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Introduction: The main cause for developing periapical lesions (PA) is the root canal infection. The mentioned causes may play a role in not controlling it but are not a "true" cause., Objective: To determine apical status and prevalence of endodontic treated tooth using radiograph assessment in relation to quality of root canal treatment and clinical factors among Saudi adults in the Eastern province., Patients and Methods: This prospective case series study included 2161 patients who received root canal treatment (RCT) at Dammam Specialized Dental Center, Dammam Medical Complex, Ministry of Health, Saudi Arabia, between October 21, 2019 and April 22, 2020, after getting ethical approval from the Institutional Research Board (IRB). Saudi natives of either gender, age ≥ 18, with at least one fixed bridge or single dental crown evaluated on a clear, high-quality radiography image were recruited for the study. To determine the periapical state of root canal-filled teeth, the 'periapical index' (PAI) was used. All pertinent patient information was analyzed in SPSS verion-20 (IBM product, Chicago)., Results: Out of 2161 cases, a PA lesion was present in 756 (35.0%). The prevalence of periapical lesions in endodontically treated teeth was 31.2%. PA lesion was associated with molar involvement (50.8% vs. 36.6%, p = 0.001), poor RCT quality (85.2% vs. 51.0%, p = 0.001), and smoking (13.6% vs. 10.5%, p = 0.028). According to logistic regression model, female gender, molar tooth, and poor RCT quality were more likely to expose PA lesion 1.5 times, 1.8 times, and 5 times, respectively., Conclusion: It is concluded that approximately 1/3rd of endodontically treated teeth are susceptible to the occurrence of periapical lesions in radiographic assessment, which are significantly associated with females, molars, and poor RCT quality, indicating a challenge for endodontists to improve their root canal assessment accuracy., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 King Saud University.)

Aim: The aim of the present study was to compare the effectiveness of mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) for treating peri-implant mucositis among prediabetic cigarette-smokers and non-smokers., Methods: Prediabetic and non-diabetic smokers and non-smokers with peri-implant mucositis were included. Patients with peri-implant mucositis were divided into 4 groups as follows: Group-1: Prediabetic smokers with peri-implant mucositis; Group-2: Prediabetic non-smokers with peri-implant mucositis; Group-3: Systemically-healthy smokers with peri-implant mucositis; and Group-4: Systemically-healthy non-smokers with peri-implant mucositis. Hemoglobin A1c levels were measured in all groups prior to MD with adjunct aPDT. Peri-implant plaque index (PI), bleeding on probing (BOP) and probing depth (PD) were assessed at baseline and at 4- and 12-weeks of follow-up. Sample-size estimation was done and data normality was assessed. Group-comparisons were performed. and P < 0.01 was selected as an indicator of statistical significance., Results: Fifteen, 15, 15 and 15 individuals were included in groups 1, 2, 3 and 4, respectively. At baseline, peri-implant PI, BOP and PD were comparable in all groups. In prediabetic smokers and non-smokers, there was no significant difference in peri-implant PI, BOP and PD at 4- and 12-weeks' follow-up. Among non-diabetic smokers and non-smokes MD with adjunct PDT significant reduced PI (P < 0.01) and PD (P < 0.01) at 4- and 12-weeks' follow-up., Conclusion: The outcomes of MD with adjunct aPDT for the treatment of peri-implant mucositis are compromised in smokers and non-smokers with prediabetes. In non-diabetic smokers and non-smokers, MD with aPDT is effective for treating peri-implant mucositis., (Copyright © 2020 Elsevier B.V. All rights reserved.)