Faculdade de Odontologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil.
J Endod. 2010 Dec;36(12):1932-7. doi: 10.1016/j.joen.2010.08.050. Epub 2010 Oct 16.
The aim of this study was to radiographically evaluate the relationship between the quality parameters of root canal fillings (apical extension, homogeneity, and taper) and periapical status. In addition, groups of teeth and complicating factors of endodontic treatment were assessed.
This retrospective cohort study assessed the quality and periapical status of root-filled canals in a 4- to 7-year follow-up period. Each parameter was dichotomized into ideal and altered conditions. A root-filled canal with an ideal condition for all 3 parameters was considered perfect, whereas the loss of 1 or more ideal conditions defined satisfactory or deficient fillings, respectively. The periapical statuses at baseline and follow-up were classified as normal, slight widening of the apical periodontal ligament, or periapical lesion.
A total of 291 root-filled canals were evaluated. The prevalence of perfect, satisfactory, and deficient fillings was 54.6%, 37.5%, and 7.9%, respectively (P < .05). The periapical status at follow-up showed normal, slight widening of the apical periodontal ligament, or periapical lesion in 69.8%, 19.2%, and 11% of the roots, respectively (P < .05). The multivariate logistic regression showed that only preoperative periapical lesions (odds ratio, 2.99; 95% confidence interval, 1.27-7.03) and altered tapers (odds ratio, 3.73; 95% confidence interval, 1.51-9.24) were significantly associated with postoperative periapical lesions.
Radiographic parameters of the quality of root-filled canals showed a significant relationship with the periapical status. Nevertheless, an altered taper was the main factor associated with the maintenance or development of periapical lesions after 4- to 7-year follow-up period.
本研究旨在通过影像学评估根管充填质量参数（根尖延伸、均匀性和锥度）与根尖周状况之间的关系。此外，还评估了牙齿组别和根管治疗的复杂因素。
本回顾性队列研究在 4 至 7 年的随访期间评估了根管充填的质量和根尖周状况。每个参数均分为理想和改变两种情况。若所有 3 个参数均为理想状态，则认为该根管充填是完美的；若丧失 1 个或更多理想条件，则分别定义为满意或不足的充填。在基线和随访时，根尖周状况分为正常、根尖牙周膜轻微增宽或根尖病变。
共评估了 291 个根管充填。完美、满意和不足充填的发生率分别为 54.6%、37.5%和 7.9%（P<.05）。随访时根尖周状况分别为正常、根尖牙周膜轻微增宽和根尖病变的根分别占 69.8%、19.2%和 11%（P<.05）。多变量逻辑回归显示，仅术前根尖病变（比值比，2.99；95%置信区间，1.27-7.03）和改变锥度（比值比，3.73；95%置信区间，1.51-9.24）与术后根尖病变显著相关。
根管充填质量的影像学参数与根尖周状况有显著关系。然而，改变锥度是在 4 至 7 年随访后维持或发展根尖病变的主要因素。
