Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis

• Published in: Clinical oral investigations Vol. 22; no. 7; pp. 2495 - 2503
• Main Authors: Nascimento, Eduarda Helena Leandro, Gaêta-Araujo, Hugo, Andrade, Maria Fernanda Silva, Freitas, Deborah Queiroz
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2018; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Computed tomography; Cone-Beam Computed Tomography; Dental Restoration, Permanent - methods; Dentistry; Endodontics; Female; Humans; Male; Mandible; Maxilla; Medical Errors - statistics & numerical data; Medicine; Middle Aged; Molars; Original Article; Periapical Periodontitis - diagnostic imaging; Periapical Periodontitis - epidemiology; Prevalence; Quality of Health Care; Root Canal Therapy - adverse effects; Root canals; Teeth; Tooth, Nonvital - diagnostic imaging; Tooth, Nonvital - therapy; Endodontics; Root canal obturation; Cone-beam computed tomography; Periapical diseases
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-018-2344-y

Objectives
The aims of this study are to identify the most frequent technical errors in endodontically treated teeth and to determine which root canals were most often associated with those errors, as well as to relate endodontic technical errors and the presence of coronal restorations with periapical status by means of cone-beam computed tomography images.
Methods
Six hundred eighteen endodontically treated teeth (1146 root canals) were evaluated for the quality of their endodontic treatment and for the presence of coronal restorations and periapical lesions. Each root canal was classified according to dental groups, and the endodontic technical errors were recorded. Chi-square’s test and descriptive analyses were performed.
Results
Six hundred eighty root canals (59.3%) had periapical lesions. Maxillary molars and anterior teeth showed higher prevalence of periapical lesions (
p
 < 0.05). Endodontic treatment quality and coronal restoration were associated with periapical status (
p
 < 0.05). Underfilling was the most frequent technical error in all root canals, except for the second mesiobuccal root canal of maxillary molars and the distobuccal root canal of mandibular molars, which were non-filled in 78.4 and 30% of the cases, respectively.
Conclusions
There is a high prevalence of apical radiolucencies, which increased in the presence of poor coronal restorations, endodontic technical errors, and when both conditions were concomitant. Underfilling was the most frequent technical error, followed by non-homogeneous and non-filled canals.
Clinical relevance
Evaluation of endodontic treatment quality that considers every single root canal aims on warning dental practitioners of the prevalence of technical errors that could be avoided with careful treatment planning and execution.