Difference in the periapical status of endodontically treated teeth between the samples of Croatian and Austrian adult patients

Periapical status and root filling quality are frequently assessed to give a complete picture of endodontic diseases and their treatment and predict the treatment outcome. Apical periodontitis (AP) is a chronic inflammatory disorder of periradicular tissues caused by etiological agents of endodontic origin. Persistent apical periodontitis occurs when root canal treatment has not adequately eliminated intraradicular infection (1). It is diagnosed by clinical and radiographic criteria. Since clinical signs and symptoms such as pain, tenderness, swelling, and sinus tract formation occur to varying degrees and are only moderately specific (2), the primary criterion for diagnosis is radiographic interpretation. The most consistent feature of periapical inflammation are bone density changes present in radiographs (3). AP mostly occurs in previously endodontically treated teeth (4), with a greater prevalence in apical than in marginal location (5). The treatment of choice for AP is endodontic treatment or extraction. During the last decades, there have been several cross-sectional studies of the prevalence of AP (4,6-12). Some epidemiological studies (4,6,10,11,13-18) of treatment outcome have applied the periapical index scoring system (PAI), first described by Orstavik et al (19). This system is attractive since it allows comparisons between the studies (13). Numerous epidemiological studies, mainly from Scandinavian countries, have investigated the prevalence of AP in relation to an inadequate endodontic treatment (4,14,20,21). Since no epidemiological studies concerning periapical status or root filling quality have been performed on either Croatian or Austrian populations, the aim of the present study was to evaluate the periapical status in endodontically treated teeth in relation to age, sex, position of teeth, and length of root canal filling.