Radiographic Evaluation Of The Success Of Root Canal Treatment In Mandibular Premolars: A Retrospective Cross-Sectional Study

Damla Erkal; Yunus Emre Çakmak; Maira Kopbayeva; Kürşat Er

doi:10.65022/clindentres.1893438

Radiographic Evaluation Of The Success Of Root Canal Treatment In Mandibular Premolars: A Retrospective Cross-Sectional Study

Abstract

Background and Aim: Radiographic assessment is essential for evaluating the technical quality of root canal fillings and periapical status after root canal treatment (RCT). This retrospective crosssectional study assessed the radiographic quality of RCT in mandibular premolars using panoramic radiographs and investigated the association between root canal filling quality and periapical lesions. Materials and Methods: Archived digital panoramic radiographs were screened, and 205 radiographs (261 mandibular premolars: 34, 35, 44, 45) were included. Two experienced endodontists independently assessed filling length (adequate: 0-2 mm from radiographic apex; short: >2 mm short; overextended: beyond apex), homogeneity, periapical status (lesion absent/present), and iatrogenic errors. A favorable radiographic outcome required adequate length, homogeneous obturation, no periapical radiolucency, and no iatrogenic errors. Interobserver agreement was calculated using Cohen’s kappa. Multivariable logistic regression with cluster-robust standard errors identified predictors of periapical lesion presence. Results: Overall, 59% of teeth met the predefined radiographic criteria. Periapical lesions were present in 26.1% of teeth. In adjusted analyses, short fillings were strongly associated with lesion presence (P < 0.001), and iatrogenic errors were also significant (p = 0.015). Tooth 35 showed higher odds than tooth 34 (p = 0.003). Inhomogeneous fillings showed a non-significant trend (aOR = 2.27; p = 0.072), while overextension was not associated (p = 0.327). Sensitivity analysis was consistent and additionally supported filling homogeneity as significant (p = 0.036). Conclusion: In mandibular premolars evaluated on panoramic radiographs, 59% of teeth met the predefined radiographic criteria. Short filling and iatrogenic errors were independent predictors of post-treatment periapical lesions, highlighting the importance of accurate working length control and meticulous technique.

Keywords

Ethical Statement

This study was approved by the Institutional Clinical Research Ethics Committee (Approval No: GO 2026/2644). The study was conducted in accordance with the Declaration of Helsinki and institutional regulations. The data were collected retrospectively from anonymized archived radiographs, and no patient-identifiable information was used.

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Details

Primary Language

English

Subjects

Endodontics

Journal Section

Research Article

Authors

Damla Erkal ^*
0000-0001-8319-6974
Türkiye

Yunus Emre Çakmak
0009-0003-4953-3772
Türkiye

Maira Kopbayeva
0000-0002-7439-5573
Kazakhstan

Kürşat Er
0000-0002-0667-4909
Türkiye

Publication Date

August 24, 2026

Submission Date

February 19, 2026

Acceptance Date

April 21, 2026

Published in Issue

Year 2026 Volume: 50 Number: 2

DOI

https://doi.org/10.65022/clindentres.1893438

IZ

https://izlik.org/JA72TM62EC

Cite

RIS / Bibtex

APA

Erkal, D., Çakmak, Y. E., Kopbayeva, M., & Er, K. (2026). Radiographic Evaluation Of The Success Of Root Canal Treatment In Mandibular Premolars: A Retrospective Cross-Sectional Study. Clinical Dentistry and Research, 50(2), 160-170. https://doi.org/10.65022/clindentres.1893438

AMA

1.Erkal D, Çakmak YE, Kopbayeva M, Er K. Radiographic Evaluation Of The Success Of Root Canal Treatment In Mandibular Premolars: A Retrospective Cross-Sectional Study. Clin Dent Res. 2026;50(2):160-170. doi:10.65022/clindentres.1893438

Chicago

Erkal, Damla, Yunus Emre Çakmak, Maira Kopbayeva, and Kürşat Er. 2026. “Radiographic Evaluation Of The Success Of Root Canal Treatment In Mandibular Premolars: A Retrospective Cross-Sectional Study”. Clinical Dentistry and Research 50 (2): 160-70. https://doi.org/10.65022/clindentres.1893438.

EndNote

Erkal D, Çakmak YE, Kopbayeva M, Er K (August 1, 2026) Radiographic Evaluation Of The Success Of Root Canal Treatment In Mandibular Premolars: A Retrospective Cross-Sectional Study. Clinical Dentistry and Research 50 2 160–170.

IEEE

[1]D. Erkal, Y. E. Çakmak, M. Kopbayeva, and K. Er, “Radiographic Evaluation Of The Success Of Root Canal Treatment In Mandibular Premolars: A Retrospective Cross-Sectional Study”, Clin Dent Res, vol. 50, no. 2, pp. 160–170, Aug. 2026, doi: 10.65022/clindentres.1893438.

ISNAD

Erkal, Damla - Çakmak, Yunus Emre - Kopbayeva, Maira - Er, Kürşat. “Radiographic Evaluation Of The Success Of Root Canal Treatment In Mandibular Premolars: A Retrospective Cross-Sectional Study”. Clinical Dentistry and Research 50/2 (August 1, 2026): 160-170. https://doi.org/10.65022/clindentres.1893438.

JAMA

1.Erkal D, Çakmak YE, Kopbayeva M, Er K. Radiographic Evaluation Of The Success Of Root Canal Treatment In Mandibular Premolars: A Retrospective Cross-Sectional Study. Clin Dent Res. 2026;50:160–170.

MLA

Erkal, Damla, et al. “Radiographic Evaluation Of The Success Of Root Canal Treatment In Mandibular Premolars: A Retrospective Cross-Sectional Study”. Clinical Dentistry and Research, vol. 50, no. 2, Aug. 2026, pp. 160-7, doi:10.65022/clindentres.1893438.

Vancouver

1.Damla Erkal, Yunus Emre Çakmak, Maira Kopbayeva, Kürşat Er. Radiographic Evaluation Of The Success Of Root Canal Treatment In Mandibular Premolars: A Retrospective Cross-Sectional Study. Clin Dent Res. 2026 Aug. 1;50(2):160-7. doi:10.65022/clindentres.1893438