Prevalence and Risk Indicators of Apical Periodontitis in an Adult Sudanese Population

Abstract

Objectives. The objectives of this descriptive cross- sectional clinically- based study are to investigate the prevalence of AP, identify some risk indicators for AP and estimate the frequency of root-filled (RF) teeth in an adult Sudanese population. Methods. Clinical examination, panoramic and periapical radiographs of all 200 patients over 18 years of age seeking routine dental care, and attending the dental clinics at the Faculty of Dentistry (University of Khartoum) and the Dental Hospital at the Faculty of Dentistry (University of Science and Technology) for the first time during the period from 1 March to 30 June 2007 were examined. The periapical status of all teeth (except third molars) was categorized on the basis of presence or absence of radiographic signs of AP. The frequency of root filled teeth was recorded. One observer evaluated the radiographs under standardized conditions. The data were analysed using the chi-square test and odds ratio. Results. Radiographs indicated that 624 teeth (48.7% in the maxilla; 51.3% in the mandible) were missing leaving a total of 4967 teeth to be assessed. AP was found in 95 patients (47%) and 3.3% of the teeth. It was found that old patients, males, patients with plaque accumulation percentage of more than 20 or more than 4 missing teeth were statistically associated with AP. A highly increased risk for AP was seen in teeth with root fillings, particularly for technically inadequate ones (OR = 4.30, P<0.05). Presence of remaining root, coronal restoration, inadequate restoration and lost restoration also increased the risk for AP (P<0.001). Teeth with mobility and probing pocket depth of more than 4 mm were also associated with AP. V There were 42 (21%) patients with ≥1 RF teeth and 80 (1.6%) teeth had been root filled. There was no difference in the number of RF teeth between males and females, the prevalence of RF teeth increased with age (OR of 48 + year =3.06, P<0.001). Conclusion. The results from the present study of a Sudanese population showed that the prevalence of AP in RF and untreated teeth were comparable to those reported in previous similar studies. The most important risk indicator of having AP in the individual was the high plaque percentage, radiographic evidence of root fillings, the presence of several caries lesions and the quality of dental treatment. Further, the frequency of RF teeth was low compared to that demonstrated in most other epidemiological studies