(PR15) Characteristics of Posterior Permanent Teeth with a Periradicular Diagnosis of Symptomatic Apical Periodontitis: A Retrospective Study

Abstract: The diagnosis of apical periodontitis is based on radiographic manifestations and the results of the various clinical tests that can be performed as part of a routine dental examination. Apical periodontitis producing clinical symptoms involving a painful response to biting and/or percussion or palpation is given the diagnosis of symptomatic apical periodontitis (SAP). This study aimed to determine associations of SAP with radiographic radiolucencies, diagnostic testing, pulpal diagnosis, location of the tooth in the arch, proximal contacts, and the presence of a permanent restoration. Data for this study were obtained from patients of record treated at Virginia Commonwealth University School of Dentistry in the Department of Endodontics by first- and second-year residents. Electronic dental charts obtained through axiUm™ were used to identify all patients diagnosed with SAP and these charts were used to determine clinical and radiographic characteristics associated with the diagnosis. The data shows SAP is associated with the presence of a periapical radiolucency or widened PDL in 41% of cases and with an intact PDL 59%. A pulpal diagnosis of symptomatic irreversible pulpitis was given in 46% of cases, previous treatment in 27%, pulp necrosis in 25%, and other 2%. Of the posterior teeth included in this study, 77% were molars and 23% were premolars. 36% of the patients presented with a crown or bridge, 23% with no restoration, and 37% with restorations.