Cross‐Sectional Study on the Relationship of Some Prognostic Factors of Endodontic Treatment With the Presence and Size of Periapical Lesions in Endodontically Treated Mandibular Anterior and Premolar Teeth Using Cone‐Beam Computed Tomography

Objectives This study evaluated the association between key prognostic factors in nonsurgical endodontic treatment and the presence and size of periapical lesions (PALs) in mandibular anterior and premolar teeth using cone‐beam computed tomography (CBCT). Materials and Methods A cross‐sectional analysis was conducted on 63 CBCT scans covering 105 mandibular anterior and premolar teeth. Variables examined included missed canals, underfilled or overfilled canals, procedural errors (e.g., perforations and fractured instruments), intracanal posts (cast or prefabricated), and restoration type. The presence and volume of PALs were assessed, and associations were evaluated using a general linear model (GLM) and multiple logistic regression ( α = 0.05). Results Among 63 patients (27 males and 36 females), PALs were observed in 43 teeth (41%) with an average lesion volume of 7.90 mm 3 . No significant association was found between PAL occurrence and age, gender, tooth type, restoration type, or intracanal posts ( p > 0.05). However, missed canals ( p = 0.042), underfilled ( p < 0.001), overfilled canals ( p < 0.001), perforations ( p = 0.020), and fractured instruments ( p = 0.033) were significantly associated with PAL presence. Lesion size correlated significantly with gender ( p = 0.047), overfilling ( p = 0.013), fractured instruments ( p < 0.001), and apical perforations ( p = 0.009). Conclusions The findings underscore the clinical relevance of missed canals, over‐ and underfilling, and procedural mishaps in the development and size of PALs. Patient gender also appeared to influence lesion size. These results highlight the need for precision in endodontic procedures to improve periapical healing.