The dynamics of periapical lesions in endodontically treated teeth that are left without intervention: a longitudinal study.
BACKGROUND
The long-term dynamics of periapical lesions in endodontically treated teeth is not fully elucidated, thus presenting a clinical dilemma regarding the need for an intervention. The aim of the study was to retrospectively evaluate the long-term dynamics of periapical lesions that were left without intervention in endodontically treated teeth.


METHODS
Periapical status surveys of patients treated in a public dental clinic were retrospectively evaluated for the presence of periapical lesions in endodontically treated coronally restored teeth. The dynamics of the included periapical lesions was evaluated based on the periapical index (PAI) score changes between 2 consecutive periapical surveys of at least a 4-year interval. The influence of various factors on lesion dynamics was statistically evaluated.


RESULTS
The study cohort consisted of 74 patients with a total of 200 endodontically treated teeth having periapical lesions that fulfilled the inclusion criteria. Fifty-seven (28.5%) lesions remained unchanged, 103 (51.5%) lesions worsened (PAI score increased), and 40 (20%) lesions improved (PAI score decreased). Poor root canal filling and poor restoration were found to adversely affect the long-term dynamics of the periapical lesions (P < .05). Age, sex, and the presence of a post had no statistically significant influence on lesion dynamics (P > .05).


CONCLUSIONS
Poor root canal filling and poor restoration may adversely affect the long-term dynamics of periapical lesions that are left without intervention in endodontically treated teeth. Therefore, in cases of poor root canal filling or poor restoration, further intervention may be indicated.
Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: dr.tsesis@gmail.com.
Igor
I
Tsesis
Tomer
T
Goldberger
Silvio
S
Taschieri
Mottie
M
Seifan
Aviad
A
Tamse
Eyal
E
Rosen
D000328:Adult; D000368:Aged; D001641:Bicuspid / Q000473:pathology; D015331:Cohort Studies; D003793:Dental Restoration, Permanent / Q000009:adverse effects / Q000145:classification; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000473:pathology; D010483:Periapical Diseases / Q000145:classification / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011176:Post and Core Technique; D019252:Radiography, Dental, Digital / Q000379:methods; D012189:Retrospective Studies; D012389:Root Canal Obturation / Q000009:adverse effects / Q000145:classification; D019553:Tooth, Nonvital / Q000628:therapy*; D016896:Treatment Outcome
Endodontically treated teeth; periapical lesion; persistent apical periodontits