Prevalence and quality of endodontic treatment in an urban adult population in Norway

Abstract There are few studies on the prevalence of chronic apical periodontitis and endodontic treatment in society. In this study, the periapical status of a representative sample of 35-year-olds in Oslo, Norway was studied by analyses of orthopantomograms and intraoral radiographs. The study also included quality assessment of root fillings and a correlation between quality and periapical status. Of the 3917 teeth evaluated, 133 (3.4%) were endodontically treated and 54 (1.4%) presented a periapical pathosis. More than half of these were associated with root-filled teeth. Endodontic treatment was considered successful with normal periapical structures in 64% of the cases. However, only 41% of the root fillings were of optimal quality, terminating 1–2 mm from the radiographic apex. Based on a survey of orthopantomograms, it was estimated that 30% of the subjects investigated presented an endodontic treatment need. The prevalence of endodontic treatment among 35-year-olds was unchanged from 1973 to 1984.     

A radiographic survey of periapical conditions in elderly people in a Swedish county population

Abstract A random sample of non-institutionalized people aged 65 years and over in Örebro County, Sweden, were examined radiographically. Periapical conditions and the prevalence and quality of root fillings were evaluated. Approximately every 10th tooth showed radiographic signs of apical periodontitis: more than 1 in 20 teeth not previously root-filled and more than 1 in 4 root-filled teeth. Only 28% of the subjects had no tooth with periapical destruction. In all, 18% of the teeth were root-filled: 27% of maxillary teeth and 11% of mandibular teeth. Periapical destructions were less prevalent in people with many remaining teeth and among married people as compared to the rest of the population. Periapical destructions were more common in subjects from “rest of county” as compared to “densely-populated areas”. Variations in treatment quality might be one explanation for this difference. The percentage of root fillings classified as “unacceptable” was high (69%).     

Radiographic features and outcome of root canal treatment carried out in the Łódź region of Poland

AIM: The aim of this study was to assess the radiographic features and factors affecting the long-term results of root canal treatment in the Lód? region of Poland. METHODOLOGY: Three hundred and fifty-five periapical radiographs of previously endodontically treated teeth (282 root-filled teeth and 73 teeth with pulpotomy) from 236 patients were evaluated in the study. The patients were aged from 15 to 76 years and randomly selected amongst subjects referred to the Institute of Dentistry. Medical University of Lód? and two private dental practices. The radiographs were examined by the authors according to criteria proposed by De Cleen et al. (1993) using an illuminated viewbox in a dark room. The Fisher's exact test was used to compare the frequencies in teeth groups. RESULTS: Amongst root-filled teeth, 49% were adequately filled within 0-2 mm of the radiographic apex. Periapical radiolucencies were observed in 25% of root-filled teeth. Teeth without periapical pathosis were more often filled within 0-2 mm of the apex (59%) than teeth with pathosis (17%). Teeth were most often adequately filled (64%) in patients attending the Institute of Dentistry. In patients attending the dental outpatients' departments, 71% of teeth were inadequately filled. Amongst the teeth treated with pulpotomy, 67% had a periapical radiolucency. CONCLUSION: The radiographic technical quality of the root canal treatment was associated with the outcome that root fillings of adequate standard were associated with health more often than inadequate root fillings. Pulpotomy was associated with periapical disease in the majority of cases.     

Post‐treatment apical periodontitis related to the technical quality of root fillings and restorations in Thai population

The aim of this study was to investigate the post‐treatment apical periodontitis in endodontically treated teeth related to the technical quality of root fillings and restorations in Thai population. Full‐mouth periapical radiographs from Thai patients attending the Faculty of Dentistry, Mahidol University, Thailand were examined. The periapical status, quality of root fillings and coronal restorations, existence of intraradicular post and its relationship to the root fillings were evaluated. Among 1586 patients, 37.4% presented endodontically treated teeth. The total number of endodontically treated teeth was 1511, and 35% presented apical periodontitis. Combined data for root filling and coronal restoration qualities revealed significantly better outcome in teeth with adequate qualities of both parameters than the other combinations (P < 0.001). The prevalence of post‐treatment apical periodontitis among Thai population was relatively high and significantly associated with substandard technical quality of root fillings and restorations.     

Prevalence and quality of root canal fillings in a German adult population

The few studies in which prevalence, technical quality, and success rates of root canal fillings performed in daily practice have been assessed demonstrated a high proportion of inappropriate root fillings and a great variety of periapical radiolucencies (25–60%). The aim of the present retrospective radiographic study was to determine if changes in prevalence, technical quality, and success of root canal fillings had occurred within a decade. To achieve this goal, orthopantomograms taken in patients who attended a University Dental Clinic for the first time in 1983 (group A) and in 1992 (group B) were evaluated by a calibrated examiner. The following criteria were applied to assess the root-filled teeth: length and homogeneity of the root fillings and the periapical state. The prevalence of root-filled teeth increased significantly from an average 0.5 per person in 1983 to 0.8 per person in 1992. The increase was proportionally greater in older patients. In group A, 55.2% of the root fillings ended 0–2 mm before the radiographic apex and in group B this percentage was 56.8. Insufficient homogeneity was found in 25.0% (group A) and 21.9% (group B) of the root fillings. The prevalence of root-filled teeth without periapical destructions was 76.1% (group A) and 74.1% (group B). It is concluded that, in the future, endodontic treatment need will increase because of the steadily growing number of older people. Further efforts in research and dental education should focus on the treatment of curved root canals. Received: 5 May 1997 / Accepted: 30 March 1998     

Periapical health related to the quality of coronal restorations and root fillings

AIMS: To evaluate the impact of the quality of coronal restorations scored on a clinical and radiographic basis and the quality of root fillings on periapical health. METHODOLOGY: Periapical radiographs were taken of 745 root-filled teeth, randomly selected from patients attending the Ghent University Dental School. The teeth had not received restorative treatment in the previous year. The coronal status was scored both clinically according to modified Ryge's criteria, and radiographically by evaluating the presence of signs of marginal leakage or decay. The quality of the root filling was scored according to criteria of length and homogeneity and the periapical status was categorized on the basis of presence or absence of radiographic signs of apical periodontitis. The relationship between coronal status, quality of root filling and periapical health was determined. The data were analyzed using Chi2 test, Odds ratio, Spearman's r(S) and logistic regression. RESULTS: Thirty-three percent of the teeth had apical periodontitis as diagnosed radiographically. Teeth with good and poor coronal restorations scored clinically had apical periodontitis in 31.1 and 36.8%, respectively; this difference was not statistically significant. The quality of the coronal restorations scored radiographically had a statistically significant influence on the periapical condition (P<0.001) with apical periodontitis in 23.8 and 49.1%, respectively, for acceptable and unacceptable restorations. Marginal decay did not influence the periapical status. Teeth restored without a base under the coronal filling had apical periodontitis in 41.3%, whereas teeth with a base had significantly less (P<0.005) apical periodontitis (25.9%). Composite-restored teeth exhibited apical periodontitis in 40.5% of cases whilst amalgam-restored teeth had apical periodontitis in 28.4% of cases; this difference was statistically significant (P<0.01). Root-canal posts had no influence on periapical health. The length and homogeneity of the root-canal fillings had a significant influence (P<0.01 and P<0.001, respectively) on the presence of apical periodontitis, as well as the quality of the coronal restoration scored radiographically (P<0.001). CONCLUSION: The importance of a good coronal restoration, as well as of a good root filling should be emphasized as the technical quality of both influencing the periapical status.     

Prevalence of apical periodontitis and the quality of endodontic treatment in an adult Belarusian population

AIM: To estimate the prevalence of teeth with apical periodontitis (AP) and technically failed root fillings in an adult Belarusian population. METHODOLOGY: Panoramic radiographs of all 1423 patients over 15 years of age not seeking emergency dental care, and attending the Dental School of the Belarusian Medical University for the first time during the period from 1 January to 31 December 2001 were examined. The quality of root fillings was scored according to criteria of length proposed by De Moor et al. [International Endodontic Journal 33 (2000) 113] and the periapical status of all teeth (except third molars) was categorized on the basis of presence or absence of radiographic signs of AP. The data were analysed using the chi-square test and odds ratio. RESULTS: Radiographs indicated that 8632 teeth (22% in the maxilla; 21% in the mandible) were missing leaving a total of 31,212 teeth to be assessed. Twenty per cent of the teeth had some filling material in the root canal(s). AP was found in 1141 subjects (80%) and 12% of the teeth. AP was more frequently associated with molar teeth (23%) than premolar (14%), canine (4%) and incisor teeth (6%). AP was diagnosed in 45% of root filled teeth, the remaining cases with AP had not been root filled. Statistical analysis showed that the probability of radiological detection of AP in root filled teeth was 25-fold higher than when the root canals had not been filled (chi2 = 8636.04, P < or = 0.001, odds ratio with 95% confidence intervals: 23.01 < 25.17 < 27.45). Periapical radiolucencies with adequately filled root canals occurred significantly less often than with teeth in which the root canal was filled more than 2 mm from radiographic apex or when filling material was extruded through the apex. CONCLUSION: The prevalence of AP in all age groups in Belarus was higher than in other populations. The probability of AP increased significantly after root canal treatment and was closely correlated with the quality of the root filling.     

Periapical health and treatment quality assessment of root-filled teeth in two Canadian populations

AIM: The prevalence of apical periodontitis (AP) and the quality of root fillings and restorations were determined in two Canadian populations differing in avail-ability of endodontists. METHODOLOGY: Radiographs of first-time university patients aged 25-40 years in Toronto and Saskatoon were examined for missing teeth, presence and standard of root fillings, standard of restoration, and AP according to the Periapical Index. Patients with root-filled teeth were invited for clinical examination and interview to inspect the restorations, and to reveal the providers of endodontic treatment and reasons for extractions of missing teeth. Chi-square and independent t-tests interpreted at the 5% significance level were used to examine associations between the prevalence of AP in root-filled teeth and the standard of the root filling, restoration, and providers of treatment. RESULTS: Proportion of patients with root-filled teeth was significantly higher (P < 0.001) in Toronto than in Saskatoon (39 and 26%, respectively). Presence of AP about root-filled teeth (44% in Toronto, 51% in Saskatoon) was significantly associated with poor density (OR = 2.7) short (OR = 2.4) and long (OR = 2.8) root fillings, and with poor radiographic quality of the restoration (OR = 1.7) Prevalence of AP did not differ significantly between teeth treated by generalists and endodontists. CONCLUSIONS: The prevalence of AP in root-filled and untreated teeth was comparable to that reported in previous methodologically compatible studies. The quality of both the root filling and the restoration were found to impact on the periapical health of root-filled teeth, with the impact of the restoration being most critical when the quality of the root filling was adequate.     

Periapical Status Related to the Quality of Coronal Restorations and Root Fillings in a Korean Population

Introduction

The purpose of this study was to assess the prevalence of apical periodontitis in root canal–treated teeth from the Korean population and to evaluate the relationship between the quality of root canal fillings and coronal restorations and the periapical status of these teeth.

Methods

Full-mouth periapical radiographs at the Dental Hospital of Yonsei University, Seoul, South Korea, were examined. A total of 1030 endodontically treated teeth restored with full veneer crown–type restorations were evaluated by 2 independent examiners. Teeth were classified as healthy or diseased according to the periapical status. The quality of endodontic treatment and coronal restorations were also classified via radiographic and clinical evaluation. The data were analyzed using the chi-square test and logistic regression.

Results

Forty-one percent of all endodontically treated teeth were classified as diseased. Approximately 35.6% of the teeth had endodontic treatments that were rated as adequate. The diseased teeth rate for cases with adequate endodontic treatment was 24.5%, which was significantly lower when compared with teeth with inadequate endodontic treatment (49.9%). The number of teeth with adequate coronal restorations was 706 (68.5%). Teeth with adequate coronal restorations had a significantly decreased prevalence of diseased teeth (34.7%) compared with teeth with inadequate coronal restorations (54.3%). Teeth with both adequate root fillings and restorations showed a significantly better outcome (82.3%) than the others, and teeth with both inadequate root fillings and restorations showed a significantly worse outcome (41.2%) than the others.

Conclusions

Data from this Korean population showed a relatively high prevalence of apical periodontitis. The quality of endodontic treatment and coronal restorations were of equal importance and were strong independent predictors of the periapical status.     

Endodontic treatment and prevalence of apical periodontitis in an adult population of Vilnius, Lithuania

Abstract— Apical periodontitis is prevalent in many Western populations and is frequently detected in connection with inferior quality of endodontic treatment. However, information about endodontic conditions from eastern European countries is limited. The aim of the present investigation was to study the prevalence of apical periodontitis and the quality of endodontic treatment in 35–44-year-old Lithuanians. The prevalence of apical periodontitis was 70%. An overall success rate of 65% was found for root-filled teeth while 56% of pulp amputations (pulpotomies) were considered successful based on a radiographic evaluation. The quality of the root fillings showed little impact on the treatment results, except for over-extended fillings, which were associated with a high number of failures.     

Periapical status, quality of root canal fillings and estimated endodontic treatment needs in an urban German population

Abstract The objective of this study was to determine the periapical status and the quality of root canal fillings and to estimate the endodontic treatment needs in a German population. Clinical and radiographic data and the operative procedures performed were evaluated on 323 patients coming to a dental surgery in Stuttgart, Germany, in 1993. In 182 individuals at least one tooth exhibited a root canal filling, a necrotic pulp or an irreversible pulpitis. Out of the 7897 teeth examined, 215 (2.7%) had a root canal treatment (category A), 122 being nonendodontically treated (1.5%) did not respond to the sensitivity test (category B) and 53 (0.7%) were diagnosed as having irreversible inflamed pulp tissue (category C). The prevalence of teeth associated with radiographic signs of periapical pathosis was 61 % in the group of root canal filled teeth and 88% in the group of pulpless and non-endodontically treated teeth. Using the level and the density of the root canal filling as criteria for evaluating the technical standard, only 14% of the endodontic treatments of non-apicectomized teeth were qualified as adequate. The minimal endodontic treatment need is 2.3% related to all examined teeth when the root canal filled teeth with clinical symptoms of periapical periodontitis (category A) and those of categories B and C are included. The real endodontic treatment need is suggested to be larger when considering that the technical quality of the obturation is poor in most symptomless endodontically treated teeth associated with a periapical lesion. In the case of retreatment of these teeth, the endodontic treatment need would then be calculated at 3.7%.     

Longitudinal study of periapical and endodontic status in a Danish population

AIM: To describe and discuss changes in periapical and endodontic status in a general Danish population. METHODOLOGY: In 1997, 616 randomly selected individuals had a full-mouth radiographic survey taken. In 2003, 77% of the participants attended for a new full-mouth radiographic examination. Information on endodontic treatment and periapical status was obtained. The periapical index (PAI) was used to assess apical periodontitis (AP). RESULTS: More participants had root filling(s) and AP in 2003 than in 1997. More teeth had AP and/or root fillings in 2003. Fewer of the root-filled teeth (RFT) had AP in 2003. Less than 3% of the teeth without root fillings (NRFT) that in 1997 had no AP, developed AP and/or received a root filling. Of the NRFT which in 1997 had AP, more than 35% still had AP and no root filling in 2003. Approximately, 30% of the NRFT with AP in 1997 received a root filling. Of the teeth that received a root filling, 40% had healed, whereas 60% had not. Approximately, 25% of the NRFT that in 1997 had AP had been extracted. In 1997 there were 618 RFT, 314 of the RFT had no AP in 1997. Almost 20% of the RFT that in 1997 were periapically sound, developed AP. Of the 304 RFT with AP in 1997, approximately 30% had healed, in 60% AP persisted, and 10% were extracted. CONCLUSIONS: The present study indicates that caution must be exercised when statements on the outcome of root canal treatment are made based on the cross-sectional studies.     

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT

Objective

This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation.

Material and Methods

The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test.

Results

The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth].

Conclusions

The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics.     

A 20-year follow-up study of endodontic variables and apical status in a Swedish population

AIM: To re-examine a population after 20 years and evaluate changes in prevalence of endodontic treatment and apical periodontitis, as well as the technical quality of root fillings. METHODOLOGY: One hundred and fifteen out of an original 200 patients living in the northern part of Sweden were re-examined with a full mouth radiographic survey after 20 years. Frequencies of root canal treated teeth, apical periodontitis and quality parameters of root fillings were registered. RESULTS: The frequency of root canal treated teeth increased significantly (P < 0.05) from 13.9% at the first investigation to 17.7% after 20 years. There was also a statistically significant increase (P < 0.05) in teeth with apical periodontitis from 3.3% to 6.8%. Apical periodontitis both in connection with root canal treated teeth and teeth without endodontic treatment, had increased during the follow-up period. Even though the quality of the root fillings had improved, there was no corresponding improvement of the apical status in teeth with root fillings. CONCLUSIONS: There is still a great need for endodontic treatment in the Swedish population, and no improvement in apical health was found during this 20-year follow up.     

Frequency of root-filled teeth and prevalence of apical periodontitis in an adult Turkish population

AIM: To report the frequency and distribution of root-filled teeth as well as the prevalence of apical periodontitis in an adult population in Turkey. SUMMARY: Digital panoramic radiographs of 1000 patients who were examined at the Baskent University Faculty of Dentistry between December 2004 and May 2005 were evaluated. Patients ageing <15 years and those with less than nine remaining teeth were excluded. The coronal and periapical status of all the teeth with the exception of third molars was examined according to the criteria proposed by De Moor et al. (2000). Statistical analysis was performed with the Rao and Scott adjusted chi-square test for the comparison of clustered binary data. In all, 24 433 teeth were examined. A total of 346 teeth (1.4%) had radiographic signs of apical periodontitis, and 812 were root filled (3.3%). Of the 812 root-filled teeth, 148 (18.2%) had apical periodontitis. Of the 23,621 nonroot-filled teeth, 198 (0.8%) had apical periodontitis. The number of root-filled teeth in male subjects was significantly less than that in female subjects (P < 0.001), but the presence of apical periodontitis in male subjects was significantly higher than that in female subjects (P < 0.05). KEY LEARNING POINTS: * The prevalence of apical periodontitis and the frequency of root-filled teeth with apical periodontitis were lower than in comparable populations in other countries. * The number of root-filled teeth was comparable to that found in other epidemiologic studies.     

Periapical status and quality of endodontic treatment in an adult Irish population

AIM: To determine the prevalence of apical periodontitis and the quality of root fillings in an adult Irish population using a retrospective analysis of orthopantomograms (OPGs). METHODOLOGY: A systematic sample of clinical records and OPGs of 302 adult patients attending the Dublin Dental Hospital, Ireland, were screened by two examiners to determine the quality of root canal treatment and the prevalence of apical periodontitis. The operators who carried out the treatment were unknown. Two examiners inspected OPGs after inter-examiner correlation. European Society of Endodontology (ESE) guidelines were used to determine adequacy of root treatment. RESULTS: Of the 7427 teeth examined 2% had root fillings. Apical periodontitis was evident in 1.6% of all nonroot filled teeth whilst 33.1% of the subjects had at least one tooth with apical periodontitis. Of the root filled teeth, 25% had apical periodontitis and 52.6% were considered technically inadequate by ESE guidelines. There was a statistically significant (P < 0.05) negative correlation between the quality of the root fillings and the prevalence of apical periodontitis. Posterior root filled teeth (premolars and molars) had a greater prevalence of apical periodontitis than anterior root filled teeth. CONCLUSIONS: The technical quality of root fillings in an adult Irish population was poor and was consistent with a high prevalence of apical periodontitis.     

Technical quality of root fillings in an adult Swedish population

Abstract The purpose of this investigation was to study the technical quality of root fillings in a sample representative of the Swedish population. The material consisted of radiographs of the mandibular premolar and molar regions from 861 individuals (20–60 years old). Pulpoiomies and root fillings were registered and the periapical status and the technical quality of the root fillings were evaluated. The results showed that more than 60% of the root-filled teeth were inadequately sealed. The defect most commonly found was incomplete obturation of the root canal. Periapical lesions were observed in 31% of the root-filled teeth. In teelh with completely obturated root canals, only 7% had a periapical lesion, as compared to 45% of the teeth with inadequately sealed root canals.     

Prevalence of apical periodontitis and quality of root canal treatment in an adult Palestinian sub-population

PurposeThe aim of this study was to determine the prevalence of apical periodontitis and the technical quality of root canal fillings in a Palestinian sub-population.MethodsThe panoramic radiographs of 258 patients (142 females, 116 males) attending dental clinics in 2010 were examined to identify the presence of apical lesions associated with any remaining teeth, excluding third molars. The technical quality of root canal fillings was also evaluated by assessing apical extension from the radiographic apex. The panoramic radiographs were taken by a well-trained radiology assistant and evaluated by a radiologist and an endodontist. Statistical analysis was performed with the chi-square test with a significant level set at P < 0.05%.ResultsOf 6482 teeth examined radiographically, 978 (15.1%) had radiographic signs of apical periodontitis (AP). The prevalence of AP was 8.3% in teeth without filled roots and 59.5% (509/855) in root canal-treated teeth. The prevalence of AP and endodontic treatment increased with age and differed significantly (p < 0.05) between males and females. The majority (74.5%) of root canal fillings was performed inadequately, and most (77.2%) inadequate fillings were >2 mm short of the radiographic apex. The presence of AP was correlated significantly with poorly executed root canal fillings (p < 0.05).ConclusionsThe present study found a high prevalence and incidence of AP in association with root-filled teeth. The technical quality of many root canal treatments was unacceptable.     

Periapical status of root-filled teeth in Norwegian children and adolescents

Objective. To study the periapical status of root-filled permanent teeth of 9–17-year-olds in Møre & Romsdal county, Norway. Materials and methods. All permanent teeth with endodontic treatment in patients born in 1994–2001 were identified in the dental records of the Public Dental Service. The data collected consisted of chart entries and radiographs. Of 1182 teeth, 174 teeth in 155 patients met further inclusion criteria, i.e. completed endodontic treatment and a follow-up with a readable radiograph of at least 1 year. Periapical status was assessed with the Periapical Index (PAI) and the technical quality of the root fillings was also quantified on a 4-grade visual scale. Results. Apical periodontitis was found on follow-up radiographs in 25% of all teeth and in 48% of the teeth with pre-operative apical periodontitis. Forty-two per cent of root fillings were of adequate technical quality. Adequate technical quality of the root filling was significantly correlated with radiographic success. Conclusions. About one fourth of all root-filled teeth and almost half of the teeth with pre-operative apical periodontitis showed clear signs of the disease at recall.     

Prevalence of apical periodontitis and frequency of root-filled teeth in an adult Spanish population

AIM: To estimate the prevalence of teeth with apical periodontitis (AP) and root-filled teeth in an adult Spanish population. METHODOLOGY: A total of 180 subjects, aged 37.1 +/- 15.7 years, presenting as new patients to the Faculty of Dentistry, Seville, Spain, were examined. All participants underwent a full-mouth radiographic survey (14 periapical radiographs). The frequency of root canal treatment and the periapical status of all teeth, using the periapical index (PAI) score, were assessed. An intraobserver agreement test on PAI scores produced a Cohen's kappa of 0.77 (substantial agreement). Results were analysed statistically using the Chi-square test. RESULTS: Apical periodontitis in one or several teeth was found in 110 subjects (61.1% prevalence), and 73 (40.6% prevalence) had at least one root-filled tooth. Among subjects with root-filled teeth, 48 (65.8%) had AP affecting at least one root-filled tooth. A total of 4453 teeth were examined, of these 186 (4.2%) had AP. The total number of root-filled teeth was 93 (2.1%), of which 60 (64.5%) had AP. Among non-root filled teeth, only 2.9% had AP. The prevalence of AP in connection with molar teeth was higher (5.5%) than for premolar (4.5%) and anterior teeth (3.2%; P < 0.01). More premolar and molar teeth were root-filled (2.8 and 2.7%, respectively) than anterior teeth (1.3%; P < 0.01). The prevalence of AP increased with age. CONCLUSIONS: The prevalence of AP in root-filled and untreated teeth, and the frequency of root-filled teeth were comparable to those reported in previous similar studies carried out in European countries. The prevalence of root-filled teeth with AP was found to be higher compared to that demonstrated in other epidemiological studies.