EC Dental Science

Research Article Volume 21 Issue 1 - 2022

Periapical Tissue Status of Endodontically Treated Teeth Restored with Fixed Coronal Restoration: A Cone-beam Computed Tomographic Study

Eman Al Hablain1*, Salsabil Al Khalifah1, Ayman Mandorah2 and Amal Abdallah A Abo-Elmagd3

1BDS, College of Dentistry, Qassim University, Kingdom of Saudi Arabia
2Restorative and Dental Materials Department, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
3Assistant Professor of Fixed Prosthodontics, College of Dentistry, Qassim University, Saudi Arabia and Assistant Professor of Fixed Prosthodontics, Faculty of Dental Surgery, Misr for Science and Technology University, 6-October, Egypt

*Corresponding Author: Eman Al Hablain, BDS, College of Dentistry, Qassim University, Kingdom of Saudi Arabia.
Received: December 11, 2021; Published: December 30, 2021



Objective: The aim of this study was to use cone beam computed tomography scans from a database to assess the prevalence of periapical radiolucency found in root canal treated teeth. Additionally, evaluate the quality of coronal restoration and root canal treatment, as well as their impact on the periapical tissue.

Material and Method: 301 root canal treated teeth were randomly selected and examined from 143 cone beam computed tomographic scans, and teeth were categorized as healthy or diseased based on the periapical status. Other variables such as tooth type, endodontic treatment quality, presence of fixed coronal restorations and posts, type and quality of coronal restorations were investigated for their relationship with periapical status. The chi-square test is a statistical method for determining the relationship between sets of data.

Results: The overall prevalence of periapical radiolucency was (64.1%), whereas the maxillary molars and mandibular molars were more affected than other teeth types (75.7%), (65.9%), respectively. The length and homogeneity of the root canal filling were significantly associated with periapical status. While the teeth had both inadequate root canal treatment and coronal restoration be revealed with diseased periapical status were (91.8%).

Conclusion: This study shows that the prevalence of periapical radiolucency is relatively high. Molar teeth were most likely to be associated with periapical radiolucency. Poor homogeneity of root canal filing was the most frequent type of technical error associated with periapical radiolucency. Moreover, the results showed that inadequate root canal filling and coronal restoration were associated with an increased incidence of periapical radiolucency.

Keywords: Periapical Radiolucency; Cone-Beam Computed Tomography; Root Canal Treated Teeth; Fixed Coronal Restoration; Adequate Coronal Restoration

  1. Hargreaves Kenneth M. “Cohen's pathways of the pulp. Elsevier (2016).
  2. Ng Y‐L., et al. "Outcome of primary root canal treatment: systematic review of the literature–Part 2. Influence of clinical factors”. International Endodontic Journal1 (2008): 6-31.
  3. Gencoglu Nimet., et al. "Periapical status and quality of root fillings and coronal restorations in an adult Turkish subpopulation”. European Journal of Dentistry01 (2010): 017-022.
  4. Lupi-Pegurier L., et al. "Periapical status, prevalence and quality of endodontic treatment in an adult French population”. International Endodontic Journal8 (2002): 690-697.
  5. Gomes Aline C., et al. "Influence of endodontic treatment and coronal restoration on status of periapical tissues: a cone-beam computed tomographic study”. Journal of Endodontics10 (2015): 1614-1618.
  6. Tsai Patrick., et al. "Accuracy of cone-beam computed tomography and periapical radiography in detecting small periapical lesions”. Journal of Endodontics7 (2012): 965-970.
  7. Malone III., et al. "An in vitro evaluation of coronal microleakage in obturated root canals without coronal restorations”. Journal of Endodontics1 (1997): 35-38.
  8. Torabinejad Mahmoud., et al. "In vitro bacterial penetration of coronally unsealed endodontically treated teeth”. Journal of Endodontics12 (1990): 566-569.
  9. Swanson Kimberly and Sandra Madison. "An evaluation of coronal microleakage in endodontically treated teeth. Part I. Time periods”. Journal of Endodontics2 (1987): 56-59.
  10. Ray HA and M Trope. "Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration”. International Endodontic Journal1 (1995): 12-18.
  11. Kirkevang L‐L., et al. "Periapical status and quality of root fillings and coronal restorations in a Danish population”. International Endodontic Journal6 (2000): 509-515.
  12. Tronstad L., et al. "Influence of coronal restorations on the periapical health of endodontically treated teeth”. Dental Traumatology5 (2000): 218-221.
  13. Ricucci D and G Bergenholtz. "Bacterial status in root‐filled teeth exposed to the oral environment by loss of restoration and fracture or caries–a histobacteriological study of treated cases”. International Endodontic Journal11 (2003): 787-802.
  14. Ingle John I., et al. "Ingle's endodontics 6th edition”. United States of America: BC Decker (2008): 342-345.
  15. Khullar Poorva., et al. "A survey report on effect of root canal fillings and coronal restorations on the periapical status of endodontically treated teeth in a selected group of population”. International Journal of Clinical Pediatric Dentistry 2 (2013): 89.
  16. Kalender Atakan., et al. "Influence of the quality of endodontic treatment and coronal restorations on the prevalence of apical periodontitis in a Turkish Cypriot population”. Medical Principles and Practice 2 (2013): 173-177.
  17. Estrela Carlos., et al. "A new periapical index based on cone beam computed tomography”. Journal of Endodontics 11 (2008): 1325-1331.
  18. Venskutonis Tadas., et al. "Periapical and endodontic status scale based on periapical bone lesions and endodontic treatment quality evaluation using cone-beam computed tomography”. Journal of Endodontics 2 (2015): 190-196.
  19. Siqueira Jr José F., et al. "Periradicular status related to the quality of coronal restorations and root canal fillings in a Brazilian population”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 3 (2005): 369-374.
  20. Gulsahi K., et al. "Frequency of root‐filled teeth and prevalence of apical periodontitis in an adult Turkish population”. International Endodontic Journal 1 (2008): 78-85.
  21. Tavares Paula BL., et al. "Prevalence of apical periodontitis in root canal–treated teeth from an urban French population: influence of the quality of root canal fillings and coronal restorations”. Journal of Endodontics 6 (2009): 810-813.
  22. Al-Omari Mohammad A., et al. "Frequency and distribution of root filled teeth and apical periodontitis in a Jordanian subpopulation”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 1 (2011): e59-e65.
  23. Paes da Silva Ramos Fernandes LM., et al. "Prevalence of apical periodontitis detected in cone beam CT images of a Brazilian subpopulation”. Dentomaxillofacial Radiology1 (2013): 80179163-80179163.
  24. Dutta A., et al. "Prevalence of periradicular periodontitis in a S cottish subpopulation found on CBCT images”. International Endodontic Journal9 (2014): 854-863.
  25. Van der Veken D., et al. "Prevalence of apical periodontitis and root filled teeth in a Belgian subpopulation found on CBCT images”. International Endodontic Journal4 (2017): 317-329.
  26. Bürklein Sebastian., et al. "Quality of root canal fillings and prevalence of apical radiolucencies in a German population: a CBCT analysis”. Clinical Oral Investigations3 (2020): 1217-1227.
  27. Meirinhos J., et al. "Prevalence of apical periodontitis and its association with previous root canal treatment, root canal filling length and type of coronal restoration–a cross‐sectional study”. International Endodontic Journal4 (2020): 573-584.
  28. De Pablo Óliver Valencia., et al. "Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review”. Journal of Endodontics12 (2010): 1919-1931.
  29. Silva Emmanuel João Nogueira Leal., et al. "Evaluation of root canal configuration of mandibular molars in a Brazilian population by using cone-beam computed tomography: an In vivo study”. Journal of Endodontics7 (2013): 849-852.
  30. De Souza Filho., et al. "Influence of the enlargement of the apical foramen in periapical repair of contaminated teeth of dog”. Oral Surgery, Oral Medicine, Oral Pathology4 (1987): 480-484.
  31. Buckley Michael and Larz SW Spаngberg. "The prevalence and technical quality of endodontic treatment in an American subpopulation”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology1 (1995): 92-100.
  32. Segura‐Egea JJ., et al. "Periapical status and quality of root fillings and coronal restorations in an adult Spanish population”. International Endodontic Journal8 (2004): 525-530.
  33. Sunay H., et al. "Cross‐sectional evaluation of the periapical status and quality of root canal treatment in a selected population of urban Turkish adults”. International Endodontic Journal2 (2007): 139-145.
  34. Georgopoulou Maria K., et al. "Periapical status and quality of root canal fillings and coronal restorations in a Greek population”. Quintessence International2 (2008): 85-92.
  35. Da Silva Katherine., et al. "Cross‐sectional study of endodontic treatment in an Australian population”. Australian Endodontic Journal3 (2009): 140-146.
  36. Ng Y‐L., et al. "A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health”. International Endodontic Journal7 (2011): 583-609.
  37. Nascimento Eduarda Helena Leandro., et al. "Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis”. Clinical Oral Investigations7 (2018): 2495-2503.
  38. Huybrechts Bart., et al. "Void detection in root fillings using intraoral analogue, intraoral digital and cone beam CT images”. International Endodontic Journal8 (2009): 675-685.
  39. Chugal Nadia M., et al. "Endodontic infection: some biologic and treatment factors associated with outcome”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology1 (2003): 81-90.
  40. Liang Yu-Hong., et al. "Endodontic outcome predictors identified with periapical radiographs and cone-beam computed tomography scans”. Journal of Endodontics3 (2011): 326-331.
  41. Tyndall Donald A and Sonali Rathore. "Cone-beam CT diagnostic applications: caries, periodontal bone assessment, and endodontic applications”. Dental Clinics of North America4 (2008): 825-841.
  42. Aquilino Steven A and Daniel J Caplan. "Relationship between crown placement and the survival of endodontically treated teeth”. The Journal of Prosthetic Dentistry3 (2002): 256-263.
  43. Malhotra Neeraj and M Kundabala. "Light-curing considerations for resin-based composite materials: a review. Part I”. Compendium of Continuing Education in Dentistry - Journals7 (2010): 498-505.
  44. Chandrasekhar Veeramachaneni., et al. "Incremental techniques in direct composite restoration”. Journal of Conservative Dentistry: JCD6 (2017): 386.
  45. Bicalho AA., et al. "Incremental filling technique and composite material-part II: shrinkage and shrinkage stresses”. Operative Dentistry2 (2014): e83-e92.
  46. Hommez GMG., et al. "Periapical health related to the quality of coronal restorations and root fillings”. International Endodontic Journal8 (2002): 680-689.

Eman Al Hablain., et al. "Periapical Tissue Status of Endodontically Treated Teeth Restored with Fixed Coronal Restoration: A Cone-beam Computed Tomographic Study". EC Dental Science 21.1 (2022): 32-41.