Pericervical Dentin Metrics in Mandibular First Molars Determined with Digital Periapical Radiography and Cone-beam Computed Tomography

Introduction

Pericervical root dentin is decisive for the long-term mechanical integrity of root-filled teeth. Current treatment protocol does not include a customized step to determine the pretreatment residual pericervical root dentin.

Objective

To determine and compare the residual root dentin and canal width using digital periapical radiography (DPR) and cone-beam computed tomography (CBCT) at the apical limit of the pericervical area (PCA) in mandibular first molars.

Methods

DPR and CBCT images of 60 patients with age between 22 and 76 years were used to determine (a) the mesiodistal widths of the root canal (pericervical dimensions [PCL]-C) and the root (PCL-R) of mandibular first molars at the apical limit of the PCA and (b) the intracanal distance from the apical limit of the PCA to the radiographic apex (intracanal distance [ICD]). The correlation between the PCL and ICD measurements obtained from DPR and CBCT were evaluated.

Results

Values between 0.10–0.80 mm and 0.00–1.10 mm were obtained for PCL-C using DPR and CBCT respectively (95% CI). The PCL values between 0.90–2.30 mm and 0.00–2.30 mm were obtained from DPR and CBCT respectively (95% CI). The ICD ranged between 4.6–12.3 mm in DPR and 4.40–12.0 mm in CBCT (95% CI). The comparative analysis showed differences from −0.9 to 0.5 mms for PCL and −2.00 to 1.5 mms for ICD between DPR and CBCT techniques respectively.

Conclusion

The PCL and ICD determined from DPR and CBCT provided the pericervical dentin metrics that could be utilized clinically as a guideline for decision-making in endodontic treatment.