BUILDING A RISK ASSESSMENT MODEL FOR MANAGEMENT OF PERSISTENT ENDODONTIC LESIONS

Abstract

Apical periodontitis is an inflammatory response aimed at restricting the spread of microbes and microbial products that have invaded the dental pulp. Endodontic treatment of the inflamed pulp is performed for healing and function, and protection of the host. The assessment of treatment has important implications for patient care, and a responsible assessment strategy includes the recommendation of further intervention if the initial treatment has not achieved the intended healing outcome over a period of time. However, difficulty arises when AP is persistent radiographically, but at the same time the tooth is asymptomatic. The need for further intervention for these ?functional? teeth has been debated, but in the absence of reliable evidence the decision to intervene has been empirical and varies widely among practitioners. This thesis aims to: (1) study the risk and distribution of persistent AP that has improved, remained unchanged or deteriorated over time; (2) identify clinical predictors; and (3) build a risk assessment model for lesion deterioration.