Introduction Success or failure of endodontic treatment is by tracy12

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									      Introduction: Success or failure of endodontic
treatment is determined on the basis of radiographic
findings like periapical radiolucent and clinical signs of
root filled teeth. Endodontically treated teeth is positively
correlated with the technical quality of root filling, but in
recent years more attention has been paid to coronal
leakage, and the quality of coronal restoration.
      Purpose: The aim of this radiographic study was to
investigate the periapical status of endodontically treated
teeth related to the quality of coronal restoration and root
        Study design: Root filled teeth were selected on
panoramic radiographs of randomly selected patients
attending the University Dental Clinic Center Skopje,
Department of Cariology & Endodontic, for routine
treatment. The patients had not received restorative and
endodotic treatment in the previous year.
        All panoramic radiographs were evaluated using an
X-ray     viewer   with   5   magnifications.   The   coronal
restoration, the presence of canal post, the root canal
filling and periapical condition were scored according the
criteria listed:
Coronal status
       Intact restoration / adequate
       Restoration with open margin / inadequate
       Restoration with recurrent decay / inadequate

Root filling - length
         0-2mm from the radiographic apex / adequate
         > 2mm from the radiographic apex / inadequate
       extending beyond the radiographic apex/inadequate
Root filling - homogeneity
         homogeneous root filling / acceptable
         inhomogeneous root filling /unacceptable

Periapical status
      normal - good periapical condition
      periapical radiolucency
 Results: A total of 120 panoramic radiographs were taken
 to evaluate the periapical status of endodontically treated
 teeth. The number of root filled teeth was 143 and 30,06%
 (43) had apical periodontitis.
  coronal     endodontic   normal       apical        total
restoration    treatment             periodontitis   N=143

adequate      adequate       35           5           40
adequate      inadequate     27           9           36
inadequate    adequate       21           8           29
inadequate    inadequate     17           21          38

 Tab.1 Periapical condition of endodontically treated teeth.
             Root filled teeth with an adequate homogeneity (62%)
   and an adequate root filling length (81%) were associated
   with a better periapical status.
                                              apical         % apical
root filling          total      normal    periodontitis   periodontitis

good                   35         31            4              11.4
overfilled             30         19            11            36.66
underfilled            22          9            13            59.09
homogeneous            27         20            6             22.22
inhomogeneous          29         20            9             31.03

         Tab. 2 Periapical status of root filled teeth
        Adequate coronal restoration had lower incidence of
  apical periodontitis (35,2%) than inadequate restoration

  coronal       total                  apical         % apical
restoration    N=143       normal   periodontitis   periodontitis

   intact        64         55           9             14.06
open margin      51         41           10             19.6
 marginal        28         11           17            60.71

  Tab. 3 Periapical status related with technical quality of
  coronal restoration.
  The results of this study, indicate that a well sealing
coronal restoration and a well-performed root canal treatment
are both important for the overall success of endodotically
treated teeth.
     The acceptable coronal restoration and adequate root
filling were associated with decreased of incidence of apical
 Periapical status of endodontically
 treated teeth related to the quality
        of root filling and coronal

Author:Dragan Eftimovski
Mentor:ass.Dr-Ivona Kovacevska
     University "Sv. Kiril & Metodij"
         Skopje R. Macedonia

          Faculty of Dentistry
Department of Cariology & Endodontology
      Department of Pedodontic
     Department of Oral surgery

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