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前磨牙根管形态及其与根管治疗技术失误的关系:CBCT 分析。

Root canal configuration and its relation with endodontic technical errors in premolar teeth: a CBCT analysis.

机构信息

Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba.

Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil.

出版信息

Int Endod J. 2019 Oct;52(10):1410-1416. doi: 10.1111/iej.13158. Epub 2019 Jun 14.

Abstract

AIM

To evaluate the association between endodontic technical errors and the root canal configuration (RCC) of human premolars, as well as their relationship with periapical lesions through cone-beam computed tomography (CBCT) images.

METHODOLOGY

The sample consisted of CBCT scans belonging to 136 patients, totalling 152 root filled premolars (185 roots). CBCT images were evaluated by two oral radiologists. RCC was recorded according to Vertucci's classification, and the endodontic treatment quality was judged on the presence and type of technical endodontic errors (underfilling, overfilling, nonhomogeneous filling, nonfilled canal, fractured instruments, root deviation and absence of coronal restoration). In addition, the presence of periapical lesions associated with each RCC was recorded. Data were expressed by frequencies and percentages, and intraobserver agreement was calculated using the Kappa test.

RESULTS

The most common RCC was type I (71%), followed by type IV (15%), type II (8%), type V (3%), type VI (1%) and type III (1%). Types VII and VIII were not observed in the sample. Underfilling was the most frequent endodontic technical error for most RCCs, except for types IV, V and 'other', whose most frequent error was a nonfilled canal. The presence of technical errors was greater with an increase in the proportion of the periapical lesions. The intraobserver agreement was excellent.

CONCLUSIONS

There was an increase in the prevalence of endodontic technical errors and in the presence of periapical lesions as the anatomical complexity of the root canals increased. Underfilled and nonfilled canal were the most frequent endodontic technical errors.

摘要

目的

通过锥形束计算机断层扫描(CBCT)图像评估人前磨牙的根管形态(RCC)与根管内技术操作失误之间的关系,以及它们与根尖病变之间的关系。

方法

该样本由属于 136 名患者的 152 个根充前磨牙(185 个根管)的 CBCT 扫描组成。由两名口腔放射科医生对 CBCT 图像进行评估。根据 Vertucci 分类记录 RCC,根据是否存在和类型判断根管内技术操作失误(欠填、超填、不均匀填、未填根管、器械折断、根管偏移和无冠部修复)。此外,还记录了与每种 RCC 相关的根尖病变的存在情况。数据以频率和百分比表示,采用 Kappa 检验计算观察者间一致性。

结果

最常见的 RCC 是 I 型(71%),其次是 IV 型(15%)、II 型(8%)、V 型(3%)、VI 型(1%)和 III 型(1%)。样本中未观察到 VII 型和 VIII 型。除了 IV 型、V 型和“其他”型,大多数 RCC 最常见的根管内技术操作失误是欠填,而其他 RCC 最常见的根管内技术操作失误是未填根管。随着根尖病变比例的增加,技术失误的存在也随之增加。观察者间一致性极好。

结论

随着根管解剖结构复杂性的增加,根管内技术操作失误和根尖病变的发生率也随之增加。欠填和未填根管是最常见的根管内技术操作失误。

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