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A single operator performed standardized multi\u2010visit RCT. Patients were clinically and radiographically examined at 6, 12\u00a0months, and a CBCT scan was taken at 24\u2009months. Two independent blinded evaluators measured the pre\u2010 and postoperative volume of periapical lesions on CBCT scans using ITK snap software (version 3.8.0\u2010beta\u201020181028\u2010win64). The outcome was assessed as a percentage change in lesion volume and dichotomized as success (resolved\/reduced) or failure (unchanged\/enlarged). Ten preoperative (gender; age; intraoral draining sinus, soft tissue swelling, tooth discoloration, pulp canal obliteration, open apex, root resorption, cortical bone defect and lesion volume) and four intraoperative (apical extent and density of root filling; number of treatment visits and type of root filling) predictive factors were observed. Bivariate and stepwise multivariable linear regression analysis was performed to identify independent predictors affecting treatment outcomes. The significance level was set at 5%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A recall rate of 88% was achieved. The success rate of RCT was 82.2% (8.9% resolved, 73.3% reduced). Median lesion volume reduction was 75% (IQR 61%\u201393%). No pre\u2010 or intra\u2010operative factors were related to treatment failure. However, presence of preoperative cortical bone defect (palatal versus no cortical defect, <jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u221251.5; 95% CI: \u221286.9 to \u221216, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.006) and apical extent of obturation (long versus flush, <jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u221227.2; 95% CI: \u221253.8 to \u22120.6, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.04) were negatively associated with reduction in lesion volume (%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Large cyst\u2010like periapical lesions may be successfully managed with RCT. Preoperative cortical bone defect and apical extent of obturation may negatively influence osseous healing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iej.13860","type":"journal-article","created":{"date-parts":[[2022,10,30]],"date-time":"2022-10-30T13:59:31Z","timestamp":1667138371000},"page":"146-163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Outcome and associated predictors for nonsurgical management of large cyst\u2010like periapical lesions: A CBCT\u2010based prospective cohort study"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6989-698X","authenticated-orcid":false,"given":"Aakriti","family":"Saini","sequence":"first","affiliation":[{"name":"Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research All India Institute of Medical Sciences  New Delhi 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