Evaluation of apical lesions in endodontically filled teeth from cone-beam computed tomography (CBCT), using the periapical index (PAI) modified
DOI:
https://doi.org/10.17533/udea.rfo.v36n2a6Keywords:
cone-beam computed tomography, periapical periodontics, endodonticsAbstract
Introduction: Apical Periodontitis (AP) usually presents without symptoms and is diagnosed mainly by radiographic imaging. Using cone-beam computed tomography (CBCT), periradicular radiolucent areas could be studied and characterized from reproducible anatomical references. This study aimed to characterized periradicular lesions in endodontically filled teeth from a Colombian population with CBCT, by means of modified periapical index (PAI). Methods: Descriptive study. 1113 computed tomographs showing apical lesions were analyzed (165 patients, equivalent to 192 teeth with 396 canals), according to the inclusion criteria. Technical errors associated with endodontic treatment were recorded. The size of the lesion was characterized based on the CBCT/PAI of Estrela 2008, maintaining the classification from 0 to 5. Measures of central tendency and dispersion were calculated. Results: On average, the lesions were 5.24 mm high, 4.73 mm wide and 4.92 mm deep. This research determined that 46.35% of the lesions were found in category 3, 40.1% in category 4, 10.42% in category 5 and 3.12% in category 2. The errors evaluated were under-obturation with 68.01%, over-obturation with 6.8%, untreated canal with 4.3%, root perforation with 1.2%, and fractured instrument with 0.25%. Conclusion: 85% of the endodontically treated teeth with periapical lesion presented an error in the procedure, being under-obturation the most predominant error with a lesion size between 3 and 8 mm corresponding to category 3 and 4. This periapical inflammatory condition should draw the attention of the dental communities in order to promote new protocols for evaluation, treatment, and control.
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