title: The detection of periapical pathoses using digital periapical radiography and cone beam computed tomography in endodontically retreated teeth - part 2: a 1 year post-treatment follow-up.
abstract: OBJECTIVE
  Part 2 of this prospective clinical study aimed to compare the 1-year outcome of root canal retreatments, when individual roots and teeth were assessed by periapical radiographs and cone beam computed tomography (CBCT).
  
  
  METHODS
  Subjects participating in this study had been referred for management of an endodontic problem associated with one or more root filled teeth. Root canal retreatment was performed by Specialists or postgraduate students under the direct supervision of Specialist endodontic staff. A total of 98 teeth (84 patients) were reassessed clinically and radiographically 1 year after completion of root canal retreatment. The postoperative periapical radiographs and CBCT scans were compared with their respective pre-treatment (diagnostic) periapical radiographs and CBCT scans. The increase or decrease in size of existing periapical radiolucencies and development of new radiolucencies were assessed by a consensus panel consisting of two calibrated examiners. They also determined an appropriate management plan for each case based on the radiographical findings. Comparison of the outcome diagnosis of individual roots and teeth and case management, when assessed by periapical radiographs and CBCT scans, was performed using chi-squared and McNemar's tests.
  
  
  RESULTS
  An overall favourable result of 93% success for teeth (96% roots) was recorded when the assessment was undertaken by periapicals compared with 77% success for teeth (87% roots) when assessed by CBCT. A significant difference in outcome diagnosis of single paired roots (P < 0.0001) and teeth (P = 0.0001) was observed when comparing periapicals to CBCT for the cohort of teeth as a whole. When comparing the future management plan on the basis of radiographic information alone, there was a significant difference between periapicals and CBCT-based management (P = 0.01).
  
  
  CONCLUSIONS
  Diagnosis using CBCT revealed a significantly lower number of favourable outcomes than periapicals in root canal retreatment. This significantly affected the future management of cases attending for a review.
authors.affiliation: Department of Endodontology, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Davies
authors.affiliation: Department of Endodontology, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Patel
authors.affiliation: Department of Endodontology, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK.
authors.forename: F
authors.initials: F
authors.lastname: Foschi
authors.affiliation: Biostatistics and Research Methods Centre, Kings College Dental Institute, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Andiappan
authors.affiliation: Department of Endodontology, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Mitchell
authors.affiliation: Department of Endodontology, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK.
authors.forename: F
authors.initials: F
authors.lastname: Mannocci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010483:Periapical Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D019252:Radiography, Dental, Digital / Q000379:methods; D012086:Reoperation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods; D019227:Tooth Apex / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: cone beam computed tomography; outcome of endodontic retreatment; periapical intraoral radiographs