Abstract
Objective The presence of periapical radiolucency has been used as a criterion for endodontic treatment failure. However, in addition to the inherent limitations of radiographic examinations, radiographic interpretations are extremely subjective. Thus, this study investigated the effect of partial analysis of root filling quality and periapical status on retreatment decisions by general dentists. Material and Methods Twelve digitalized periapical radiographs were analyzed by 10 observers. The study was conducted at three time points at 1-week intervals. Radiographs edited with the Adobe Photoshop CS4 software were analyzed at three time points: first, only root filling quality was analyzed; second, only the periapical areas of the teeth under study were visualized; finally, observers analyzed the unedited radiographic image. Spearman's coefficient was used to analyze the correlations between the scores assigned when the periapical area was not visible and when the unedited radiograph was analyzed, as well as between the scores assigned when root fillings where not visible and when the unedited radiograph was analyzed. Sensitivity, specificity, positive and negative predictive values between partial images and unedited radiographs were also used to analyze retreatment decisions. The level of significance was set at 5%. Results The visualization of the root filling on the unedited radiograph affected the interpretation of the periapical status and the technical quality of the fillings has a greater influence on the general dentist's decision to prescribe endodontic retreatment than the periapical condition. Conclusion In order to make endodontic diagnosis, radiographic interpretation process should not only emphasize technical aspects, but also consider biological factors.
Highlights
The potential methods to evaluate results of endodontic treatment are clinical signs and V\PSWRPV UDGLRJUDSKLF ¿QGLQJV DQG KLVWRORJLFDO studies7,16,19
Clinical signs are infrequent and periapical biopsies are difficult to obtain, but changes in periapical tissues after endodontic treatment are usually detected on radiographs12,23
Several studies have shown that the poor quality RI URRW ¿OOLQJV PD\ OHDG WR HQGRGRQWLF IDLOXUH An inadequate apical seal and the presence of HPSW\ VSDFHV EHWZHHQ ¿OOLQJ PDWHULDO DQG FDQDO walls may increase chances of unsuccessful treatment6 $GHTXDWH URRW ¿OOLQJV DUH DVVRFLDWHG with a lower prevalence of periapical disease5. +RZHYHU KLJKTXDOLW\ URRW ¿OOLQJV GR QRW SUHYHQW the penetration of bacteria and their byproducts when coronal restorations are not adequate15
Summary
The potential methods to evaluate results of endodontic treatment are clinical signs and V\PSWRPV UDGLRJUDSKLF ¿QGLQJV DQG KLVWRORJLFDO studies. Clinical signs are infrequent and periapical biopsies are difficult to obtain, but changes in periapical tissues after endodontic treatment are usually detected on radiographs. The development or persistence of periapical radiolucencies on postoperative follow-up radiographs is a usual sign of root canal treatment failure. The wide variation in success and failure rates in studies that report on results of endodontic treatment may be at least partly explained by interobserver variation during radiographic analysis. Several studies have shown that the poor quality RI URRW ¿OOLQJV PD\ OHDG WR HQGRGRQWLF IDLOXUH An inadequate apical seal and the presence of HPSW\ VSDFHV EHWZHHQ ¿OOLQJ PDWHULDO DQG FDQDO walls may increase chances of unsuccessful treatment6 $GHTXDWH URRW ¿OOLQJV DUH DVVRFLDWHG with a lower prevalence of periapical disease. Radiographs alone do not provide a FRPSOHWH HYDOXDWLRQ RI WKH HI¿FLHQF\ RI URRW FDQDO
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call