Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, Sao Paulo, 13414-903, Brazil.
Clin Oral Investig. 2018 Sep;22(7):2495-2503. doi: 10.1007/s00784-018-2344-y. Epub 2018 Jan 21.
The aims of this study are to identify the most frequent technical errors in endodontically treated teeth and to determine which root canals were most often associated with those errors, as well as to relate endodontic technical errors and the presence of coronal restorations with periapical status by means of cone-beam computed tomography images.
Six hundred eighteen endodontically treated teeth (1146 root canals) were evaluated for the quality of their endodontic treatment and for the presence of coronal restorations and periapical lesions. Each root canal was classified according to dental groups, and the endodontic technical errors were recorded. Chi-square's test and descriptive analyses were performed.
Six hundred eighty root canals (59.3%) had periapical lesions. Maxillary molars and anterior teeth showed higher prevalence of periapical lesions (p < 0.05). Endodontic treatment quality and coronal restoration were associated with periapical status (p < 0.05). Underfilling was the most frequent technical error in all root canals, except for the second mesiobuccal root canal of maxillary molars and the distobuccal root canal of mandibular molars, which were non-filled in 78.4 and 30% of the cases, respectively.
There is a high prevalence of apical radiolucencies, which increased in the presence of poor coronal restorations, endodontic technical errors, and when both conditions were concomitant. Underfilling was the most frequent technical error, followed by non-homogeneous and non-filled canals.
Evaluation of endodontic treatment quality that considers every single root canal aims on warning dental practitioners of the prevalence of technical errors that could be avoided with careful treatment planning and execution.
本研究旨在确定根管治疗牙中最常见的技术错误，并确定哪些根管最常与这些错误相关，同时通过锥形束计算机断层扫描图像将根管治疗技术错误与冠部修复及根尖周状况联系起来。
评估了 618 颗根管治疗牙（1146 个根管）的根管治疗质量、冠部修复情况和根尖周病变情况。根据牙位将每个根管分类，并记录根管治疗技术错误。采用卡方检验和描述性分析。
680 个根管（59.3%）有根尖周病变。上颌磨牙和前牙的根尖周病变发生率更高（p<0.05）。根管治疗质量和冠部修复与根尖周状况相关（p<0.05）。除上颌磨牙第二近中颊根和下颌磨牙远中颊根外，所有根管均存在欠充，其中分别有 78.4%和 30%的根管未充填。
根尖周存在明显的放射性透亮区，当存在不良冠部修复、根管治疗技术错误且两种情况同时存在时，病变发生率增加。欠充是最常见的技术错误，其次是非均质性和未充填的根管。
评估根管治疗质量时，考虑每个根管的情况，可以提醒牙医注意那些通过仔细的治疗计划和执行可以避免的技术错误的发生率。
