Is the quality of root canal filling obtained by cone-beam computed tomography associated with periapical lesions? A systematic review and meta-analysis

Santos, Guilherme Nilson Alves dos; Faria-e-Silva, André Luís; Ribeiro, Vitor Luís; Pelozo, Laís Lima; Candemil, Amanda Pelegrin; Oliveira, Matheus Lima; Lopes, Fabiane Carneiro; Mazzi‐Chaves, Jardel Francisco; Sousa-Neto, Manoel Damião

doi:10.1007/s00784-022-04558-y

Cited by 17 publications

(8 citation statements)

References 85 publications

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“…Aysal et al (2022) showed in their CBCT study that the risk of periapical lesions was just over 3 times higher in roots with under lled canals, 5. [29] Similar correlations have been observed in studies based on orthopantomograms. Jersa et al (2013) showed a 3-fold increased risk of periapical lesions in teeth with poor quality ET compared to teeth with correctly performed ET.…”

Section: Discussionsupporting

confidence: 79%

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

Lewusz-Butkiewicz,

Kulas-Bałaban,

Kaczor-Wiankowska

et al. 2023

Preprint

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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.

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Section: Discussionsupporting

confidence: 79%

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

Lewusz-Butkiewicz,

Kulas-Bałaban,

Kaczor-Wiankowska

et al. 2023

Preprint

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“…This complex anatomy poses significant challenges during root canal treatment, particularly at the filling stage. A systematic review and meta-analysis examining the impact of root canal filling quality on periapical lesion status, using CBCT, found that the success of root canal treatment is closely linked to the apical extension of the filling, ideally terminating 0 to 2 mm short of the apical foramen, and to the homogeneity of the filling, which should be gap-free [ 19 ]. Kim et al identified the most frequent causes of treatment failure in mandibular second molars with C-shaped canals as leaky canals and issues with the isthmus [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative factors involve the quality of the restoration done after the procedure [ 15 ]. Notably, the homogeneity and apical extension of the root canal filling play a critical role in the healing or persistence of periapical lesions following endodontic treatment [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Failure rates, varying between 15 and 25%, depend on the stringency of the success criteria used, whether it is the complete resolution (strict criteria) or just a reduction in the size of a periapical lesion (loose criteria) [14]. Numerous studies in endodontics have focused on identifying risk factors that influence treatment outcomes, categorizing them into three main areas: pre-operative, intra-operative, and postoperative factors [15][16][17][18][19]. Pre-operative factors include patient demographics, systemic health, tooth characteristics and root canal anatomy, diagnosis, and the presence of periapical lesions [15].…”

Section: Introductionmentioning

confidence: 99%

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Endodontic Retreatment of a Mandibular Second Molar With a C-shaped Root Canal Configuration: A Case Report

Liu,

Shen

2024

Cureus

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Root canal retreatment in mandibular second molars with C-shaped root canal configurations presents notable challenges. This article presents a case of successful root canal retreatment in a mandibular second molar exhibiting this complex configuration. Achieving a successful endodontic outcome in such cases necessitates a comprehensive understanding of the unique root canal anatomy. Moreover, the employment of advanced instruments and techniques is crucial to effectively address the intricacies of the C-shaped root canal system.

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“…Endodontic healing is related to the quality of root–canal treatment (Alves Dos Santos et al, 2022). Even though the quality of primary endodontic treatment was observed by our informants, its impact on the decision‐making process appeared to be limited.…”

Section: Discussionmentioning

confidence: 99%

Pre‐medical assessment of root–canal–filled teeth with asymptomatic apical periodontitis—A multifaceted balancing act

2023

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AimPrior to certain medical therapies, dental assessment and treatment of oral foci of infection are recommended. The aim of the present study was to acquire a deeper understanding of the decision‐making process regarding the pre‐medical management of root–canal–filled teeth with asymptomatic apical periodontitis (AAP).MethodologyHospital‐affiliated dentists in Sweden were contacted for a semi‐structured, in‐depth interview. The absolute inclusion criterion was that the dentists had experienced and could recount at least two authentic cases involving root–canal–filled teeth with AAP—one case having resulted in pre‐medical treatment, and one having resulted in expectancy. Fourteen interviews, with fourteen informants, were conducted and included in the study. During the interviews, open‐ended questions and comments encouraging the informants to elaborate and clarify their experiences were offered. The interviews were digitally recorded, transcribed verbatim and analysed using Qualitative Content Analysis with an inductive approach.ResultsA theme describing the latent content was identified through interpretation of the collected data: A multifaceted balancing act characterized by a sometimes‐difficult risk–benefit‐estimation, where an increased uncertainty entails an increased reliance on external opinions. Three main categories, comprising four sub‐categories, describing the manifest content were recognized: The tipping scale, The team effort and The frame of reference.ConclusionsThe current interview study found pre‐medical decision‐making regarding root–canal–filled teeth with AAP to be a multifactorial and contextual process marked by uncertainty and collaborative measures. Further research, resulting in the development of evidence‐based treatment guidelines, is suggested necessary.

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Is the quality of root canal filling obtained by cone-beam computed tomography associated with periapical lesions? A systematic review and meta-analysis

Cited by 17 publications

References 85 publications

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

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

Endodontic Retreatment of a Mandibular Second Molar With a C-shaped Root Canal Configuration: A Case Report

Pre‐medical assessment of root–canal–filled teeth with asymptomatic apical periodontitis—A multifaceted balancing act

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