Association between the Root Canal Configuration, Endodontic Treatment Technical Errors, and Periapical Hypodensities in Molar Teeth: A Cone-beam Computed Tomographic Study

Hugo Gaêta-Araujo; Rocharles Cavalcante Fontenele; Eduarda Helena Leandro Nascimento; Monikelly do Carmo Chagas Nascimento; Deborah Queiroz Freitas; Christiano de Oliveira-Santos

doi:10.1016/j.joen.2019.08.007

Association between the Root Canal Configuration, Endodontic Treatment Technical Errors, and Periapical Hypodensities in Molar Teeth: A Cone-beam Computed Tomographic Study

J Endod. 2019 Dec;45(12):1465-1471. doi: 10.1016/j.joen.2019.08.007. Epub 2019 Sep 28.

Authors

Hugo Gaêta-Araujo¹, Rocharles Cavalcante Fontenele², Eduarda Helena Leandro Nascimento², Monikelly do Carmo Chagas Nascimento³, Deborah Queiroz Freitas², Christiano de Oliveira-Santos⁴

Affiliations

¹ Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil. Electronic address: hugogaeta@hotmail.com.
² Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
³ Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil; Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Sao Paulo, Brazil.
⁴ Department of Stomatology, Public Oral Health, Forensic Dentistry, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil.

PMID: 31575389
DOI: 10.1016/j.joen.2019.08.007

Abstract

Introduction: This study aimed to evaluate the association between the root canal configuration (RCC), endodontic technical errors, and periapical hypodensities in molars using cone-beam computed tomographic (CBCT) images.

Methods: Two hundred twenty-one roots were assessed from 79 patients referred for CBCT examination because of symptomatology in endodontically treated molars. Two oral and maxillofacial radiologists classified the RCC of each dental root according to Vertucci's classification. Root canals were assessed for the presence of technical errors from endodontic treatment. The presence of periapical hypodensity for each dental root and the coronal sealing condition of each tooth were also recorded.

Results: For RCC type I, the most prevalent technical error was underfilling (17.4%). For types II and VIII, nonfilled canals were found in 54% and 100% of the cases, respectively. For type III, underfilling, nonhomogeneous filling, and nonfilled canals were equally frequent (33.3%), whereas for type IV underfilling and nonfilled canals had a prevalence of 42%. In general, there was a higher prevalence of apical hypodensities among roots with technical errors. It was also observed for type I, with an increase from 41.2%-62.9% when a technical error was present.

Conclusions: The prevalence of different endodontic technical errors varies depending on the RCC for molars. A greater complexity of RCC is related to a higher occurrence of errors and a higher prevalence of periapical hypodensity.

Keywords: Anatomy; cone-beam computed tomography; dental pulp cavity; endodontics; molar.

MeSH terms

Cone-Beam Computed Tomography*
Dental Care
Dental Pulp Cavity* / diagnostic imaging
Humans
Molar
Root Canal Therapy*
Tooth Root