A retrospective analysis of factors associated with the periapical status of restored, endodontically treated teeth.
OBJECTIVE
The purpose of this study was to explore possible associations between prosthodontic, occlusal, endodontic, and periodontal factors and the endodontic status of endodontically treated teeth.


METHODS
Forty-six patients who had received endodontic treatment followed by a fixed restoration for at least one of their teeth were recalled and examined clinically and radiographically according to a predetermined set of evaluation criteria. A total of 89 teeth were included, and data obtained included assessments of the coronal restoration and post and core, occlusal contact relationships, a number of endodontic parameters, and periodontal status of the study teeth. For the latter assessment, 54 contralateral teeth were available for purposes of comparison. Teeth were grouped into those with and without periapical radiolucencies, and differences between the groups, with respect to all parameters, were analyzed by logistic regression.


RESULTS
Three factors were significantly associated with the presence of radiolucency: confirmed occlusal contact, by virtue of the tooth being either involved in group function or the only contact in working-side and protrusive movements, and endodontic filling and crown margins of poor quality. None of the other independent variables showed significant associations with the dependent variable of periapical radiographic appearance. Contralateral teeth had better periodontal conditions than restored study teeth.


CONCLUSIONS
The finding that a good-quality endodontic filling and crown margin improve endodontic outcome corroborates many other similar reports; however, with occlusal contact shown to be associated with failing endodontic treatment, the range of factors that may influence endodontic outcome appears to have widened.
Iqbal
Mian K
MK
Department of Endodontics, University of Pennsylvania, Philadelphia 19104, USA. miqbal@pobox.upenn.edu
Johansson
Anders A
AA
Akeel
Riyadh F
RF
Bergenholtz
Axel
A
Omar
Ridwaan
R
D000328:Adult; D000368:Aged; D003442:Crowns; D000044:Dental Abutments; D003766:Dental Occlusion; D017267:Dental Prosthesis Design; D003830:Denture, Partial, Fixed; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D010483:Periapical Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D010510:Periodontal Diseases / Q000150:complications; D011176:Post and Core Technique; D011859:Radiography; D012189:Retrospective Studies; D012390:Root Canal Therapy; D018709:Statistics, Nonparametric; D013499:Surface Properties; D019553:Tooth, Nonvital / Q000628:therapy; D016896:Treatment Outcome