Periapical bone defects of root filled teeth with persistent lesions evaluated by cone-beam computed tomography

• Published in: International endodontic journal Vol. 44; no. 3; pp. 245 - 252
• Main Authors: Yoshioka, T., Kikuchi, I., Adorno, C. G., Suda, H.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-03-2011
• Subjects: Alveolar Bone Loss - diagnostic imaging; Alveolar Bone Loss - pathology; Alveolar Process - diagnostic imaging; Alveolar Process - pathology; apical fenestration; apical protrusion; Bone; Computed tomography; Cone-Beam Computed Tomography; cone-beam computerized tomography; Dental roots; Dentistry; Humans; Mandible; Maxilla; periapical bone defect; Periapical Diseases - classification; Periapical Diseases - diagnostic imaging; Periapical Diseases - pathology; Radiography, Dental, Digital - instrumentation; Teeth; Tooth Apex - diagnostic imaging; Tooth Apex - pathology; Tooth Root - diagnostic imaging; Tooth Root - pathology; Tooth, Nonvital - diagnostic imaging; Tooth, Nonvital - pathology
• ISSN: 0143-2885; 1365-2591
• DOI: 10.1111/j.1365-2591.2010.01814.x

Yoshioka T., Kikuchi I., Adorno C.G., Suda H. Periapical bone defects of root filled teeth with persistent lesions evaluated by cone‐beam computed tomography. International Endodontic Journal 44, 245–252, 2011.
Aim  To evaluate and categorize the bone defects of root filled teeth with persistent periapical lesions by cone‐beam computed tomography (CBCT).
Methodology  Slice images of 532 teeth with persistent periapical lesions were obtained by CBCT in 427 patients and were examined by two endodontists. The periapical lesions were categorized into five types according to the characteristics of the bone defect based on CBCT images. The prevalence of each type was determined and analysed statistically at a 5% significance level using logistic regression.
Results  Of the 532 teeth analysed, 67% had buccal or labial bone plate defects (type II), 4% palatal or lingual bone plate defects (type III), 7%‘through and through’ defects (type IV) and 10% apical root protrusions from the bone plate (type V). Mandibular teeth had a significantly greater prevalence of type I lesions (P = 0.0005) and a significantly lower prevalence for types IV (P = 0.041), V (P = 0.001), V‐1 (P = 0.015) and V‐2 (P < 0.001) as compared to maxillary teeth.
Conclusion  CBCT accurately identified the type of periapical bone defect in persistent lesions. Because 10% of the teeth had apical root protrusions, which could not be identified by periapical radiography, the diagnostic information obtained by CBCT was an essential component of the treatment planning process.