Prevalence of periapical radiolucent lesions in endodontically-treated teeth with intraradicular posts: a cross-sectional CBCT study.

Abstract

Background: The literature has reported contradictory findings regarding the association of Intra-radicular posts (IRPs) presence and periapical radiolucent lesions (PRLs) prevalence in endodontically treated teeth (ETT). Considering this, the study aimed to investigate the association between IRPs presence and PRLs prevalence.

Methods: A cross-sectional study was conducted to compare PRLs prevalence in ETT with and without IRPs. CBCT images were utilized, and the teeth with at least 2 mm of remaining gutta-percha apical to the post-end were included. Two calibrated assessors assessed the PRLs presence. A stepwise backward binomial logistic regression was conducted to evaluate the effect of age, post presence, gender, tooth position (anterior/posterior), and arch location (maxillary/mandibular) on the likelihood of periapical radiolucency presence. The null hypothesis is that the presence of IRPs does not influence the prevalence of PRLs.

Results: Teeth with IRPs showed significantly higher PRLs prevalence. However, there were insignificant differences in PRLs prevalence with respect to IRPs type or remaining gutta-percha length. The model, including all five predictors, demonstrated significant fit (χ²(7) = 22.528,p = .002), explaining 14.5% of the variance in the presence of radiolucency (Nagelkerke R²). The Hosmer-Lemeshow test showed no evidence of a lack of fit (χ²(8) = 11.550,p = .172), supporting the model's adequacy. The model correctly classified 67.3% of cases, with a sensitivity of 54.5%, specificity of 75.4%, positive predictive value (PPV) of 58.3%, and negative predictive value (NPV) of 72.4%. Among the predictors, post presence was the only statistically significant variable (B = 1.300,p < .001,]OR = 3.670,95%CI[1.985-6.785]).

Conclusions: A higher prevalence of PRLs was noted among the ETT with IRPs. Within the limitations of this study, we recommend that clinicians should carefully weigh the risks and benefits of using IRPs during the restoration of ETT.