Elsevier

Journal of Endodontics

Volume 43, Issue 2, February 2017, Pages 218-224
Journal of Endodontics

Clinical Research
Change in Periapical Lesion and Adjacent Mucosal Thickening Dimensions One Year after Endodontic Treatment: Volumetric Cone-beam Computed Tomography Assessment

https://doi.org/10.1016/j.joen.2016.10.023Get rights and content

Abstract

Introduction

Changes in periapical lesion dimensions along with mucosal thickening after endodontic treatment have not been studied yet. Therefore, the objectives of this study were (1) to obtain linear and volumetric measurements of lesion dimensions in maxillary first molars with periapical pathology and (2) to measure maxillary sinus mucosal thickening in the vicinity of periapical lesions before and 1 year after endodontic treatment by using cone-beam computed tomography (CBCT).

Methods

Twenty-one maxillary first molar teeth of 21 patients (14 female and 7 male) with periapical lesion that had local mucosal thickening in the vicinity of the periapical lesion were endodontically treated. A total of 21 maxillary first molar roots (8 mesiobuccal roots, 6 distobuccal roots, and 7 palatal roots), each one from different patients, was included. Pretreatment and 1-year post-treatment CBCT images of each tooth were obtained by using Kodak CS 9300 3D CBCT unit. Width, height, surface area, and volume measurements of periapical lesions and mucosal thickening of the maxillary sinus mucosa in the vicinity of the periapical lesion were measured before and 1 year after endodontic treatment. General linear model (analysis of variance) was used for the comparisons between measurements, and significance was set at P < .05. Regression analysis was also used to test the correlation between different measurements.

Results

We found statistically significant differences between mean pretreatment and mean post-treatment measurements conducted by using CBCT images (width, P = .002; height, P < .001; maximum mucosal thickening, P < .001; medium mucosal thickening, P < .001; minimum mucosal thickening, P < .001; surface area, P = .032; and volume, P = .034). Considering gender, age, and root-type variables, no significant differences were found for all the measurements conducted (P > .05). There were 36%, 41%, 53%, 54%, 53%, 73%, and 75% mean reductions in lesion width, lesion height, maximum sinus mucosal thickness, medium sinus mucosal thickness, minimum sinus mucosal thickness, lesion surface area, and lesion volume, respectively, before and 1 year after endodontic treatment. Regression analysis of pretreatment lesion volume versus percentage of post-treatment lesion volume change revealed a low regression coefficient (R2 = 16.7%, P > .05), showing a weak linear relationship.

Conclusions

CBCT assessment of changes in periapical lesion and mucosal thickening dimensions may reveal useful information regarding endodontic treatment success.

Section snippets

Materials and Methods

Ethical approval for the present study was obtained through Başkent University Ethical Committee, Ankara, Turkey (D-KA15/9). Patients were asked to sign an informed consent before the treatment.

Twenty-one maxillary first molar teeth (11 left and 10 right molars) of 21 patients (14 female and 7 male) with periapical lesion that had local mucosal thickening ≥ 2 mm (defined by Maillet et al [9]) in the vicinity of the affected root and without prior endodontic treatment were treated by an

Results

There was no significant difference between the 2 software (Kodak and 3D DOCTOR) used for the width (P = .857), height (P = .948), and mucosal thickening measurements (maximum mucosal thickening, P = .757; medium mucosal thickening, P = .805; minimum mucosal thickening, P = .803). Therefore, dedicated Kodak software was taken for width, height, and mucosal thickening measurements, and 3D DOCTOR was taken for surface area and volume measurements for the rest of the statistical analyses. We found

Discussion

This study revealed that periapical lesion dimensions along with mucosal thickening in the vicinity of roots with periapical lesions showed a significant reduction when assessed by CBCT. Periapical lesions and sinus mucosal thickening measured in this study had obscure borders; therefore, observer performance, selection of reference points, mouse sensitivity and software capabilities along with segmentation process are all important factors affecting measurement process. In this study, a very

Conclusion

Within the limitations of this study, we found significant reduction in periapical lesion width, lesion height, surface area, and volume in maxillary molar teeth along with adjacent sinus mucosal thickening by using CBCT and specific software 1 year after endodontic treatment. The results of this study are to be considered specific to the one CBCT system and software used under certain settings.

Acknowledgments

The authors deny any conflicts of interest related to this study.

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