Prevalence of apical periodontitis in people living with HIV in Southern Brazil / Prevalência de periodontite apical em pessoas vivendo com HIV no Sul do Brasil

Objective: This cross-sectional study aimed to describe the prevalence of apical periodontitis (AP) in people living with HIV (PLHIV) over 50 years old and explore its association with sociodemographic, medical, and oral characteristics. Methods: Data from 59 PLHIV were collected, and the periapical area of 1018 teeth was evaluated through periapical radiographs (Rx) using the periapical index (PAI). The presence and quality of root fillings and restorations (coronal fillings and crowns) were assessed with Rx, and caries presence was based on Rx and clinical data. Viral load (VL) and T CD4 counts were also analyzed. Results: AP prevailed in 71% of individuals and 8% of teeth. Family income of >5 Brazilian minimum wages (OR=0.06, 95% CI=0.005-0.62) and having at least one root-filled tooth (OR=14.55, 95% CI=1.45-145.72) were associated with AP prevalence, whereas VL and T CD4 were not. Caries, root filling, and restorations were associated with AP occurrence. Conclusion: PLHIV presented a high AP prevalence, but intrinsic factors related to HIV infection were not associated with AP in the studied subjects. PLHIV would benefit from oral health policies to prevent AP, as the results indicate that the endodontic disease in the present sub-population might be related to social problems.(AU)

Objetivo: este estudo transversal teve como objetivo descrever a prevalência de periodontite apical (PA) em pessoas vivendo com HIV (PVHIV) acima de 50 anos de idade, e explorar sua associação com características sociodemográficas, médicas e bucais. Métodos: os dados de 59 PVHIV foram coletados e a região periapical de 1018 dentes foi avaliada através de radiografias periapicais (Rx) usando o Índice Periapical (PAI). A presença e qualidade das obturações radiculares e restaurações (restaurações diretas e coroas) também foram avaliadas no Rx; a presença de cárie foi baseada em dados clínicos e radiográficos. Carga Viral (CV) e contagem de linfócitos T CD4 também foram avaliados. Resultados: a prevalência de PA nos indivíduos foi de 71%, e 8% dos dentes apresentaram PA. Renda familiar >5 salários mínimos (OR=0.06, 95% CI=0.005-0.62) e ter pelo menos um dente com obturação endodôntica (OR=14.55, 95% CI=1.45-145.72) foram associados com a prevalência de PA, enquanto que CV e T-CD4 não foram. A presença de cárie, obturação endodôntica e restaurações foram associadas com a presença de PA no dente. Conclusão: PVHIV apresentaram uma alta prevalência de PA, mas fatores intrínsecos relacionados à infecção pelo HIV não foram associados com PA nos sujeitos avaliados. PVHIV se beneficiariam de políticas públicas de saúde para prevenir a PA, uma vez que os resultados indicam que a doença endodôntica na presente subpopulação pode ser relacionada a problemas sociais.(AU)

Lesiones perirradiculares asociadas a primeros molares superiores tratados endodónticamente: estudio a través de tomografías computadas / Periradicular lesions associated with endodontically treated maxillary first molars: study through computed tomography

Objetivos: Estudiar con tomografías computadas de haz cónico (CBCT) las lesiones perirradiculares de primeros molares superiores tratados endodónticamente; evaluar la lo- calización y, en los que tenían lesión en la raíz mesiovestibu- lar (MV), evaluar la frecuencia del conducto MV2. Materiales y métodos: A partir de una muestra de 179 tomografías, que incluían primeros molares superiores, se seleccionaron y analizaron aquellas en las cuales estos ha- bían recibido un tratamiento endodóntico previo, presentaban lesiones perirradiculares y conservaban una restauración co- ronaria. Las variables analizadas fueron: la localización de áreas radiolúcidas compatibles con lesiones perirradiculares de origen endodóntico y la correlación entre diferentes loca- lizaciones y la calidad del tratamiento realizado (adecuado, defectuoso o sin tratamiento). Los datos fueron analizados mediante la prueba de chi-cuadrado y la prueba de Spearman. Resultados: De las 179 CBCT que incluían primeros molares superiores, 90 reunían las condiciones requeridas. La frecuencia de las lesiones perirradiculares fue significativa- mente mayor en la raíz MV al compararla con las raíces disto- vestibular y palatina (p<0,05). El conducto MV1 presentó un tratamiento adecuado en todos los casos. El conducto MV2 recibió un tratamiento adecuado en 4 casos (4,44%), defec- tuoso en 4 casos (4,44%) y no tratado en 82 casos (91,1%); con una diferencia estadísticamente significativa (p<0,05). Conclusiones: En la muestra analizada, la localización de lesiones perirradiculares postratamiento endodóntico en primeros molares superiores se encontró con mayor frecuencia asociada a la raíz mesiovestibular, donde en la mayoría de los casos el con- ducto MB2 no fue tratado o presentó un tratamiento defectuoso (AU)

Aim: To study with cone-beam computed tomography (CBCT) the periradicular lesions of maxillary first molars with endodontical treatment; to evaluate its localization and, in those with a mesiobuccal root (MB) injury, assess the fre- quency of the MB2 root canal. Materials and methods: From a sample of 179 tomog- raphies (CBCT) that included maxillary first molars, those in which they had received previous endodontic treatment, pre- sented periradicular lesions and had a coronary restoration were selected and analyzed. The analyzed variables were: localization of radiolucent areas compatible with periradic- ular lesions of endodontic origin and the correlation between different localizations and quality of the performed treatment (adequate, defective, or untreated). Data were analyzed by the chi-square test and the Spearman test. Results: Of the 179 CBCT that included maxillary first molars, 90 met the required conditions. The frequency of periradicular lesions was significantly higher in the MB root when compared with distobuccal and palatal roots (P<0,05). The MB1 canal presented an adequate treatment in all cas- es. The MB2 canal received adequate treatment in 4 cases (4.44%), a defective one in 4 cases (4.44%) and was untreated in 82 cases (91.1%). The differences among these frequencies were statistically significant (P<0.05). Conclusions: In the analyzed sample, the localization of periradicular lesions after endodontic treatment in maxillary first molars was associated more frequently with the mesio- buccal root in which in the majority of cases the MB2 canal was untreated or presented a defective treatment

Presença de cárie e periodontite apical em pacientes portadores de doença renal crônica com necessidade de transplante renal / Presence of caries and apical periodontitis in patients with chronic kidney disease requiring kidney transplantation

A doença renal crônica (DRC) é caracterizada pela alteração progressiva e irreversível da função dos rins. A presença de lesões cariosas e da periodontite apical exercem influência na saúde sistêmica dos pacientes com DRC. O objetivo do presente estudo foi avaliar a presença de cáries e periodontites apicais em pacientes que estão em tratamento de hemodiálise e na lista de espera para transplante renal. Vinte e seis pacientes aceitaram participar do estudo, porém as informações de um foram excluídas por se enquadrarem nos critérios de exclusão. Então, foi realizado exame clínico e radiográfico periapical em 25 pacientes, onde o índice CPO-D foi determinado considerando as faixas etárias, assim como, foi verificado a presença de periodontites apicais e a sua indicação para tratamento endodôntico ou extração dentária. Os pacientes também relataram práticas de saúde bucal e presença de sintomatologia durante a anamnese. Em 12 pacientes foi detectado pelo menos um dente com lesão cariosa e a média de dentes com lesões de cárie por paciente foi de 2,64. O índice CPO-D foi de 12,66 para pacientes com idade entre 23 e 34 anos, índice considerado moderado pela OMS; CPO-D de 15,71 para pacientes na faixa etária dos 35 à 44 anos e de 17,16 para pacientes entre 45 e 64 anos, índices considerados como "alto" pela OMS. Foi observado a presença de periodontite apical em 32% dos pacientes e a média de lesões por paciente foi de 2,37. Do total de periodontites apicais presentes 7 foram indicadas ao tratamento endodôntico e 6 à extração dentária. Foi observado ausência de cárie e/ou periodontite apical em 10 dos 25 pacientes avaliados. Conclui-se que os pacientes portadores de doença renal crônica possuem alta incidência de lesões de cáries e alta prevalência de periodontites apicais(AU)

Chronic kidney disease (CKD) is characterized by the progressive and irreversible alteration of the function of the kidneys. The presence o f carious lesions and periapical periodontitis have an influence on the systemic health of patients with CKD. The aim of the present study was to evaluate the presence of dental caries and periapical periodontitis in patients undergoing hemodialysis treatm ent and on the kidney transplant. Twentysix patients agreed to participate in the study waiting list of . Because of the inclusion criteria, one of them had to be excluded . Then, a clinical and periapical radiographic examination was performed in 25 patien ts, where the DMFT index was determined considering the age groups, as well as the presence of apical periodontitis and the indication of endodontic treatment or tooth extraction. Patients also reported oral health practices and symptomatology during anamn esis. In 12 patients less than one tooth with dental carie was detected and the average of teeth with dental caries per patient was 2.64. The DMFT index was 12.66 for patients aged 23 to 34 years, a rate considered moderate by the WHO; DMFT of 15.71 for pa tients aged 35 to 44 years and 17.16 for patients aged 45 to 64 years, rates considered "high" by the WHO. Apical periodontitis was observed in 32% of patients and the average of lesions per patient was 2.37. The total apical periodontitis presents 7 indic ators of endodontic treatment and 6 of tooth extraction. Absence of caries and / or apical periodontics was observed in only 10 of 25 patients. It was concluded that patients with chronic kidney disease suffer a high incidence of dental caries and a high p revalence of periapical periodontitis(AU)

Associação entre a periodontite apical e o diabetes mellitus: uma revisão da literatura / Association between apical periodontitis and diabetes mellitus: a literature review

Objetivo: realizar uma revisão de literatura para verificar a relação entre o diabetes mellitus e a periodontite apical (PA). Revisão da literatura: a PA caracteriza-se por uma perda óssea na região do ápice dental, que decorre principalmente da contaminação do sistema de canais radiculares. Embora a PA seja um processo inflamatório local, na região do periápice radicular, sua progressão pode ser influenciada por patologias sistêmicas, como o diabetes. O diabetes melittus é uma patologia crônica na qual há alteração na produção de insulina ou resistência à ação desta, esse hormônio auxilia a manter a concentração normal de glicose sanguínea. O quadro de hiperglicemia crônica presente no paciente diabético descompensado ocasiona alterações fisiológicas, que permitem suspeitar de uma relação entre o diabetes e a progressão de lesões periapicais. Considerações finais: a literatura estudada sugere uma associação positiva entre a presença do diabetes e a progressão de lesões periapicais. Porém, apesar de os estudos apontarem que existe uma maior prevalência de periodontite apical em diabéticos, ainda são poucas as evidências científicas sobre o assunto. (AU)

Objective: the present study aims to review the lit-erature to verify the relationship between diabetes mellitus and apical periodontitis (AP). Literature Review: the AP is characterized by bone loss in the tooth apex region, mainly resulting from the contamination of the root canal system. Although AP is a local inflammatory process in the root peri-apex region, its development may be affected by systemic pathologies such as diabetes. Diabetes mellitus is a chronic condition that causes chang-es in insulin production or the resistance to its action, considering this hormone helps maintain-ing the normal concentration of blood glucose. The chronic hyperglycemia condition in decom-pensated diabetic patients causes physiological changes that allow establishing a relationship be-tween diabetes and the development of the peri-apical lesions. Final considerations: the literature studied suggests a positive association between the presence of diabetes and the development of periapical lesions. However, although studies in-dicate a higher prevalence of apical periodontitis in diabetics, there is still little scientific evidence on the subject. (AU)

Validation of self-reported history of root canal treatment in a southern Brazilian subpopulation

Abstract The aim of this study was to assess self-reported history of root canal treatment (SRHRCT) as a method for detecting the presence of root canal treatment (RCT) and apical periodontitis (AP) in a southern Brazilian subpopulation. In this cross-sectional study, 136 military police officers from the city of Porto Alegre, Brazil, were included. The participants were interviewed and full-mouth periapical radiographs were taken. A calibrated examiner determined the presence of RCT and AP by applying standardized criteria. The diagnostic accuracy of SRHRCT was calculated separately for RCT and AP. Accuracy, sensitivity, specificity, positive and negative predictive values (+PV and -PV), efficiency, and positive and negative likelihood ratios (+LR and -LR) were estimated. The mean age of the participants was 34.1 ± 10.4 years and 88.2% were males. Overall, SRHRCT demonstrated high sensitivity and specificity for RCT, but not for AP: sensitivity (RCT = 0.960, AP = 0.757) and specificity (RCT = 0.835, AP = 0.631). The estimated values for PV and LR were: +PV (RCT=0.777, AP=0.396), -PV (RCT = 0.972, AP = 0.890), +LR (RCT = 5.853, AP = 2.057), and -LR (RCT = 0.046, AP = 0.383). SRHRCT proved to be a good predictor of the presence of RCT, but a weak predictor of AP in this subpopulation.

Periapicopatias inflamatórias de origem endodôntica: estudo multicêntrico na população brasileira / Endodontic periapical lesions: A multicenter study in the Brazilian population

Introdução: as periapicopatias inflamatórias de origem endodôntica são as doenças mais frequentes dos ossos maxilares e ocorrem principalmente como consequência da disseminação da infecção endodôntica. Apesar de vários estudos, não existem dados recentes sobre as características epidemiológicas e clínicas dessas lesões envolvendo uma amostra tão grande da população. Objetivo: Investigar as características epidemiológicas e clínicas das periapicopatias inflamatórias de origem endodôntica, incluindo o granuloma periapical, o cisto radicular e o abscesso periapical. Metodologia: foi realizado um estudo retrospectivo e multicêntrico em quatro instituições com centros de referência em diagnóstico oral no Brasil. Todos os registros histopatológicos foram revisados e foram incluídos todos os casos diagnosticados microscopicamente como granuloma periapical, cisto radicular e abscesso periapical. Foram coletados os seguintes dados demográficos e clínicos: sexo, idade e cor da pele dos pacientes, sintomas, duração, tamanho e localização das lesões e concordância entre o diagnóstico clínico e histopatológico. Análises estatísticas descritivas e bivariadas, utilizando o teste Qui-quadrado de Pearson, foram realizadas. Em casos de variáveis com mais de duas categorias, utilizou-se o teste Z para comparação das proporções de colunas e a correção de Bonferroni. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados: foram encontrados 10.381 casos de lesões periapicais entre 74.931 espécimes arquivados (13,8%) em 65 anos. Os cistos radiculares foram as lesões mais comuns (59,9%). As lesões periapicais acometeram principalmente mulheres (56,1%), com média de idade de 37,01 anos (13 a 100 ± 14,42 anos) e cor de pele branca (59,2%). As lesões eram geralmente assintomáticas (28,1%), persistindo por mais de um ano (13,3%), com tamanho de até 10 mm (25,2%) e localizadas na maxila (60,1%) e região posterior (49,8%). Os cistos radiculares foram maiores (p < 0,001), com maior ocorrência de sintomatologia (p < 0,027) e maior frequência na região posterior (p < 0,001) em relação aos granulomas periapicais. A possibilidade de discordância entre o diagnóstico clínico e histopatológico foi maior nos granulomas periapicais (p < 0,001). Conclusões: as periapicopatias inflamatórias de origem endodôntica foram comuns em serviços de Patologia Bucomaxilofacial, acometendo principalmente adultos. Isso deve ser uma consequência da carga de cáries não tratadas em dentes permanentes. As mulheres são mais afetadas e o cisto radicular é a lesão mais comum.

Introduction: Inflammatory periapical lesions are the most frequent diseases of maxillary bones and occur mainly as a consequence of the dissemination of endodontic infection. Despite several studies, there are no recent data on the epidemiological and clinical characteristics of these lesions involving such a large sample. Objective: To investigate the epidemiological and clinical characteristics of periapical lesions, including periapical granuloma, radicular cyst and periapical abscess. Methodology: A multicenter retrospective study was realized in four institutional reference centers in oral diagnosis in Brazil. Histopathological records were reviewed and included all cases diagnosed microscopically as periapical granuloma, radicular cyst and periapical abscess. Data on patient sex, age, skin color, symptoms, lesion duration, lesion size, lesion location and concordance between clinical and histopathological diagnosis were collected. Descriptive statistics and bivariate analyses using Pearson's Chi-square test were done. A z-test, to compare the column proportions, and Bonferroni correction were used, in the case of variables with more than two categories. P values < 0.05 were considered statistically significant. Results: Were found 10,381 cases of periapical lesions among 74,931 archived specimens (13.8%) in 65 years. Radicular cysts were the most common lesions (59.9%). Periapical lesions affected mainly women (56.1%), with a mean age of 37,01 years (range 13 to 100 ± 14,42) and white-skinned (59.2%). The lesions were generally asymptomatic (28.1%), persisting for more than one year (13.3%), size up to 10 mm (25.2%) and located in the maxilla (60.1%) and posterior region (49.8%). The radicular cysts were larger (p < 0.001), with a higher occurrence of symptomatology (p < 0.027) and higher frequency in the posterior region (p < 0.001) compared to periapical granulomas. The possibility of disagreement between clinical and histopathological diagnosis was higher in periapical granulomas (p < 0.001) than radicular cyst. Conclusions: Endodontic periapical lesions were common in the Bucomaxillofacial Pathology services affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst is the most common lesion.

Cross-sectional assessment of the periapical status as related to quality of root canal fillings and coronal restorations in a Yemeni population

Aim: the present study aimed to examine the influence of the quality of root canal fillings and coronal restorations on the prevalence of periapical lesions. Materials and Methods: Two hundred digital panoramic radiographs were obtained from the archive of Al‑HamziDental Center in Sana’a, Yemen. The final sample consisted of 120 radiographs, and 675 root filled teeth.The quality of root canal fillings was scored according to criteria of length, homogeneity and taper. Coronal status (type of restoration, signs of marginal leakage or decay) was also evaluated. The periapical status was categorized on the basis of presence or absence of radiographical signs of apical periodontitis. Chi-square test was used to determine statistical significance between different parameters. Results: We found that 93.6 percent of root filled teeth were associated with apical periodontitis. Only 9.2 percent of root filled teeth were found to have an acceptable standard of root canal fillings, of which 32.3 percent was also associated to signs of periapical disease. In roots with an unacceptable root canal filling, 95.4 percent had periapical disease. Teeth with good (14.4 percent) and poor (32.9 percent) intra-coronal restorations had apical periodontitis in 93.8 percent and 97.7 percent of cases, respectively. Crown restorations were present in 52.7 percent of root filled teeth, of which 91.0 percent were associated with periapical lesions. Conclusion: The poor technical quality of root canal fillings and coronal restorations is consistent with a high prevalence of apical periodontitis.

Prevalence of endodontic diseases: an epidemiological evaluation in a Brazilian subpopulation

Aim: To determine the prevalence of pulp and periradicular diseases in a Brazilian subpopulation, correlating the prevalence with sex, age and most affected teeth. Methods: Data collected from medical records of patients treated at the Clinic of Specialization in Endodontics of the Federal University of Pernambuco between 2003 and 2010. The following variables were recorded for each patient: sex, age, affected teeth and diagnosed endodontic disease. Using Pearson's chi-square and Fisher's exact tests, the collected data analysis was set at a 5% significance level. Results: From all the treated teeth, 57% were diagnosed with pulp diseases, with the symptomatic irreversible pulpitis being the most prevalent (46.3%), while among the diagnosed periradicular diseases (43%), chronic apical periodontitis was the most prevalent (81%). Pulp diseases were detected in men and women in an unequal mode (p=0.008). Subjects under 40 years old had higher prevalence of pulp disease (p=0.286), and patients over 50 years were most affected by periradicular diseases (p=0.439). Maxillary incisors and mandibular first molars were the most affected teeth by endodontic diseases. Conclusions: In the evaluated subpopulation, the endodontic diseases were more prevalente in the maxillary incisive, affected indiscriminately individuals of different age groups and chronic apical periodontitis was the most prevalent diagnosed disease (Au)

Epidemiological evaluation of apical periodontitis prevalence in an urban Brazilian population

The present study aimed to assess the prevalence of apical periodontitis (AP) in an urban Brazilian population according to gender, age group and tooth type. Data were collected from clinical files containing the medical and dental histories and periapical radiographs of 1,126 patients treated at the School of Dentistry at Universidade do Estado do Rio de Janeiro between March 2000 and December 2010. A total of 15,724 periapical radiographs were evaluated. All the radiographs were evaluated by two independent, previously calibrated endodontists (kappa = 0.88). Periapical areas on the radiographs were classified as N (normal) or AR (apical radiolucency). The frequency of AP and the 95% Confidence Interval (95%CI) were calculated according to gender, age group and tooth type. Differences between groups were calculated using the Z-test at a significance level of 5% (p < 0.05). AP was present in 7.87% of the samples, with 16.70% occurring on previously endodontically treated teeth and 44.65% occurring on teeth referred for endodontic treatment (TR-RCT). The frequency of AP was higher among females (64%) than among males (35%). The central and lateral maxillary incisors were the most frequently affected teeth. The frequency of AP was higher among individuals between 30 and 49 years of age. In this population, AP was more prevalent among females and among individuals between 30 and 49 years of age, and the central and lateral maxillary incisors were the most frequently affected teeth.

Prevalence of apical periodontitis and endodontictreatment in Portuguese adult population / Prevalência da periodontite apical e tratamentoendodôntico na população adulta portuguesa

Introduction: Studies on the prevalence of apical periodontitis and endodontic treatment in Portugal are scarce and outdated. However, studies in other countries have shown that the prevalence of apical periodontitis is high, especially in endodontic treated teeth. Objective: To estimate the prevalence of root-filled teeth and apical periodontitis in an adult Portuguese population. Materials and methods: Panoramic radiographs of a random sample of 222 subjects over 18 years old, who had more than seven teeth, and went to the Faculty of Dentistry, University of Porto, for the first time in 2010, were examined. The number of teeth that were root-filled and the periapical status of all teeth were assessed. Results: Apical periodontitis (PAI ≥ 3) was found in 1.7% of all teeth in the population study. Out of 5.552 teeth, 215 (3.9%) had filled roots. The prevalence of apical periodontitis was greater for root-filled teeth, posterior teeth, and men. The prevalence of apical periodontitis is also increased with age. Conclusion: The prevalence of apical periodontitis in Portugal is similar to its prevalence in other European countries and is higher for root-filled teeth than for non-treated teeth. The prevalence of root-filled teeth is different for Portugal than for other countries, which may be due to the differences in healthcare services provided in various countries.

Introdução: Estudos sobre a prevalência da periodontite apical e o tratamento endodôntico em Portugal são raros e desatualizados. Contudo, estudos noutros países revelaram que a prevalência da periodontite apical é alta, especialmente em dentes com tratamento endodôntico. Objetivo: Estimar a prevalência de tratamento endodôntico e periodontite apical em uma população adulta portuguesa. Materiais e métodos: Foram examinadas radiografias panorâmicas de uma amostra aleatória de 222 indivíduos maiores de 18 anos, que tiveram mais de sete dentes, e que atenderam a Faculdade de Odontologia da Universidade do Porto pela primeira vez em 2010. O número de dentes que receberam tratamento endodôntico e o estado periapical de todos os dentes foi avaliado. Resultados: Encontrou-se periodontite apical (PAI ≥ 3) em 1,7% de todos os dentes na população do estudo. De um total de 5.552 dentes, 215 (3,9%) apresentavam tratamento endodôntico. A prevalência de periodontite apical foi maior para dentes com canal tratado, dentes posteriores e homens. A prevalência de periodontite apical também aumentou com a idade. Conclusão: A prevalência de periodontite apical em Portugal é semelhante à sua prevalência em outros países europeus e é maior para dentes com canal tratado do que para os dentes não tratados. A prevalência de dentes com canal tratado é diferente em Portugal, comparado a outros países, em razão de diferenças nos cuidados de saúde prestados nos países.

Lesiones periapicales agudas en pacientes adultos / Acute periapical lesions in adult patients

Se realizó un estudio analítico de corte transversal en el área de salud del Policlínico 27 de Noviembre del municipio Marianao, La Habana, en el periodo correspondiente de enero a diciembre de 2009. Se incluyeron todos los pacientes que acudieron al servicio de urgencia y que presentaron lesiones periapicales agudas. Se recogió información de las variables edad, sexo, grupo dentario, causa de la enfermedad, características clínicas e higiene bucal. Esta última se clasificó en las categorías eficiente y deficiente según el índice simplificado de higiene bucal. Se utilizó el X² para estimar la relación entre las variables, y la comparación de proporciones para contrastar la hipótesis de que existieran diferencias entre las lesiones periapicales para las categorías de las variables grupo dentario, causa de la enfermedad y características clínicas. Se encontró un predominio del absceso periapical agudo en un 84,7 por ciento del grupo de edad de 35 a 59 años y del sexo masculino, aunque no se encontraron diferencias significativas para estas variables, ni en los grupos dentarios con respecto a la enfermedad. La higiene bucal resultó estar relacionada con las lesiones periapicales. Se encontraron diferencias significativas en las lesiones periapicales respecto a todas las causas estudiadas, con excepción de las enfermedades periodontales. Respecto a las características clínicas hubo significación en cuanto al aumento de volumen del fondo del surco vestibular y la movilidad dentaria(AU)

A cross-sectional and analytical study was conducted in the health area of the 27 de Noviembre of Marianao municipality, La Habana, from January to December, 2009 including all patients came to emergency service presenting with acute periapical lesions. Information on following variables was available: age, sex, dental group, cause of disease, clinical features and oral hygiene. This latter was classified in the efficient and deficient categories according to the simplified index of oral hygiene. To estimate the relation between the variables and the comparison of ratios to contrast the hypothesis on potential differences among periapical lesions for the category of variables of dental group, cause of disease and clinical features. The was predominance of the acute periapical abscess in a 84,7 percent of the 35-39 age group and of male sex, although there were not significant differences for these variables neither in dental groups regarding the disease. The oral hygiene was related to periapical lesions. There were significant differences in periapical lesions regarding all the study causes, except for the periodontal diseases. Regarding the clinical features there was significance as regards the increase of volume of the vestibular groove fundus and tooth mobility(AU)

Frecuencia de periodontitis apical en tratamientos endodónticos de pregrado / Frequency of apical periodontitis in endodontic treatment in undergraduate

La periodontitis apical es una enfermedad de los tejidos periapicales de etiología bacteriana. Su tratamiento requiere erradicar los microorganismos del conducto radicular y obturarlo para lograr la reparación posterior. El objetivo de éste trabajo fue determinar la frecuencia de periodontitis apical en la población que asiste a la clínica de Endodoncia de la Facultad de Odontología de la Universidad de Chile y su relación con diferentes variables: diagnóstico específico, edad, sexo, agudas vs. crónicas, éxito/fracaso del tratamiento y rehabilitación post-tratamiento. Se recolectó información de 292 dientes de pacientes tratados en dicha clínica, analizándose la información de aquellos con dientes diagnosticados con algún tipo de periodontitis apical clasificándolo según la nueva nomenclatura de la asociación de endodoncia americana. La frecuencia de periodontitis apical fue de un 36.7 por ciento (92 pacientes), de los cuales un 77.8 por ciento presentaron patologías de tipo crónicas. Un 75 por ciento de los pacientes pertenecieron al sexo femenino y la 5ta década representó un 34.8 porciento de los pacientes. El 100 por ciento de los pacientes que acudieron a control presentó éxito en sus tratamientos según variables clínico-radiográficas, mientras que la restauración más frecuente post-tratamiento fue la resina compuesta (52.4 por ciento). Dado el pequeño número de pacientes que concurrieron a la citación de control para determinar el éxito del tratamiento, esta variable debe ser considerada como preliminar. Nuestros resultados mostraron que la condición mas frecuente fue la periodontitis apical de tipo crónica, afectando más a mujeres y a la 5ta década.

Apical periodontitis is a microbially induced inflammatory disease of the periapical tissues. Its treatment requires eliminating microorganism from root canal and sealing it properly to induce further tissue repair. The aim of this study was to determine the frequency of apical periodontitis and its distribution by gender, age, range, acute vs. chronic, treatment success and rehabilitation in the population attended at the undergraduate clinic of Endodontic at the Faculty of Dentistry, Universidad de Chile. Information was collected from 292 teeth of patients treated at the clinic, recording data of those with teeth diagnosed with some type of apical periodontitis and related to different variables: specific diagnosis, age, gender, acute vs. chronic, successful or failed treatment and post-treatment restoration. The frequency of apical periodontitis was 36.7 percent (92 patients). 77.8 percent of the teeth with apical periodontitis had a chronic disease. 75 percent of the patients were female. The 5th decade represented a 34.8 percent. There was a 100 percent success rate in their treatments, while the most common restoration was the composite (52.4 percent). The low number of patients who responded to the dental revision to determine the success of the treatment, despite the 100 percent rate, cannot be evaluated as a significant result. Our data showed that the most frequent condition was chronic apical periodontitis, affecting more female patients, and the 5th decade and incisors.

Prevalence of endodontically treated teeth in a Brazilian adult population

This cross-sectional study examined the prevalence of endodontically treated teeth in 1,401 Brazilian adults. Panoramic radiographs were selected at the Radiological Center of Orofacial Images (CRIOF, Cuiabá, MT, Brazil) between August 2002 and September 2007. Three independent endodontists discussed interpretation criteria and classified specimens according to the following data: presence of root canal treatment, which was defined as partially or completely filled canal space, regardless of whether filling ended at the radiographic apex or not; presence of intracanal post; and associated apical periodontitis. Odds ratio, logistic regression and a chi-square test were used for statistical analyses. Significance level was set at p<0.05. Of 29,467 teeth evaluated, 6,313 (21.4 percent) were treated endodontically. Endodontic treatment was most frequent in maxillary premolars and molars, whereas mandibular incisors showed the lowest prevalence. Most endodontically treated teeth were found in people aged 46 to 60 years (47.6 percent, p<0.001) and the prevalence increased with age in this age range. Females (61.9 percent, p<0.001) showed a higher prevalence of teeth with root fillings than males. The present study found a higher prevalence of endodontically treated teeth in a Brazilian adult population compared to the prevalence reported in epidemiological studies conducted in other countries.

O objetivo do estudo transversal foi avaliar a prevalência de dentes tratados endodonticamente em uma população de Brasileiros adultos. Um total de 1.401 radiografias panorâmicas, oriundas do banco de imagens do Centro de Radiologia e Imagens Orofacial de Cuiabá (CRIOF, Cuiabá, MT, Brasil), entre agosto de 2002 e setembro de 2007 foi analisado. Três examinadores avaliaram todas as imagens, considerando-se a presença de tratamento endodôntico, indiferente à qualidade do tratamento (presença ou ausência de retentor intra-radicular ou periodontite apical). Os dados foram estatisticamente avaliados empregando-se razão de chances (odds ratio), regressão logística e teste Qui-quadrado. A partir de 29.467 dentes avaliados, 6.313 (21,4 por cento) eram endodonticamente tratados. Os pré-molares e molares superiores foram os dentes com maior prevalência de tratamento, enquanto os incisivos inferiores representaram o grupo de menor prevalência. Indivíduos do gênero feminino (61,9 por cento), e com idade entre 46 a 60 anos apresentaram maior prevalência de tratamento endodôntico. O presente estudo encontrou elevada prevalência de dentes tratados endodonticamente em adultos Brasileiros comparada com outros estudos epidemiológicos.

Prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults

The aim of this study was to assess the prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults. A total of 1,372 periapical radiographs of endodontically treated teeth were analyzed based on the quality of root filling, status of coronal restoration and presence of posts associated with apical periodontitis (AP). Data were analyzed statistically using odds ratio, confidence intervals and chi-square test. The prevalence of AP with adequate endodontic treatment was low (16.5 percent). This percentage dropped to 12.1 percent in cases with adequate root filling and adequate coronal restoration. Teeth with adequate endodontic treatment and poor coronal restoration had an AP prevalence of 27.9 percent. AP increased to 71.7 percent in teeth with poor endodontic treatment associated with poor coronal restoration. When poor endodontic treatment was combined with adequate coronal restoration, AP prevalence was 61.8 percent. The prevalence of AP was low when associated with high technical quality of root canal treatment. Poor coronal restoration increased the risk of AP even when endodontic treatment was adequate (OR=2.80; 95 percentCI=1.87-4.22). The presence of intracanal posts had no influence on AP prevalence.

O objetivo deste estudo foi avaliar a prevalência e os fatores de risco da periodontite apical (PA) em dentes com tratamento endodôntico em seleta população adulta do Brasil. Um total de 1.372 radiografias periapicais de dentes com tratamento endodôntico foi analisado, considerando-se a qualidade da obturação, o estado da restauração coronária e a presença de pinos intrarradiculares, associados com a PA. Os dados foram analisados estatisticamente empregando-se odds ratio, intervalos de confiança e teste do qui-quadrado. A prevalência de PA associada a tratamento endodôntico adequado foi baixa (16,5 por cento). Este número reduziu-se a 12,1 por cento quando se considerou obturação e restauração coronária adequadas. Os dentes com tratamento endodôntico adequado, porém com restauração coronária inadequada apresentaram prevalência de PA igual a 27,9 por cento. A PA aumentou para 71,7 por cento nos dentes com tratamento endodôntico e restauração coronária inadequados. Quando o tratamento endodôntico inadequado foi combinado com restaurações coronárias adequadas encontrou-se 61,8 por cento de PA. A prevalência de PA foi baixa quando associada com a elevada qualidade técnica do tratamento endodôntico. A restauração coronária deficiente aumentou o risco de PA mesmo na presença de adequado tratamento endodôntico. A presença de pinos intrarradiculares não influenciou a prevalência de PA.

Radiographic study of the prevalence of apical periodontitis and endodontic tratment in the adult population of São Luís, MA, Brazil

This study investigated the prevalence of apical periodontitis (AP) and its association with endodontically treated teeth in residents of São Luís, MA, Brazil. Two-hundred complete series of periapical radiographs taken over a 10-year period (1993-2003) were retrieved from the files of four prosthesists and five periodontists. The Periapical Index (PAI) was used and the age range, sex, tooth groups, location and association with endodontic treatment (ET) were also analyzed. The Cohen Kappa and Chi-square tests were used for statistical analysis. Out of 200 patients, 135 presented at least one case of AP, which corresponds to a prevalence of 67.5 percent. Of the 5008 teeth examined, 296 had AP and 553 had ET. Therefore, considering the total number of teeth, AP and ET prevalences were 5.9 percent and 11 percent, respectively. Of the 553 endodontically treated teeth, 235 (42.5 percent) were associated with AP. Chi-square test showed a strong correlation between AP and ET (p<0.05). The 40-year-old age group was significantly the most prevalent (p<0.05). There was no association between AP and patient's sex (p>0.05). The maxillary incisors were the most affected group of teeth (p<0.05). AP had predilection for the maxilla and was strongly associated with endodontically treated teeth (p<0.05). The prevalence of apical periodontitis and endodontically treated teeth with AP was high and similar to the results of studies performed in other countries.

O objetivo deste estudo foi investigar a prevalência de Periodontite Apical (PA) e sua associação com dentes tratados endodonticamente em residentes de São Luís, MA, Brasil. Foram selecionadas 200 séries completas de radiografias periapicais de arquivos de quatro protesistas e cinco periodontistas dos últimos 10 anos (1993-2003). O índice Periapical (PAI) foi utilizado e a faixa etária, sexo, grupos dentais, localização de maior prevalência e associação aos dentes com tratamento endodôntico (TE) foram analisados. Os testes Cohen Kappa e qui-quadrado foram utilizados para análise estatística. Dos registros de 200 pacientes, 135 apresentavam algum caso de PA, resultando numa prevalência de 67,5 por cento. Do total de 5008 dentes, 296 tinham PA e 553 tinham TE. Desse modo, a prevalência de PA foi de 5.8 por cento e de TE foi de 11 por cento. Dos 553 casos de dentes tratados endodonticamente, 235 (42.5 por cento) estavam associados com PA. A faixa etária de 40 anos foi significativamente mais prevalente (p<0.05). Não houve associação entre PA e sexo (p>0.05). O grupo dental mais acometido foi dos incisivos superiores (p<0.05). A PA teve predileção pela maxila e apresentou-se fortemente associada com dentes tratados endodonticamente (p<0.05). A prevalência de periodontite apical e de tratamento endodôntico de dentes associado com PA encontrada neste estudo foi alta e está de acordo com resultados de estudos realizados em outros países.

Radiographic study of the prevalence of apical periodontitis and endodontic tratment in the adult population of São Luís, MA, Brazil%Estudo radiográfico da prevalência de periodontite apical e tratamento endodôntico na população adulta de São Luís, MA, Brasil

O objetivo deste estudo foi investigar a prevalência de Periodontite Apical (PA) e sua associação com dentes tratados endodonticamente em residentes de São Luís, MA, Brasil. Foram selecionadas 200 séries completas de radiografias periapicais de arquivos de quatro protesistas e cinco periodontistas dos últimos 10 anos (1993-2003). O índice Periapical (PAI) foi utilizado e a faixa etária, sexo, grupos dentais, localização de maior prevalência e associação aos dentes com tratamento endodôntico (TE) foram analisados. Os testes Cohen Kappa e qui-quadrado foram utilizados para análise estatística. Dos registros de 200 pacientes, 135 apresentavam algum caso de PA, resultando numa prevalência de 67,5 por cento. Do total de 5008 dentes, 296 tinham PA e 553 tinham TE. Desse modo, a prevalência de PA foi de 5.8 por cento e de TE foi de 11 por cento. Dos 553 casos de dentes tratados endodonticamente, 235 (42.5 por cento) estavam associados com PA. A faixa etária de 40 anos foi significativamente mais prevalente (p<0.05). Não houve associação entre PA e sexo (p>0.05). O grupo dental mais acometido foi dos incisivos superiores (p<0.05). A PA teve predileção pela maxila e apresentou-se fortemente associada com dentes tratados endodonticamente (p<0.05). A prevalência de periodontite apical e de tratamento endodôntico de dentes associado com PA encontrada neste estudo foi alta e está de acordo com resultados de estudos realizados em outros países