Clinical decision-making and importance of the AAE/AAOMR position statement for CBCT examination in endodontic cases.

AIM: To compare conventional radiographic and cone beam computed tomography (CBCT) findings with reference to the American Association of Endodontics and American Academy of Oral and Maxillofacial Radiology (AAE/AAOMR) joint position statement and to determine the effect of the CBCT on the initial diagnoses and treatment plans in a single-centre Postgraduate Endodontic Programme. METHODOLOGY: The clinical CBCT scans of patients, treated at the Endodontic Department of the University of British Columbia, were reviewed for CBCT referrals by comparing them with corresponding radiographs. The features considered were periapical lesions, missed/extra canals, root fractures, complex anatomy, calcified canals and root resorption of tooth/teeth in question. Reasons for the CBCT prescriptions were assigned to 3 groups: to formulate the primary diagnosis, to confirm the diagnosis achieved by clinical examination and conventional radiographs, and to assist in treatment planning. Variables were compared statistically using chi-square and McNemar tests. RESULTS: A total of 128 CBCT examinations were performed on 110 patients. No CBCT examination was performed more than once on the same tooth. Overall, 76% of CBCT examinations were performed on previously root filled teeth. CBCT images revealed a significantly higher incidence of periapical lesions (P = 0.002), missed canals (P < 0.001), vertical root fractures (P = 0.004) and complex anatomy (P = 0.008) than periapical radiographs. CBCT was prescribed most frequently to assist surgical treatment planning (62%) rather than for generating a diagnosis (9%) or confirming diagnoses (29%). Both the diagnosis (P = 0.001) and the treatment plan (P = 0.005) initially made by examining periapical radiographs were altered significantly by the subsequent CBCT examination by revealing information such as new periapical lesions, missed canals or involvement of buccal or lingual cortical bone. CONCLUSION: CBCT examinations were prescribed mainly to assist treatment planning rather than for diagnosis. The majority of CBCT examinations were performed on previously root filled teeth. The additional information obtained from CBCT scans resulted in the alteration of the initial diagnoses as well as subsequent treatment plans in 59 out of 128 cases.

A cluster randomized theory-guided oral hygiene trial in adolescents-A latent growth model.

OBJECTIVES: (i) To test whether theory-guided interventions are more effective than conventional dental instruction (CDI) for changing oral hygiene in adolescents and (ii) to examine whether such interventions equally benefit both genders and different socio-economic (SES) groups. METHODS: A total of 244 adolescents were recruited from three schools, and cluster randomization allocated adolescents to one of the three types of interventions: two were theory-based interventions (Precaution Adoption Process Model or Authoritative Parenting Model) and CDI served as an active control. Oral hygiene levels % (OH) were assessed at baseline, after 3 months and after 12 months. RESULTS: A complete data set was available for 166 adolescents (the total follow-up rate: 69%). There were no significant differences in baseline OH between those who participated throughout the study and those who dropped out. Bivariate and multivariate analyses showed that theory-guided interventions produced significant improvements in oral hygiene and that there were no significant gender or socio-economic differences. CONCLUSIONS: Theory-guided interventions produced more positive changes in OH than CDI, and these changes did not differ between gender and SES groups.

Mothers' self-efficacy and children's oral health.

OBJECTIVES: To (i) test the validity of the Spanish Self-Efficacy Scale for Maternal Oral Care (SESMO), (ii) compare SESMO scores among socio-demographic groups and (iii) relate mothers' SESMO to children's dental status. METHODS: A limited census sample included 130 children and their mothers. The SESMO was applied through an interview, and the children's DMFT/dmft (number of decayed, missing and filled teeth) and OHI-S (oral hygiene score) were assessed through clinical examinations. To test the internal consistency and validity, the Spanish and English SESMO versions were compared. Dental status and oral hygiene were examined in different socio-demographic groups. RESULTS: Most of the families were from the middle socio-economic class, and the majority of children (65%) were ≤6 years of age. Cronbach's α was 0.82 for the English SESMO and 0.86 for the Spanish SESMO; both versions had a three-factor structure (one for each self-efficacy subscale). Overall, the factor loadings of the total and its subscale items were similar between the two SESMO versions. There was a correlation between the mothers' self-efficacy and the children's dental health status in deciduous dentition. CONCLUSIONS: The Spanish SESMO scale had similar internal consistency and validity as the previously validated English SESMO scale. Mothers' self-efficacy was associated with children's dental status in deciduous dentition but not with children's status in permanent dentition.

Student ePortfolios to develop reflective skills and demonstrate competency development: Evaluation of a curriculum pilot project.

INTRODUCTION: The University of British Columbia Faculty of Dentistry developed a longitudinal curriculum pilot project to assess the usefulness of portfolios for dental students to develop reflective skills and demonstrate competency development, and to examine relationships between portfolio grades and clinical success. MATERIALS AND METHODS: Students in one dental class created portfolios with reflections on examples relevant to eight selected competency statements each year of the program. As part of our program evaluation, we set out to look at trends in portfolio grades, meta-reflection skills, student and faculty views of the project, and relationships among portfolio grades, 4th year clinical grades and faculty rankings. RESULTS: Portfolio grades improved from years 1 to 3, dropping off slightly in year 4. The highest level of internal consistency for grades within and between years occurred with Competency 42, while the lowest level occurred with Competency 4. Most students were able to demonstrate meta-reflection by 4th year. Students generally agreed with portfolios and reflection in concept, but suggested a looser structure, and they shared concerns with faculty about the workload involved. Portfolio grades did not correlate with clinical course grades (P = 0.092), but they did correlate significantly with faculty rankings except for year 1. CONCLUSION: While portfolio grades for reflections were not consistent, and they did not quite correlate with clinical course grades, they correlated strongly with faculty rankings. Future use of portfolios at UBC Dentistry will be enhanced by increasing curricular support regarding both competency development and the importance of reflection for professionals, decreasing workload by focusing on five Key Competencies, incorporating more formative and face-to-face feedback, and providing greater opportunities for peer sharing.

Time trends and determinants of acute odontogenic maxillofacial infections in Lithuania: a retrospective national 2009-2013 treatment data audit.

OBJECTIVES: To examine the distribution of treatment facilities accepting patients with acute odontogenic maxillofacial infections (AOMIs), time trends in incidence and relate these infections with a number of determinants. METHODS: A national Lithuanian retrospective study gathered data on all patients treated in outpatient/inpatient treatment facilities. Adjusted Incidence Ratios (AIRs) of AOMIs were calculated separately for each type of infection and for each year. Administrative districts (ADs) were grouped into low, medium, and high thirds based on the regional determinants: socio-economic index (R-SEI), access to basic (R-BDCI) or specialized dental care (R-SDCI) and index of systemic diseases (R-ISD). RESULTS: There were no statistically significant geographical differences in the distribution of TFs providing care for patients with AOMIs. Numbers of treatment facilities consistently increased from 2009 to 2013, but there was no consistent increase/decrease in the incidence of AOMIs (-1%). Regions with the highest R-SEI tended to have a higher incidence of AOMIs as compared to regions with medium or low R-SEI. When controlled for other determinants, lower R-BDCI/R-SDCI scores were associated with a higher incidence of AOMIs. CONCLUSIONS: High annual incidences (-1% of a total population) were diagnosed and treated for AOMIs, but there was no consistent time trend for these infections.

Dental health and disease in patients with haemophilia--a case-control study.

Management of patients with hereditary bleeding disorders in dentistry causes considerable problems. This study examined different aspects of dental health or disease of Lithuanian children and adults with haemophilia and compared them with the general population. Two study groups of cases and controls were formed. Cases were recruited through census sampling and controls were randomly chosen from the general population matched for gender, age and place of residence. Dental health of permanent and deciduous dentitions was assessed by one examiner employing the WHO Criteria for Oral Health Surveys. The following aspects of dental health/disease were considered: overall caries experience, treatment experience, unmet dental treatment needs and the presence of functional dentition. Data were collected from 76 patients with haemophilia among which 27 were children and 49 were adults and a control group of 76 subjects comprising 30 children and 46 adults. Children with haemophilia had a significantly lower overall caries experience and less unmet dental treatment needs in deciduous teeth as compared to healthy children. In permanent dentitions, overall caries experience, unmet dental treatment needs or treatment experience did not differ between cases and controls either in older children or adult cohorts. There were no differences between the study groups regarding the functional dentition-related indices. Healthier deciduous teeth were observed in children with haemophilia than in children without haemophilia, but other dental health or disease-related outcomes did not differ between cases and controls.

Dental treatment needs in vancouver inner-city elementary school-aged children.

Aims. To examine the dental treatment needs of inner-city Vancouver elementary school-aged children and relate them to sociodemographic characteristics. Methods. A census sampling comprising 562 children from six out of eight eligible schools was chosen (response rate was 65.4%). Dental treatment needs were assessed based on criteria from the World Health Organization. Results. Every third child examined needed at least one restorative treatment. A higher proportion of children born outside Canada were in need of more extensive dental treatments such as pulp care and extractions compared to the children born in Canada. There were no statistically significant differences in dental treatment needs between age, gender, or income groups or between children with or without dental insurance (Chi Squared P > 0.05). The best significant predictors (Linear Multiple Regression, P > 0.05) of higher dental treatment needs were being born outside Canada, gender, time of last dental visit, and family income. Having dental insurance did not associate with needing less treatment. Conclusion. A high level of unmet dental treatment needs (32%) was found in inner-city Vancouver elementary school-aged children. Children born outside Canada, particularly the ones who recently arrived to Canada, needed more extensive dental treatments than children born in Canada.

Mode of delivery, mutans streptococci colonization, and early childhood caries in three- to five-year-old Thai children.

OBJECTIVE: To investigate whether mode of delivery is associated with mutans streptococci (MS) colonization and early childhood caries (ECC) in preschool Thai children. METHODS: Three hundred and fifty mothers and their 3- to 5-year-old children (184 born vaginally and 166 born by Caesarean section) participated in the study. Data included a dental examination, MS colonization assessed by the Dentocult(®) SM Strip Mutans method, and a questionnaire survey of family socio-demographic information, as well as children's birth history, dietary habits, and oral health practices. RESULTS: Overall, ECC prevalence was 56% in 3-year-old and 78% in 5-year-old Thai children. Compared to children delivered by C-section, vaginally born children experienced increased ECC prevalence (73.8% versus 59.6%; P = 0.009) and were more likely to have higher MS scores (OR = 1.8, 95% CI = 1.1-2.9), adjusting for mother's gestational age, MS score, feeding practice habits; child's age and tooth brushing habits. Children's MS scores were highly correlated with their mothers' MS scores (P < 0.001). Additionally, children's age, MS colonization, and mothers' prechewing feeding habits were the most significant risk indicators for ECC in Thai children. CONCLUSION: Our findings suggest that mode of delivery is significantly correlated with MS colonization and caries outcomes in young Thai children. Future studies are needed to further understand the possible biological mechanisms linking mode of child delivery to the colonization of cariogenic microbiota and development of ECC.

Oral hygiene education in adolescence based on the Precaution Adoption Process Model.

OBJECTIVE: The present study hypothesised that interventions based on the Precaution Adoption Process Model (PAPM) are more effective than the conventional approach in modifying oral hygiene behaviour in adolescents. METHOD: A stratified random sampling method was used with subject groups (classrooms) randomly allocated to a control or to one of intervention groups (conventional instruction or PAPM). Short-term and long-term results were assessed after 3 and 12 months. The study sample comprised 254 12-13 year olds whose plaque levels were assessed by two outcome measures, namely the Quantitative Plaque Percent Index and its derivative the Ratio of Plaque % Change. RESULTS: Subject retention rate was 69%. The most substantial decrease in plaque scores was in the PAPM group (12% after 3 months, 18% after 12 months), while the smallest reduction was in the control group (4% after 3 months and 12% after 12 months). There was a trend of reduction in plaque levels (p < 0.001) in all study groups from baseline to the 12 month follow-up. CONCLUSIONS: The intervention based on the Precaution Adoption Process Model was only slightly more effective in changing adolescent oral hygiene behaviour as compared to the conventional approach. The positive change in the control group was unexpected and needs further exploration.

Oral squamous cell carcinoma and cultural oral risk habits in Vietnam.

OBJECTIVES: In South-Central Asia, 80% of head and neck cancers are found in the oral cavity and oropharynx. In Vietnam, oral cancer is often not being detected until people experience debilitating circumstances to normal oral function. The aims of the study were to explore the patterns of oral squamous cell carcinoma (OSCC) and its risk indicators, the structure of oral health care in Vietnam and trends in prevalence of cultural risk habits in southern Vietnamese patients. MATERIALS AND METHODS: A retrospective clinical study was performed from 1 July 2005 to 1 April 2006 at Ho Chi Minh City Oncology hospital in Vietnam. Of the 161 cases, 147 subjects were diagnosed with OSCC, including 100 male and 47 female adults aged 24-85 years. Data were collected by a structured interview and clinical examination. RESULTS: Over 40% of the women with OSCC reported chewing betel quid and the most prevalent risk habit in males was smoking (91.0%). Daily alcohol use was reported by 79.0% of males and 2.1% of females. Two-thirds of the cases of OSCC were diagnosed at the 2nd and 3rd stage of cancer. The more advanced stages of cancer were observed in males than in females. The prevalence of tobacco and alcohol use in males with OSCC was higher in this study than in the previous Vietnamese studies. CONCLUSION: High frequency of risk habits in both genders was reported in OSCC Vietnamese patients. A trend of increased tobacco and alcohol use was observed in male OSCC patients. A lower prevalence of later staging in Vietnam was observed in this study than in earlier studies.

DIAGNOdent--an adjunctive diagnostic method for caries diagnosis in epidemiology.

UNLABELLED: The DIAGNOdent system is intended as an aid to caries detection and has undergone extensive investigation in experimental and clinical studies. Its applicability for epidemiological purposes has yet to be evaluated. The Objective of the present study was to evaluate the DIAGNOdent system under field conditions. BASIC RESEARCH DESIGN: The subjects comprised a sub-sample from an on-going epidemiological study. PARTICIPANTS AND CLINICAL SETTING: In 39 individuals, 97 sites were visually identified as possibly carious: 42 occlusal, 13 lingual, 19 buccal and 23 approximal sites. MAIN OUTCOME MEASURES: Three DIAGNOdent measurements were taken at each site under varying conditions: (1) naturally wet, (2) dried, and (3) polished and dried surfaces. Three sets of measurements were obtained and compared by intra-class correlation and paired sample t-tests. RESULTS: All correlation coefficients were > 0.9. There was a systematic difference between mean scores from naturally wet sites (without cleaning) and from either dried, or polished and dried sites. The difference was marginal and did not impact on the threshold for recording sites as carious. In two subjects, high unexpected values were recorded on sound sites prior to actual measurements, i.e. during establishment of a standard value for a sound site. The overall findings were not affected by these values, as they were consistently high in all three measurements. CONCLUSIONS: The DIAGNOdent system performed satisfactorily under different measurement conditions. The present study indicates that the DIAGNOdent system would be applicable in field studies, provided consistent study conditions are maintained and unexpected values are interpreted with caution.

Inter-individual variation in the plaque formation rate of young individuals.

OBJECTIVES: The aim of the present study was to describe the inter-individual variation in the plaque formation rate of 38 young adults. METHODS: The plaque formation rate was estimated by employing a quantitative plaque percent index (P% index). A substantial inter-individual variation in the plaque formation rate was observed. The possible contributions of stimulated salivary flow rate, buffer capacity, diet and smoking to the variation in plaque formation were estimated by regression analysis. RESULTS: The control variables explained only 2.5% of the variance in the plaque formation rate. Neither associations nor the total model were significant. The present method of measuring plaque presented as a simple and time-effective procedure. CONCLUSIONS: It is suggested that the observed variation in the plague formation rate between the young individuals can be regarded as a biological function which is possibly an inherent individual characteristic. Studies with larger sample sizes are required to confirm the findings of the present study.

Causal patterns of dental health in populations. An empirical approach.

In the present investigation we aimed to analyse causally the pattern of determinants leading to the maintenance of functional teeth in adults. Clinical and self-reported information was used. The hypothesis was that socio-economic conditions operate through psychosocial circumstances that influence lifestyle, and are thus related to oral hygiene and levels of remaining teeth. Testing of the patterns for adults residing in high- and low-fluoride areas did not reveal any principal differences in dental health, therefore further testing was combined for both fluoride areas. Further analysis also indicated that testing should be performed separately for each gender. Social structure and dental health-related lifestyle were important in an overall pattern of maintaining functional teeth, but general lifestyle and psychosocial conditions were not found to be part of the pattern influencing dental health. Gender-specific patterns were revealed. New hypotheses may be suggested for further research with regard to studying patterns of dental health in Lithuanian adults.

Caries in populations--a theoretical, causal approach.

The focus of this paper is caries in populations. Caries is assessed as a phenomenon and as it occurs in populations. It is observed that in recent literature the notion of causation of caries is restricted to the biological process on the tooth surface. This may be sufficient to explain caries as a phenomenon, but it is argued that a biological causation is insufficient in order to understand caries and its variation in populations. The understanding of the determinants of a population's oral health has been seriously impeded by the absence of a theoretical framework. A framework would be useful to the extent that it would bridge relevant categories for portraying complex causal patterns of caries in populations. An approach to a framework has therefore been outlined, and the idea of such a framework has been confronted with three critical comments. The framework is as yet pragmatic, incomplete, uncertain and fragmented. Yet, even such an approach may invite greater precision in epidemiological concepts about causes of caries than presently prevails. The framework directs attention to health effects of collective phenomena that cannot be reduced to individual attributes. The image proposed in this paper is intended to spur discussion about important aspects of the epidemiology of caries in populations.

Dental caries in adult Lithuanians.

There are few data on the incidence of dental caries in Lithuanian adults. The aim of the present study was to describe caries and treatment experience among 35-44 and 65-74-year-olds, and to relate this to certain selected independent variables (gender, urban/rural residence, drinking water fluoride levels, and years of education). A total of 680 subjects selected based on a stratified random sampling procedure (response rate 52%) were examined by one examiner. Dental caries was recorded as DMFT following the WHO recommendations. The results showed that the median DMFT scores were 18 for the 35-44-year-olds (n = 380) with median DT = 2, MT = 5, FT = 7. For the 65-74-year-olds (n = 300) the median DMFT was 24, with DT = 1, MT = 18, FT = 2, respectively. One percent of all 35 year-olds and 11% of 65-74-year-olds were edentulous. In the younger age group, statistically significant differences in the DMFT scores were related to gender, urbanization and drinking water fluoride levels. Participants from areas with high fluoride content in the drinking water (> 1.5 ppm F/1) had lower DT, MT, and FT values. Females and participants from urban areas had higher numbers of FT. Participants with more years of education had lower DT, MT, and higher FT values. In the elderly, DMFT scores were related to water fluoride levels and years of education. Individuals with more years of education had higher numbers of FT and lower MT values in this age group. Poor oral hygiene was associated with high numbers of DT in both age groups. The data indicate that dental caries is widespread among adult Lithuanians.

Variation in caries and treatment experience in 35-44-year-old Lithuanians.

Data summarising caries levels differ between countries and often conceal large variations. These differences may reflect variations at individual, group, social and other levels. Caries and treatment experience differences are found to be significantly related to a variety of clinical and non-clinical factors. Variation in caries within Lithuanian children has been reported and related to background-, behavior-, dental care- and other factors. Variation in general or related to any factors in adult Lithuanian population has not been studied. The aim of the present study was to estimate variation in caries and treatment experience and relate them to biological-, psychosocial-, health-related, behavioral- and dental care related aspects. The existing knowledge from other oral health studies was used to select the factors found of importance in relation to variations in caries scores. The study consisted of clinical and self-reported data collected from a stratified random sample of 382 individuals (attendance rate 50%). Two statistical approaches, a bivariate and a multivariate, were applied. The two dependent variables DMFT and DS were tested with a set of independent variables. The bivariate analysis revealed significant associations for approximately one half of all variables studied. For multivariate testing, a backward linear multiple regression was used. Forty-one percent of the variation in DS was explained and 48% in DMFT scores. Differences in scores were related to various factors in the two analyses. The strength and significance of a few relationships differed in both of the analyses. The multivariate testing revealed some strong and significant associations with independent variables which were found to be weak and non-significant (P>0.05) when tested bivariately and vice versa. Less than half of the variation could be explained in dental caries scores in 35-44-year-olds and not only dental care related factors were important. In both of the analyses, the varying degrees of strength (significance levels) give rise to a hypothesis that this incomplete explanation of the variation can be due to interrelated effects of different estimates.

Apical periodontitis and related factors in an adult Lithuanian population.

OBJECTIVES: The objectives of this investigation were to study determinants of apical periodontitis among Lithuanians who were 35 to 44 years old and to study possible associations between apical periodontitis, relevant general diseases, and perceived general health. STUDY DESIGN: Information was collected from a randomly selected sample, consisting of 147 individuals from Vilnius, Lithuania. Aspects of oral and general health, health-related habits and attitudes, and social parameters were used as independent variables, with various aspects of apical periodontitis as the dependent variable. Associations were tested by regression analysis. RESULTS: Apical periodontitis was highly prevalent in this Lithuanian population. Oral health-related variables showed the strongest association with apical periodontitis. Decayed and filled teeth scores were found to be strongly associated with periapical disease, and sound teeth were strongly associated with periapical health. In addition, behavioral variables were found to be important disease determinants. CONCLUSIONS: Apical periodontitis appeared to be an oral health problem closely related to dental caries. No association could be detected between general diseases and apical periodontitis, but an association between perceived general health and apical periodontitis was demonstrated.

Oral health behavior and attitudes of adults in Lithuania.

In Lithuania, the oral health system is currently in transition and systematic data are needed for public oral health care planning. The objectives of this study were (i) to describe the self-assessment of oral health status in Lithuanian adults, the oral hygiene practices, and dental visiting habits; (ii) to assess the attitudes towards teeth and oral health, dental care and oral health services; (iii) to determine whether oral health attitudes and behavior are affected by socio-economic factors; and (iv) to analyse the association between self-care practices and use of oral health services. The study comprised random samples of 35-44-year-olds (n = 381) and 65-74-year-olds (n = 302). Data were collected during 1997 98 by means of self-administered questionnaires and the response rate was 53%. Nearly all persons of ages 35-44 had natural teeth, whereas 14% of 65-74-year-olds were edentulous. Among the dentate persons, 45% of the young adults against 36% of the elderly claimed having poor teeth, and 66% and 55%, respectively, had experience of pain from teeth or mouth during the past year. At ages 35-44, 33% of participants reported toothbrushing at least twice a day and this was the case for 21% of 65-74-year-olds. Dental visits within the past year were indicated by 60% of young adults and 43% of the elderly; 83% of all participants reported that their last visit to the dentist was due to acute oral symptoms. In general, the participants had positive dental knowledge and attitudes; however, 56% were unaware of any effect of fluoride. The bivariate analyses showed that perceived oral health status and oral self-care practices were related to use of dental services. The multivariate analyses of dental visiting habits revealed the effects of gender, urbanization, presence of natural teeth, experience of dental problems, attitudes to dental care and dentists, and education. In conclusion, preventive dental services should be introduced and the establishment of community-based oral health promotion programs is urgently needed for Lithuania.

Patterns of dental caries and treatment experience in elderly Lithuanians.

OBJECTIVE: The aim of the study was to evaluate patterns of caries experience in a representative sample of Lithuanians, aged 65-74. METHODS: This cross-sectional study included 301 participants (response rate 54%). Information was obtained from a clinical examination (caries experience, stimulated salivary flow rates and oral hygiene levels) and a questionnaire. The questionnaire comprised questions about oral, general, physical, mental and social health and about background, knowledge, attitudes and lifestyle. The study had a multidimensional approach to negative consequences of disease and positive aspects of health. For bivariate testing, t-test, ANOVA and Spearman's correlation were used. Factor analysis was combined with linear multiple regression for a multivariate study of caries experience patterns. RESULTS: Elderly Lithuanians were found to have lower levels of edentulousness (range 11-15%) than elderly people in other European countries. The mean number of missing teeth was also lower than in any of the neighbouring countries. A comparison of dentate and edentulous groups did not show any major differences. Those who reported that they had general disease had higher levels of oral health maintenance. In dentate elderly, caries experience differed according to place of residence, fluoride content in the drinking water, socioeconomic status, gender, lifestyle, and many other factors. The multivariate approach explained 52%, 61% and 55% of the variation in the number of filled or sound teeth (FS-T), decayed (DT) and missing teeth (MT) respectively. CONCLUSION: Levels of oral health maintenance and caries experience show substantial variation among elderly Lithuanians, according to many health-related characteristics. These elderly people require appropriate oral care, just as much as people in other population sub-groups.

Endodontic treatment and prevalence of apical periodontitis in an adult population of Vilnius, Lithuania.

Apical periodontitis is prevalent in many Western populations and is frequently detected in connection with inferior quality of endodontic treatment. However, information about endodontic conditions from eastern European countries is limited. The aim of the present investigation was to study the prevalence of apical periodontitis and the quality of endodontic treatment in 35-44-year-old Lithuanians. The prevalence of apical periodontitis was 70%. An overall success rate of 65% was found for root-filled teeth while 56% of pulp amputations (pulpotomies) were considered successful based on a radiographic evaluation. The quality of the root fillings showed little impact on the treatment results, except for over-extended fillings, which were associated with a high number of failures.