(PO100) A Retrospective Analysis of Teeth with Carrier-Based Obturation Requiring Endodontic Retreatment

Abstract: Due to the popularity of carrier-based obturation (CBO) systems, the ability to identify such cases is crucial when considering endodontic retreatment. Literature exists regarding CBO's inability to fill the root canal system completely. However, little research has been conducted related to the clinician's ability to identify CBO cases based on radiographic presentation. The purpose of this study was to determine interobserver and intraobserver reliability in detecting carriers using preoperative radiographs. A chart review was conducted for patients seen at the VCU graduate endodontic clinic. Eligible cases included previously treated teeth that were nonsurgically retreated, with and without identified carriers. A total of 150 cases were identified, including 75 carrier and 75 non-carrier cases. Preoperative radiographs were randomized, and evaluators assessed each case for the presence of CBO, with a repeat assessment two months later. Evaluators included three endodontists, three general dentists, and four endodontic residents. Statistical analysis was performed to assess the accuracy, as well as inter- and intraobserver reliability, of detecting CBO radiographically. There were no statistically significant associations between radiographic presentation and the clinician's ability to identify CBO. Interobserver and intraobserver reliabilities were low, with no differences across evaluators. Evaluators reported three radiographic factors in their identification of carriers: thin apical fill, voids in obturation, and linear radiopacity in the pulp chamber. While certain radiographic features may be predictive of CBO, the present study found no direct correlation between radiographic presentation and the clinician's ability to accurately detect the presence of carriers.