Defense Date


Document Type


Degree Name

Master of Science in Dentistry



First Advisor

Dr. Garry Myers

Second Advisor

Dr. Caroline Carrico

Third Advisor

Dr. Robert Grover

Fourth Advisor

Dr. Aniket Jadhav


Purpose: To assess the changes in CBCT-PAI score as well as 3-D volume of periapical findings associated with endodontically treated roots and to see how these findings change over time.

Methods: Retrospective chart review with the following inclusion criteria: 1. At least one tooth was endodontically treated at the endodontic private practice; 2. Patient had a recall examination and the treated tooth was asymptomatic, functional and a CBCT was exposed; 3. CBCT interpretation found a periapical finding associated with the treated tooth; 4. A follow-up recall examination was completed and CBCT exposed. Cases that fulfilled the inclusion criteria had the CBCT volumes evaluated by an oral radiologist and an endodontic resident. Each CBCT had a CBCT-PAI score assigned and 3-D volume of the periapical finding was determined in the initial recall and follow-up recall CBCT images in a randomized and blinded fashion.

Results: At total of 38 roots with periapical findings were included with average time elapsed from treatment to initial recall of 7.9 years and an average of 2.88 years between recalls. The change in CBCT-PAI score was not significant (p-value=0.6505). CBCT-PAI score improved in 36%, unchanged in 40% and increased in 24%. The median change in 3-D volume was 0.80mm3 smaller at recall and was not statistically significant (p-value=0.2859). There was a total of 16 cases with volume less than 3.0mm3 at initial recall and 93% of those remained less than 3.0mm3 at follow-up recall. The correlation between volume change and time elapsed since treatment was not statistically significant (r=0.06, p-value=0.7020).

Conclusion: Clinicians may consider active surveillance as a treatment option for endodontically treated teeth with periapical findings, especially those that are small in size, as long as the patient is immunocompetent, clinically free of pathologic signs and symptoms and the tooth is functional. Further long-term recall examination is warranted to see how asymptomatic periapical findings change over time.


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