Prevalence of Apical Periodontitis by Cone Beam Computed Tomography: A Cross Sectional Study

Objective: This study aimed to assess the prevalence of apical periodontics (AP) from a sample of Iraqi adult population by using cone beam computed tomography (CBCT) images.           Methods: Two hundred and fifty-one CBCT images (116 male and 135 female) were obtained, 6738 teeth were examined of these patients who attended for dental treatment from January 2017 to June 2018 in the B&R private dental clinic in Sulaimani, Kurdistan region/Iraq. Apical periodontitis was divided according to tooth types (anatomical) in both upper and lower jaw, root canal treatment (RCT) and non-root canal treatment (Non-RCT), affected root by AP, and quality of RCT. Pearson’s chi-square test was used to determine the level of significance (p<0.05). Results: Apical periodontitis was found in 294 teeth from 6738 examined teeth, of these, 59.9% of AP incidence was linked to RCT. The percentage of periapical lesions was not significantly different between male and female patients. Among RCT teeth, maxillary teeth were found to be most susceptible to AP (61.92%) compared to mandibular teeth (38.07%). Mesiobuccal root of upper first molar and mesial root of lower first molar were most commonly affected with AP (12.4%). The most reported defects where under filling, followed by missed canal, and pulpotomy which were 32%, 20% and 18 % respectively. Missed upper second mesiobuccal canal presented with a higher percentage of AP (40.6%) and palatal roots of maxillary molars showed the least AP (2.7%).  Conclusions: The prevalence of AP was low on population level; however, the prevalence of AP was high in inadequate endodontically treated teeth and increased in teeth with complex anatomy.