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Risk Score Algorithm of Yu et al for Persistent Apical Periodontitis (Deterioration Risk Score, DRS)

Description

Yu et al developed a risk score for evaluating a patient with persistent apical periodontitis. This can help to identify a patient who may require additional therapy. The authors are from the National University of Singapore and the University of Melbourne.


Patient selection: persistent apical periodontitis following root canal treatment

 

Outcome: need for further endodontic intervention

 

Parameters:

(1) time since treatment in years

(2) tooth painful now

(3) sinus tract

(4) lesion size in mm

 

Parameter

Finding

Points

time since treatment

<= 4 years

0

 

> 4 years

(years) - 4

tooth painful now

no

0

 

yes

13

sinus tract

no

0

 

yes

14

lesion size

< 2 mm

0

 

>= 2 mm

20

 

total deterioration risk score (DRS) =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: > 50 (depends on time since treatment)

• The higher the score the greater the risk.

 

Deterioration Risk Score

Risk

Management

0 to 14

very low

no further treatment

15 to 20

low

further review (see below)

21 to 30

moderate

further review(see below)

31 to 40

high

endodontic intervention recommended

>= 41

very high

endodontic therapy highly recommended

 

For low and moderate risk, endodontic therapy may be considered (low risk) or recommended (moderate risk) if new coronal restoration is indicated.


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