Aim: To identify risk indicators of apical periodontitis (AP) in teeth in an attempt to develop evidens-based selection criteria for periapical radiography in new patients. Methods: The material consisted of full-mouth surveys (FMS) of 613 randomly selected individuals (20-60 years of age) living in Aarhus County, DK in 1997. All teeth present in the FMS (except third molars) were assessed with respect to: endodontic status, caries status, type and quality of restorative work. The variables included were those which can be identified from a bitewing examination. Conditional logistic regression analyses were performed. The independent variables consisted of the above dental parameters, and the dependent variable was the presence or absence of AP in the tooth. Odds Ratios (OR) and confidence intervals for the OR were estimated for each variable. Results: Molars (OR 3.3) had a significantly higher risk of AP than other tooth groups. A higher risk of AP was further seen in teeth with: root fillings (OR 59.3), adequate and inadequate crowns (OR 7.5; 10.2), adequate and inadequate fillings (OR 3.0; 4.8) and primary caries lesions (OR 3.5). Mandibular teeth had a significantly lower risk of AP than maxillary teeth (OR 0.7). Conclusions: Within the individual, teeth with root fillings, crowns (particularly inadequate crowns), adequate and inadequate fillings and primary caries lesions have a higher risk of having AP and should be considered for periapical radiography. Further, molars and maxillary teeth are more at risk.

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