Apical periodontitis in mesiobuccal roots of maxillary molars: influence of anatomy and quality of root canal treatment, a CBCT study

Abstract

Objectives This study aimed to evaluate the prevalence of apical periodontitis (AP) in the mesiobuccal roots of root canal-treated maxillary molars. Materials and Methods One thousand cone-beam computed tomography images of the teeth were examined by 2 dental specialists in oral radiology and endodontics. The internal anatomy of the roots, Vertucci’s classification, quality of root canal treatment, and presence of missed canals were evaluated; additionally, the correlation between these variables and AP was ascertained. Results A total of 1,000 roots (692 first molars and 308 second molars) encompassing 1,549 canals were assessed, and the quality of the root canal filling in the majority (56.9%) of the canals was satisfactory. AP was observed in 54.4% of the teeth. A mesiolingual canal in the mesiobuccal root (MB2 canal) was observed in 54.9% of the images, and the majority (83.5%) of these canals were not filled. Significant associations were observed between the presence of an MB2 canal and the quality of the root canal filling and the presence of AP. Conclusions AP was detected in more than half of the images. The MB2 canals were frequently missed or poorly filled.

Relationship between apical periodontitis and missed canals in mesio-buccal roots of maxillary molars: CBCT study

“…have reported 83.5% missed MB2 canals in MM, and apical periodontitis associated with 54.4% of these teeth. 45 The discrepancies in findings among studies may be explained by differences in the expertise of the observing clinicians, the methods and aids used in canal location and negotiation, and the research methods used. Another study has reported that the MB2 canal in the MB root of MFM is the most commonly missed canal during ET and has also demonstrated that 90% of teeth with missed canals are associated with apical periodontitis.…”

Retrospective study of the morphology of third maxillary molars among the population of Lower Silesia based on analysis of cone beam computed tomography

“…Literature evidence suggests that while the tooth-clearing technique and canal staining used to be the gold standard procedure, CBCT is considered the new standard [48]. CBCT has been found to be equally accurate and effective both in vitro and in vivo, offering the benefit of being noninvasive [3][4][5]7].…”

“…Proper diagnosis of the root canal system is necessary to successfully conduct endodontic treatment, and failure of root canal treatment can result from many factors, such as not detecting or omitting canals due to their complex morphology. Untreated canals are reservoirs of bacteria that ultimately lead to complications [3][4][5][6][7][8]. Various techniques have been used to assess root canal morphology in vivo and in vitro studies: staining techniques, ground teeth sections, stereomicroscopy, scanning electron microscopy, optical coherence tomography, endoscopy, conventional twodimensional (2D) periapical radiographs, cone beam computed tomography (CBCT), and micro-computed tomography (micro-CT).…”

“…CBCT examination eliminates the overlapping of adjacent structures, and its three-dimensional nature makes it superior to conventional two-dimensional radiography. CBCT is considered to be an effective diagnostic tool that can produce results similar to using a modified tooth staining technique to identify differences in root canal morphology [3][4][5]7]. An alternative methodology that facilitates three-dimensional (3D) imaging is X-ray micro-computed tomography (micro-CT), which excels in capturing images at a considerably reduced scale while preserving a markedly enhanced resolution.…”