Predicting the outcome of initial non-surgical endodontic procedures by periapical status and quality of root canal filling: a cohort study

Abstract

To assess the previous periapical status and the quality of root canal filling as predictors of the outcome in initial nonsurgical endodontic procedures. A retrospective cohort study was designed in which the presence of a previous periapical lesion was determined radiographically. The quality of the root filling was evaluated in terms of homogeneity, taper, and apical extension. The response variable was dichotomized to success and failure. Bivariate analyzes and a mixed generalized linear model interpreted the association between the explanatory variables and the outcome of the initial non-surgical endodontic procedures. A total of 349 roots were evaluated, and a failure rate of 13.18% was established. Poor filling quality was determined in 8.3% of the roots. As a main result, the presence of a preoperative periapical lesion did not determine a significant risk to the failure of the initial treatment. Unlike, a poor quality of the obturation determined association with an unfavorable outcome like this: (1) homogeneity (OR 2.32; p = 0.0181); (2) taper (OR 5.8; p = 0.0); and, (3) extension (OR 3.41; p = 0.0). Therefore, a significant association between inadequate quality of the root filling and failure of the primary non-surgical endodontic procedures was found. Short length of filling was highly associated with failure. The presence of previous periapical lesion was not found to be a significant predictor for treatment outcomes.

Effect of obturation technique using a new bioceramic sealer on the presence of voids in flattened root canals

“…The prognosis of endodontic treatment depends on three-dimensional filling 1,2 and sealing of the root canal system, 3 to ensure prevention of reinfection. 4 However, the quality of the filling is influenced by root canal morphology.…”

Effect of Propolis, Neem and Calcium Hydroxide as Intracanal Medicaments on the Sealing Ability of Resin-Based Endodontic Sealer

“…Root canal system hermetic seal after cleaning and shaping is a prerequisite for a favorable endodontic treatment outcome (27) . Inadequate seal could result in microorganisms and tissue fluids leak inside the canal space leading to initiation of unwanted periapical inflammation (28) .…”

Analysis of endodontic success using a Periapical Index in teeth with different types of intraradicular posts

“…The intra-observer values on PAI scores for the two examiners produced kappa values of 0.83 and 0.84, indicating high agreement. Most studies that evaluate endodontic treatment only by radiographic exam, observe the conditions of canal fillings, apical limit, and density of obturation material, trying to relate the presence or absence of periapical pathology (García-Guerrero et al, 2020).…”