(PR75) Apical Periodontitis: The Role of the Quality of Root Canal Treatment, Root Canal Anatomy and Missed Canals in Mesiobuccal Roots of Maxillary Molars, a CBCT Study

Abstract:

Objectives: This study aimed to evaluate the correlation between root canal anatomy, the quality of root canal treatment, and the prevalence of apical periodontitis.

Methods: 1,549 canals from 1,000 images of maxillary molars presenting root canal treatment were assessed. The images were obtained from the database of a radiology clinic including adult patients. The Cone-beam Computed Tomographic (CBCT) images were obtained from a Prexion 3D machine (San Mateo, CA) with a field of view (FOV) of 5 x 5 cm and, voxel size of 100 µm. The images were evaluated by 2 experienced endodontists and radiologists using the OnDemand3D (Cybermed, Irvine, CA) software. The evaluators assessed the presence of root canal treatment, the quality of the treatment, missed canals, and the presence of apical periodontitis. The statistical analysis included the Kappa test, Odds Ratio, and Confidence Interval at the significance level of 5%.

Results: The most prevalent anatomic configurations were Vertucci Type I (44.7%), Type IV (38.7%), and Type II 15.9%). The chi-square test demonstrated a significant association between the number of foramina with the quality of root canal treatment (p < 0.001) and the quality of root canal treatment with apical periodontitis (p=0.005). The correlations between apical periodontitis, the number of root canals, number of foramina were statistically significant.

Conclusion: The presence of 2 or more foramina in the mesiobuccal roots resulted in the decreased quality of the root canal treatment. The majority of MB2 canals is missed and only a few of them are properly filled.