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OR07 - Association of the Portal of Exit of Missed Second Mesio-buccal Canal in Root Canal Treated Maxillary Molars with the Prevalence of Apical Periodontitis: A CBCT Study

Wednesday, May 3, 2023

10:15 AM – 10:30 AM CT

Location: E353B (Level 3)

Presenter(s)

Jing Ye, D.M.D.

Resident
Virginia Commonwealth University
Richmond, Virginia

Disclosure information not submitted.

Co-Author(s)

Garry L. Myers, D.D.S.

Graduate Program Director
Virginia Commonwealth University
Richmond, Virginia

Disclosure information not submitted.
Caroline Carrico, Ph.D.

Biostatistician
Virginia Commonwealth University
Richmond, Virginia

Disclosure information not submitted.
Ana Cristina Andrada, D.D.S., M.Sc.

Director of Predoctoral Endodontics
Virginia Commonwealth University
Richmond, Virginia

Disclosure information not submitted.
Aniket Jadhav, D.D.S., M.D.S., M.S.

Director of Dental Radiology
Virginia Commonwealth University
Richmond, Virginia

Disclosure information not submitted.
Amber Ather, D.D.S., B.D.S., M.D.S., M.S.

Assistant Professor
Virginia Commonwealth University
Richmond, Virginia

Disclosure information not submitted.

Failure to identify and debride the complex root canal morphology in its entirety can lead to unfavorable outcomes. The majority of maxillary molar retreatment cases are associated with a missed second mesio-buccal (MB2) canal. The objective of this retrospective cohort study was to evaluate the association of portal of exit (POE) of MB2 canal on the prevalence of apical periodontitis in previously treated maxillary molars. Cone beam computed tomography (CBCT) scans of 200 previously treated maxillary molars seen for either recall or retreatment in the past five years were included in the study. Scans were reviewed by three endodontists, one endodontic resident, and one oral radiologist to determine the POE (separate versus joined) of missed MB2 canal and the presence or absence of periapical hypo-dense area. A single proportion chi-squared test at the 0.05 significance level was used to determine if apical periodontitis occurred more frequently than expected when the MB2 canal had a separate POE. Analysis of the data revealed that a separate POE of missed MB2 canal accounted for 86% of cases with apical periodontitis compared to 14% with a joined POE (p-value < 0.0001). A significantly greater proportion of cases with apical periodontitis were associated with missed MB2 canals which had a separate POE compared to cases when the missed MB2 canals joined with the main mesio-buccal canals.