Pacific Dental Services Partners with Commonwealth Primary Care ACO to Improve Health Outcomes and Reduce Medical Expenses of ACO's Medicare Patient Population

ABSTRACT Introduction Root resorption is a destructive process that compromises tooth structure and can result in tooth loss. Often it remains asymptomatic and is an incidental finding on radiographic examinations. The purpose of this study was to determine prevalence and characteristics of root resorption in patients referred for cone beam computed tomography (CBCT) imaging for a variety of indications. Methods The study included CBCT scans of 1,086 consecutive patients referred for CBCT imaging over an 18-month period. A total of 1,148 scans were acquired. Data were abstracted from radiology reports, and prevalence estimates of resorption were computed for the aggregate sample and also across specific indications. Results Resorption was identified in 171 patients (15.7%, 95% CI: 13.6% - 17.9%) and in 249 teeth with a prevalence range of 2.6% - 92.3% across specific indications. An 18.7% of the patients had two resorption sites whereas 8.8% had three or more resorption sites. The majority of affected teeth were anteriors (43.8%), followed by molars (40.6%) and premolars (14.5%). The most prevalent resorption types were external (29.3%), cervical (22.5%), infection-induced apical resorption (13.7%), internal (9.6%) and impacted tooth induced (8.8%). The majority of teeth with resorption did not have prior endodontic treatment (73.9%) and had radiographically normal periapex (69.5%). Of 249 teeth with resorption, 31% presented as incidental finding. The prevalence of incidental findings of resorption (IFR) increased with age, p<0.05, and was significantly lower for anterior teeth (20.2%) as compared to premolars (41.7%) and molars (36.6%), (p < 0.05). Conclusion The high proportion of IFR detected by CBCT suggests that resorption is not recognized/detected by conventional radiography and therefore remains underdiagnosed.