Assessment of endodontic treatment and prevalence of apical periodontitis using cone-beam computed tomography: a cross-sectional study

Abstract

Background The purpose of this study was a retrospective cross-sectional study of the population of Szczecin (Poland) performed to evaluate the quality of endodontic treatment and the condition of the periapical tissues of permanent teeth based on cone-beam computed tomography images and the influence of the quality of endodontic treatment on the occurrence of periapical lesions. Methods The retrospective study included a group of patients who underwent cone-beam computed tomography at the University Dental Clinic of the Pomeranian Medical University in Szczecin. An endodontically treated tooth index (ETTI) was used to evaluate endodontic treatment. Once apical periodontitis was recognised, the size, extent and ratio of adjacent anatomical structures were assessed using the complex periapical index (COPI). The ETTI and COPI indicators mentioned above are combined to form the Periapical and Endodontic Status Scale (PESS). Results Analysis of the cone-beam computed tomography images showed that endodontic treatment was performed in 9.9% of the teeth examined, of which 52.7% of the canals were treated correctly, while 28.1% of the root canals were found to be underfilled, 6.8% were overfilled, 9.3% of the root canals were not obturated at all, and in 3.1% of the teeth examined, the filling material was only visible in the pulp chamber. Apical periodontitis was observed in 6% of all teeth examined, while the percentage of teeth following endodontic treatment was 38.5%. Conclusions The quality of the endodontic treatment provided to the population of Szczecin is unsatisfactory. Lack of root canal filling homogeneity is a significant risk factor for endodontic treatment failure. Improper endodontic treatment and poor quality of crown restoration after endodontic treatment have an impact on the increased risk of occurrence, size, degree of root coverage and extent of inflammatory periapical lesions in relation to adjacent anatomical structures.