Department of Endodontics, UNC School of Dentistry, Chapel Hill, North Carolina.
Department of Endodontics, UNC School of Dentistry, Chapel Hill, North Carolina.
J Endod. 2018 Oct;44(10):1487-1491. doi: 10.1016/j.joen.2018.06.018. Epub 2018 Aug 31.
This microsurgical clinical study evaluated if teeth that have undergone endodontic retreatment are associated with more dentinal defects than primary root canal-treated teeth.
One hundred fifty-five patients who underwent periapical microsurgery treatment in a private practice setting were evaluated. The root ends were resected, and the roots were inspected for the presence of dentinal defects through the surgical operating microscope with the help of a 0.8-mm-diameter light-emitting diode probe light and methylene blue dye. The root canal treatment history (primary vs retreatment) of the teeth was documented and related to the presence or absence of dentinal defects. Bivariate analysis was performed using the chi-square test, and a multivariate analysis was performed using logistic regression to evaluate possible confounding effects of patient age, sex, and tooth location on the association between treatment and the presence of dentinal defects.
Of the 155 treated teeth, 33 were excluded (3 fractured and 30 missing treatment history). Of the remaining 122 included teeth, 73 (59.8%) had undergone primary root canal treatment and 49 (40.2%) retreatment. Sixteen teeth (22.5%) of the primary root canal group versus 33 (64.7%) of the retreatment group had dentinal defects. The proportion of retreated teeth with dentinal defects compared with primary treatment was statistically significant (P < .001) with a higher proportion of retreated teeth having dentinal defects. In the multivariate analysis, only the type of treatment was statistically significant (P < .001).
This clinical study showed that root canal-retreated teeth are associated with more dentinal defects than primary root canal-treated teeth.
本显微临床研究评估了经过根管再治疗的牙齿是否比初次根管治疗的牙齿更容易出现牙本质缺损。
评估了在一家私人诊所接受根尖显微手术治疗的 155 名患者。切除根尖末端,在手术显微镜下借助直径为 0.8 毫米的发光二极管探头光和亚甲蓝染料检查根是否存在牙本质缺损。记录牙齿的根管治疗史(初次治疗与再治疗),并将其与牙本质缺损的存在情况相关联。使用卡方检验进行双变量分析,使用逻辑回归进行多变量分析,以评估患者年龄、性别和牙齿位置对治疗与牙本质缺损之间关联的可能混杂影响。
在 155 颗治疗的牙齿中,有 33 颗(3 颗折断和 30 颗缺失治疗史)被排除在外。在剩余的 122 颗纳入的牙齿中,73 颗(59.8%)接受了初次根管治疗,49 颗(40.2%)接受了再治疗。初次根管治疗组的 16 颗牙齿(22.5%)与再治疗组的 33 颗牙齿(64.7%)有牙本质缺损。与初次治疗相比,再治疗的牙齿有牙本质缺损的比例具有统计学意义(P<0.001),再治疗的牙齿有牙本质缺损的比例更高。在多变量分析中,只有治疗类型具有统计学意义(P<0.001)。
本临床研究表明,根管再治疗的牙齿比初次根管治疗的牙齿更容易出现牙本质缺损。