Huang X X, Fu M, Yan G Q, Hou B X
Department of Endodontics, Capital Medical University School of Stomatology, Beijing 100050, China.
Beijing Institute of Traumatology and Orthopaedics, Beijing 100035, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2018 Apr 9;53(4):243-247. doi: 10.3760/cma.j.issn.1002-0098.2018.04.006.
To investigate the association between the frequency and filling rate of lateral canals and the sealing quality in the apical third roots of the permanent teeth with failed endodontic treatments, so as to explore the failure factors of root canal therapy. Clinical records of the permanent teeth with failed endodontic treatments were collected from the Department of Endodontics, Capital Medical University School of Stomatology during a period of 2 years. The teeth were diagnosed as chronic apical periodontitis and then undergone endodontic microsurgery. The sealing quality of the apical root canal was observed by means of periapical radiographs. The surgical treatments were performed and the resected root apices were collected. The samples were scanned by micro-computed tomography and the 3D volume rendered images of the resected root apices were reconstructed. Moreover, the frequency and the filling rate of lateral canals in the apical third roots were calculated. The potential relationship between tooth position and the presence of lateral canals was evaluated. Totally 89 teeth with 89 root apices met the inclusion criteria and were included in the present study. The rate of correct-filling, underfilling and overfilling was 40% (36/89), 32% (28/89), and 28% (25/89), respectively, examined by periapical radiographs. Amongst all of the 89 samples, lateral canals were found in 44 samples. The incidence of apices with lateral canals was 49% (44/89). Furthermore, 3 out of 44 samples were fully filled with material in the lateral canals, and the rest 41 samples showed no filling materials. The filling rate of the lateral canals was 7% (3/44). However, no significant difference was detected between the tooth position and the presence of lateral canals (>0.05). The sealing quality of the apical third roots in permanent teeth with failed endodontic treatments was not good enough. The incidence of apices with lateral canals was high, but the filling rate of the canals was low. Further studies are needed to explore the relationship between lateral canals and the failure of endodontic treatment.
探讨根管治疗失败的恒牙根尖三分之一处侧支根管的发生率、充填率与根尖封闭质量之间的关系,以探寻根管治疗失败的因素。收集首都医科大学口腔医学院牙体牙髓科2年内根管治疗失败的恒牙临床记录。这些牙齿被诊断为慢性根尖周炎,随后接受根管显微外科手术。通过根尖X线片观察根尖根管的封闭质量。进行手术治疗并收集切除的根尖。对样本进行显微计算机断层扫描,并重建切除根尖的三维容积渲染图像。此外,计算根尖三分之一处侧支根管的发生率和充填率。评估牙位与侧支根管存在之间的潜在关系。共有89颗牙齿及其89个根尖符合纳入标准并被纳入本研究。通过根尖X线片检查,恰填、欠填和超填的比例分别为40%(36/89)、32%(28/89)和28%(25/89)。在所有89个样本中,44个样本发现有侧支根管。有侧支根管的根尖发生率为49%(44/89)。此外,44个样本中有3个侧支根管完全被材料充填,其余41个样本未显示有充填材料。侧支根管的充填率为7%(3/44)。然而,牙位与侧支根管的存在之间未检测到显著差异(>0.05)。根管治疗失败的恒牙根尖三分之一处的封闭质量不够好。有侧支根管的根尖发生率较高,但根管的充填率较低。需要进一步研究来探讨侧支根管与根管治疗失败之间的关系。