Cone-beam computed tomography in the assessment of periapical lesions in endodontically treated teeth

 

 Permissions and Reprints

ABSTRACT

Objective: This study aimed to evaluate the relationship between the quality of the coronal restoration and the root canal filling on the periapical status of endodontically treated teeth using CBCT. Materials and Methods: CBCT data were obtained from the records of patients who deny any dental treatment in the 2 years prior to the CBCT examination. CBCT images (90 kVp and 7 mA, exposure time of 23 s, and a voxel size of 0.2 mm, with a field of view of 13 cm x 13 cm) of 1011 endodontically treated teeth were observed. A score was given to the quality of the root filling and the quality of the coronal restoration. Statistical Analysis Used: Data were statistically analyzed to correlate the periapical status with gender, dental group. and quality of endodontic treatment and restoration (Chi-square test with a significance level of P < 0.001). Results: Absence of periapical periodontitis was found in 54.9% of the cases. The periapical outcome was not related to gender or dental group (P > 0.05). A statistically significant factor (Chi-square test, P < 0.0001) resulted when different qualities of sealing were compared. Conclusions: CBCT showed that high-quality root canal treatments followed by an adequate coronal sealing restoration avoid the presence of periapical periodontitis in time.

• REFERENCES

• 1 Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J 1995; 28: 12-8
  CrossrefPubMedGoogle Scholar
• 2 Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod 1990; 16: 498-504
  CrossrefPubMedGoogle Scholar
• 3 Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: Systematic review of the literature-Part 1. Effects of study characteristics on probability of success. Int Endod J 2007; 40: 921-39
  CrossrefPubMedGoogle Scholar
• 4 Gomes AC, Nejaim Y, Silva AI, Haiter-Neto F, Cohenca N, Zaia AA. et al. Influence of endodontic treatment and coronal restoration on status of periapical tissues: A cone-beam computed tomographic study. J Endod 2007; 41: 1614-8
  Google Scholar
• 5 Song M, Park M, Lee CY, Kim E. Periapical status related to the quality of coronal restorations and root fillings in a Korean population. J Endod 2014; 40: 182-86
  CrossrefPubMedGoogle Scholar
• 6 Gillen BM, Looney SW, Gu LS, Loushine BA, Weller RN, Loushine RJ. et al. Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: A systematic review and meta-analysis. J Endod 2011; 37: 895-902
  CrossrefPubMedGoogle Scholar
• 7 Hommez GM, Coppens CR, De Moor RJ. Periapical health related to the quality of coronal restorations and root fillings. Int Endod J 2002; 35: 680-9
  CrossrefPubMedGoogle Scholar
• 8 Georgopoulou MK, Spanaki-Voreadi AP, Pantazis N, Kontakiotis EG, Morfis AS. Periapical status and quality of root canal fillings and coronal restorations in a Greek population. Quintessence Int 2008; 39: e85-92
  PubMedGoogle Scholar
• 9 Dugas NN, Lawrence HP, Teplitsky PE, Pharoah MJ, Friedman S. Periapical health and treatment quality assessment of root-filled teeth in two Canadian populations. Int Endod J 2003; 36: 181-92
  CrossrefPubMedGoogle Scholar
• 10 Segura-Egea JJ, Jiménez-Pinzón A, Poyato-Ferrera M, Velasco-Ortega E, Ríos-Santos JV. Periapical status and quality of root fillings and coronal restorations in an adult Spanish population. Int Endod J 2004; 37: 525-30
  CrossrefPubMedGoogle Scholar
• 11 Tavares PB, Bonte E, Boukpessi T, Siqueira Jr. JF, Lasfargues JJ. Prevalence of apical periodontitis in root canal-treated teeth from an urban French population: Influence of the quality of root canal fillings and coronal restorations. J Endod 2009; 35: 810-3
  CrossrefPubMedGoogle Scholar
• 12 Kalender A, Orhan K, Aksoy U, Basmaci F, Er F, Alankus A. et al. Influence of the quality of endodontic treatment and coronal restorations on the prevalence of apical periodontitis in a Turkish Cypriot population. Med Princ Pract 2013; 22: 173-7
  CrossrefPubMedGoogle Scholar
• 13 Moreno JO, Alves FR, Gonçalves LS, Martinez AM, Rôças IN, Siqueira Jr JF. Periradicular status and quality of root canal fillings and coronal restorations in an urban Colombian population. J Endod 2013; 39: 600-4
  CrossrefPubMedGoogle Scholar
• 14 Tronstad L, Asbjørnsen K, Døving L, Pedersen I, Eriksen HM. Influence of coronal restorations on the periapical health of endodontically treated teeth. Endod Dent Traumatol 2000; 16: 218-21
  CrossrefPubMedGoogle Scholar
• 15 Gündüz K, Avsever H, Orhan K, Demirkaya K. Cross-sectional evaluation of the periapical status as related to quality of root canal fillings and coronal restorations in a rural adult male population of turkey. BMC Oral Health 2011; 11: 20
  CrossrefPubMedGoogle Scholar
• 16 Craveiro MA, Fontana CE, Martin AS, Bueno CE. Influence of coronal restoration and root canal filling quality on periapical status: Clinical and radiographic evaluation. J Endod 2015; 41: 836-40
  CrossrefPubMedGoogle Scholar
• 17 Nur BG, Ok E, Altunsoy M, Aglarci OS, Çolak M, Güngör E. Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT. J Appl Oral Sci 2014; 22: 502-8
  CrossrefPubMedGoogle Scholar
• 18 Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod 2008; 34: 273-9
  CrossrefPubMedGoogle Scholar
• 19 Cotton TP, Geisler TM, Holden DT, Schwartz SA, Schindler WG. Endodontic applications of cone-beam volumetric tomography. J Endod 2007; 33: 1121-32
  CrossrefPubMedGoogle Scholar
• 20 Low KM, Dula K, Bürgin W, von Arx T. Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery. J Endod 2008; 34: 557-62
  CrossrefPubMedGoogle Scholar
• 21 Tsai P, Torabinejad M, Rice D, Azevedo B. Accuracy of cone-beam computed tomography and periapical radiography in detecting small periapical lesions. J Endod 2012; 38: 965-70
  CrossrefPubMedGoogle Scholar
• 22 Patel S, Wilson R, Dawood A, Foschi F, Mannocci F. The detection of periapical pathosis using digital periapical radiography and cone beam computed tomography-part 2: A 1-year post-treatment follow-up. Int Endod J 2012; 45: 711-23
  CrossrefPubMedGoogle Scholar
• 23 Lofthag-Hansen S, Huumonen S, Gröndahl K, Gröndahl HG. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103: 114-9
  CrossrefPubMedGoogle Scholar
• 24 de Paula-Silva FW, Wu MK, Leonardo MR, da Silva LA, Wesselink PR. Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard. J Endod 2009; 35: 1009-12
  CrossrefPubMedGoogle Scholar
• 25 Patel S, Dawood A, Mannocci F, Wilson R, Pitt Ford T. Detection of periapical bone defects in human jaws using cone beam computed tomography and intraoral radiography. Int Endod J 2009; 42: 507-15
  CrossrefPubMedGoogle Scholar
• 26 Venskutonis T, Plotino G, Juodzbalys G, Mickevičienė L. The importance of cone-beam computed tomography in the management of endodontic problems: A review of the literature. J Endod 2014; 40: 1895-901
  CrossrefPubMedGoogle Scholar
• 27 Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pécora JD. A new periapical index based on cone beam computed tomography. J Endod 2008; 34: 1352-31
  Google Scholar
• 28 Peters CI, Peters OA. Cone beam computed tomography and other imaging techniques in the determination of periapical healing. Endodontic Topics 2012; 10: 57-75
  Google Scholar
• 29 Ørstavik D, Pitt Ford TR. Apical periodontitis: Microbial infection and host responses. In Ørstavik D, Pitt Ford TR. editors Essential Endodontology. Vol. 1 Oxford: Blackwell Science; 1998: p. 8-9
  Google Scholar
• 30 Ricucci D, Russo J, Rutberg M, Burleson JA, Spångberg LS. A prospect cohort study of endodontic treatments of 1369 root canals: Results after 5 years. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112: 825-42
  CrossrefPubMedGoogle Scholar
• 31 Liang YH, Li G, Wesselink PR, Wu MK. Endodontic outcome predictors identified with periapical radiographs and cone-beam computed tomography scans. J Endod 2011; 37: 326-31
  CrossrefPubMedGoogle Scholar
• 32 Altman DG. Practical Statistics for Medical Research. London: Chapman & Hall; 1991
  Google Scholar
• 33 Kirkevang LL, Ørstavik D, Hörsted-Bindslev P, Wenzel A. Periapical status and quality of root fillings and coronal restorations in a Danish population. Int Endod J 2000; 33: 509-15
  CrossrefPubMedGoogle Scholar
• 34 Eckerbom M, Magnusson T. Evaluation of technical quality of endodontic treatment-reliability of intraoral radiographs. Endod Dent Traumatol 1997; 13: 259-64
  CrossrefPubMedGoogle Scholar
• 35 Møller L, Wenzel A, Wegge-Larsen AM, Ding M, Væth M, Hirsch E. et al. Comparison of images from digital intraoral receptors and cone beam computed tomography scanning for detection of voids in root canal fillings: Anin vitro study using micro-computed tomography as validation. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115: 810-8
  CrossrefPubMedGoogle Scholar
• 36 Weber MT, Stratz N, Fleiner J, Schulze D, Hannig C. Possibilities and limits of imaging endodontic structures with CBCT. Swiss Dent J 2015; 125: 293-311
  PubMedGoogle Scholar
• 37 Sansare K, Singh D, Sontakke S, Karjodkar F, Saxena V, Frydenberg M. et al. Should cavitation in proximal surfaces be reported in cone beam computed tomography examination?. Caries Res 2014; 48: 208-13
  CrossrefPubMedGoogle Scholar
• 38 Ozturk E, Sinanoglu A. Histological validation of cone-beam computed tomography versus laser fluorescence and conventional diagnostic methods for occlusal caries detection. Photomed Laser Surg 2015; 33: 61-8
  CrossrefPubMedGoogle Scholar
• 39 Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod Top 2005; 10: 3-29
  CrossrefGoogle Scholar
• 40 Kirkevang LL, Vaeth M, Wenzel A. Ten-year follow-up of root filled teeth: A radiographic study of a Danish population. Int Endod J 2014; 47: 980-8
  CrossrefPubMedGoogle Scholar
• 41 Nair PN, Sjögren U, Figdor D, Sundqvist G. Persistent periapical radiolucencies of root-filled human teeth, failed endodontic treatments, and periapical scars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 87: 617-27
  CrossrefPubMedGoogle Scholar