Journal of endodontics · 2025
The Evaluation of Resolution of Maxillary Sinus Mucosal Thickening of Endodontic Origin Using Periapical and Endodontic Status Scale: A Clinical CBCT Study.
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Gürhan Ceyda, Şener Elif, Miçooğulları Seniha, Mert Ali, Baksı B Güniz
Аннотация
INTRODUCTION: The primary factors influencing the rate of recovery from maxillary sinusitis of endodontic origin (MSEO) are the features of the periapical lesion and the integrity of root canal therapy (RCT). The aim of study was to evaluate the impact of the periapical and endodontic status scale (PESS) on the resolution of maxillary sinus mucosal thickening (MT) using cone beam computed tomography (CBCT).
METHODS: Clinical endodontic examination findings and sinonasal symptoms of patients were recorded at baseline and 1-year post-treatment The sagittal CBCT slices of 14 patients with MSEO were used for the measurements of periapical lesion size and MT adjacent to the roots of maxillary molars at 3 different points before and 1 year after RCT. The PESS, comprising the complex periapical index (COPI) and endodontically treated tooth index (ETTI), was used for evaluations of periapical lesions and quality of RCT. Pre- and post-treatment measurements, including changes in PESS scores, were compared using paired samples t test and Wilcoxon signed-rank test.
RESULTS: Fourteen patients were included in the study. The reduction in mean MT was significant for all measurements following RCT (P < .05). A significant decrease was observed in all COPI scores including the lesion size (P < .05). ETTI scores revealed complete obturation and adequate seal for all patients; however, periapical radiolucency around treated roots was observed in 11 of 14 patients (78.6%). Sinonasal complaints were resolved in all patients.
CONCLUSIONS: The combination of PESS and CBCT imaging shows promise in assessing the quality of RCT as well as the detection of periapical lesion features for MSEO treatment.
METHODS: Clinical endodontic examination findings and sinonasal symptoms of patients were recorded at baseline and 1-year post-treatment The sagittal CBCT slices of 14 patients with MSEO were used for the measurements of periapical lesion size and MT adjacent to the roots of maxillary molars at 3 different points before and 1 year after RCT. The PESS, comprising the complex periapical index (COPI) and endodontically treated tooth index (ETTI), was used for evaluations of periapical lesions and quality of RCT. Pre- and post-treatment measurements, including changes in PESS scores, were compared using paired samples t test and Wilcoxon signed-rank test.
RESULTS: Fourteen patients were included in the study. The reduction in mean MT was significant for all measurements following RCT (P < .05). A significant decrease was observed in all COPI scores including the lesion size (P < .05). ETTI scores revealed complete obturation and adequate seal for all patients; however, periapical radiolucency around treated roots was observed in 11 of 14 patients (78.6%). Sinonasal complaints were resolved in all patients.
CONCLUSIONS: The combination of PESS and CBCT imaging shows promise in assessing the quality of RCT as well as the detection of periapical lesion features for MSEO treatment.