ENDODONTiK TEDAViLi DişLERDE APiKAL PERiODONTiTiS VE TEKNiK HATALARIN PERiAPiKAL RADYOGRAFi VE KONiK IşINLI BiLGiSAYARLI TOMOGRAFi KULLANILARAK iNCELENMESi

EVALUATION OF APICAL PERIODONTITIS AND TECHNICAL ERRORS IN ENDODONTICALLY-TREATED TEETH USING PERIAPICAL RADIOGRAPHY AND CONE-BEAM COMPUTED TOMOGRAPHY

Özet

Amaç: Bu çalışmanın amacı, periapikal radyografi (PR) ve konik ışınlı bilgisayarlı tomografi (KIBT) görüntüleri bulunan endodontik tedavili dişlerin köklerindeki apikal periodontitis (AP) ve sıkça yapılan iyatrojenik hataların tespit edilmesi ve bu iki görüntüleme sisteminin etkinliklerinin karşılaştırılmasıdır. Gereç ve Yöntem: Bu retrospektif çalışmada, endodontik nedenlerle alınmış KIBT görüntülerinin alanında tesadüfen tespit edilmiş, apikal periodontitis ve iyatrojenik hataların mevcut olduğu endodontik tedavili dişler incelenmiştir. Tüm dişlerin daha önceden çekilmiş olan PR’leri de mevcuttur. Önyargıları önlemek adına, hedef dişler KIBT analizlerine dahil edilmemiştir. İki endodontist, hem PR hem KIBT görüntülerini AP, taşkın dolum, geride dolum ve tespit edilememiş kök kanalları açısından değerlendirmişlerdir. Bulgular: PR ile incelenmiş 85 (%58.2) kökte, KIBT ile incelenmiş 130 (%89) kökte AP tespit edilmiştir ve istatistiksel olarak anlamlı bir fark bulunmuştur (p

Abstract

Background and Aim: The aim of the present study was to examine the accuracy of cone beam computed tomography (CBCT) scanning in identifying apical periodontitis (AP) and common iatrogenic errors on individual roots of endodontically treated teeth that were not detected by periapical radiography (PR) according to tooth type. Materials and Methods: This was a retrospective study of endodontically treated teeth in which AP and iatrogenic errors were coincidentally detected in the area of interest of CBCT images taken for endodontic reasons. All the teeth had previously been assessed by PR. To avoid sampling bias, the target teeth were excluded in the CBCT analysis. Two endodontists assessed both the PR and CBCT scans for AP, overfilling, underfilling and untreated root canals. Results: AP was detected in 85 (58.2%) roots when evaluated with PR and 130 (89%) roots when evaluated with CBCT, with a statistically significant difference (p< 0.05). According to PR, 9.6% of the roots were overfilled, whereas 21.9% of the roots were overfilled according to CBCT (p< 0.05). Four of 64 underfillings (6.25%) detected by PR seemed to be flush fillings on the CBCT scans. Untreated root canals were detected by PR and CBCT in 6.2% and 10.3% of the roots, respectively (p< 0.05). Conclusions: This study demonstrated that many significant radiographic indicators obtained using CBCT imaging are not always detectable in PR. It also showed that CBCT imaging can be used to manage diagnostic and endodontic failures accurately