Faculty of Dentistry, Department of Endodontics, Estácio de Sá University, Rio de Janeiro, Brazil.
Private Oral Radiology Clinic, Rio de Janeiro, Brazil.
Int Endod J. 2019 Apr;52(4):400-406. doi: 10.1111/iej.13022. Epub 2018 Oct 30.
To evaluate the frequency of post-treatment apical periodontitis associated with root filled teeth with at least one untreated root canal.
Eight hundred and seven cone beam computed tomography images containing at least one root filled tooth were selected from a collection of 1543 images from Brazilian individuals. Scans were taken using ICAT Classic devices (Imaging Sciences, Hatfield, PA, USA) in a private oral radiology clinic from January to April 2015. All root filled teeth were analysed for the presence of missed canals and apical periodontitis. The chi-square and odds ratio tests were used to verify if there were an association and risk relationship between the occurrence of untreated canals and apical periodontitis.
A total of 2294 teeth with evidence of root fillings were identified. Two hundred and eighty-one teeth had at least one untreated missed canal (12%). The frequency of apical periodontitis in teeth with at least one untreated canal was significantly greater in comparison to teeth with all canals treated (274/281, 98% versus 1736/2013, 86%) (P < 0.01). The odds for apical periodontitis to be present was 6.25 times greater for teeth with an untreated canal. The mesiobuccal roots of maxillary first molars had the greatest frequency of untreated canals (114/154, 74%), with the second mesiobuccal canal being the most frequently missed (n = 106/114, 93%).
Root filled teeth with at least one missed canal had a high prevalence of post-treatment apical periodontitis.
评估至少有一个未治疗根管的根管治疗后根尖周炎的发生频率。
从巴西个体的 1543 张图像中选择了 807 张锥形束计算机断层扫描图像,这些图像至少包含一颗已填充的牙齿。扫描是在 2015 年 1 月至 4 月期间在一家私人口腔放射科诊所使用 ICAT Classic 设备(Imaging Sciences,Hatfield,PA,USA)进行的。所有已填充的牙齿均进行了是否存在遗漏根管和根尖周炎的分析。使用卡方检验和优势比检验来验证未治疗根管的发生与根尖周炎之间是否存在关联和风险关系。
共发现 2294 颗有根充证据的牙齿。有 281 颗牙齿至少有一个未治疗的遗漏根管(12%)。与所有根管均治疗的牙齿相比,至少有一个未治疗遗漏根管的牙齿发生根尖周炎的频率明显更高(281/281,98%比 1736/2013,86%)(P<0.01)。有未治疗根管的牙齿发生根尖周炎的可能性是所有根管均治疗的牙齿的 6.25 倍。上颌第一磨牙的近中颊根有最高的未治疗根管发生率(114/154,74%),其中第二近中颊根管是最常遗漏的(n=106/114,93%)。
至少有一个遗漏根管的根充牙齿有很高的治疗后根尖周炎的患病率。