LAUSR

INTRODUCTION Radiography has played a fundamental role in the advancement of non-surgical root canal therapy (NSRCT), allowing for more accurate diagnosis and treatment. Typically, providers choose to perform NSRCT using periapical radiographs (PA) alone or, often in more difficult cases, in conjunction with cone-beam computed tomography (CBCT). This study aimed to evaluate the outcomes of NSRCT based on imaging modality selection for the initial treatment of maxillary first molars. METHODS A retrospective chart review was conducted using 1,385 cases of NSRCT on maxillary first molars. Charts were reviewed for patient demographics and treatment outcomes. Based on the imaging modality employed, patients were stratified into two groups (PA alone or PA + CBCT). Those who required additional treatment(s) after the completion of NSRCT were classified as having 'post-treatment disease'. Statistical analysis was performed to assess differences between groups. RESULTS After the completion of primary endodontic therapy, 5.8% (n=81) of the entire sample had post-treatment disease. CBCT was used in 13.4% (n=185) of NSRCTs. Although not significant, cases that were difficult enough to require the use of CBCT had a higher rate of post-treatment disease compared to those that could be completed with PA alone (8.6% vs. 5.4%) (P>0.05). Results from a multivariable logistic regression model showed that the need for CBCT had a non-significant positive association with post-treatment disease (P>0.05). CONCLUSIONS The decision to use CBCT appears to serve as a proxy for case complexity and the associated increase in risk of post-treatment disease. This is important to keep in mind when assessing treatment prognosis.