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Related Concept Videos

Assessment of apical radial pulse01:25

Assessment of apical radial pulse

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Related Experiment Video

Updated: Apr 24, 2026

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Risk score algorithm for treatment of persistent apical periodontitis.

V S Yu1, L W Khin2, C S Hsu3

  • 1Faculty of Dentistry, National University of Singapore, Singapore denyshv@nus.edu.sg.

Journal of Dental Research
|September 6, 2014
PubMed
Summary
This summary is machine-generated.

A new Deterioration Risk Score (DRS) helps identify persistent apical periodontitis that may not need intervention. This score differentiates lesions compatible with health from those requiring further treatment, aiding clinical decision-making.

Keywords:
decision makingendodonticsperiapical periodontitisprobabilityregression analysisroot canal therapy

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Area of Science:

  • Endodontics
  • Dental Radiology
  • Biostatistics

Background:

  • Persistent apical periodontitis after root canal treatment may not always require intervention.
  • Differentiating between lesions requiring treatment and those compatible with health is crucial for efficient patient care.

Purpose of the Study:

  • To develop a Deterioration Risk Score (DRS) for persistent apical periodontitis.
  • To identify lesions that are likely to be compatible with health and do not need further intervention.

Main Methods:

  • A cross-sectional study analyzed 228 periapical lesions in 182 patients from 2003-2008.
  • Risk factors were screened against outcomes (improved, unchanged, deteriorated) using multivariate probit regression.
  • A 5-level DRS was constructed based on predicted probabilities of deterioration.

Main Results:

  • Most lesions (55.7%) improved, while 30.3% deteriorated over time.
  • Significant predictors of deterioration included time since treatment, current pain, sinus tract presence, and lesion size.
  • The DRS categorizes risk from very low (<15) to very high (>40).

Conclusions:

  • The developed DRS can assist clinicians in identifying persistent apical periodontitis at low risk for deterioration.
  • Implementing the DRS may reduce overtreatment and improve the efficiency of disease management.
  • Further validation of the DRS is recommended for widespread clinical adoption.