Prognostic validity of the Periapical and Endodontic Status Scale for the radiographically assessed 2-year treatment outcomes in teeth with apical periodontitis: a prospective clinical study

BMC Oral Health

Jelena Gudac¹  Vita Machiulskiene¹  Kristina Hellén-Halme² 

[1] Clinic of Dental and Oral Pathology, Lithuanian University of Health Sciences, Eiveniu str. 2, 50161, Kaunas, Lithuania;Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Carl Gustafs väg 34, 21421, Malmö, Sweden;

关键词: Cone-beam computed tomography;    Apical periodontitis;    PESS;    Root canal treatment outcome;   

DOI  :  10.1186/s12903-021-01723-9

来源: Springer

【 摘 要 】

BackgroundEndodontic treatment planning and treatment success evaluation are largely based on radiographic assessment of anatomical and treatment-related parameters of teeth with apical periodontitis (AP). This prospective clinical study aimed to assess radiographically the 2-year endodontic treatment outcomes for teeth with AP, and to evaluate prognostic validity of Periapical and Endodontic Status Scale (PESS).MethodsA total of 128 patients, representing 176 teeth with AP were examined by cone-beam computed tomography at baseline and at 24 months after endodontic treatment. Treatment outcome was evaluated using estimates of periapical radiolucency and the relationship between anatomical structures and location. The strength of the associations between these and treatment-related parameters was tested by logistic regression analysis. PESS sensitivity and specificity were calculated for every treatment risk group (low, moderate, high) of teeth.ResultsOne hundred and fifty-seven teeth, representing 350 root canals had a positive treatment outcome, while 19 teeth, representing 53 root canals had a negative treatment outcome at 24 months. The probability of negative outcome was 25 times higher in the moderate/high-risk group than in the mild-risk group of teeth (OR = 25.1; 95%CI [12.2–51.5]). Pre-treatment complications and retreatment cases with radiolucency were associated with negative outcomes (OR = 35.9; 95%CI [12.6–102.4]; OR = 26.437; 95%CI [10.9–64.1], respectively). PESS sensitivity and specificity was over 80% in all risk groups except for high risk group, due to very low number of cases.ConclusionsEndodontic treatment outcome depends on the severity of periapical changes. The presence of complications and retreatment cases with periapical lesions are associated with negative treatment outcome. The PESS is a valid instrument to predict outcome of teeth with low-moderate treatment risk of AP.

【 授权许可】

CC BY