Defense Date


Document Type


Degree Name

Master of Science in Dentistry



First Advisor

Dr. Garry L. Myers, DDS

Second Advisor

Dr. Steven M. Marinelli, DDS, ABGD

Third Advisor

Dr. Caroline K. Carrico, PhD


The diagnosis of apical periodontitis is based on radiographic manifestations and the results of the various clinical tests that can be performed as part of a routine dental examination. Apical periodontitis producing clinical symptoms involving a painful response to biting and/or percussion or palpation is given the diagnosis of symptomatic apical periodontitis (SAP). This study aimed to determine associations of SAP with gender, age, radiographic findings, diagnostic testing, pulpal diagnosis, and location of the tooth in the arch. Data for this study were obtained from patients of record treated at Virginia Commonwealth University School of Dentistry in the Department of Endodontics by first- and second-year residents. Electronic dental charts obtained through axiUm™ were used to identify all patients diagnosed with SAP and these charts were used to determine clinical characteristics associated with the diagnosis. Radiographs of charts included in the initial data set were analyzed using the digital database, MiPACS™. The data showed SAP is associated with the presence of a periapical radiolucency or widened PDL in 63% of cases. A pulpal diagnosis of symptomatic irreversible pulpitis was given in 45% of cases, pulp necrosis in 30%, previous treatment in 19%, and other 6%. Of the posterior teeth included in this study, 73% were molars with mandibular molars representing 44%. Of pulps that responded to cold, 23% presented with radiographic deviations from normal. The study showed more than half of the patients were female (62%) with roughly equal distribution of age, which ranged from 18-94 years.


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission