Abstract
Background This study aimed to assess the prevalence of missed canals in endodontically treated teeth and their association with apical periodontitis in a Saudi Arabian population using CBCT. Materials and Methods A total of 208 CBCT radiographs were investigated. For each tooth, radiographs of axial, coronal, and sagittal segments were acquired to appraise the external as well as the internal structure of the root canal system and apical area. In root canal-treated teeth, unfilled canals appearing from the cementoenamel junction to the apex were defined as missed untreated canals; and a periapical lesion was considered when disruption of the lamina dura was detected, and the low-density area associated with the radiographic apex was at least twice the width of the periodontal ligament space. The data were presented as frequencies and percentages. The Z-test was used to analyze the differences in proportions with the significance level set at P value <0.05. Results The overall prevalence of missed canals among endodontically treated teeth was 18%. The prevalence of missed canals was higher in maxillary first molars with 40.6%. The overall prevalence of apical periodontitis among teeth with missed canals was 90%. It was 84.2% in the maxilla and 100% in the mandible. The second mesiobuccal canal in the maxillary first molars and mesiobuccal and distobuccal canals in mandibular teeth were the most missed canals. Conclusion Apical periodontitis in root canal-treated teeth with missed canals was high (90%), with most identified missed canals in maxillary and mandibular first molars.
Highlights
Mohammed Mashyakhy,1 Fatimah Ali Hadi,2 Hashimah Alhassan Alhazmi,2 Rawan Ali Alfaifi,2 Fatimah Saleem Alabsi,1 Hashim Bajawi,1 Mazen Alkahtany,3 and Abdulaziz AbuMelha 4
In root canal-treated teeth, unfilled canals appearing from the cementoenamel junction to the apex were defined as missed untreated canals; and a periapical lesion was considered when disruption of the lamina dura was detected, and the low-density area associated with the radiographic apex was at least twice the width of the periodontal ligament space. e data were presented as frequencies and percentages. e Z-test was used to analyze the differences in proportions with the significance level set at P value
E importance of locating all existing canals within the root canal system (RCS) to achieve optimal prognosis has been discussed by many authors, and potential negative effects of untreated canals on the treatment result have been debated with overwhelming evidence of missed canals in failed cases requiring endodontic retreatment [5, 9, 10]
Summary
Prevalence of Missed Canals and Their Association with Apical Periodontitis in Posterior Endodontically Treated Teeth: A CBCT Study. Is study aimed to assess the prevalence of missed canals in endodontically treated teeth and their association with apical periodontitis in a Saudi Arabian population using CBCT. E prevalence of missed canals in endodontically treated teeth and their association with apical lesions have been evaluated by means of CBCT in recent studies in different populations [6,7,8], where it showed more accurate and reliable results. The aim of this study, was to assess the prevalence of missed canals in endodontically treated teeth and their association with apical periodontitis in a Saudi Arabian population utilizing in vivo CBCT. Results e prevalence of RCT among 3046 screened teeth (1529 maxillary and 1517 mandibular) was 5.4% (n 165 teeth)
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