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Clinical Oral Investigations

, Volume 16, Issue 6, pp 1619–1626

First Online: 10 January 2012Received: 06 September 2011Accepted: 21 December 2011


AimThe technical quality of a root canal treatment is clinically judged by the apical extension and homogeneity of the filling material imaged by periapical radiographs PA. The aim of this experiment was to evaluate the association between the technical quality of the root canal filling and treatment outcome.

Materials and methodsIn 234 teeth 268 roots that underwent root-canal treatment, the quality of the root canal filling as well as the outcome of the treatment were assessed with both PA and cone-beam computed tomography CBCT 2 years after treatment. Satisfactory root filling on PA was defined as 0–2 mm within the radiographic apex without voids; on CBCT scans, the apical end of the canal replaced the radiographic apex. The outcome predictors were analyzed using multivariate logistic regression.

ResultsAt recall, periapical radiolucent areas were absent in 198 74% roots on PA and 164 61% roots on CBCT scans. The presence of preoperative periapical radiolucency and the quality of root filling and coronal restoration were identified by both PA and CBCT as outcome predictors p < 0.01. Complete absence of post-treatment periapical radiolucency was observed in CBCT scans in 81% and 49% of satisfactory and unsatisfactory root fillings, respectively, as compared to 87% and 61% revealed by PA.

ConclusionSatisfactory root fillings were associated with a favorable outcome, confirmed by both PA and CBCT.

Clinical relevanceThe outcome of root canal treatment is improved once the filling is 0–2 mm from the apex, and no voids could be detected. Technical skills and performance of root canal filling procedures should be emphasized, and suitable methods should be developed in order to achieve more compacted filling materials without voids and at the correct length.

KeywordsCone-beam computed tomography Outcome Satisfactory root filling Unsatisfactory root filling  Download fulltext PDF

Autor: Yu-Hong Liang - Gang Li - Hagay Shemesh - Paul R. Wesselink - Min-Kai Wu


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