{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T09:28:19Z","timestamp":1786613299763,"version":"build-2736575974"},"reference-count":35,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AOS"],"abstract":"<jats:p>Objective: The aim of this cross-sectional study was to assess the root canal filling quality and the frequency of apical periodontitis (AP) in root-canal-filled teeth in a randomly selected adult non-patient population in Sweden. \nMaterials and Methods: In 2023, 295 root-canal-filled teeth were identified in 126 adults in a cross-sectional study in J\u00f6nk\u00f6ping, Sweden. Periapical radiographs were assessed by two calibrated observers. The periapical status was scored according to the periapical index (PAI) and then dichotomized as either healthy (PAI 1\u20132) or diseased (PAI 3\u20135). The root canal filling quality was deemed as adequate\/inadequate. An adequate root canal filling was considered to end 0.5\u20132 mm from the radiographic apex and to have no radiolucent voids.\nResults: Adequate root canal fillings were seen in 89 (30.2%) of the teeth. AP was present in 94 (31.9%) of the teeth, and of these, 72 (76.6%) had an inadequate root canal filling. Of the 122 root-canal-filled molars, 101 (82.8%) had inadequate root canal filling and 57 (46.7%) had AP. \nConclusion: A large proportion of root-canal-filled teeth have inadequate root canal filling quality and AP, especially in molars. Both contributing factors and strategies for improvement require further study.<\/jats:p>","DOI":"10.2340\/aos.v85.46663","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T08:46:42Z","timestamp":1786610802000},"page":"559-567","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of apical periodontitis in root-canal-filled teeth \u2013 a cross-sectional study"],"prefix":"10.2340","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0359-2094","authenticated-orcid":false,"given":"Nikki","family":"Savolainen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2685-3656","authenticated-orcid":false,"given":"Thomas","family":"Kvist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4290-2283","authenticated-orcid":false,"given":"Helena","family":"Fransson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0519-5842","authenticated-orcid":false,"given":"Fredrik","family":"Frisk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"165649","doi-asserted-by":"crossref","unstructured":"European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2006;39(12):921\u201330.","DOI":"10.1111\/j.1365-2591.2006.01180.x"},{"key":"165650","doi-asserted-by":"crossref","unstructured":"Gulabivala K, Ng YL. Factors that affect the outcomes of root canal treatment and retreatment: a reframing of the principles. Int Endod J. 2023;56 Suppl 2:82\u2013115.","DOI":"10.1111\/iej.13897"},{"key":"165651","doi-asserted-by":"crossref","unstructured":"Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature: part 1. Effects of study characteristics on probability of success. Int Endod J. 2007;40(12):921\u201339.","DOI":"10.1111\/j.1365-2591.2007.01322.x"},{"key":"165652","doi-asserted-by":"crossref","unstructured":"Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature: part 2. Influence of clinical factors. Int Endod J. 2008;41(1):6\u201331.","DOI":"10.1111\/j.1365-2591.2007.01323.x"},{"key":"165653","doi-asserted-by":"crossref","unstructured":"Jakovljevic A, Nikolic N, Jacimovic J, Pavlovic O, Milicic B, Beljic-Ivanovic K, et al. Prevalence of apical periodontitis and conventional nonsurgical root canal treatment in general adult population: an updated systematic review and meta-analysis of cross-sectional studies published between 2012 and 2020. J Endod. 2020;46(10):1371\u201386.e8. https:\/\/doi.org\/10.1016\/j.joen.2020.07.007. Erratum in: J Endod. 2021;47(2):336. https:\/\/doi.org\/10.1016\/j.joen.2020.11.010","DOI":"10.1016\/j.joen.2020.07.007"},{"key":"165654","doi-asserted-by":"crossref","unstructured":"Laukkanen E, Vehkalahti MM, Kotiranta AK. Radiographic outcome of root canal treatment in general dental practice: tooth type and quality of root filling as prognostic factors. Acta Odontol Scand. 2021;79(1):37\u201342.","DOI":"10.1080\/00016357.2020.1773531"},{"key":"165655","doi-asserted-by":"crossref","unstructured":"Koch M, Wolf E, Tegelberg \u00c5, Petersson K. Effect of education intervention on the quality and long-term outcomes of root canal treatment in general practice. Int Endod J. 2015;48(7):680\u20139.","DOI":"10.1111\/iej.12367"},{"key":"165656","doi-asserted-by":"crossref","unstructured":"Dahlstr\u00f6m L, Molander A, Reit C. The impact of a continuing education programme on the adoption of nickel-titanium rotary instrumentation and root-filling quality amongst a group of Swedish general dental practitioners. Eur J Dent Educ. 2015;19(1):23\u201330.","DOI":"10.1111\/eje.12097"},{"key":"165657","doi-asserted-by":"crossref","unstructured":"Tib\u00farcio-Machado CS, Michelon C, Zanatta FB, Gomes MS, Marin JA, Bier CA. The global prevalence of apical periodontitis: a systematic review and meta-analysis. Int Endod J. 2021;54(5):712\u201335.","DOI":"10.1111\/iej.13467"},{"key":"165658","doi-asserted-by":"crossref","unstructured":"Razdan A, Jungnickel L, Schropp L, Vaeth M, Kirkevang LL. Trends of endodontic and periapical status in adult Danish populations from 1997 to 2009: a repeated cross-sectional study. Int Endod J. 2022;55(2):164\u201376.","DOI":"10.1111\/iej.13658"},{"key":"165659","doi-asserted-by":"crossref","unstructured":"Silnovic Z, Kvist T, Frisk F. Periapical status and technical quality in root canal filled teeth in a cross-sectional study in J\u00f6nk\u00f6ping, Sweden. Acta Odontol Scand. 2023;81(3):249\u201354.","DOI":"10.1080\/00016357.2022.2121322"},{"key":"165660","doi-asserted-by":"crossref","unstructured":"Frisk F, Hugoson A, Hakeberg M. Technical quality of root fillings and periapical status in root filled teeth in J\u00f6nk\u00f6ping, Sweden. Int Endod J. 2008;41(11):958\u201368.","DOI":"10.1111\/j.1365-2591.2008.01457.x"},{"key":"165661","doi-asserted-by":"crossref","unstructured":"B\u00fcrklein S, Sch\u00e4fer E, J\u00f6hren HP, Donnermeyer D. Quality of root canal fillings and prevalence of apical radiolucencies in a German population: a CBCT analysis. Clin Oral Investig. 2020;24(3):1217\u201327.","DOI":"10.1007\/s00784-019-02985-y"},{"key":"165662","doi-asserted-by":"crossref","unstructured":"Keratiotis G, Spineli L, De Bruyne MAA, De Moor RJG, Meire MA. A 22-year follow-up cross-sectional study on periapical health in relation to the quality of root canal treatment in a Belgian population. Int Endod J. 2024;57(5):533\u201348.","DOI":"10.1111\/iej.14032"},{"key":"165663","doi-asserted-by":"crossref","unstructured":"Dawson VS, Petersson K, Wolf E, \u00c5kerman S. Periapical status of root-filled teeth restored with composite, amalgam, or full crown restorations: a cross-sectional study of a Swedish adult population. J Endod. 2016;42(9):1326\u201333.","DOI":"10.1016\/j.joen.2016.06.008"},{"key":"165664","unstructured":"Norderyd O, Koch G, Papias A, K\u00f6hler AA, Helkimo AN, Brahm CO, et al. Oral health of individuals aged 3\u201380 years in J\u00f6nk\u00f6ping, Sweden during 40 years (1973-2013). II. Review of clinical and radiographic findings. Swed Dent J. 2015;39(2):69\u201386."},{"key":"165665","doi-asserted-by":"crossref","unstructured":"Thompson LA, Chen H. Physiology of aging of older adults: systemic and oral health considerations: 2021 update. Clin Geriatr Med. 2023;39(2):225\u201334.","DOI":"10.1016\/j.cger.2023.01.009"},{"key":"165666","unstructured":"Migrationsverket. Asylstatistik. Norrk\u00f6ping: Migrationsverket; n.d. [cited 2026 Mar 20]. Available from: https:\/\/www.migrationsverket.se\/om-migrationsverket\/statistik\/asyl.html"},{"key":"165667","unstructured":"Socialstyrelsen (National Board of Health and Welfare). Resurs- och kapacitetskarta f\u00f6r tandv\u00e5rdens personalf\u00f6rs\u00f6rjning. Stockholm: Socialstyrelsen (National Board of Health and Welfare); 2024 [cited 2026 Mar 20]. Available from: https:\/\/www.socialstyrelsen.se\/contentassets\/00793192c74f41da80f4239c8260f1de\/2024-3-8945.pdf"},{"key":"165668","unstructured":"Riksrevisionen. Tandv\u00e5rdsst\u00f6det \u2013 en konstruktion med h\u00e5l. Stockholm: Riksrevisionen; 2025 [cited 2026 Mar 20]. Available from: https:\/\/www.riksrevisionen.se\/download\/18.1dcf58fb19ae7c672f22d24\/1766158784661\/RiR-2025-34-rapport.pdf"},{"key":"165669","doi-asserted-by":"crossref","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453\u20137.","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"165670","doi-asserted-by":"crossref","unstructured":"\u00d8rstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol. 1986;2(1):20\u201334.","DOI":"10.1111\/j.1600-9657.1986.tb00119.x"},{"key":"165671","doi-asserted-by":"crossref","unstructured":"Demirci M, Tuncer S, Yuceokur AA. Prevalence of caries on individual tooth surfaces and its distribution by age and gender in university clinic patients. Eur J Dent. 2010;4(3):270\u20139.","DOI":"10.1055\/s-0039-1697839"},{"key":"165672","doi-asserted-by":"crossref","unstructured":"Huumonen S, Suominen AL, Vehkalahti MM. Prevalence of apical periodontitis in root filled teeth: findings from a nationwide survey in Finland. Int Endod J. 2017;50(3):229\u201336.","DOI":"10.1111\/iej.12625"},{"key":"165673","doi-asserted-by":"crossref","unstructured":"Yu VS, Messer HH, Yee R, Shen L. Incidence and impact of painful exacerbations in a cohort with post-treatment persistent endodontic lesions. J Endod. 2012;38(1):41\u20136.","DOI":"10.1016\/j.joen.2011.10.006"},{"key":"165674","doi-asserted-by":"crossref","unstructured":"Frisk F, Hakeberg M. Socio-economic risk indicators for apical periodontitis. Acta Odontol Scand. 2006;64(2):123\u20138.","DOI":"10.1080\/00016350500469680"},{"key":"165675","doi-asserted-by":"crossref","unstructured":"Liu HE, Li MC. Factors influencing the willingness to participate in medical research: a nationwide survey in Taiwan. PeerJ. 2018;6:e4874.","DOI":"10.7717\/peerj.4874"},{"key":"165676","doi-asserted-by":"crossref","unstructured":"Galea S, Tracy M. Participation rates in epidemiologic studies. Ann Epidemiol. 2007;17(9):643\u201353.","DOI":"10.1016\/j.annepidem.2007.03.013"},{"key":"165677","doi-asserted-by":"crossref","unstructured":"Lyngs\u00f8e S, Lophaven S, Jepsen R, Holmager T, Janssens A, Lynge E. Non-participation in a health examination survey in a rural-provincial area of Denmark \u2013 results from the Lolland-Falster Health Study (LOFUS). Scand J Public Health. 2024;52(8):951\u20139.","DOI":"10.1177\/14034948231206879"},{"key":"165678","doi-asserted-by":"crossref","unstructured":"Petersson K, H\u00e5kansson R, H\u00e5kansson J, Olsson B, Wennberg A. Follow-up study of endodontic status in an adult Swedish population. Endod Dent Traumatol. 1991;7(5):221\u20135.","DOI":"10.1111\/j.1600-9657.1991.tb00440.x"},{"key":"165679","unstructured":"Statistics Sweden (SCB). Population by age and sex, 1860\u20132024 [Internet]. Stockholm: Statistics Sweden; [updated 2025 Feb 21; cited 2026 Mar 20]. Available from: https:\/\/www.statistikdatabasen.scb.se\/pxweb\/sv\/ssd\/START__BE__BE0101__BE0101A\/BefolkningR1860N\/"},{"key":"165680","doi-asserted-by":"crossref","unstructured":"Jonsson Sj\u00f6gren J, Kvist T, Eliasson A, EndoReCo, Pigg M. The frequency and characteristics of pain and discomfort associated with root filled teeth: a practice-based study. Int Endod J. 2019;52(9):1264\u201373.","DOI":"10.1111\/iej.13124"},{"key":"165681","unstructured":"F\u00f6rs\u00e4kringskassan. N\u00e4r t\u00e4nderna f\u00e5r v\u00e4nta: analys av de som inte har regelbunden kontakt med tandv\u00e5rden [Internet]. Stockholm: F\u00f6rs\u00e4kringskassan; 2012 [cited 2026 Jun 25]. Available from: https:\/\/www.forsakringskassan.se\/download\/18.7cd2923018425d8c4fc326\/1667228082589\/nar-tanderna-far-vanta-socialforsakringsrapport-2012-10.pdf (Socialf\u00f6rs\u00e4kringsrapport; 2012:10). [in Swedish]."},{"key":"165682","doi-asserted-by":"crossref","unstructured":"Zadik Y, Raber-Durlacher JE, Epstein JB, Majorana A, Miranda-Silva W, Yang S, et al. MASCC\/ISOO Clinical Practice Statement: dental evaluation and management prior to treatment for hematologic malignancies and CAR T-cell therapy. Support Care Cancer. 2025;33(10):853.","DOI":"10.1007\/s00520-025-09845-4"},{"key":"165683","unstructured":"Swedish Government Official Reports. When needs take precedence: a dental care system for more equitable oral health [N\u00e4r behovet f\u00e5r styra \u2013 ett tandv\u00e5rdssystem f\u00f6r en mer j\u00e4mlik tandh\u00e4lsa]. Stockholm: Swedish Government Official Reports; 2021. Report No.: SOU 2021:8. Appendix 6, Dental care interventions as part of medical treatment. p. 1098."}],"container-title":["Acta Odontologica Scandinavica"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/actaodontologica\/article\/download\/46663\/55150","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/actaodontologica\/article\/download\/46663\/55150","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T08:47:06Z","timestamp":1786610826000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/actaodontologica\/article\/view\/46663"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":35,"URL":"https:\/\/doi.org\/10.2340\/aos.v85.46663","relation":{},"ISSN":["1502-3850","0001-6357"],"issn-type":[{"value":"1502-3850","type":"electronic"},{"value":"0001-6357","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8,13]]}}}