Prevalence of Lateral Radiolucency, Apical Root Resorption and Periapical Lesions in Portuguese Patients: A CBCT Cross-Sectional Study with a Worldwide Overview

Apical periodontitis in endodontically-treated teeth: association between missed canals and quality of endodontic treatment in a Colombian sub-population. A cross-sectional study

A high prevalence of post-treatment apical periodontitis associated to variables such as endodontic treatment quality and missed canals has been reported.

AIM

The aim of this study was to evalúate the quality of endodontic treatment and the frequency of missed canals associated with teeth with apicalperiodontitis (AP) through CBCTin a Colombian sub-population.

MATERIAL AND METHOD

This was a cross-sectional study assessing 318 cone beam computed tomography (CBCT) scans of endodontically treated teeth from Colombian individuals. The scans were taken using J Morita X550 (J Morita Corporation, Osaka, Japan), with voxel size 0.125 to 0.20 mm. All endodontically treated teeth were assessed for quality of treatment, presence of missed canals and AP. Allsamples were analyzed bytwo endodontics specialists and an radiology specialist. Chi-square or Fisher 's test and odds ratio were calculated to identify the association and risk relationship between the presence of AP and the study variables.

RESULTS

Missed canals were found in 18.61% (86/462), and 95.3% were associated with AP. The frequency of AP was 62.34% (288/462) for all the evaluated teeth. AP was found in 27.43 % (79/288) of the teeth with adequate endodontic treatment, in contrast to 72.57% (209/288) of the teeth with inadequate treatment (P<0.01). The frequency of missed canals was highest in maxillary molars, with 55.23% (58/105), with 96.55% presenting AP. The second mesiobuccal canal wasthe most frequently missed canal, 88.52%o(54/61), with AP in 90.74% (49/54) of the cases.

CONCLUSIÓN

There was a high frequency of teeth with missed canals and PA. More than half of the teeth with missed canals were maxillary molars, with MB2 being the most common canal, commonly presenting apical periodontitis.

The association of endodontic prognostic factors with the presence of periapical lesion, its volume, and bone characteristics in endodontically treated molars: a cross-sectional study

BACKGROUND

This study intended to evaluate the association between several endodontic prognostic factors with the presence of periapical lesions (PLs), their volume, and bone characteristics including cortical bone destruction (CBD) and buccal plate bone height (BPBH) in root-filled molar teeth using cone-beam computed tomography.

METHODS

A collection of 143 scans of endodontically treated maxillary/mandibular first or second molars recorded over 8 years, were obtained from a specialized radiology center. Data on prognostic factors including tooth number, gender, jaw type, the status and number of missed canals, obturation length, restoration type, presence of a separated instrument, presence of a post or screw in the canals, and presence of perforation were collected. The assessed outcomes included PL presence, PL volume, CBD, and BPBH. The association between prognostic factors and outcomes was evaluated using multiple logistic regression models with adjusted covariates and multifactorial ANOVA at a significance level of 0.05.

RESULTS

A total of 282 molars from 82 women and 50 men with a mean age of 40.6 ± 12.27 were included. Among those, 139 teeth presented PL with a mean volume of 18.68 mm3. CBD was prevalent in 137 teeth and the mean BPBH appeared to be 9.45 mm. The presence of a missed canal (OR = 10.022, P < .05), underfilled canal (OR = 3.725, P < .05), overfilled canal (OR = 15.859, P = .018), and perforation (OR = 15.261, P = .013) was significantly associated with PLs. None of the prognostic factors could considerably contribute to the CBD (P > .05). The presence of a missed canal was positively associated with the PL volume (P < .05). Similarly, missed canals (P < .05), perforation (P < .05), and separated instruments (P = .004) were associated with a significantly reduced BPBH.

CONCLUSIONS

Overfillings, perforations, missed canals, and underfillings were identified as remarkable predictors of PL, arranged in descending order of their respective impact. The only factor capable of significantly increasing the PL volume was the missed canal. In brief, obturation length errors, perforations, missed canals, and separated instruments were robustly correlated with endodontic failure, which highlights the importance of mitigating the potential for errors by following the fundamentals of endodontics.

Prevalence of Periapical Radiolucency and Conventional Root Canal Treatment in Adults: A Systematic Review of Cross-Sectional Studies

Cross-sectional studies assess a population's health state and the prevalence of diseases or treatments. Few systematic reviews regarding the prevalence of periapical radiolucency (PARL) and nonsurgical root canal treatment (NSRCT) were conducted in the last decade. The goal of this study was to collect and review all updated and available cross-sectional studies that focus on the prevalence of both PARL and NSRCT in adult populations. It involves a systematic literature review of cross-sectional studies on the prevalence of PARL and NSRCT published from 1987 to 2022 in PubMed, Google Scholar, Web of Science, and Scopus with specific keywords used in the search process. A total of 52 articles were included in this systematic review. The majority of the included articles were from different populations. The overall prevalence of teeth with PARL was 43,522 (6.40%), while the prevalence of NSRCT teeth was 52,149 (7.67%). On the other hand, the overall prevalence of PARL in teeth that have received endodontic treatment and teeth that have not received endodontic treatment were 22,110 (3.25%) and 21,412 (3.15%), respectively. A meta-analysis was not performed due to underreporting of publication bias and the high degree of heterogeneity between studies. The overall risk of bias assessment revealed a low risk of bias in 25 (48%) of the included studies. The prevalence of NSRCT was higher at 7.67%, followed by PARL at approximately 6.40%. However, future studies are recommended to investigate the prevalence of both PARL and NSRCT in different patient populations.