Management of Apical Periodontitis: Healing of Post-treatment Periapical Lesions Present 1 Year after Endodontic Treatment

Introduction: Post-treatment periapical lesions present 1 year after treatment may heal during the second year or later. The aim of this study was to assess second-year volumetric changes in post-treatment periapical radiolucencies detected 1 year after treatment. Methods: Post-treatment periapical radiolucencies were detected on cone-beam computed tomographic (CBCT) scans obtained from 93 single-rooted teeth 1 year after endodontic treatment. The outcome of these teeth was evaluated 2 years after treatment. Two examiners independently measured the volume of the radiolucencies on CBCT images twice. A Wilcoxon signed rank test was used to assess the 1- and 2-year post-treatment volumes. Results: The intraclass correlation coefficients for the CBCT volumetric measurements were 0.971 and 0.998 for the 2 examiners, and the interexaminer correlation coefficient was 0.998. Of the 93 teeth with post-treatment radiolucencies at 1 year, 61were examined at the second-year evaluation. The overall size of the radiolucencies significantly decreased during the second year (P = .01); the volume decreased in 38 teeth (63%), remained unchanged in 20 (33%), and increased in 2 (3%). Conclusions: The volume of post-treatment periapical radiolucencies detected 1 year after treatment was significantly reduced after the second year in 63% of teeth.