Abstract
Background: Previous literature has investigated the association between the attribute of coronal restoration and root canal obturation with the radiographic periapical status of endodontically treated teeth. Objectives: This study intends to assess the status of periapical lesions/pathology and, the main factors influencing the healing of periapical lesions of root canal-treated teeth clinically and radiographically exploiting CBCT. The quality of coronal restoration, canal obturation, and apical seal were selected to be assessed, as they have a greater impact on healing peri apical pathology. Method: This analysis was conducted at the Department of Restorative Dentistry and the Division of Oral Medicine and Radiology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. All the patients who presented between January 2020 and January 2021, had root canal treatment done at least one year prior, were referred for CBCT assessment for some other conditions, and fulfilled the inclusion criteria, were selected. Root canal-treated teeth were recognized by radio-opaque filling material inside the canals in any anterior or posterior teeth. Results: A sum of 50 CBCT reports from 50 patients was encompassed in the dissertation. Median age was 26 (±4) years, with 37.5% of reports belonging to males. Statistical analysis was performed utilizing Statistical Package for Social Sciences (SPSS) version 20.0 software (IBM Corp). Out of fifty patients, 32 had been found to have adequate clinical coronal seal while 31 have been found to have adequate radiographical coronal seal. Further, 31 patients were found to have insufficient obturation and 28 were found to have adequate apical seal. A significant association was observed between periapical healing and adequate coronal restoration in root-filled teeth (p=0.048). However, the association between the healing of the periapical region, and adequate root canal obturation (p=0.09) and adequate apical seal (p=0.777) were found to be non-significant. Conclusion: The most influential factor for the healing of periapical lesions in endodontically treated teeth appears to be adequate coronal restoration, compared to root canal obturation and apical seal, in a cohort of patients in Sri Lanka
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