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Prognostic value of the full-scale Periapical Index.

L-L Kirkevang1,2, D Ørstavik1, A Wenzel2

  • 1Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.

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|October 30, 2014
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Summary

The full-scale Periapical Index (PAI) effectively predicts the long-term periapical status of both root-filled and non-root-filled teeth. Higher baseline PAI scores indicate an increased risk of extraction and predict future periapical disease progression.

Keywords:
PAIapical periodontitisepidemiologylongitudinalprognosis

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Area of Science:

  • Endodontics
  • Oral Radiology
  • Dental Public Health

Background:

  • Periapical lesions are common findings in dental radiography.
  • The Periapical Index (PAI) is a widely used scoring system to assess the severity of periapical lesions.
  • Predicting the progression of periapical disease is crucial for treatment planning and prognosis.

Purpose of the Study:

  • To evaluate the predictive capability of the full-scale Periapical Index (PAI) for the future periapical status.
  • To assess this predictive value in both root-filled and non-root-filled teeth over a 5-year period.

Main Methods:

  • Longitudinal study using full-mouth radiographic surveys from 1997, 2003, and 2008.
  • Included 330 participants with three examinations and 143 with two examinations.
  • Assigned PAI scores (1-5) to all teeth, recording root filling status and retreatment.

Main Results:

  • Non-root-filled teeth had lower baseline PAI scores than root-filled teeth (P < 0.0001).
  • High baseline PAI scores significantly increased the risk of extraction for both types of teeth (P < 0.001).
  • Follow-up PAI scores correlated with baseline scores, indicating disease progression predictability (P < 0.001).

Conclusions:

  • The full-scale PAI demonstrates distinct prognostic value for the course of periapical disease.
  • This predictive capability applies to both non-root-filled and root-filled teeth over a 5-year timeframe.
  • Radiographic assessments using PAI aid in predicting periapical disease outcomes.