Frequency and Causes of Periapical Radiolucency Associated with Post Endodontic Treatment
DOI:
https://doi.org/10.52206/jsmc.2025.15.1.1147Abstract
Background: Periapical radiolucency, often observed in radiographs following inadequate endodontic treatment, is a key radiographic diagnostic marker of periapical pathology.
Objective: To determine the frequency and causes of periapical radiolucency associated with post-endodontic treatment.
Materials and Methods: A cross-sectional descriptive study was conducted on 208 patients who had undergone endodontic treatment, at Saidu College of Dentistry, Swat. Patients aged 15-55 years, presenting with symptoms like pain, tenderness, or sinus formation after treatment, were included. Exclusion criteria were mental impairment, periodontal compromise, pregnancy, and medical conditions impacting bone formation. Radiographs were analyzed to identify periapical radiolucency and its causes such as over-obturation, underfilling, instrument separation, and missed canals. The causes of radiolucency were compared by using the chi-square or Fisher's exact test in R software 4.3.1.
Results: The mean age was 33.85 ± 10.94 years; 58.17% were female. Periapical radiolucency was observed in 48.56% of cases. Among 208 cases, separated instruments were more common in those with periapical radiolucency (12.87%) than without (6.54%), though not statistically significant (p = 0.12). Missed canals were more frequent in cases with radiolucency (33.66%) than without (22.43%; p = 0.071). Resorption rates were similar in both groups (~10%; p = 0.9). A significant association was found with obturation quality (p < 0.001), as over-obturation occurred only in cases with radiolucency (18.81%). Under-obturation was more frequent in cases without radiolucency (91.59% vs. 69.31%), and non-obturation rates were comparable (11.88% vs. 8.41%).
Conclusion: Periapical radiolucency after endodontic treatment is relatively common, often resulting from procedural errors like missed canals and over-obturation.
Keywords: Endodontic treatment, Obturation, Periapical radiolucency, Post-treatment failure, Radiographic assessment.
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