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A prospective study assessing the effect of coronal tooth structure loss on the outcome of root canal retreatment
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evaluate the outcome of secondary root canal treatment (retreatment) on
posterior teeth in relation to the residual volume of coronal tooth
structure, measured with an intraoral scanner, using periapical
radiography and cone beam computed tomography (CBCT).
total of 137 posterior teeth in 121 patients were assessed clinically
and radiographically using periapical radiographs and CBCT scans at
baseline and 1-year after root canal retreatment. The increase or
decrease in the size of preoperative periapical radiolucencies and
development of new radiolucencies were assessed by a consensus panel
consisting of two pre-calibrated examiners. A clinical impression was
obtained for each tooth after completion of root canal retreatment,
before the placement of the temporary restoration and following cast
restoration placement to produce two casts. All casts were scanned using
an intraoral digital scanner and the three-dimensional volume of
remaining tooth structure calculated. Teeth were also classified
according to the number of remaining coronal walls before core build-up.
Chi-square test was used to determine the association between the
outcome of root canal retreatments and the volume of remaining coronal
the 1-year recall, teeth retaining less than 30% of their original
tooth structure volume had a significantly higher proportion of
unfavourable outcomes (χ2, P<0 .05="" 1.026-6.487="" 2.580="" 95="" ci="" odds="" p="" ratio="">0>
loss of tooth structure volume is an objective parameter that can be
used to predict the probability of success of root canal retreatments.
At 1-year follow-up, the percentage of unfavourable outcomes of root
canal retreated teeth was significantly higher when less than 30% of the
original tooth tissue structure was present at baseline.