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:: Volume 20, Issue 2 (jrds 2023) ::
J Res Dent Sci 2023, 20(2): 43-50 Back to browse issues page
Prevalence of Technical Errors in a Sample of Endodontically Treated Teeth: a CBCT Analysis
Elya Alizade , Parisa Ranjbarian , Azadeh Torkzade , Sahar sadat Shariati Najafabadi
Faculty of dentistry, Isfahan (Khorasgan) branch, Islamic Azad university , Parian1381@gmail.com
Abstract:   (494 Views)
Background and  Aims: Success in endodontic treatment is directly related to proper diagnosis and neutralization of microorganisms using mechanical and chemical methods and full canal obturation. Given that technical errors can affect the success of treatment and cone beame CT can detect these errors perfectly, the aim of this study was to determine the frequency of technical errors in root canal treatment using CBCT
Materials and Methods: In this descriptive-analytical study, 1067 endodontically treated roots in CBCT stereotypes were investigated. Fine-grained diagnostic radiographies were investigated in coronal, sagittal and axial planes. Filling length errors (tip to tip obturation, underfilling, overfilling, voide), errors during preparation (perforations, transport, broken instruments, missed canal and vertical root fracture) were recorded. The data were analyzed by Chi-square and Fisher's exact test 
Results: Moreover, the highest technical errors occurred were transport (23.8%), overfilling (21.2%), underfilling (21.1%) and voide (17.8%) and the lowest technical error occurred was zipping (0.3%). The highest technical errors occurred in the anterior regions including single canal teeth (18.7%) and single canal premolar (11.4%) and the lowest technical errors were found in the buccal and lingual canal of double canal canines (4 %). The frequency of radiographic lesions (p = 0.005) and the expansion of PDL (p <0.001) were significantly different between different dental areas; however, the frequency of resorption was not significantly different between different dental areas (p = 0.11).
Conclusion: The highest observed error was in the anterior area of a canal and the lowest error rate determined by the CBCT was related to the two canal canine (buccal) and two canal canine (lingual). transport, short-term filling, and void were the most endodontic errors and the lowest ones were related to zipping cousing with broken file and post perforation  in the root canal treatment.
Keywords: Root canal therapy, CBCT, Periapital lesion, Technical errors
Full-Text [PDF 1105 kb]   (270 Downloads)    
Type of Study: original article | Subject: Endo
References
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2. Razavian H, Kalantar Motamed MR, Saeidi A, Barekatian B, Noormohammadi H, Davoodi HR. An in vitro comparative study of digital and conventional imaging system for detection of endodontic procedural errors. Indian J Sci Res. 2014;4(3):430-6.
3. Estrela C, Holland R, Estrela CRA, Alencar AHG, Sousa-Neto MD, Pécora JD. Characterization of successful root canal treatment. Braz Dent J 2014;25(1):3-11. https://doi.org/10.1590/0103-6440202004551 [DOI:10.1590/0103-6440201302356]
5. Torabinejad M, Fouad A, Shabahang Sh. Endodontics principles and practice.6th ed. St Louis: Elsevier. 2020; 317.
6. Lee G, Lankalis J, Tamari K, Singer SR. Use of cone-beam computed tomography in diagnosing and treating endodontic treatment failure: A case study. J Orofac Sci, 2017;9(1):58-62. [DOI:10.4103/0975-8844.207950]
7. Patel S, Dawood A, Whaites E, Pitt Ford T. New dimensions in endodontic imaging: Part 1. Conventional and alternative radiographic systems. Int Endod J 2009;42(6):447-62. [DOI:10.1111/j.1365-2591.2008.01530.x] [PMID]
8. Silva JA, Alencar AH, Rocha SS, Lopes LG, Estrela C. Three-dimensional image contribution for evaluation of operative procedural errors in endodontic therapy and dental implants. Braz Dent J 2012;23(2):127-34. [DOI:10.1590/S0103-64402012000200007] [PMID]
9. Patel S, Brown J, Pimentel T, Kelly RD, Abella F, Durack C. Cone beam computed tomography in Endodontics - a review of the literature. Int Endod J. 2019;52(8):1138-52. [DOI:10.1111/iej.13115] [PMID]
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11. Tyndall DA, Rathore S. Cone-beam CT diagnostic applications: caries, periodontal bone assessment, and endodontic applications. Dent Clin North Am. 2008;52:825-41. [DOI:10.1016/j.cden.2008.05.002]
12. Tsai P, Torabinejad M, Rice D, Azevedo B. Accuracy of cone-beam computed tomography and periapical radiography in detecting small periapical lesions. J Endod. 2012;38(7):965-70. [DOI:10.1016/j.joen.2012.03.001] [PMID]
13. Ramos Brito AC, Verner FS, Junqueira RB, Yamasaki MC, Queiroz PM, Freitas DQ, et al. Detection of Fractured Endodontic Instruments in Root Canals: Comparison between Different Digital Radiography Systems and Cone-beam Computed Tomography. J Endod. 2017;43(4):544-9. [DOI:10.1016/j.joen.2016.11.017] [PMID]
14. Zambon da Silva P, Carlos Ribeiro F, Machado Barroso Xavier J, Pratte-Santos R, Demuner C. Radiographic Evaluation of Root Canal Treatment Performed by Undergraduate Students, Part I; Iatrogenic Errors. Iran Endod J. 2018;13(1):30-6.
15. 14Forsberg J. Estimation of the root filling length with the paralleling and bisecting-angle techniques performed by undergraduate students. Int Endod J. 1987;20(6):282-6 [DOI:10.1111/j.1365-2591.1987.tb00628.x] [PMID]
16. Yazdi M, Beaulieu L. Artifacts in Spiral x-ray CT Scanners: problems and solutions. In J Biolog life sci 2008;4(3):135-8
17. Eriksen HM, Kirkevang LL, Petersson K. Endodontic epidemiology and treatment outcome: General considerations. Endod Top 2002; 2(5): 1-9. [DOI:10.1034/j.1601-1546.2002.20101.x]
18. Obermayr G, Walton RE, Leary JM, Krell KV. Vertical root fracture and relative deformation during obturation and post cementation. J Prosthet Dent. 1991;66(2):181-7. [DOI:10.1016/S0022-3913(05)80045-9]
19. Mallya SM, Lam EWN. White and Pharoah's oral radiology: principles and interpretation.8th ed. St. Louis: Elsevier, 2019. 225-43.
20. da Cunha LZ V, Solda C, Padoin K, Rigo L. Endodontic Procedural Errors: analysis of images from Cone Beam Computed Tomography. Forensic Imaging 2022; 28(3):200493 [DOI:10.1016/j.fri.2022.200493]
21. Eleftheriadis GI, Lambrianidis TP. Technical quality of root canal treatment and detection of iatrogenic errors in an undergraduate dental clinic. Int Endod J. 2005;38(10):725-34. [DOI:10.1111/j.1365-2591.2005.01008.x] [PMID]
22. Moradi S, Gharechahi M, Javan A. Evaluation of Iatrogenic error in Root Canal Therapy Performed by Students of Mashhad Dental School 2011-2013. J Mash Dent Sch 2015;39(3): 261-72.
23. Barrieshi-Nusair KM, Al-Omari MA, Al-Hiyasat AS. Radiographic technical quality of root canal treatment performed by dental students at the Dental Teaching Center in Jordan. J Dent. 2004;32(4):301-7. [DOI:10.1016/j.jdent.2004.01.002] [PMID]
24. Shahrezaei M. Clinical and radiographic examination of errors during root canal treatment in patients undergoing treatment by 11th semester students in the endodontics department of Shahid Beheshti School of Dentistry in 2018 [dissertation]. Dental school, shahid Beheshti University of Medical Science, 2018.p:60
25. Van der Veken D, Curvers F, Fieuws S, Lambrechts P. Prevalence of apical periodontitis and root filled teeth in a Belgian subpopulation found on CBCT images. Int Endod J. 2017;50(4):317-329. [DOI:10.1111/iej.12631] [PMID]
26. Lemagner F, Maret D, Peters OA, Arias A, Coudrais E, Georgelin-Gurgel M. Prevalence of Apical Bone Defects and Evaluation of Associated Factors Detected with Cone-beam Computed Tomographic Images. J Endod. 2015;41(7):1043-7. [DOI:10.1016/j.joen.2015.03.011] [PMID]
27. Al-Nuaimi N, Patel S, Davies A, Bakhsh A, Foschi F, Mannocci F. Pooled analysis of 1-year recall data from three root canal treatment outcome studies undertaken using cone beam computed tomography. Int Endod J. 2018;51 Suppl 3: e216-26. [DOI:10.1111/iej.12844] [PMID]
28. Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J. 2011;44(7):583-609. [DOI:10.1111/j.1365-2591.2011.01872.x] [PMID]
29. Nascimento EHL, Gaêta-Araujo H, Andrade MFS, Freitas DQ. Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis. Clin Oral Investig. 2018;22(7):2495-503 [DOI:10.1007/s00784-018-2344-y] [PMID]
30. Razavian H, Kalantar Motamed MR, Saeidi A, Barekatian B, Noormohammadi H, Davoodi HR. An in vitro comparative study of digital and conventional imaging system for detection of endodontic procedural errors. Indian J Sci Res. 2014;4(3):430-6.
31. Estrela C, Holland R, Estrela CRA, Alencar AHG, Sousa-Neto MD, Pécora JD. Characterization of successful root canal treatment. Braz Dent J 2014;25(1):3-11. https://doi.org/10.1590/0103-6440202004551 [DOI:10.1590/0103-6440201302356]
33. Torabinejad M, Fouad A, Shabahang Sh. Endodontics principles and practice.6th ed. St Louis: Elsevier. 2020; 317.
34. Lee G, Lankalis J, Tamari K, Singer SR. Use of cone-beam computed tomography in diagnosing and treating endodontic treatment failure: A case study. J Orofac Sci, 2017;9(1):58-62. [DOI:10.4103/0975-8844.207950]
35. Patel S, Dawood A, Whaites E, Pitt Ford T. New dimensions in endodontic imaging: Part 1. Conventional and alternative radiographic systems. Int Endod J 2009;42(6):447-62. [DOI:10.1111/j.1365-2591.2008.01530.x] [PMID]
36. Silva JA, Alencar AH, Rocha SS, Lopes LG, Estrela C. Three-dimensional image contribution for evaluation of operative procedural errors in endodontic therapy and dental implants. Braz Dent J 2012;23(2):127-34. [DOI:10.1590/S0103-64402012000200007] [PMID]
37. Patel S, Brown J, Pimentel T, Kelly RD, Abella F, Durack C. Cone beam computed tomography in Endodontics - a review of the literature. Int Endod J. 2019;52(8):1138-52. [DOI:10.1111/iej.13115] [PMID]
38. Rudolph DJ, White SC. Film-holding instruments for intraoral subtraction radiography. Oral Surg Oral Med Oral Pathol. 1988;65(6):767-72. [DOI:10.1016/0030-4220(88)90027-8] [PMID]
39. Tyndall DA, Rathore S. Cone-beam CT diagnostic applications: caries, periodontal bone assessment, and endodontic applications. Dent Clin North Am. 2008;52:825-41. [DOI:10.1016/j.cden.2008.05.002] [PMID]
40. Tsai P, Torabinejad M, Rice D, Azevedo B. Accuracy of cone-beam computed tomography and periapical radiography in detecting small periapical lesions. J Endod. 2012;38(7):965-70. [DOI:10.1016/j.joen.2012.03.001] [PMID]
41. Ramos Brito AC, Verner FS, Junqueira RB, Yamasaki MC, Queiroz PM, Freitas DQ, et al. Detection of Fractured Endodontic Instruments in Root Canals: Comparison between Different Digital Radiography Systems and Cone-beam Computed Tomography. J Endod. 2017;43(4):544-9. [DOI:10.1016/j.joen.2016.11.017] [PMID]
42. Zambon da Silva P, Carlos Ribeiro F, Machado Barroso Xavier J, Pratte-Santos R, Demuner C. Radiographic Evaluation of Root Canal Treatment Performed by Undergraduate Students, Part I; Iatrogenic Errors. Iran Endod J. 2018;13(1):30-6.
43. 14Forsberg J. Estimation of the root filling length with the paralleling and bisecting-angle techniques performed by undergraduate students. Int Endod J. 1987;20(6):282-6 [DOI:10.1111/j.1365-2591.1987.tb00628.x] [PMID]
44. Yazdi M, Beaulieu L. Artifacts in Spiral x-ray CT Scanners: problems and solutions. In J Biolog life sci 2008;4(3):135-8
45. Eriksen HM, Kirkevang LL, Petersson K. Endodontic epidemiology and treatment outcome: General considerations. Endod Top 2002; 2(5): 1-9. [DOI:10.1034/j.1601-1546.2002.20101.x]
46. Obermayr G, Walton RE, Leary JM, Krell KV. Vertical root fracture and relative deformation during obturation and post cementation. J Prosthet Dent. 1991;66(2):181-7. [DOI:10.1016/S0022-3913(05)80045-9] [PMID]
47. Mallya SM, Lam EWN. White and Pharoah's oral radiology: principles and interpretation.8th ed. St. Louis: Elsevier, 2019. 225-43.
48. da Cunha LZ V, Solda C, Padoin K, Rigo L. Endodontic Procedural Errors: analysis of images from Cone Beam Computed Tomography. Forensic Imaging 2022; 28(3):200493 [DOI:10.1016/j.fri.2022.200493]
49. Eleftheriadis GI, Lambrianidis TP. Technical quality of root canal treatment and detection of iatrogenic errors in an undergraduate dental clinic. Int Endod J. 2005;38(10):725-34. [DOI:10.1111/j.1365-2591.2005.01008.x] [PMID]
50. Moradi S, Gharechahi M, Javan A. Evaluation of Iatrogenic error in Root Canal Therapy Performed by Students of Mashhad Dental School 2011-2013. J Mash Dent Sch 2015;39(3): 261-72.
51. Barrieshi-Nusair KM, Al-Omari MA, Al-Hiyasat AS. Radiographic technical quality of root canal treatment performed by dental students at the Dental Teaching Center in Jordan. J Dent. 2004;32(4):301-7. [DOI:10.1016/j.jdent.2004.01.002] [PMID]
52. Shahrezaei M. Clinical and radiographic examination of errors during root canal treatment in patients undergoing treatment by 11th semester students in the endodontics department of Shahid Beheshti School of Dentistry in 2018 [dissertation]. Dental school, shahid Beheshti University of Medical Science, 2018.p:60
53. Van der Veken D, Curvers F, Fieuws S, Lambrechts P. Prevalence of apical periodontitis and root filled teeth in a Belgian subpopulation found on CBCT images. Int Endod J. 2017;50(4):317-329. [DOI:10.1111/iej.12631] [PMID]
54. Lemagner F, Maret D, Peters OA, Arias A, Coudrais E, Georgelin-Gurgel M. Prevalence of Apical Bone Defects and Evaluation of Associated Factors Detected with Cone-beam Computed Tomographic Images. J Endod. 2015;41(7):1043-7. [DOI:10.1016/j.joen.2015.03.011] [PMID]
55. Al-Nuaimi N, Patel S, Davies A, Bakhsh A, Foschi F, Mannocci F. Pooled analysis of 1-year recall data from three root canal treatment outcome studies undertaken using cone beam computed tomography. Int Endod J. 2018;51 Suppl 3: e216-26. [DOI:10.1111/iej.12844] [PMID]
56. Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J. 2011;44(7):583-609. [DOI:10.1111/j.1365-2591.2011.01872.x] [PMID]
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Alizade E, Ranjbarian P, Torkzade A, Shariati Najafabadi S S. Prevalence of Technical Errors in a Sample of Endodontically Treated Teeth: a CBCT Analysis. J Res Dent Sci 2023; 20 (2) :43-50
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Volume 20, Issue 2 (jrds 2023) Back to browse issues page
مجله تحقیق در علوم دندانپزشکی Res Dent Sci
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