Author(s):
1. Irena Kuzmanović Radman, Medicinski fakultet Banja Luka , Republic of Srpska, Bosnia and Herzegovina
2. Radmila Arbutina, University of Banja Luka, School of Medicine, Dentistry Study Program, Republic of Srpska, Bosnia and Herzegovina
3. Tijana Adamovic, University of Banja Luka, School of Medicine, Dentistry Study Program, Republic of Srpska, Bosnia and Herzegovina
4. Vladan Mirjanić, Republic of Srpska, Bosnia and Herzegovina
5. Renata Josipović, Medicinski fakultet Banja Luka , Republic of Srpska, Bosnia and Herzegovina
6. Adriana Arbutina, Medicinski fakultet Banja Luka , Republic of Srpska, Bosnia and Herzegovina
7. Mirjana Umićević Davidović, Medicinski fakultet Banja Luka , Republic of Srpska, Bosnia and Herzegovina
8. Marijana Arapović Savić, Medicinski fakultet Banja Luka , Republic of Srpska, Bosnia and Herzegovina

Abstract:
Abstract: Endodontic treatment failure is defined as the radiographic presence of an inflammatory periapical lesion, or its persistence or enlargement following primary endodontic therapy. The reasons for treatment failure may include inadequate (improper) root canal obturation (lack of an adequate hermetic seal) or an inadequate coronal restoration of the tooth. Treatment success is assessed by determining the Periapical Index (PAI), i.e., a radiographic evaluation of the condition of the periapical tissues. The aim of this study was to evaluate the association between diagnosis, the quality of root canal obturation, and the quality of coronal restoration with the radiographic periapical status of endodontically treated teeth. The study included 29 teeth that had undergone endodontic treatment. The analysis of each tooth comprised the assessment of: diagnosis (acute or chronic apical periodontitis – PAA or PAH), quality of root canal obturation (adequate, homogeneous, short, or non-homogeneous), quality of coronal restoration (adequate/inadequate), and periapical status determined using the Periapical Index (PAI; scores 1–5). The clinical study included teeth diagnosed with chronic apical periodontitis in 62.1% of cases and acute apical periodontitis in 37.9% of cases. Adequate root canal obturation was observed in 34.5% of teeth, homogeneous obturation in 37.9%, short obturation in 20.7%, and non- homogeneous obturation in 6.9% of teeth. Adequate coronal restoration was present in 55.2% of teeth, whereas 44.8% had inadequate restorations. The largest proportion of teeth had a PAI score of 2 (31.03%), while the fewest had a PAI score of 5 (6.90%). A trend was observed indicating an association between higher PAI scores (4 and 5) and inadequate coronal restorations, whereas most teeth with lower PAI scores (1 and 2) had adequate coronal restorations. A similar trend was observed for the quality of root canal obturation: short and non-homogeneous canal fillings were more frequently found in teeth with higher PAI scores. Endodontic treatment failure was most commonly associated with chronic apical periodontitis and inadequate quality of both coronal restoration and root canal obturation. Long-term treatment success depends on precise and homogeneous root canal obturation as well as the placement of an adequate coronal restoration.

Key words:
endodontic treatment failure,Periapical Index (PAI),quality of coronal restoration,quality of root canal obturation,apical periodontitis.,endodontski neuspjeh,PAI indeks,kvalitet restauracije,kvalitet opturacije,apikalni parodontitis.

Thematic field:
SYMPOSIUM B - Biomaterials and nanomedicine

Date of abstract submission:
07.07.2026.

Conference:
Contemporary Materials 2026 - Savremeni Materijali

Applied paper from author