Assessment of Correlation of Post-therapy Apical Periodontitis and Quality of Root Canal Therapy in Geriatric Patients: A Retrospective Analysis

Apical periodontitis (AP) is the result of infection of the periapical tissues. Clinical and radiographic diagnosis determines whether to treat the infected teeth with root canal therapy or not. Prognosis of pulpal therapy is mostly dependent on the quality of treatment pursued. Therefore, we evaluated the prevalence of AP along with the quality of pulp therapy in geriatric patients in a given population. The present study included 1942 teeth in 1000 patients if age 60 years and above. Diagnosis irreversible pulpitis was confirmed after radiographic and clinical examination of the patients. Pulp therapy was carried out in these patients after confirmation of the diagnosis. Periapical index scores of teeth and treatment quality were assessed using Tronstad et al. and Ørstavik's criteria, respectively. Chi-square test was used to evaluate the level of significance. About 36% of the total study population was of females with maximum subjects belonging to the age group of 60-69 years. In more than 40% of the teeth, adequate root canal therapy was performed. Over 90% of the teeth with adequately performed root canal therapy had healthy periapical tissue. Approximately 59% of the teeth with inadequately filled root canal had periapical lesions. Statistically significant results were obtained while comparing the periapical tissues with the quality of root canal therapy and coronal restorations. Quality of root canal therapy is significantly associated with post-treatment AP. Persistence of infectious agents in the treated teeth can lead to failure of endodontic therapy and further significantly increases the chances of occurrence of AP.