Periapical Status of Post-Restored Teeth: A Two-Year Follow-Up Study

Area of Science:

• Endodontics and Restorative Dentistry
• Oral Radiology and Pathology

Background:

• Endodontically treated teeth restored with cast post-and-core systems require evaluation for long-term periapical health.
• Factors influencing periapical health in these restorations are not fully elucidated.

Purpose of the Study:

• To determine the prevalence of periapical lesions in teeth restored with cast post-and-core systems after at least two years.
• To identify restorative and clinical factors associated with periapical lesions in these teeth.

Main Methods:

• A cross-sectional study analyzed 118 endodontically treated teeth with post-and-core restorations (>2 years follow-up).
• Periapical lesions were assessed using the Periapical Index (PAI) on radiographs.
• Statistical analysis (Chi-square test) identified associations between lesions and factors like post/filling gaps and root filling density.

Main Results:

• A significant prevalence of 31.4% for radiologically detectable periapical lesions (PAI ≥ 3) was observed.
• Lesion prevalence was strongly associated with post/filling gaps (≥ 2 mm) and low-density root fillings.
• Diabetes showed a trend toward increased lesion prevalence (p=0.056).

Conclusions:

• Rigorous techniques are crucial for restoring endodontically treated teeth with cast posts.
• Absence of gaps and homogeneous root filling density are vital for maintaining periapical health.
• Regular radiographic follow-up and further longitudinal studies are recommended.