Al-Awasi Khalaf A, Altaroti Ghada A, Aldajani Mustafa A, Alshammari Abeer Assaf, Almunasif Marwah Ahmed, AlQarni Abdulrahman Abdullah M, Aldokhi Mohammed Ameer, Ezzeldin Tarek, Siddiqui Intisar Ahmad
Endodontic Department, Dammam Specialized Dental Center, Dammam Medical Complex, Ministry of Health, Saudi Arabia.
Depatment of Pediatric Dentistry, Dammam Specialized Dental Center, Dammam Medical Complex, Ministry of Health, Saudi Arabia.
Saudi Dent J. 2022 Sep;34(6):473-478. doi: 10.1016/j.sdentj.2022.06.005. Epub 2022 Jun 22.
The main cause for developing periapical lesions (PA) is the root canal infection. The mentioned causes may play a role in not controlling it but are not a "true" cause.
To determine apical status and prevalence of endodontic treated tooth using radiograph assessment in relation to quality of root canal treatment and clinical factors among Saudi adults in the Eastern province.
This prospective case series study included 2161 patients who received root canal treatment (RCT) at Dammam Specialized Dental Center, Dammam Medical Complex, Ministry of Health, Saudi Arabia, between October 21, 2019 and April 22, 2020, after getting ethical approval from the Institutional Research Board (IRB). Saudi natives of either gender, age ≥ 18, with at least one fixed bridge or single dental crown evaluated on a clear, high-quality radiography image were recruited for the study. To determine the periapical state of root canal-filled teeth, the 'periapical index' (PAI) was used. All pertinent patient information was analyzed in SPSS verion-20 (IBM product, Chicago).
Out of 2161 cases, a PA lesion was present in 756 (35.0%). The prevalence of periapical lesions in endodontically treated teeth was 31.2%. PA lesion was associated with molar involvement (50.8% vs. 36.6%, p = 0.001), poor RCT quality (85.2% vs. 51.0%, p = 0.001), and smoking (13.6% vs. 10.5%, p = 0.028). According to logistic regression model, female gender, molar tooth, and poor RCT quality were more likely to expose PA lesion 1.5 times, 1.8 times, and 5 times, respectively.
It is concluded that approximately 1/3rd of endodontically treated teeth are susceptible to the occurrence of periapical lesions in radiographic assessment, which are significantly associated with females, molars, and poor RCT quality, indicating a challenge for endodontists to improve their root canal assessment accuracy.
根尖周病变（PA）发生的主要原因是根管感染。上述因素可能在无法控制感染方面起作用，但并非“真正”原因。
通过X线片评估，确定沙特东部省份成年患者根管治疗牙齿的根尖状态和患病率，并分析根管治疗质量及临床因素。
本前瞻性病例系列研究纳入了2161例患者，这些患者于2019年10月21日至2020年4月22日期间，在沙特阿拉伯卫生部达曼医疗中心达曼专科牙科中心接受了根管治疗（RCT），并获得了机构研究委员会（IRB）的伦理批准。研究招募了年龄≥18岁、至少有一个固定桥或单颗牙冠且在清晰、高质量X线片上进行评估的沙特籍男女患者。为确定根管充填牙齿的根尖状态，采用了“根尖指数”（PAI）。所有相关患者信息均在SPSS 20版（IBM产品，芝加哥）中进行分析。
在2161例病例中，756例（35.0%）存在PA病变。根管治疗牙齿的根尖周病变患病率为31.2%。PA病变与磨牙受累（50.8%对36.6%，p = 0.001）、RCT质量差（85.2%对51.0%，p = ！）和吸烟（13.6%对10.5%，p = 0.028）相关。根据逻辑回归模型，女性、磨牙和RCT质量差分别有1.5倍、1.8倍和5倍的可能性出现PA病变。
得出结论，在X线片评估中，约三分之一的根管治疗牙齿易发生根尖周病变，这些病变与女性、磨牙和RCT质量差显著相关，这表明牙髓病医生提高根管评估准确性面临挑战。
