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Monitoring Asymptomatic Apical Periodontitis in Root-Filled Teeth-Results From a One-Year Follow-Up Prospective Study
M Sayady-Ölander1, J Östlin1, V S H Yu2
1Public Dental Service, Västra Götalandsregionen, Sweden.
Aim:
To prospectively investigate the incidence of symptoms and changes in the size of the apical bone destruction in symptom-free root-filled teeth with persistent apical periodontitis (AP) over 1 year without treatment.
Methodology:
Patients referred to two specialist endodontic clinics in Västra Götaland, Sweden, with asymptomatic periapical bone destructions (summing to ≤ 10 mm in diameter, when measured in two dimensions) on intraoral radiographs were invited. After informed consent, participants underwent cone-beam computed tomography (CBCT). Patients with bone destructions beyond cortical boundaries were excluded. A 1-year follow-up included recording subjective symptoms, clinical findings and estimating bone destruction size.
Results:
Of 187 eligible patients, 171 (91.4%) participated. After CBCT, four were excluded, and 10 were lost to follow-up. Among 157 patients, three developed symptomatic AP and were treated, and one tooth was lost due to fracture. Of the 153 patients with complete follow-up, eight (5.2%) reported mild pain or discomfort but did not seek care. Lesion size changes were small (M = 0.059 mm), with the mean increasing from 7.25 mm (SD 2.11) to 7.31 mm (SD 2.33), which was not statistically significant.
Conclusion:
The findings align with previous studies, suggesting that patients with symptom-free root-filled teeth with apical periodontitis rarely experience exacerbation or significant increase in size of bone destruction in the short term. Longer follow-up is needed to identify potential risk factors.
