Prevalence of apical periodontitis and quality of root canal treatment in an adult Saudi population.

OBJECTIVES: To determine the health status of periradicular tissue and the quality of root canal fillings in an adult Saudi population attending dental clinics for the first time. Methods: This cross sectional study was conducted  in the dental clinics at King Saud University, Riyadh and other dental centers (Jeddah, Najran, and Albaha City), Kingdom of Saudi Arabia between year 2010   and 2012. Good-quality panoramic radiographs of 926 Saudi subjects (540 males and 386 females)were analyzed based on the gender, age, health status, smoking habits, periapical status of the endodontically treated teeth, technical quality of the root canal fillings, and the presence or absence of coronal restoration. Data were calibrated and statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 17.  Results: Of the 25,028 teeth examined, 1,556 teeth (6.2%) had apical periodontitis (AP). Male subjects aged over 55 years and females between 36 and 45 years had higher AP. A total of 36 diabetic and 87 smokers subjects had AP. The AP was more common in male diabetics than female (p=0.383), and in female smokers more than male (p=0.44). Only 42.2% of male and 57.7% of female teeth had adequate root canal treatment.  Conclusions: Apical periodontitis was significantly related to diabetes, smoking, and inadequate endodontic treatment.

Tactile working length determination for root canal therapy in underserved settings.

DESIGN: Multicentre randomised controlled clinical trial in a rural underserved African setting. INTERVENTION: The technical and electrical infrastructure still remains unstable in Gambia. Therefore, block randomisation was chosen. Patients included in 2010 were treated according to the original BRT method with tactile working length determination, whereas patients included in 2011 were treated with radiographic working length control. During the latter study period and the 24-month evaluation, a generator was provided to ensure sufficient power supply to run a radiographic unit. OUTCOME MEASURE: The primary end point was the apical extension score of the radiographic quality parameter of root canal fillings. The secondary radiographic end point was the periapical index, and the secondary clinical end point was tooth tender to percussion. The safety end point was tooth loss as a consequence of endodontic failure. RESULTS: BRT with tactile working length determination compared with standard radiographic working length control did not significantly differ in terms of radiographic and clinical outcomes after 24 months. The apical extension of the root canal fillings and the periapical anatomic structures showed no significant differences according to radiographic analyses (P = 0.5). Corresponding results were found in clinical aspects of tooth tender to percussion (P = 0.6) and tooth loss (P = 0.7). CONCLUSIONS: Within the limits of this randomised controlled trial it was shown that tactile working length determination in BRT resulted in comparable treatment outcomes in radiographic and clinical aspects compared with standard endodontic treatment with radiographic working length determination. Tactile working length determination turned out to be an accurate method in BRT.