Periapical bone defects of root filled teeth with persistent lesions evaluated by cone-beam computed tomography

Area of Science:

• Endodontics
• Oral and Maxillofacial Radiology
• Dental Imaging

Background:

• Persistent periapical lesions in root-filled teeth present diagnostic challenges.
• Accurate characterization of associated bone defects is vital for effective treatment planning.

Purpose of the Study:

• To evaluate and categorize bone defects of root-filled teeth with persistent periapical lesions using cone-beam computed tomography (CBCT).

Main Methods:

• CBCT scans of 532 teeth with persistent periapical lesions from 427 patients were analyzed.
• Two endodontists categorized periapical bone defects into five types based on CBCT imaging.
• Prevalence of each defect type was statistically analyzed using logistic regression.

Main Results:

• Buccal/labial bone plate defects (type II) were most common (67%), followed by apical root protrusions (type V, 10%).
• Mandibular teeth showed a higher prevalence of type I lesions and lower prevalence of types IV and V compared to maxillary teeth.
• CBCT identified apical root protrusions, which are often missed by periapical radiography.

Conclusions:

• CBCT is a valuable tool for accurately identifying and categorizing periapical bone defects.
• The diagnostic information from CBCT, particularly for apical root protrusions, is essential for comprehensive treatment planning in endodontics.