Influence of Traumatic Overbite on the Periapical Healing of Endodontically Treated Anterior Teeth with Periapical Pathosis - A Preliminary Prospective Study

Aim: The aim is to evaluate the influence of traumatic overbite on the outcome of nonsurgical endodontic therapy (NSET) performed on the anterior teeth with periapical pathosis. Subjects and Methods: A total of 48 maxillary and mandibular anterior teeth with periapical pathology and a periapical index (PAI) score ≥3 were recruited from the patient’s pool requiring NSET. The subjects were divided into two groups: Group I (normal overbite) and Group II (Akerly’s traumatic overbite. Standardized two-visit NSETs were performed for both groups. Outcome evaluation was carried out at 3, 6, and 12 months, and the teeth were categorized as healed (PAI score ≤2) or nonhealed (PAI score ≥3). Statistical Analysis: Data were analyzed using the Chi-square and Fisher’s extract tests. A P < 0.05 was predetermined to be significant. Results: A recall rate of 88.8% was achieved. In both groups, all the teeth were clinically asymptomatic. Radiographic healing was observed to be 17 (70.6%) and 8 (33.3%) for Group I (normal overbite) and Group II (Akerly’s traumatic overbite), respectively, and the difference was statistically significant ( P = 0.028). Conclusion: Co-existing traumatic overbite can delay or result in nonhealing of the periapical lesion in endodontically treated anterior teeth. Further, it can be inferred that a traumatic deep overbite can be considered as a primary cause for loss of pulp vitality.