The association between complete absence of post-treatment periapical lesion and quality of root canal filling.
OBJECTIVE
The technical quality of a root canal treatment is clinically judged by the apical extension and homogeneity of the filling material imaged by periapical radiographs (PA). The aim of this experiment was to evaluate the association between the technical quality of the root canal filling and treatment outcome.


METHODS
In 234 teeth (268 roots) that underwent root-canal treatment, the quality of the root canal filling as well as the outcome of the treatment were assessed with both PA and cone-beam computed tomography (CBCT) 2 years after treatment. Satisfactory root filling on PA was defined as 0-2 mm within the radiographic apex without voids; on CBCT scans, the apical end of the canal replaced the radiographic apex. The outcome predictors were analyzed using multivariate logistic regression.


RESULTS
At recall, periapical radiolucent areas were absent in 198 (74%) roots on PA and 164 (61%) roots on CBCT scans. The presence of preoperative periapical radiolucency and the quality of root filling and coronal restoration were identified by both PA and CBCT as outcome predictors (p < 0.01). Complete absence of post-treatment periapical radiolucency was observed in CBCT scans in 81% and 49% of satisfactory and unsatisfactory root fillings, respectively, as compared to 87% and 61% revealed by PA.


CONCLUSIONS
Satisfactory root fillings were associated with a favorable outcome, confirmed by both PA and CBCT.


CONCLUSIONS
The outcome of root canal treatment is improved once the filling is 0-2 mm from the apex, and no voids could be detected. Technical skills and performance of root canal filling procedures should be emphasized, and suitable methods should be developed in order to achieve more compacted filling materials without voids and at the correct length.
Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China.
Yu-Hong
YH
Liang
Gang
G
Li
Hagay
H
Shemesh
Paul R
PR
Wesselink
Min-Kai
MK
Wu
D015331:Cohort Studies; D054893:Cone-Beam Computed Tomography / Q000379:methods; D003786:Dental Pulp Cavity / Q000000981:diagnostic imaging; D003793:Dental Restoration, Permanent / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006171:Gutta-Percha / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D010485:Periapical Periodontitis / Q000000981:diagnostic imaging / Q000628:therapy*; D016300:Radiography, Bitewing / Q000379:methods; D012189:Retrospective Studies; D012387:Root Canal Filling Materials / Q000592:standards*; D012389:Root Canal Obturation / Q000592:standards*; D018915:Root Canal Preparation / Q000379:methods / Q000592:standards; D013499:Surface Properties; D019227:Tooth Apex / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D015035:Zinc Oxide-Eugenol Cement / Q000592:standards
C495565:Cortisomol; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; D006171:Gutta-Percha