Is Coronal Restoration a Predictor of Posttreatment Apical Periodontitis?

Objectives To investigate the posttreatment apical periodontitis (AP) in endodontically treated teeth through a multivariate approach and to analyze the relative importance of quality and type of coronal restoration as predictors of periapical disease. Materials and Methods The present study sample was drawn within 2-year period from the 1,072 consecutive patients older than 18 years, first time attending the Dental Clinic of the Clinical Hospital Center Rijeka, Croatia. A total of 1,350 endodontically treated teeth were included in the study. For each tooth, the periapical status, root filling quality, intracanal post, separated file presence, marginal bone loss, and quality and type of coronal restoration were recorded. Statistical Analysis Chi-square tests were used to analyze the variations in the periapical status, quality of root canal filling, and quality of coronal restoration in different tooth types. The effect of explanatory variables on periapical status was explored using univariate and multivariate logistic regression models. The outcome variable was set as the presence versus absence of AP in the tooth. Results Multivariate logistic regression analysis revealed statistically significant associations and increased risk for AP presence in molars (odds ratio [OR] = 2.15; p < 0.001), teeth positioned in mandible (OR = 1.49; p = 0.007), teeth with short length of root filling (OR = 4.08; p < 0.001), overfilled teeth (OR = 2.99; p = 0.001), and teeth with inadequate density of root filling (OR = 4.14; p < 0.001). Considering variables related to coronal restoration, neither coronal restoration type nor quality was found to be predictive for posttreatment AP. Merely, the presence of intracanal post significantly increased the odds of AP presence (OR = 1.57; p = 0.009). Conclusion The results of the present study did not indicate that type or quality of coronal restoration may be predictors of posttreatment AP. Periapical disease was significantly associated with molars, mandibular teeth, substandard quality of root fillings, and intracanal post presence.

Unusual Location of a Second Mesiobuccal Canal in the Maxillary First Molar managed with the Aid of Cone-beam Computed Tomography

ABSTRACT Introduction The purpose of this article was to emphasize the importance of understanding root canal anatomy and its variations for successful endodontic treatment. Methods This case report presents the detection and endodontic management of eccentrically placed second mesiobuccal (MB) canal in maxillary first molar with the help of dental operating microscope and cone-beam computed tomography (CBCT) scanning. Results Cone-beam computed tomography images showed broad MB root with second MB canal located closer to palatal orifice. Conclusion This report describes a variation in canal location and complex anatomy of maxillary first molar with posttreatment apical periodontitis which was managed successfully with the aid of dental operating microscope and CBCT. How to cite this article Randhya R, Sundar S, Kowsky D, Velmurugan N, Arul B. Unusual Location of a Second Mesiobuccal Canal in the Maxillary First Molar managed with the Aid of Cone-beam Computed Tomography. J Oper Dent Endod 2016;1(1):35-38.