Abstract

Objective This case-control study compared the outcome of the nonsurgical root canal treatment/retreatment of teeth with small and large apical periodontitis lesions. Other factors associated with the outcome of the treatment of teeth with apical periodontitis were also assessed.

Methods Ninety-six patients (48 cases and 48 controls) were selected from 240 treated teeth from 206 individuals, and paired for age and tooth type. An experienced operator treated all teeth over a period of 23 years. Cases were treated/retreated using irrigation with 2.5% sodium hypochlorite. The clinical and radiographic outcome was classified as healed, healing or diseased. Healed cases were considered as success and diseased cases were considered as failures. Healing cases consisted of teeth with lesions that decreased in size and were regarded as failure in a rigid criterion or as success in a lenient criterion.

Results Overall, 62.5% of the cases were classified as healed, 28% as healing, and 9% as diseased. In the lenient criterion, the success rates in teeth with small and large lesions were 91.7% and 89.6%, respectively (P > .05). In the rigid criterion, the success rate was the same for both conditions (62.5%). Logistic regression analysis showed that history of a previous abscess significantly affected the outcome (P < .05).

Conclusions The size of apical periodontitis lesion did not impact the outcome of the endodontic treatment when performed by the same experienced operator.

Introduction

Apical periodontitis is caused by bacterial infection of the root canal system (Sundqvist 1976). This disease is characterized by an inflammatory response to bacteria leaving the canal via apical and lateral foramina and typically results in bone resorption around the root apex.

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