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Recorded patient\u2010level parameters included gender, age, number of teeth, number of root filled teeth, presence of any AP lesion, and number of implants. The following tooth\u2010level data were collected: tooth presence, coronal status, quality of coronal restoration, post presence, type of root\u2010filling material, length and density of root filling, root\u2010end filling material, presence of AP, and adjacent implant. Multivariable multilevel binary logistic regression was used to explore the association between patient and tooth characteristics and AP prevalence. Risk differences and confidence intervals were calculated to compare the present with the previous study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of AP at patient and tooth level was 46.9% and 5.6%, respectively. Fifty\u2010one per cent of the 614 patients had at least one root filled tooth, and 5.9% of the 14\u2009655 teeth studied were root filled. AP was found in 45% of root filled teeth. Fifty\u2010four per cent of the root\u2010filled teeth were rated as inadequate. Multivariable multilevel logistic regression revealed that more teeth, more implants, fewer root\u2010filled teeth, adequate density, adequate coronal restoration, and no caries reduced the likelihood of AP. There were no statistically significant differences between the two studies regarding the prevalence of root\u2010filled teeth or AP and the technical quality of root canal treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prevalence of AP and the technical quality of root canal treatment in Belgium have not substantially changed over the last 22\u2009years, despite the technological advancements and continuing education in the field.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iej.14032","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T09:25:49Z","timestamp":1707297949000},"page":"533-548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A 22\u2010year follow\u2010up cross\u2010sectional study on periapical health in relation to the quality of root canal treatment in a Belgian population"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4785-9221","authenticated-orcid":false,"given":"Georgios","family":"Keratiotis","sequence":"first","affiliation":[{"name":"Department of Oral Health Sciences, Section of Endodontology Ghent University  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loukia","family":"Spineli","sequence":"additional","affiliation":[{"name":"Midwifery Research and Education Unit Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mieke A. 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