The detection of periapical pathoses using digital periapical radiography and cone beam computed tomography in endodontically retreated teeth – part 2: a 1 year post‐treatment follow‐up

A Davies, S Patel, F Foschi, M Andiappan, PJ Mitchell, F Mannocci

Research output: Contribution to journalArticlepeer-review

Abstract

<jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>Part 2 of this prospective clinical study aimed to compare the 1‐year outcome of root canal retreatments, when individual roots and teeth were assessed by periapical radiographs and cone beam computed tomography (CBCT).</jats:p></jats:sec><jats:sec><jats:title>Methodology</jats:title><jats:p>Subjects participating in this study had been referred for management of an endodontic problem associated with one or more root filled teeth. Root canal retreatment was performed by Specialists or postgraduate students under the direct supervision of Specialist endodontic staff. A total of 98 teeth (84 patients) were reassessed clinically and radiographically 1 year after completion of root canal retreatment. The postoperative periapical radiographs and <jats:styled-content style="fixed-case">CBCT</jats:styled-content> scans were compared with their respective pre‐treatment (diagnostic) periapical radiographs and <jats:styled-content style="fixed-case">CBCT</jats:styled-content> scans. The increase or decrease in size of existing periapical radiolucencies and development of new radiolucencies were assessed by a consensus panel consisting of two calibrated examiners. They also determined an appropriate management plan for each case based on the radiographical findings. Comparison of the outcome diagnosis of individual roots and teeth and case management, when assessed by periapical radiographs and <jats:styled-content style="fixed-case">CBCT</jats:styled-content> scans, was performed using chi‐squared and McNemar's tests.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>An overall favourable result of 93% success for teeth (96% roots) was recorded when the assessment was undertaken by periapicals compared with 77% success for teeth (87% roots) when assessed by <jats:styled-content style="fixed-case">CBCT</jats:styled-content>. A significant difference in outcome diagnosis of single paired roots (<jats:italic>P</jats:italic> &lt; 0.0001) and teeth (<jats:italic>P</jats:italic> = 0.0001) was observed when comparing periapicals to <jats:styled-content style="fixed-case">CBCT</jats:styled-content> for the cohort of teeth as a whole. When comparing the future management plan on the basis of radiographic information alone, there was a significant difference between periapicals and <jats:styled-content style="fixed-case">CBCT</jats:styled-content>‐based management (<jats:italic>P</jats:italic> = 0.01).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Diagnosis using <jats:styled-content style="fixed-case">CBCT</jats:styled-content> revealed a significantly lower number of favourable outcomes than periapicals in root canal retreatment. This significantly affected the future management of cases attending for a review.</jats:p></jats:sec>
Original languageEnglish
Pages (from-to)623-635
Number of pages0
JournalInternational Endodontic Journal
Volume49
Issue number7
Early online date29 Jul 2015
DOIs
Publication statusPublished - Jul 2016

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