Department of Conservative and Endodontic Dentistry, Hangzhou Stomatology Hospital, Hangzhou, Zhejiang, China (mainland).
Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.
Med Sci Monit. 2023 Jul 4;29:e940533. doi: 10.12659/MSM.940533.
BACKGROUND Periapical lesions (PL) are a common complication of endodontically treated teeth (ETT), which can result from a missed canal (MC). This study aimed to assess the prevalence of PL and MC in the ETT of a Chinese subpopulation and investigate potential associations between them. MATERIAL AND METHODS A total of 561 cone-beam computed tomography images were selected and analyzed. A total of 1024 endodontically treated posterior teeth excluding third molars were evaluated for the presence of PL and MC. The chi-square test or Fisher's exact test, as well as the odds ratio test, were used to determine whether there was an association and risk relationship between the incidence of PL and the occurrence of MC. RESULTS The overall prevalence of PL and MC in ETT was 56.1% and 19.0%, respectively. In endodontically treated molars, the incidence of PL and MC was 64.1% and 27.6%, whereas in premolars, it was 42.1% and 4.27%. The maxillary first molar showed the highest frequency of PL (71.5%) and MC (65.7%), with the mesiobuccal second canal being the most missed (78.8%). Teeth with an MC were found to be 3.658 times (95% confidence interval=2.541-5.301, P<0.0001) more likely to be associated with a PL. CONCLUSIONS Endodontically treated teeth with missed canals are associated with higher risks of periapical lesions. The high prevalence of these complications in a Chinese subpopulation underscores the importance of implementing enhanced diagnostic and treatment methods for root canal treatment or retreatment.
根尖周病变（PL）是牙髓治疗牙（ETT）的常见并发症，可能是由于遗漏根管（MC）引起的。本研究旨在评估中国亚群 ETT 中 PL 和 MC 的患病率，并调查它们之间的潜在关联。
共选择和分析了 561 个锥形束计算机断层扫描图像。评估了 1024 颗除外第三磨牙的牙髓治疗后后牙是否存在 PL 和 MC。使用卡方检验或 Fisher 精确检验以及优势比检验来确定 PL 的发生率与 MC 的发生之间是否存在关联和风险关系。
ETT 中 PL 和 MC 的总体患病率分别为 56.1%和 19.0%。在牙髓治疗的磨牙中，PL 和 MC 的发生率分别为 64.1%和 27.6%，而在前磨牙中，其发生率分别为 42.1%和 4.27%。上颌第一磨牙的 PL（71.5%）和 MC（65.7%）发生率最高，第二近中颊根管的遗漏率最高（78.8%）。发现有 MC 的牙齿与 PL 相关的风险是无 MC 的牙齿的 3.658 倍（95%置信区间=2.541-5.301，P<0.0001）。
遗漏根管的牙髓治疗牙与根尖周病变的风险增加相关。这些并发症在中国亚群中高发，这突显了实施增强的根管治疗或再治疗的诊断和治疗方法的重要性。
