Periapical repair following endodontic surgery: two- and three-dimensional imaging evaluation methods

Area of Science:

• Dentistry
• Oral Surgery
• Radiology

Background:

• Periapical bone lesions often require endodontic surgery.
• Quantitative assessment of bone repair is crucial for treatment evaluation.
• Comparing imaging modalities for assessing periapical bone repair is important.

Purpose of the Study:

• To quantitatively assess periapical bone repair after endodontic surgery.
• To compare planimetric evaluation using conventional and digital intraoral radiography (IR) with cone beam computed tomography (CBCT).

Main Methods:

• Eleven patients with periapical bone lesions underwent endodontic surgery.
• Intraoral radiography (IR) and CBCT images were taken pre-surgery and at 48 hours, 4 months, and 8 months post-surgery.
• Planimetric evaluation measured bone lesion area (mm²) in 2D (IR) and 3D (CBCT) images.

Main Results:

• A significant reduction in periapical bone lesion area was observed over the 8-month period (p=0.002).
• No statistically significant difference was found between the imaging methods (p=0.023).
• CBCT measurements were slightly larger than IR measurements (10-15%), but showed similar progressive bone repair patterns.

Conclusions:

• Both 2D and 3D imaging methods provide reliable quantitative assessment of periapical bone repair following endodontic surgery.
• CBCT offers comparable results to conventional and digital IR for evaluating bone healing post-surgery.
• Significant periapical bone regeneration is evident from 48 hours to 8 months after endodontic surgical procedures.