Moura Marcelo Sampaio, Guedes Orlando Aguirre, De Alencar Ana Helena Gonçalves, Azevedo Bruno Correa, Estrela Carlos
Department of Endodontics, Brazilian Dental Association, Brasília, DF, Brazil.
J Endod. 2009 Jun;35(6):805-9. doi: 10.1016/j.joen.2009.03.013.
The verification of the best length of root canal instrumentation and obturation still is controversial theme in endodontics. The purpose of this study was to determine the influence of length of root canal obturation on apical periodontitis (AP) detected by periapical radiography and cone beam computed tomography (CBCT).
A total of 503 root canal obturations were evaluated by using periapical radiography and CBCT. Distances from the radiographic apex to the tip of filling material were measured and classified as close to 2 mm, 1 mm short or beyond apex, and at the apex. Obturations at the apex were associated with AP. Odds ratio, confidence intervals, and chi(2) test were used for statistical analyses.
Periapical radiographs showed that root canal obturations were 1-2 mm short of the apex in 88%, 89.3%, and 95% of the anterior teeth, premolars, and molars, respectively. CBCT images showed obturations had the same length in 70%, 73.7%, and 79% of anterior teeth, premolars, and molars, respectively. The frequency of AP was significantly greater in molars than in the other tooth groups, regardless of diagnostic method. AP was detected more frequently when CBCT was used.
AP was detected at all lengths of root canal obturation. The analyses of diagnostic methods showed that AP was detected more frequently when CBCT was used.
根管预备和充填的最佳长度的确定在牙髓病学中仍然是一个有争议的话题。本研究的目的是确定根管充填长度对根尖周炎（AP）的影响，根尖周炎通过根尖片和锥形束计算机断层扫描（CBCT）进行检测。
通过根尖片和CBCT对总共503例根管充填进行评估。测量从影像学根尖到充填材料尖端的距离，并分类为接近2mm、短于根尖1mm或超出根尖以及位于根尖处。根尖处的充填与根尖周炎相关。使用比值比、置信区间和卡方检验进行统计分析。
根尖片显示，在前牙、前磨牙和磨牙中，分别有88%、89.3%和95%的根管充填短于根尖1 - 2mm。CBCT图像显示，在前牙、前磨牙和磨牙中，分别有70%、73.7%和79%的充填长度相同。无论诊断方法如何，磨牙中根尖周炎的发生率均显著高于其他牙组。使用CBCT时，根尖周炎的检出频率更高。
在所有根管充填长度下均检测到根尖周炎。对诊断方法的分析表明，使用CBCT时根尖周炎的检出频率更高。
