Central Interdisciplinary Ambulance in the School of Dentistry, Albert-Schweitzer-Campus 1, Building W 30, 48149, Münster, Germany.
Dental Clinic Bochum, Bergstraße 28, 44791, Bochum, Germany.
Clin Oral Investig. 2020 Mar;24(3):1217-1227. doi: 10.1007/s00784-019-02985-y. Epub 2019 Jul 15.
The aim of this study was to determine the frequency and quality of root canal fillings (RCF) and the prevalence of apical radiolucency (AR) in a German population.
Five hundred randomly selected full-size CBCT images (Planmeca ProMax 3D, FOV = 8 × 8 cm, voxel size 160 μm or 200 μm) were obtained from German patients (40.6% = ♂; 59.4% = ♀; mean age = 50.21 ± 12.45 years). A total of 8254 teeth were examined for pathology (AR, widened periodontal ligament). The relationship between AR and existing RCF and the quality of RCF were documented. Frequency and correlations between the left and right sides and gender distribution were analyzed statistically using the chi-square test.
The overall prevalence of AR was 3.8%, whereas for teeth with RCF, it was 42.5%. Patients had approximately 1.4 root canal-filled teeth (8.2% of all teeth). RCF terminated more than 2 mm short of the radiological apex in 31.2%, 5.1% reached beyond the apex, 8.1% were associated with extruded sealer, and 5.3% presented untreated root canals. Odds ratio of having an AR was highest in teeth with RCF beyond the apex (OR = 27.0) followed by RCF <2 mm short of the apex (OR = 4.4), untreated root canals (OR = 2.9), and inhomogeneity of RCF (OR = 1.2). Extrusion of sealer was least associated with AR. Molars were most frequently associated with AR (P < 0.05). Root canal-filled teeth showed significantly more AR in men compared with women (P < 0.05).
About 42.5% of root canal-filled teeth were associated with AR, and in about one-third of these teeth, the RCF terminated more than 2 mm short of the apex.
Each step in root canal therapy influences treatment outcome and prevalence of periapical radiolucencies. Determination of the working length is still one of the key points to achieve predictable periapical healing, and homogenous root canal filling reaching the foramen major seems to be essential.
本研究旨在确定德国人群中根管充填（RCF）的频率和质量以及根尖放射性透亮区（AR）的发生率。
从德国患者中获取了 500 张随机选择的全尺寸 CBCT 图像（Planmeca ProMax 3D，FOV=8×8cm，体素大小 160μm 或 200μm）（40.6%=♂；59.4%=♀；平均年龄=50.21±12.45 岁）。共检查了 8254 颗牙齿的病理情况（AR，牙周膜增宽）。记录 AR 与现有的 RCF 以及 RCF 质量之间的关系。使用卡方检验对左侧和右侧以及性别分布之间的频率和相关性进行了统计学分析。
总的 AR 发生率为 3.8%，而对于有 RCF 的牙齿，其发生率为 42.5%。患者大约有 1.4 颗根管填充的牙齿（占所有牙齿的 8.2%）。RCF 在根尖 2mm 以内终止的比例为 31.2%，超出根尖的比例为 5.1%，与挤出的密封剂相关的比例为 8.1%，未处理的根管比例为 5.3%。在根尖以上有 AR 的牙齿中，OR 值最高（OR=27.0），其次是根尖 2mm 以内的 RCF（OR=4.4）、未处理的根管（OR=2.9）和 RCF 不均匀（OR=1.2）。密封剂挤出与 AR 的相关性最小。磨牙与 AR 的相关性最高（P<0.05）。与女性相比，根管填充的牙齿在男性中 AR 发生率显著更高（P<0.05）。
约 42.5%的根管填充的牙齿与 AR 相关，在这些牙齿中，大约有三分之一的 RCF 在根尖 2mm 以外终止。
根管治疗的每一步都影响治疗效果和根尖放射性透亮区的发生率。确定工作长度仍然是实现可预测的根尖愈合的关键点之一，并且到达主根管的均匀根管填充似乎是必不可少的。
