Maryam Foroozandeh
Azita Ehsani
Salman Khazaei

Background: Periapical radiolucency occurs due to root canal infections. In this respect, effective root canal treatment and appropriate coronal restoration can aid in preventing these lesions. Thus, the present study aimed to assess the periapical status in posterior root canal-treated teeth by cone-beam computed tomography (CBCT) in the Iranian population. Methods: The CBCT images of ۲۱۰ patients (۴۷۵ endodontically treated molars and premolars) referred to the Hamadan Dental School (from ۲۰۲۰ to ۲۰۲۲) were evaluated in this observational study. The images were obtained by a NewTom ۳G CBCT device (NewTom, Verona, Italy) with an FOV of ۶×۶ inches at ۱۱۰ kVp and varying milliampers and exposure times according to the patient’s age and body size. They were observed by two maxillofacial radiologists who recorded the periapical status, coronal seal, and endodontic treatment quality of root canal-treated teeth. The Chi-square test was used for data analysis (P≤۰.۰۵). Finally, the periapical lesion was determined, along with its association with gender, type of tooth, endodontic treatment quality, and appropriate restoration. Results: The results revealed no significant association between periapical radiolucency and gender. The prevalence of periapical lesions was higher in males aged ۲۵–۵۰ years, but no significant correlation was found in this regard. There was no significant relationship between tooth type and the presence of periapical lesions, while it had the highest prevalence in maxillary molars. Endodontic treatment quality and coronal restoration showed significant correlations with the presence of periapical radiolucency. Conclusion: There was no significant association between the presence of periapical radiolucency and gender and age. The prevalence of periapical lesions was higher in males. Cases with poor endodontic treatment and poor restoration demonstrated the highest prevalence of periapical lesions.