Risk indicators of apical periodontitis in an adult Sudanese population

Endodontic and periapical status are significant restraints that can predict tooth existence and the potential necessity for dental treatment in the growing dental population. The aim of this study is to estimate risk indicators for apical periodontitis (AP) in an adult Sudanese patients. This is an observational cross-sectional hospital-based study. Clinical and radiographical examination of 200 patients above18 years seeking routine dental management for the first time at the dental clinics (University of Khartoum) and the Dental Hospital (University of Science and Technology) was performed. The clinical examination included history and intra oral examination of coronal and periodontal status of each individual tooth. Data were assessed using the chi-square test and odds ratio at significant level of 5% and confidence level of 95%. Radiographs revealed that 624 teeth (48.7% in the maxilla; 51.3% in the mandible) were lost leaving a total of 4967 teeth to be examined. AP was found in 95 patients (47%) and 3.3% of the teeth. A remarkably increased risk for AP was detected in teeth with root fillings, specifically technical inadequate ones (OR = 4.30, P<0.05). Presence of remaining root, coronal restoration, inadequate restoration and lost restoration also increased the risk for AP (P<0.001). Teeth with mobility and probing pocket depth of more than 4 mm were also associated with AP.  Therefore, the main risk indicators of AP were the high plaque percentage, radiographic evidence of root fillings, the incidence of numerous carious lesions and the inappropriateness of dental treatment.