Retrospective clinical and radiologic evaluation of nonsurgical endodontic treatment in human immunodeficiency virus (HIV) infection.

PURPOSE This retrospective study evaluated the clinical and radiographic status of nonsurgical endodontic treatment (ET) of anterior and posterior teeth in HIV-seropositive patients. METHODS ET was analyzed in 26 anterior and 34 posterior teeth from 54 consecutive HIV patients (gender ratio 3 Male : 1 Female, mean age 40.2 years, mean CD4 240, CD4<500 in 88%, 12 with AIDS) over a six year period with a minimum of six months follow-up. ET was evaluated as successful, questionable, or failure based upon clinical factors (palpation, mobility, sinus tract, percussion, function, infection/swelling, occlusion, symptoms) and radiographic factors (periodontal ligament space, rarefaction, lamina dura, root resorption, obturation) during post-treatment examinations with a mean follow up of 26 months. RESULTS Clinical evaluation at follow up found ET outcome was successful in 88%, questionable in 10% (tenderness with percussion, mobility, widened ligament), and a failure in 2% (developed lesion after ET). Periapical lesions were present in 37% of cases (mean lesion size 6.2 mm). Following ET, mean lesion size (1.8 mm) had decreased by 71%. Obturation was evaluated as optimal or acceptable in 68%. Radiographic evaluation was considered successful in 80%, no change in 15%, and a failure in 5%. CONCLUSIONS Despite obturation deficiencies and the immunocompromised state of the patients, endodontic therapy has a relatively high degree of success in the majority of HIV/AIDS patients. HIV infection and AIDS should not be considered as a contraindication to endodontic therapy in this patient population.