Effect of Academic-Environmental Stress on Apical Periodontitis of Non-Endodontic Teeth

Abstract
Background: The periapical area of a tooth was diagnosed using radiography; many types of risk factors can affect the health of
the apical area which is the stress during life. Objective: To analyze the prevalence of academic-environmental stress and apical
periodontitis in non-endodontic teeth of dental students using cone-beam computed tomography (CBCT) X-ray, and to demonstrate
the association between stress and the prevalence of apical periodontitis. Materials and Methods: Cross-sectional study was done on
the 103 recruited dental students aged 22–24 years during the final examination year of study in dentistry college. The academicenvironmental
stress scale was used to measure the level of stress in each student. The CBCT X-ray was taken for each student.
The apical area was measured only for non-root canal-treated teeth using the CBCT periapical radiography index. Chi-square (χ2)
test was used to show the percentages of stress and the relationship between apical periodontitis and stress in students. Results: 53
students (51.5%) had a stressed state, whereas 50 students (48.5%) had a non-stressful state. The prevalence of apical periodontitis was
greater among stressed than that of non-stressed students in non-endodontic teeth. Statistically, there was a significant relationship
between academic-environmental stress and apical periodontitis in non-endodontic teeth. Conclusion: There was a negative effect of
examination stress on the apical healthy of teeth that can be increased with the presence of any additional factors such as problems
of life.
Keywords: Cone-beam computed tomography, stress, students, three-dimensional imaging apical periodontitis