Cone-beam computed tomographic imaging provides more precise evaluation of periapical lesions

Endodontic microsurgery (EMS) is a surgical endodontic retreatment approach characterised by modern microsurgical techniques that integrate the use of an operating microscope or endoscope, root-end cavity preparation with ultrasonic tips, and more biocompatible root-end filling materials such as immediate restorative material, super ethoxy benzoic acid, or mineral trioxide aggregate.

The overall pooled success rate of EMS is more than 90%. Its success is usually assessed through radiographic and clinical examinations during follow-up. In endodontics, conventional periapical radiographs (CPRs) are commonly used to visualise osseous healing outcomes after EMS.

CPR is the most common radiographic examination for routine clinical use. Rud's and Molven's criteria have been developed as efficacy diagnostic criteria for 2-dimensional (2D) images.

This study aimed to compare the healing outcomes of endodontic microsurgery (EMS) using 2-dimensional (2D) and 3-dimensional (3D) radiographic evaluation in a Chinese population. The prognostic factors of EMS were identified according to the 2D and 3D healing classifications.

The teeth (n = 82) were studied using 2D and 3D radiographic examinations. The 2D and 3D healing criteria were used to evaluate the healing outcome. Prognostic factors were investigated based on healing outcomes. Data were analysed using SPSS, and P < .05 was considered significant.

Results:

There were significant differences between 2D and 3D healing outcomes (P = .004). For the 3D images, age older than 45 years was found to be a significant negative predictor (P = .005).

Cone-beam computed tomographic images provided more precise evaluation of periapical lesions and healing outcomes of EMS than conventional periapical radiographs. Age (>45 years) of the patients exhibited a significant influence on the healing outcome of EMS as determined using 3D images.

Reference:

Chaonan Su, Rui Zhang, Rong Wang, Chengcan Yang, Zan Wang, Liuyan Meng. Prognostic Predictors of Endodontic Microsurgery: Radiographic Assessment, International Dental Journal, Volume 72, Issue 5, 2022, Pages 628-633, ISSN 0020-6539, https://doi.org/10.1016/j.identj.2022.02.007.

Keywords:

Endodontic microsurgery, Prognostic factors, Cone-beam, computerised tomography, Chaonan Su, Rui Zhang, Rong Wang, Chengcan Yang, Zan Wang, Liuyan Meng, International Dental Journal