RISK FACTORS FOR CHRONIC APICAL PERIODONTITIS ACCORDING TO THE CASE-CONTROL STUDY

Purpose. To evaluate the relationship of behavioral, dental, and systemic factors recorded during interviews of adult outpatient dental patients with the likelihood of developing chronic apical periodontitis (CAP) based on odds ratio (OR). Materials and methods. The single-center retrospective case-control study from 2024 to 2025 included 1227 patients aged 30–65 years. The main group included 974 patients with a verified diagnosis of CAP (K04.5), the comparison group included 253 conditionally healthy patients without periapical pathology. Risk factors were assessed through questionnaires and clinical examination before treatment, with data documentation and subsequent calculation of odds ratio with a 95% confidence interval (CI). Results. Statistically significant associations of CAP with low socio-economic status (OR = 3.31; 95% CI [2.48; 4.43]; p < 0.001), periodontal diseases (OR = 3.16; 95% CI [2.37; 4.22]; p < 0.001) and poor oral hygiene (OR = 3.19; 95% CI [2.40; 4.24]; p < 0.001). Significant risk factors also included living in a region with a fluoride deficiency (OR = 2.97; p < 0.001), irregular dental visits (OR = 3.47; p < 0.001), and smoking (OR = 2.23; p < 0.001). Among the psychosocial factors, chronic stress and panic fear are highlighted. Conclusion. A set of modifiable behavioral and social factors has been identified that significantly increase the likelihood of developing CAP, which justifies the need to take them into account when planning prevention. The established risk profile allows for the clinical stratification of patients and targeted prevention, as well as the formulation of hypotheses for cohort studies taking into account new confounders