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The aim of this paper is to compare the detection rate of chronic periapical lesions using radiographic exam and CBCT. Materials and methodsThe study group included 12 patients with 30 teeth with root canal fillings (aged at least 24 months). An assessment of the periapical status was performed using radiographic exam (ortopantomograph) and CBCT. The recorded data were compared to determine periapical lesions detection accuracy related to dental group, the type and extension of periapical lesions. ResultsThe detection rate of incipient periapical lesions for teeth with old root canal fillings is higher for CBCT (17%) compared with radiographic exam (10%). In the case of the extended periapical lesions, the detection rate is similar for radiography and CBCT (44%). ConclusionCBCT can be recommended in clinical situations of teeth treated endodonticallyor pulp necrotic untreated teeth associated with mild periapical symptoms and the failure of radiographic exam to detect the presence of periapical lesion.