Epidemiology of apical periodontitis
Endodontics is one of the most technically demanding disciplines of dentistry. For this reason, much of the research and most standard texts focused on the mechanical aspects of the clinical method, not the biology and epidemiology of the disease being treated. This contrasts greatly with related disciplines cariology and Periodontology, for which there are serious published data on the prevalence and treatment need.
Tooth decay is the most common cause of cellulose death and apical periodontitis, but quite how much of an illness is not known. Some idea of the scale provided by countries with nationalized health care system, such as the UK, where, as it is known, that more than 1 million of root canal treatment is conducted permanent teeth every year, the cost is more than $ 40 million pounds. This figure does not include many teeth in preference is saved for root canal treatment, and similar numbers of teeth with non-urgent slurries, who symptoms, or occasionally inconvenient for which no treatment is sought.
The cost of root canal treatment is also does not take into account what price they have to pay for the restoration of the crown damaged, pulpless teeth, or any procedural care required in the future for management of treatment failure.
A number of studies have attempted to determine cellulose death and the development of apical periodontitis in response to operative dental procedures. Many of them, such as the provision of CZK should, apparently, had followed earlier episodes of diseases of the teeth and repair such as tooth decay and cavities restoration. It seems obvious that the crown training, associated with increasing endodontic failure periods to increase. Approximately 2-4% of cellulose can lose vitality within the first 5 years cementation of crowns, this figure rises to almost 20% from 20 to 25 years to remember. This has serious pathological and economic consequences for populations with high life expectancy, and requires serious thought before embarking on aggressive courses of rehabilitation treatment, including in patients coming in the middle ages.
Service planning requires some knowledge about the prevalence of disease in the community served. Levels of apical periodontitis are rarely investigated in caries screening, because x-ray exposure is required. However, studies have been conducted with the purpose of quantitative evaluation of apical periodontitis as a separate entity disease. All surveys from developed countries, revealed significant regulatory treatment needs, including management not previously treated periapical diseases and lesions that do not heal after primary health care.
A comprehensive summary of prevalence data for apical periodontitis, mainly from Scandinavian and European studies was made Eriksen in 1998. Table 6.1 shows that 33% 20-30 years have at least one periapical lesions, this figure rises to 62% for those over 60. It was amazing to compare apical periodontitis (infected pulp space channel that requires a comprehensive intervention) with data for marginal periodontitis (1 CPITN a score of 4, indicating the need for a comprehensive intervention). Perhaps apical periodontitis is much more common than in Western societies advanced forms of periodontitis with implications in terms of resource allocation for conservative treatment, the risks of acute exacerbation or needs to be extracted.
The risk of acute exacerbation of chronic apical periodontitis, according to estimates, up to 5% per year, in other words, 50% within 10 years. Of great concern in some silent and the damage that can be caused by untreated or insufficiently treated periapical diseases. In homeopathic age when many recognize that unquan-tifiably small number of agents that can have a beneficial or harmful effect on the body, and the link between chronic inflammation and systemic malaise, many people find the prospect of harboring asymptomatic, chronic infectious lesions as undesirable, as the Ghost of an acute episode. There is, however, no clear evidence, at present, to support or refute such a system links...