Adequate Root Canal Fillings Halved the Odds of Apical Periodontitis on CBCT

Posted: August 26, 2026

Adequate Root Canal Fillings Halved the Odds of Apical Periodontitis on CBCT

Edited by Dentaltown staff

Root canal-treated teeth with adequate fillings were about half as likely to show apical periodontitis as teeth with inadequate fillings, and their lesions were smaller when present, according to a cross-sectional cone beam computed tomography study published Aug. 20 in Clinical Oral Investigations.

Researchers reviewed CBCT scans acquired between 2021 and 2024 at a private radiology clinic in Santiago, Chile, for reasons unrelated to the study. The analysis covered 830 root canal-treated teeth in 520 patients.

Apical periodontitis was present in 37.3% of the teeth, or 310 of 830. Adequate fillings were associated with lower lesion prevalence, at an odds ratio of 0.514 with a 95% confidence interval of 0.383 to 0.689.

Lesion size followed the same pattern. Mean lesion volume was 65.5 mm³ in inadequately filled teeth and 50.3 mm³ in adequately filled teeth.

Molars carried the highest prevalence of any tooth type, at 43.7%.

Investigators also measured the ratio of canal diameter to root diameter 1 mm short of the filling terminus and quantified lesions using the CBCT Periapical Volume Index. Larger canal-to-root ratios correlated weakly with smaller lesion volumes, at a correlation coefficient of -0.110.

Rita A. Toloza-Espinoza, Pilar A. Araya-Cumsille, Marcela Torrealba, José F. Siqueira, Flávio R. F. Alves, and colleagues conducted the study.

The design was retrospective and cross-sectional, so it cannot establish that filling quality caused the lesions. The scans also came from a single private radiology practice in one city, which limits how far the prevalence figures can be generalized.

Sources:
Clinical Oral Investigations, “Association between root canal filling quality and apical periodontitis lesion volume: a cross-sectional cone-beam computed tomography study in a Chilean population,” published online Aug. 20, 2026:
link.springer.com/10.1007/s00784-026-07085-2


Adequate Root Canal Fillings Halved the Odds of Apical Periodontitis on CBCT

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