Evaluation of the Impact of Osteoporosis and Rheumatoid Arthritis on the Outcomes of Nonsurgical Endodontic Therapy: A Prospective Cohort Study

Introduction: Osteoporosis (OP) and rheumatoid arthritis (RA) can potentially disrupt periapical healing following nonsurgical endodontic therapy (NSET) due to changes in bone metabolism and persistent inflammation.Methods: We assigned 80 participants to three groups: healthy controls (n = 40), OP (n = 20), and RA (n = 20).All participants received standardized NSET.We assessed periapical healing using digital radiovisiography and cone-beam computed tomography scans at baseline and one, three, and six months, based on measurements of periapical radiolucency and periapical index (PAI) scores.Data were analyzed using Wilcoxon signed-rank and Kruskal-Wallis tests (p < 0.05).Results: There was statistically significant improvement in radiographic healing among all groups during the six-month study period (p < 0.001).PAI scores at baseline were similar among all groups.Healthy participants had significantly more periapical healing compared with OP and RA groups at six months (p < 0.05).Higher mean values of residual radiolucency and PAI scores were noted among the OP and RA groups.Conclusions: OP and RA groups exhibited delayed periapical healing after NSET when compared with healthy controls; however, all groups experienced significant periapical healing following therapy.