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22 May 2023 : Clinical Research  

[In Press] Periapical Lesions and Missed Canals in Endodontically Treated Teeth: A Cone-Beam Computed Tomographic Study of a Chinese Subpopulation

Jing Hao1BCDEG, He Liu2ACDEF, Ya Shen2DEF

DOI: 10.12659/MSM.940533

Med Sci Monit In Press; DOI: 10.12659/MSM.940533  

Available online: 2023-05-22, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


Periapical lesions (PL) are a common complication of endodontically treated teeth (ETT), which can result from a missed canal (MC). This study aimed to assess the prevalence of PL and MC in the ETT of a Chinese subpopulation and investigate potential associations between them.
A total of 561 cone-beam computed tomography images were selected and analyzed. A total of 1024 endodontically treated posterior teeth excluding third molars were evaluated for the presence of PL and MC. The chi-square test or Fisher’s exact test, as well as the odds ratio test, were used to determine whether there was an association and risk relationship between the incidence of PL and the occurrence of MC.
The overall prevalence of PL and MC in ETT was 56.1% and 19.0%, respectively. In endodontically treated molars, the incidence of PL and MC was 64.1% and 27.6%, whereas in premolars, it was 42.1% and 4.27%. The maxillary first molar showed the highest frequency of PL (71.5%) and MC (65.7%), with the mesiobuccal second canal being the most missed (78.8%). Teeth with an MC were found to be 3.658 times (95% confidence interval=2.541-5.301, P<0.0001) more likely to be associated with a PL.
Endodontically treated teeth with missed canals are associated with higher risks of periapical lesions. The high prevalence of these complications in a Chinese subpopulation underscores the importance of implementing enhanced diagnostic and treatment methods for root canal treatment or retreatment.

Keywords: Cone-Beam Computed Tomography; Endodontics; Periapical Periodontitis; Root Canal Therapy; Tooth, Nonvital


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Med Sci Monit 2023; 29:e940911


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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750