Prevalence of Apical Periodontitis and Its Association With Missed Canals and the Quality of Endodontic Filling Using Cone-Beam Computed Tomography (CBCT)

Introduction: The success of endodontic treatment is mostly determined by the absence of apical periodontitis. This cross-sectional study aims to assess the prevalence of apical periodontitis and its association with missed canals and the quality of endodontic filling using cone-beam computed tomography (CBCT) in a Lebanese subpopulation. Methods: One hundred and eighty-three CBCTs were analyzed by a 30-year experienced oral and maxillofacial radiologist over the period of three months. Every case of apical periodontitis was identified, and in every endodontically treated tooth, the quality of endodontic filling was recorded along with the presence of missed canals. All statistical analyses were performed using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, New York, United States). A significance level of α=0.05 was applied to all analyses. Results: Four hundred and twenty-four cases of periapical periodontitis in endodontically treated teeth were identified. Forty-five (5.1%) of endodontically treated teeth presented with a missed canal, with 16 (35.56%) being the second mesiobuccal canal. Out of those, 24 (53.3%) showed a periapical lesion formation. Most canals, 584 (66.7%), presented with an adequate root canal filling. However, the overfilled ones showed a high prevalence of periapical lesions, seven (58.3%), followed by 139 (49.8%) in short-filled canals. Conclusion: This study found a high prevalence of periapical lesions in endodontically treated teeth, particularly in teeth with missed canals and short and overfilled canals.