Area and 3-dimensional Volumetric Changes of Periapical Lesions after Root Canal Treatments

By van der Borden WG, Wang X, Wu MK, Shemesh H

Date: 01/2013
Journal: JOE

Purpose:

Answer the question: Is the outcome measured by PA and CBCT the same?

Materials/Methods:

Subjects: RCT teeth with pre-operative PARLO

Experimental Design: PA and CBCT taken post-op and at recall. The lesion area was measured in mm squared for PA and lesion volume was measured in mm cubed for CBCT and then compared.

Criteria of evaluation: 4 categories: lesion undetected, decreased, unchanged or enlarged.

Statistically compared with McNemar and chi-squared tests

Results:

  • The 4-category diagnosis made using both methods were in agreement in 54.9 % roots, whereas disagreement was observed in 45.1 % roots (P < .001).
  • Lesion was absent in 15.5 % roots on CBCT scans and 45.1 % roots on PA (P < .001)
  • When success was defined as the absence of a lesion or a reduction in size of a lesion, no statistical difference (P = 0.073) was found between the methods .

Clinical Significance:

Lesion changes after root canal treatments determined with 3D volumetric CBCT data and 2-dimensional PA data were different, and outcome determined with PA could be untrue (This statement is not supported by author’s result).