Medical University of Plovdiv, Plovdiv, Bulgaria.
Folia Med (Plovdiv). 2021 Feb 28;63(1):81-87. doi: 10.3897/folmed.63.e52204.
The advent of Cone Beam Computed Tomography (CBCT) in endodontics has enhanced the diagnosis of periapical radiolucencies and the assessment of endodontically treated teeth.
The purpose of this study was to assess the prevalence of periapical radiolucencies in a Bulgarian subpopulation and the quality of previous endodontic treatment using CBCT scans.
This study included 2795 roots from 160 Large FOV CBCT which were evaluated by two independent examiners using two scoring systems: CBCT-PAI and PESS.
The inter-examiner agreement spanned from strong to almost perfect (0.892 and 0.983). The prevalence of periapical lesions according to the two scoring systems was 23.1% and 12.9 %, respectively. The prevalence of endodontically treated teeth was high (34.1%). Sixty-five percent of them presented with signs of periapical radiolucencies, while only 1.4% of all non-treated roots had a periapical lesion. A significant association between periapical disease, poor quality of the root canal filling and inadequate coronal seal was found (p<0.001).
The prevalence of periapical disease in endodontically-treated teeth in the Bulgarian subpopulation was high. Poor qual-ity of the root canal filling and inadequate coronal seal were assessed as prognostic determinants of treatment failure. CBCT techniques can augment conventional diagnostic techniques in the field of endodontics.
锥形束 CT（CBCT）在牙髓学中的应用提高了根尖周放射透影的诊断能力，以及对根管治疗牙的评估。
本研究旨在评估保加利亚亚人群中根尖周放射透影的患病率以及使用 CBCT 扫描评估根管治疗牙的质量。
本研究纳入了 2795 根来自 160 个大视野 CBCT 的根，由两名独立的检查者使用两种评分系统（CBCT-PAI 和 PESS）进行评估。
两名检查者之间的一致性从强到几乎完美（0.892 和 0.983）。两种评分系统的根尖病变患病率分别为 23.1%和 12.9%。根管治疗牙的患病率较高（34.1%）。其中 65%的牙齿有根尖周放射透影的迹象，而所有未治疗的根中只有 1.4%有根尖周病变。发现根尖周疾病、根管充填质量差和冠部密封不足之间存在显著关联（p<0.001）。
保加利亚亚人群中根管治疗牙的根尖周疾病患病率较高。根管充填质量差和冠部密封不足被评估为治疗失败的预后决定因素。CBCT 技术可以增强牙髓学领域的常规诊断技术。
