A One-Year Radiographic Healing Assessment after Endodontic Microsurgery Using Cone-Beam Computed Tomographic Scans.

Sumi Kang,Ukseong Kim,Se-Won Ha,Sunil Kim,Euiseong Kim

doi:10.3390/jcm9113714

Abstract

This study aimed to evaluate one-year radiographic healing after endodontic microsurgery using CBCT with modified PENN 3D criteria and to compare the outcome with results evaluated using Molven’s criteria. A total of 107 teeth from 96 patients were evaluated one year after endodontic microsurgery by using CBCT scans with modified PENN 3D criteria and periapical radiographs with Molven’s criteria. Both preoperative and postoperative lesion volumes were calculated using ITK-SNAP (free software). Radiographic healing assessment using periapical radiographs and CBCT images, and preoperative and postoperative lesion volume measurements were performed independently by two examiners. The assessment using Molven’s criteria resulted in 75 complete healings, 18 incomplete healings, eight uncertain healings, and six unsatisfactory healings. Based on modified PENN 3D criteria, 64 teeth were categorized as complete healing, 29 teeth as limited healing, six teeth as uncertain healing, and eight teeth as unsatisfactory healing. With the one-year follow-up, CBCT scans showed a lower healing tendency than did periapical radiography. The volumes of apical radiolucency after the surgery were reduced by 77.7% on average at one-year follow up.

Highlights

The radiographic healing of endodontic microsurgery has been traditionally evaluated using the criteria defined by Rud et al and Molven et al [1,2]
Cone-beam Computed Tomography (CBCT) imaging has gained a wide reputation for diagnostics and treatment planning, it does not yet have the same impact on the assessment of endodontic treatment outcome because of economic aspects and concerns about radiation dose [8]
A clinical database was searched for patients who had received endodontic microsurgery between March 2011 and December 2018 performed by the same surgeon (E.K.)

Summary

Introduction

The radiographic healing of endodontic microsurgery has been traditionally evaluated using the criteria defined by Rud et al and Molven et al [1,2]. Since Rud’s and Molven’s criteria were based on periapical radiographs, they have some innate limitations of periapical radiographs in terms of their interpretation, such as background noise, distortion, and superimposition of anatomic structures. Despite these limitations, the criteria are still dominantly used for outcome assessment of apical surgery, especially for long-term follow-ups [3,4]. CBCT imaging has gained a wide reputation for diagnostics and treatment planning, it does not yet have the same impact on the assessment of endodontic treatment outcome because of economic aspects and concerns about radiation dose [8]

Objectives

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Conclusion