Objectives: The purpose of this study was to investigate the effect of coronal leakage and periodontal pocket depths on the prevalence of apical periodontitis (AP) in root-filled teeth, in patients treated for periodontal disease. Methods: All teeth scored in this study were selected retrospectively from patients attending the Department of Periodontology, Ghent University Hospital. Data were collected from an available periodontal status and an associated full intra-oral radiographic status. Several parameters, including type and quality of coronal fillings, type and quality of root fillings, coronal level of root-fillings in relation to the marginal bone and the periapical condition, were scored on periapical radiographs and correlated to the periodontal pocket depths, scored on the periodontal status and on the radiographs. Results: A total of 272 root-filled teeth were scored on 94 patients. According to the results from the two-tailed t-test, teeth with AP had a statistically significantly increased average pocket depth (p<0.001), showed more marginal bone loss (p<0.001) and a higher measure of deepest pocket depth (p<0.001). No significant correlation between length (ANOVA) and homogeneity (t-test) of the root filling and periodontal pocket depth was detected. ChiČ analysis revealed a significant correlation between the prevalence of AP and the quality of the root filling (p<0.001), as well as the quality of the coronal filling (p<0.05). The coronal level of the root-filling in relation to the marginal bone had a statistically significant effect on the presence of periapical pathology (p<0.005). Conclusion: The presence of apical pathology was significantly correlated to an increased pocket depth. The quality and the coronal level of the root filling and the quality of the coronal restoration also had a significant effect on the prevalence of AP.

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