Ultrasound examination with color power Doppler to assess the early response of apical periodontitis to the endodontic treatment

Objectives: The purpose of this study was to assess the possibility to detect early vascular changes in apical periodontitis (AP) using ultrasound examination with color power Doppler (US-CPD) and to establish a correlation between the early response of AP to treatment and its potential healing. Materials and methods: Twenty-one apical lesions were visualized with US-CPD before endodontic treatment, 1 week after the first access to endodontic system and 4 weeks after root canal obturation. A differential diagnosis between cystic lesions (CLs) and granulomatous lesions (GLs) was attempted. The vascular modifications were then correlated with long-term radiographic follow-up using Fisher’s exact test. Results: The decrease or disappearance of vascular flow observed in AP 4 weeks after root canal obturation was significantly related to a healing trend (p = 0.0206) of the lesions. Combining the data with preoperative US-CPD diagnosis showed a reproducibility for GLs only (p = 0.0022). Conclusions: This study showed the possibility to detect early vascular changes in AP using US-CPD, correlating them with a healing trend after endodontic treatment. Future investigations should be conducted and more attention should be dedicated to the potential of this alternative and biologically safe imaging technique. Clinical relevance: US-CPD in endodontics may be a helpful tool to identify healing processes after endodontic treatment and to understand the behavior of different forms of AP.