OR10 - CBCT Evaluation of Treatment Outcomes Following Regenerative Endodontic Procedures in Immature Permanent Teeth

Objective: This study evaluated the radiographic outcome of regenerative endodontic procedures (REPs) and apexification (APEX) in immature teeth with necrosis and periapical pathosis using 2D periapical radiographs (PR) and 3D CBCT imaging. We hypothesized that CBCT offers superior precision in detecting periapical healing and apical development.

Methods: A retrospective record review of unidentified teeth treated with REPs or APEX between 2014 and 2021was complemented with a prospective visit. Collected clinical data included pain, swelling, percussion/palpation sensitivity, sinus tract presence, vitality test results, periodontal probing depths, discoloration, and restoration quality. Radiographic assessments were evaluated by three independent examiners; periapical lesion size, apical closure, increases in root dentine thickness and root length, periodontal ligament (PDL) widening, active inflammatory external root resorption, canal obliteration, apical hard tissue formation, intracanal calcifications, and changes in radiographic root area (RRA). Intra- and inter-rater reliability and Mann-Whitney U-tests were used for statistical analyses, p<0.05.

Results: The cohort comprised 22 subjects, 26 teeth: 14 REPs and 12 APEX, with all cases deemed clinically successful. Higher detection of periapical lesions was confirmed by 3D-CBCT (PR:7%, CBCT: 57%), reflecting differences in success rate by 2D: APEX 92% vs. REP 64% and by 3D; APEX 83% vs. REP 50%. 3D-CBCT analysis detected a significantly higher number of cases with incomplete apical closure (PR: 41%, CBCT: 64%).

Conclusions: 3D-CBCT has proven to be highly sensitive in detecting periapical healing and evaluating apical development. This highlights its value for more precise clinical assessments and informed treatment decision-making.