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Endodontic treatment can be a great challenge, because it tries to eliminate vital or necrotic pulp tissue, disinfect the root canal system as much as possible. Aim. Written report of a clinical case of two infected and necrotic teeth. Materials and methods. Periapical diagnoses are related to an inflammatory defense response to different types of irritants and mechanical, thermal, or chemical stimuli that can lead to pulpal necrosis and subsequent periapical injury if prompt treatment is not received. Results. Once the treatment has been carried out, the resolution of the periapical lesion depends on various factors that will make it possible to determine the evolution and effectiveness of the treatment carried out. Conclusion. The adequate treatment and cleaning of the infected ducts allows to resolve and heal the infected areas and thus preserve the teeth for longer., El tratamiento endodóntico puede ser un gran desafío, porque trata de eliminar el tejido pulpar vital o necrótico, desinfectar lo mejor posible el sistema de conductos. Objetivo. Relato escrito de un caso clínico de dos dientes infectados y necrosados. Materiales y Métodos. Los diagnósticos periapicales están relacionados con una respuesta inflamatoria de defensa ante diferentes tipos de irritantes y estímulos mecánicos, térmicos o químicos que pueden llegar a desencadenar una necrosis pulpar y la subsecuente lesión periapical si no recibe tratamiento oportuno. Resultados. Una vez realizado el tratamiento la resolución de la lesión periapical depende de diversos factores que permitirán determinar la evolución y la efectividad del tratamiento realizado. Conclusión. El adecuado tratamiento y limpieza de los conductos infectados permite resolver y sanar las zonas infectadas y de esa manera conservar los dientes por más tiempo.

Aim: Cone beam computed tomography (CBCT) is the most refined and affordable method available today for the examination of an incoming patient for different dental pathologies. The aim of this paper is to evaluate the significance of some factors influencing the prevalence of apical periodontitis. Materials and methods: An ortopantomography (OPT) and CBCT scan of the dental arches were examined for each of the selected 45 patients. The presence of apical periodontitis (AP) was compared for CBCT and OPT examination. Sensitivity, specificity, predictive values, and accuracy were calculated for CBCT, using OPT as a reference. The impact of protective/risk factors on the development of AP was examined. Results: CBCT showed higher sensitivity (250%), predictive values (111%), accuracy (111%), and specificity (101%) than OPT. It was found to have higher sensitivity in all the dentition areas, especially where empty anatomical spaces or more radiotransparent structures have a strict relationship with the tooth apex and periapical structures like upper front area, premolar areas, and, especially, in the upper molar area. The prevalence of AP increased from 16 to 17% in the case of insufficient conservative restoration or 25% in the case of microleakage, 35-42% in the case of prosthetic restoration, 56-67% for posts, and 60 and 85%, respectively, for inadequate endodontic treatment and missed canals. Conclusion: CBCT plays a decisive role in the evaluation of molar areas and in the endodontic treatment planning, when a close relationship between the apex and important anatomical structures exists. Different risk factors with different relevance are identified. Clinical significance: As CBCT-examined results show, coronal restorations are moderate-risk factors, while insufficient endodontic treatments and posts are high-risk factors for the development of AP.

Aim: Cone beam computed tomography (CBCT) is the most refined and affordable method available today for the examination of an incoming patient for different dental pathologies. The aim of this paper is to evaluate the significance of some factors influencing the prevalence of apical periodontitis. Materials and methods: An ortopantomography (OPT) and CBCT scan of the dental arches were examined for each of the selected 45 patients. The presence of apical periodontitis (AP) was compared for CBCT and OPT examination. Sensitivity, specificity, predictive values, and accuracy were calculated for CBCT, using OPT as a reference. The impact of protective/risk factors on the development of AP was examined. Results: CBCT showed higher sensitivity (250%), predictive values (111%), accuracy (111%), and specificity (101%) than OPT. It was found to have higher sensitivity in all the dentition areas, especially where empty anatomical spaces or more radiotransparent structures have a strict relationship with the tooth apex and periapical structures like upper front area, premolar areas, and, especially, in the upper molar area. The prevalence of AP increased from 16 to 17% in the case of insufficient conservative restoration or 25% in the case of microleakage, 35-42% in the case of prosthetic restoration, 56-67% for posts, and 60 and 85%, respectively, for inadequate endodontic treatment and missed canals. Conclusion: CBCT plays a decisive role in the evaluation of molar areas and in the endodontic treatment planning, when a close relationship between the apex and important anatomical structures exists. Different risk factors with different relevance are identified. Clinical significance: As CBCT-examined results show, coronal restorations are moderate-risk factors, while insufficient endodontic treatments and posts are high-risk factors for the development of AP.