Private Practice Allerød, Allerød, Denmark.
Section of Cariology & Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Int Endod J. 2019 May;52(5):559-568. doi: 10.1111/iej.13038. Epub 2018 Nov 26.
To report the precision of guided access cavity preparations in relation to demographical and dental variables in 50 patients.
This observational study was carried out during the period 2014-2017. The patients were consecutive referrals to a private endodontic practice. The inclusion criteria were as follows: (i) pulp space obliteration associated with signs of apical periodontitis (PAI score >3 or sensitive to percussion, (ii) teeth with pulp space obliteration in need of a post, where the referring dentist had attempted or failed to negotiate the obliterated root canal (and it was not possible to negotiate using the operating microscope within a reasonable time frame) and (iii) a surgical intervention was not justified. A published methodology for guided endodontics was used. Measures on demographical and previous dental history were analysed and related to drill path precision, being evaluated on radiographs as optimal (centre of the root canal) or acceptable (peripheral/tangential). The chi-square test was used for analyses of correlation between predictor variables and binary logistic regression analysis using backward elimination with degree of obliteration, guided access cavity preparation depth and precision as dependent variables. Significance level was 0.05.
Thirty-one female (median age 65 year) and 19 males (median age 69 year) were enrolled. Overall, 88% (n = 44) of the teeth had pulp space obliteration associated with signs of apical periodontitis, whereas the remaining teeth were in need of a post. The pulp space obliterations were longer in maxillary compared with mandibular teeth (P = 0.024). The performance of the drill path in mandibular teeth versus maxillary teeth resulted in a significantly greater number of optimal precision scores (P = 0.033), and when a previous attempt at access and canal negotiation had occurred versus no attempt (P = 0.009). Even in cases with the worst outcome, the technique was still successful clinically.
The clinical implementation of guided root canal treatment in fifty serial cases of single-rooted teeth with pulp space obliteration was associated with a precision that in all cases led to the location and negotiation of the root canal and completion of the treatment.
报告 50 例患者中与人口统计学和牙科变量相关的引导式入口腔预备的精确性。
本观察性研究于 2014 年至 2017 年进行。患者为一家私人牙髓病学诊所的连续转诊患者。纳入标准如下：（i）牙髓腔闭塞伴根尖周病迹象（PAI 评分>3 或叩诊敏感），（ii）需要桩核修复的牙髓腔闭塞牙，而转诊牙医曾试图或未能预备闭塞的根管（并且在合理的时间内不可能使用手术显微镜进行预备），（iii）不需要手术干预。使用已发表的引导牙髓病学方法。分析人口统计学和既往牙科史的相关测量值，并将其与钻路精度相关联，在影像学上评估为最佳（根管中心）或可接受（周边/切线）。使用卡方检验分析预测变量与二项逻辑回归分析之间的相关性，使用向后消除法，以闭塞程度、引导入口腔预备深度和精度为因变量。显著性水平为 0.05。
共纳入 31 名女性（中位年龄 65 岁）和 19 名男性（中位年龄 69 岁）。总体而言，88%（n=44）的牙齿伴有牙髓腔闭塞和根尖周病迹象，而其余牙齿需要桩核修复。上颌牙齿的牙髓腔闭塞长度长于下颌牙齿（P=0.024）。与上颌牙齿相比，下颌牙齿的钻路性能导致更多的最佳精度评分（P=0.033），并且在有先前尝试进入和根管预备与无尝试的情况下（P=0.009）。即使在预后最差的情况下，该技术在临床上仍然成功。
在 50 例伴有牙髓腔闭塞的单根牙连续病例中实施引导根管治疗的临床应用与精确性相关，所有病例均导致根管的定位和预备以及治疗的完成。
