at 3- and 6-month follow-ups. Statistical analysis was done using the Chi-square and Friedman’s test. Results: The mean of periapical lesions for Meta CeraSeal (4.7, 1.6), AH Plus (4.68, 3.19), 24 and eugenol-based (2.66, 1.75) at 3 months and 6 months, respectively. The mean & std. deviation of pain scores at 24 h for Meta CeraSeal (0.62 ± 1.857), AH Plus (1.62 ± 1.962), and eugenol-based (0.48 ± 1.250). At 48 h for Meta CeraSeal (0.33 ± 1.528), AH Plus (1.33 ± 1.798). On the 7th day, Meta CeraSeal (0.24 ± 1.091) and AH Plus (0.71 ± 1.384) for eugenol-based at 48 h, and on the 7th day, none of the patients had pain. Evaluation of the apical sealer puff displayed no suggestive variations (P = 0.634). Notably, no analgesics were taken. Conclusions: No suggestive dissimilarity was noted between eugenol, resin-based, and CSBSs sealers.
36
Rajasekhar, Reshma, Kailash Attur, and Sooraj Soman. "Analysis of volumetric changes following endodontic therapy in teeth with apical periodontitis utilizing cone beam computed tomography periapical volume index: A retrospective observational study." Saudi Endodontic Journal 15, no. 2 (2025): 181–85. https://doi.org/10.4103/sej.sej_283_24.
Full textAbstract:
Abstract Introduction: The fundamental goal of endodontic treatment revolves around the prevention and treatment of apical periodontitis (AP). Several indices based on two-dimensional and three-dimensional imaging systems have been developed for assessing AP. The primary objective of this study was to evaluate the volumetric changes in periapical lesion following endodontic therapy adopting cone-beam computed tomography periapical volume index (CBCTPAVI) using a semi-automatic segmentation software for lesion segmentation and volume calculation. Materials and Methods: This study included pretreatment and follow-up CBCT images of 33 permanent teeth with pulpal necrosis and AP of patients who had endodontic treatment from the department of conservative dentistry from February 2022 to August 2023. ITK SNAP software were used for periapical lesion segmentation from CBCT images and CBCTPAVI were assigned based on calculated lesion volume. Pretreatment and posttreatment lesion volume and CBCTPAVI were compared using the Wilcoxon signed-rank test. Results: There was no significant difference between pretreatment and posttreatment CBCTPAVI scores (P = 0.240); however, a significant difference was seen when lesion volume was compared (P < 0.001). Conclusion: Lesion healing can be clearly appreciated in terms of volume by utilizing segmentation software.
37
Niluh Ringga Woroprobosari, Dinda Vinca Rosa, and Adisty Restu Poetri. "Application Of Tooth Coronal Index (TCI) Benindra Method In Estimating Biological Age at Sultan Agung Dental Hospital Semarang." DENTA 17, no. 1 (2023): 30–36. http://dx.doi.org/10.30649/denta.v17i1.6.
Full textAbstract:
Background: Estimation of age through teeth is one way to identify living and dead individuals. Age estimates can clarify statements of death, legal and civil matters. One way to identify victims is using periapical radiographs. The use of periapical radiographs in age estimation requires certain method, one of which is the TCI (Tooth Coronal Index) Benindra method modified from Drusini's TCI method. Tooth age assessment using Benindra TCI method based on pulp chamber height measurements.Purpose: to clarify the application of TCI Benindra method in estimating biological age in Semarang population. Material and Method: This research was using total sampling method with a number of 23 periapical radiographs with 7 male and 16 female. The estimated age of the Benindra TCI method was done at the age of 9-21 years and using a mandibular premolar. Tooth age assessment was based on measurements of pulp chamber height using the TCI formula, the results of TCI measurements were entered into the prediction age formula to determine the biological age. Result: the average difference between biological age estimated used the Benindra method and chronological age reached 0,46 years in the 9-21 years age group. There were 7 data that underestimated, 6 data over estimation, and 10 data on estimation.Conclusion: The application of the Benindra TCI method shows good results in estimating the biological age of the Semarang population, because the difference between the estimated age and the chronological age produced by this method is quite small.
38
Araújo, Laíssa Gualberto Silva de, Larissa Macedo Marques, Ana Claudia Garcia Rosa, Eduardo Zambaldi da Cruz, and André Machado de Senna. "Prevalence of Apical Periodontitis in a Public Dental Service in Northern Brazil." International Journal of Advanced Engineering Research and Science 9, no. 6 (2022): 265–68. http://dx.doi.org/10.22161/ijaers.96.27.
Full textAbstract:
Apical periodontitis (AP) is characterized by a peri-root inflammatory process presented by the host's immune response, from infections that affect the root canal system. The objective of this study was to verify the prevalence of apical lesions in digital periapical radiographs performed in a public dental care service in the northern region of Brazil. To this end, 3967 digital periapical radiographs performed on patients seen in 2019 were analyzed and classified using the Ørstavik periapical index (PAI). A total of 7172 teeth were analyzed. Four hundred and twenty-one of these teeth had already received endodontic treatment with root filling. The prevalence of AP in teeth without endodontic treatment was equivalent to 14.6%. In teeth with TE, the prevalence was 33.5%. The overall prevalence, when at least one tooth of an individual had apical periodontitis, was 49.9%. The prevalence found was lower than the reported worldwide prevalence, but still considered high in this specific population and indicates the need for directing public policies to improve this condition.
39
Wahyuni, Otty Ratna, Deny Saputra, Nastiti Faradilla Ramadhani, and Dennaya Listya Dias. "Measurement of the lower canine pulp chamber through periapical radiography for age estimation." Jurnal Radiologi Dentomaksilofasial Indonesia (JRDI) 5, no. 2 (2021): 48. http://dx.doi.org/10.32793/jrdi.v5i2.710.
Full textAbstract:
Objectives: The principle of measurement using the TCI (Tooth Coronal Index) method is to compare the pulp chamber height with a person's chronological age based on the formation of secondary dentin. The purpose of this study is to estimate age based on pulp chamber height in lower canines using periapical radiographs with TCI measurement.
 Materials and Methods: This study is an observational analytic study using 42 samples of periapical radiographs with the parallel technique of the lower canines. Samples were measured for CH and CPCH heights to determine TCI values and then linear regression was made to determine their biological age. Finally, the difference between biological and chronological age is calculated to determine the approximate age.
 Results: The mean difference between chronological age and biological age was ± 5.05 years and an average biological age of 29.38 years.
 Conclusion: TCI method based on pulp chamber height in lower canines using periapical radiographs can be used to estimate age with the difference between chronological age and biological age of ±5.05 years.
40
Khadse, Kranti Rajesh, Rana K. Varghese, Malwika Sisodia, Naveen Kumar Gupta, Priyanka Damodhar Ippar, and Anushri Uge. "In vivo evaluation of apical third enlargements to twice and thrice larger than initial apical binding file in final treatment outcome." Bioinformation 20, no. 9 (2024): 1116–19. https://doi.org/10.6026/9732063002001116.
Full textAbstract:
Root canal treatment is a critical procedure in endodontics, aimed at eliminating microorganisms and pathological debris from the root canal system to prevent reinfection and ensure the health of the periradicular tissues. A total of 180 patients with asymptomatic apical periodontitis (PAI score ≥3) were included in this randomized clinical trial. Patients were divided into two main groups, each with three subgroups based on the biomechanical preparation of the canals using different file sizes and tapers. Biomechanical preparation was followed by intracanal medicament placement, and patients were recalled for obturation and final restoration. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 6, 12, 24, 48 and 72 hours post-treatment. Periapical healing was evaluated using the Periapical Index (PAI) at 3,6 and 12 months post-treatment. While larger apical preparation sizes and tapers can enhance periapical healing, excessive enlargement beyond three sizes larger than the IABF does not significantly improve outcomes. Optimal root canal treatment should balance adequate cleaning and disinfection with the preservation of tooth structure.
41
Ianos, Kantor, Sorana Maria Bucur, Ioana Todor, et al. "EFFECTS OF ORTHODONTIC TREATMENT ON PERIAPICAL HEALTH IN ENDODONTICALLY TREATED TEETH." Romanian Journal of Oral Rehabilitation 16, no. 4 (2024): 35–40. https://doi.org/10.62610/rjor.2024.4.16.3.
Full textAbstract:
This retrospective study evaluated the impact of orthodontic treatment on endodontically treated teeth. 32 teeth from 25 patients were analyzed, focusing on CBCT evaluations. All endodontic treatments utilized EDTA and 5.25% NaOCl in conjunction with Er:YAG laser-activated irrigation. Post-treatment assessment revealed that 21 teeth (66%) had root canal fillings of correspondent length, while 10 teeth (31%) were insufficient, and 1 tooth (3%) was uncertain. In terms of density and homogeneity, 25 teeth (78%) were classified as correspondent, 5 teeth (16%) as inadequate, and 2 teeth (6%) as uncertain. The periapical bone destruction probability index (PRI) demonstrated a significant increase in periapical destruction following orthodontic treatment. Specifically, the odds ratios for bone destruction were 1.67 (90% CI: 1.16–2.49, P=0.008) for present versus absent and 1.77 (90% CI: 1.11–2.85, P=0.031) for present versus uncertain. The proportion of teeth without periapical destruction decreased from 15 (14.9%) during treatment to 14 (23.9%) post-treatment. These findings highlight the critical relationship between endodontic quality and treatment outcomes, emphasizing the need for meticulous endodontics during orthodontic therapies.
42
Lewusz-Butkiewicz, Katarzyna, Kinga Kaczor-Wiankowska, Aleksandra Kulas-Bałaban, Elżbieta Kubala, and Alicja Nowicka. "Assessment of endodontic treatment and prevalence of apical periodontitis using cone-beam computed tomography: a cross-sectional study." Polish Journal of Radiology 89 (August 16, 2024): 391–401. http://dx.doi.org/10.5114/pjr/190412.
Full textAbstract:
PurposeThe purpose of this study was a retrospective cross-sectional study of the Polish subpopulation, performed to evaluate the quality of endodontic treatment (ET) and the condition of the periapical tissues of permanent teeth based on cone-beam computed tomography (CBCT) images.Material and methodsThe retrospective study included a group of patients who underwent CBCT at the University Dental Clinic of the Pomeranian Medical University in Szczecin. An endodontically treated tooth index (ETTI) was used to evaluate ET. Once apical periodontitis was recognised, the size, extent, and ratio of adjacent anatomical structures were assessed using the complex periapical index (COPI).ResultsAnalysis of the CBCT images showed that ET was performed in 9.9% of the teeth examined, of which 52.7% of the canals were treated correctly, while 28.1% of the root canals were found to be underfilled, 6.8% were overfilled, 9.3% of the root canals were not obturated at all, and in 3.1% of the teeth examined, the filling material was only visible in the pulp chamber. Apical periodontitis was observed in 6% of all teeth examined, while the percentage of teeth following ET was 38.5%.ConclusionsThe quality of the ET provided to the Polish subpopulation is unsatisfactory. Lack of root canal filling homogeneity is a significant risk factor for ET failure. Improper ET and poor quality of crown restoration after ET have an impact on the increased risk of occurrence, size, degree of root coverage, and extent of inflammatory periapical lesions in relation to adjacent anatomical structures.
43
Si, Hongling, and Ruidi Wang. "Effect of ultrasonic oscillation in combination with laser microsurgery on chronic periapical periodontitis." Postępy Higieny i Medycyny Doświadczalnej 78, no. 1 (2024): 66–73. http://dx.doi.org/10.2478/ahem-2024-0008.
Full textAbstract:
Abstract Introduction We aimed to evaluate the effect of ultrasonic oscillation in combination with laser microsurgery on chronic periapical periodontitis. Materials and Methods Ninety patients with chronic periapical periodontitis admitted from January 2020 to March 2023 were divided into a control group (n=45) and a treatment group (n=45) using a random number table. The control group was treated with laser microsurgery, while the treatment group was given ultrasonic oscillation plus laser microsurgery. Results At 4 weeks and 8 weeks after treatment, the visual analogue scale (VAS) score significantly declined, while the mean gray value (MGV) significantly rose in both groups (P<0.05). The treatment group had a lower VAS score and a higher MGV than those of the control group at 4 weeks after treatment (P<0.05). Old-periapical index (O-PAI) of the treatment group was lower after treatment than that before treatment, and it was lower at 8 weeks after treatment than that of the control group (P<0.05). After treatment, the levels of serum calcium, phosphorus, and alkaline phosphatase in the treatment group were higher than those in the control group (P<0.05). After treatment, their levels declined in both groups, and they were lower in the treatment group than those in the control group (P<0.05). Conclusions Ultrasonic oscillation plus laser microsurgery can treat chronic periapical periodontitis effectively and safely, relieve pain and inflammatory response.
44
Sisli, Selen Nihal. "Evaluation of the Relationship between Type II Diabetes Mellitus and the Prevalence of Apical Periodontitis in Root-Filled Teeth Using Cone Beam Computed Tomography: An Observational Cross-Sectional Study." Medical Principles and Practice 28, no. 6 (2019): 533–38. http://dx.doi.org/10.1159/000500472.
Full textAbstract:
Objective: This study aimed to investigate the prevalence of apical periodontitis (AP) in patients with type II diabetes mellitus (DM) with either optimal glycemic control (OGC) or poor glycemic control (PGC) compared with nondiabetics using cone beam computed tomography (CBCT). Subjects and Methods: The periapical status of 75 teeth with adequate root canal treatment performed at least 1 year ago that could be visualized in the field of view of CBCT images of 43 DM patients (29 females, 14 males) was compared with a control group consisting of 162 teeth of 86 nondiabetics (56 females, 30 males). In addition, the DM group was divided into subgroups according to the patients’ mean glycated hemoglobin level as either having OGC or PGC. The periapical status of the teeth was evaluated using the CBCT periapical index (CBCTPAI), and AP was diagnosed as a CBCTPAI ≥1. χ2, Fisher’s exact test, and independent-samples t tests were used for the statistical analysis, and p < 0.05 was considered significant. Results: Significant differences between the DM group and the control group were observed (p< 0.05) in terms of AP (the frequencies of both CBCTPAI ≥1 and CBCTPAI ≥3) and the frequency of cardiovascular disease, while there were no significant differences between the DM subgroups (p > 0.05). Conclusion: The prevalence of AP and severe bone destruction in periapical tissues was significantly higher in the DM patients compared with the nondiabetic patients.
45
Orstavik, Dag, Kasmer Kerekes, and Harald M. Eriksen. "The periapical index: A scoring system for radiographic assessment of apical periodontitis." Dental Traumatology 2, no. 1 (1986): 20–34. http://dx.doi.org/10.1111/j.1600-9657.1986.tb00119.x.
Full text
46
El Merini, Hafsa, Hind Amarir, Amine Lamzawaq, and Mouna Hamza. "Periapical Status and Quality of Root Canal Fillings in a Moroccan Subpopulation." International Journal of Dentistry 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/1068982.
Full textAbstract:
Aim. The aim of the study was to assess the prevalence of apical periodontitis (AP) and quality of root canal fillings in an adult Moroccan subpopulation. Methods. In the study 508 patients were included, attending the Conservative Dentistry Clinic at the Faculty of Dentistry of Casablanca. 508 panoramic and 709 periapical radiographs were observed. The periapical status of all teeth (with the exception of third molars) was examined according to Ørstavik’s periapical index. The statistical analysis was performed with the software Epi Info Version 6.04dfr, April 2001. Results. A total of 12719 teeth were examined. 45.3% of patients had apical periodontitis. 4.2% of teeth were treated endodontically and 70.4% of these treatments were inadequate. 91,5% with inadequate endodontic treatment presented apical periodontitis, while only 8,2% with adequate endodontic treatment had apical periodontitis. The lower molars and the upper premolars were the most affected teeth. The presence of apical periodontitis was correlated significantly with insufficient root canal fillings (p<0.05). Conclusions. The present study found a high prevalence of apical periodontitis in this Moroccan population. Inadequate root canal fillings were associated with an increased prevalence of apical periodontitis.
47
Sălceanu, Mihaela, Anca Melian, Cristian-Levente Giuroiu, et al. "Influence of Diabetes on Periapical Pathology in Treated and Untreated Teeth: A Cross-Sectional Comparison with Non-Diabetic Patients." Journal of Clinical Medicine 14, no. 11 (2025): 3907. https://doi.org/10.3390/jcm14113907.
Full textAbstract:
The aim of this study was to explore diabetes mellitus type 2 as a risk factor in the prevalence of chronic apical periodontitis (CAP) in untreated and endodontically treated teeth. The second objective was to describe the correlation between the presence of periapical lesions and blood glucose/glycated hemoglobin levels among diabetic (DM) and non-diabetic patients with endodontically treated or untreated teeth with CAP. Materials and methods: This cross-sectional study was conducted on 90 patients (55 with DM, 35 without DM), admitted to the Oral and Maxillofacial Surgery Department of “St. Spiridon” Hospital in Iași, Romania. Endodontic and perapical status was evaluated using the Periapical Index (PAI) based on clinical and radiological evaluations with blood glucose levels and HbA1c analysis. Statistical analysis included data, correlations and regression analysis, and group comparisons using appropriate parametric or non-parametric tests. DM subjects had a higher mean value of untreated teeth with CAP (2.53 vs. 2.00) compared to the control group (p = 0.010) and a lower mean number of endodontically treated teeth without CAP (1.53 vs. 2.74) compared to the control group (p < 0.001). Diabetic patients also had a higher mean number of root-filled teeth with CAP (3.33 vs. 1.94; p < 0.001). Conclusions: There was a clear association between diabetes and oral pathology, with diabetic patients having fewer teeth, more untreated teeth, and a higher prevalence of periapical lesions. Elevated blood glucose and HbA1c levels indicated that poor metabolic control negatively impacts periapical healing and overall endodontic health.
48
Pantaleo, Giuseppe, Alessandra Amato, Alfredo Iandolo, et al. "Two-Year Healing Success Rates after Endodontic Treatment Using 3D Cleaning Technique: A Prospective Multicenter Clinical Study." Journal of Clinical Medicine 11, no. 20 (2022): 6213. http://dx.doi.org/10.3390/jcm11206213.
Full textAbstract:
Background: Various irrigation techniques for cleansing the endodontic space have been proposed, and internal heating combined with ultrasonic activation (3D cleaning technique) is considered an effective technique. This prospective multicenter clinical study aims to evaluate healing rates for teeth after root canal treatment utilizing the 3D cleaning technique and to report predictive values for success. Material and Methods: Ninety patients referred for a root canal treatment were included. All enrolled patients were treated with the 3D cleaning protocol. Four endodontists performed the clinical procedures and follow-up evaluations. Preoperative, postoperative and follow-up data were gathered from the consented patients. Each patient was assessed for any clinical signs or symptoms. Afterwards, two trained, blinded, and independent evaluators scored the subject’s periapical radiographs. This score was made by checking for the presence or absence of apical periodontitis using the periapical index (PAI). Then, the teeth were classified as healing or healed and were considered a success based on a cumulative success rate of healing. Statistical analysis was performed using the Fisher’s exact test, Pearson correlation, and logistic regression analyses of the preoperative prognostic factors at a 0.05 significance level. Results: 90 patients were evaluated at two years with a follow-up rate of 97.7%. The cumulative success rate of healing was 95.4%. Eight predicting aspects were identified by employing bivariate analyses. Then, using logistic analyses, the two prognostic significant variables directly correlated to healing were the preoperative presence of periapical index (p value = 0.016). Conclusions: In this two-year clinical study, the cumulative success rate of healing was 95.4% when patients were treated with the 3D cleaning protocol.
49
Ma, Qiuxiang, and Yi He. "Effect of Multiple-Visit Root Canal Therapy on the Nutritional State of Patients with Acute Pulpitis Complicated by Pulpal/Periapical Disease." Current Topics in Nutraceutical Research 22, no. 1 (2023): 295–302. http://dx.doi.org/10.37290/ctnr2641-452x.22:295-302.
Full textAbstract:
Acute pulpitis poses a serious threat to oral health and nutritional status, making prompt treatment crucial. In this study, we compared the therapeutic effects of single-visit versus multiple-visit root canal therapy on patients with acute pulpitis complicated by pulpal/periapical disease. First, 76 patients with acute pulpitis complicated by pulpal/periapical disease who underwent root canal therapy in our hospital from January 2020 to January 2023 were selected and randomly divided into Groups A and B for single-visit and multiple-visit root canal therapy, respectively. The differences in clinical outcomes and nutritional status were compared. The results showed that both groups exhibited no statistical difference in the duration of medication, bite force, and masticatory efficiency (P > 0.05). Group A demonstrated a shorter pain resolution time, treatment completion time, and a lower incidence of adverse reactions (P < 0.05). Conversely, the Group B exhibited a better clinical efficacy and higher gingival index and sulcus bleeding index (P < 0.05). Additionally, there was no difference in the posttreatment markers of nutritional status between the two groups (P > 0.05). However, the results of the modified quantitative subjective global assessment survey were better in Group A.
50
Korona-Glowniak, Izabela, Dominika Piatek, Emilia Fornal, et al. "Patterns of Oral Microbiota in Patients with Apical Periodontitis." Journal of Clinical Medicine 10, no. 12 (2021): 2707. http://dx.doi.org/10.3390/jcm10122707.
Full textAbstract:
In this study, microbial diversity of the root canal microbiota related to different endodontic infections was investigated. In total, 45 patients with endo–perio lesions (8 patients), chronic periapical periodontitis (29 patients) and pulp necrosis (8 patients) were recruited. In 19 (42.2%) patients there was secondary infection of root canals. Microbial specimens were collected from root canals of non-vital teeth with or without changes in periapical area visible in X-ray. Then, oral microbiota were detected and identified using the culture method and real-time PCR amplification primers and hydrolysis-probe detection with the 16S rRNA gene as the target. Overall, 1434 species/genes from 41 different genera of 90 various microbial species were retrieved. Of the major reported phyla, Firmicutes (62.9%), Actinobacteria (14.0%), Bacteroidetes (12.1%), Proteobacteria (9.1%) and Fusobacteria (4.2%) were detected. Of the bacterial species, 54.6% were strict anaerobes. Corynebacterium matruchotii (p = 0.039) was present significantly more frequently in chronic periapical periodontitis. Moreover, the higher values of Decayed, Missing and Filled Permanent Teeth index were positively correlated with relative abundance of Actinomyces spp. (p = 0.042), Lactobacillus spp. (p = 0.006), Propionibacterium spp. (p = 0.024) and Rothia spp. (p = 0.002). The multivariate analyses revealed differences in total root canal samples, where components that affected grouping of root samples into four main categories were identified. Anaerobic Gram-negative bacteria predominated in root canals of teeth with pulp necrosis and periapical lesions. Facultative anaerobic Gram-positive bacteria predominated in canals with secondary infections. All detected members of mixed population groups that might serve as keystone species contributed to the entire community in its clinical relevance.