Prevalence of Apical Periodontitis and Conventional Nonsurgical Root Canal Treatment in General Adult Population: An Updated Systematic Review and Meta-analysis of Cross-sectional Studies Published between 2012 - 2020.

ABSTRACT Introduction This study aimed to summarize data on apical periodontitis (AP) and nonsurgical root canal treatment ( NSRCT ) prevalence and risk factors related to age, gender, and quality of restorative and endodontic treatment in the general population from cross-sectional studies published between 2012 and 2020. Methods An electronic search was performed in the following databases: Web of Science, Scopus, and PubMed. The conducted literature search covered studies published between 2012 and 2020, without restrictions on language. The STROBE and NOS tools were used for quality assessment of the included studies. Results Sixteen articles were included in the review. In total, 200.041 teeth were examined. On average, 6.3% of teeth had AP, and 7.4% had NSRCT . Forty-one percent of RCT teeth had AP, while 3.5% of untreated teeth had AP. Females are less prone to AP in endodontically treated teeth only, compared to males (P Variable stratification of age subgroups among included studies prevented us from conducting a meta-analysis. An increase in AP frequency was found in teeth with inadequate restorative and endodontic treatment (P Due to high heterogeneity, these results should be taken with caution. Conclusions There is an increased AP prevalence in the adult general population compared to data from 2012 ( 6.3% versus 5.4 %), both in endodontically treated ( 41.3 % versus 35.9%) and untreated teeth ( 3.5 % versus 2.1 %). Additionally, AP developed more frequently in females with endodontically treated teeth and in teeth with inadequate compared to adequate restorative and endodontic treatment.