School of Dentistry, Basic Sciences Department, Endodontics Postgraduate Program Director. Research Group INVENDO, Universidad Nacional de Colombia, Carrera 45#26-85, 111111, Bogotá, Colombia.
Research Group INVENDO, Basic Sciences and Oral Medicine Department, School of Dentistry, Universidad Nacional de Colombia, Bogotá, Colombia.
Odontology. 2020 Oct;108(4):697-703. doi: 10.1007/s10266-020-00494-z. Epub 2020 Feb 20.
To assess the previous periapical status and the quality of root canal filling as predictors of the outcome in initial non-surgical endodontic procedures. A retrospective cohort study was designed in which the presence of a previous periapical lesion was determined radiographically. The quality of the root filling was evaluated in terms of homogeneity, taper, and apical extension. The response variable was dichotomized to success and failure. Bivariate analyzes and a mixed generalized linear model interpreted the association between the explanatory variables and the outcome of the initial non-surgical endodontic procedures. A total of 349 roots were evaluated, and a failure rate of 13.18% was established. Poor filling quality was determined in 8.3% of the roots. As a main result, the presence of a preoperative periapical lesion did not determine a significant risk to the failure of the initial treatment. Unlike, a poor quality of the obturation determined association with an unfavorable outcome like this: (1) homogeneity (OR 2.32; p = 0.0181); (2) taper (OR 5.8; p = 0.0); and, (3) extension (OR 3.41; p = 0.0). Therefore, a significant association between inadequate quality of the root filling and failure of the primary non-surgical endodontic procedures was found. Short length of filling was highly associated with failure. The presence of previous periapical lesion was not found to be a significant predictor for treatment outcomes.
为了评估既往根尖病变和根管充填质量作为初始非手术根管治疗预后的预测因素。本研究设计了一项回顾性队列研究，通过影像学确定是否存在既往根尖病变。根管充填质量通过均匀性、锥度和根尖延伸进行评估。将反应变量分为成功和失败。进行双变量分析和混合广义线性模型，以解释解释变量与初始非手术根管治疗结果之间的关联。共评估了 349 个牙根，失败率为 13.18%。8.3%的牙根被确定为充填质量差。作为主要结果，术前根尖病变的存在并不能确定初始治疗失败的显著风险。相反，根管充填质量差与不良预后相关，具体表现为：（1）均匀性（OR 2.32；p=0.0181）；（2）锥度（OR 5.8；p=0.0）；和（3）延伸（OR 3.41；p=0.0）。因此，发现根管充填质量不足与原发性非手术根管治疗失败之间存在显著关联。充填长度较短与失败高度相关。既往根尖病变的存在并未被发现是治疗结果的显著预测因素。
