Endodontic outcome predictors identified with periapical radiographs and cone-beam computed tomography scans.

INTRODUCTION

The outcome predictors identified with data from periapical radiographs (PA) and cone-beam computed tomography (CBCT) scans might not be the same. This retrospective study evaluated various factors that might affect the outcome of root canal therapy.

METHODS

In total, 115 teeth (143 roots) with vital pulps were endodontically treated and followed up 2 years after treatment. Multivariate logistic regression was performed on the data from PA or CBCT to analyze outcome predictors.

RESULTS

At recall, PA detected periapical lesions in 18 roots (12.6%), as compared with 37 on CBCT images (25.9%). The length and density of root filling determined by PA and CBCT were often different (p < .001). Overall, 20 of the 25 short root fillings (80%) diagnosed by PA appeared as flush fillings on CBCT images. PA revealed 23 root fillings (16.1%) with voids, as compared with 66 on CBCT images (46.2%). When findings from PA were analyzed, density and apical extent of root filling were identified as predictors (p < .05). When findings from CBCT were analyzed, density of root filling and quality of coronal restoration influenced the outcome significantly (p ≤ .001), whereas gender, tooth type, root curvature, number of visits, CBCT-determined apical extent of root filling, and use as abutment did not (p > .1).

CONCLUSIONS

Treatment outcome, length and density of root fillings, and outcome predictors as determined with CBCT scans might not be the same as corresponding values determined with PA.