Alotaibi Badi B, Khan Kiran I, Javed Muhammad Q, Dutta Smita D, Shaikh Safia S, Almutairi Nawaf M
Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, KSA.
Department of Operative Dentistry, Frontier Medical and Dental College, Abbottabad, Pakistan.
J Taibah Univ Med Sci. 2023 Sep 9;19(1):18-27. doi: 10.1016/j.jtumed.2023.08.009. eCollection 2024 Feb.
The objectives of this study were to: (1) assess the frequency of missed canals in the mesiobuccal root (MB) of endodontically treated maxillary molars and its association with apical periodontitis (AP); (2) examine the correlation between the presence of a confluent or separate missed MB2 canal and the prevalence of AP; and (3) examine the correlation between the technical quality of endodontic treatment in the MB1 canal and the prevalence of AP.
We obtained and examined 800 cone-beam computed tomography (CBCT) scans from 800 patient records over 6 months. The parameters noted for each tooth included the tooth number; presence of missed canals in the MB root; configuration of missed MB2 canals (confluent or separate); technical acceptability of root canal treatment (RCT) of treated MB1 canals; and the CBCT periapical index score. Data were analyzed in SPSS version 24.
A total of 203 maxillary molars from 148 CBCT scans were included. The MB2 canal prevalence was 88.2% in maxillary first molars and 62.7% in maxillary second molars. MB2 was found in 164 endodontically treated maxillary molars. During treatment, MB2 was missed in 150 (91.5%) and treated in 14 (8.5%) teeth. A total of 103 teeth (50.73%) had AP, which was observed in 67.3% of teeth with a missed MB2 canal but only 14.3% of teeth with a treated MB2 canal. The prevalence of AP was 43.7% in teeth with confluent MB2 canals and 80.9% in teeth with separate MB2 canals.
The MB2 canal frequency was significantly higher in the examined maxillary first molars than the maxillary second molars. The MB2 canal was missed in most teeth that underwent endodontic treatment. The AP prevalence was relatively higher in endodontically treated maxillary molars with missed MB2 canals.
本研究的目的是：（1）评估根管治疗后的上颌磨牙近中颊根（MB）中遗漏根管的频率及其与根尖周炎（AP）的相关性；（2）检查融合或分离的遗漏MB2根管的存在与AP患病率之间的相关性；（3）检查MB1根管内根管治疗的技术质量与AP患病率之间的相关性。
我们在6个月内从800份患者记录中获取并检查了800张锥形束计算机断层扫描（CBCT）图像。记录每颗牙齿的参数包括牙位；MB根中遗漏根管的情况；遗漏的MB2根管的形态（融合或分离）；已治疗的MB1根管根管治疗（RCT）的技术可接受性；以及CBCT根尖指数评分。数据在SPSS 24版中进行分析。
共纳入148例CBCT扫描中的203颗上颌磨牙。上颌第一磨牙的MB2根管患病率为88.2%，上颌第二磨牙为62.7%。在164颗根管治疗后的上颌磨牙中发现了MB2根管。治疗期间，150颗牙齿（91.5%）遗漏了MB2根管，14颗牙齿（8.5%）进行了治疗。共有103颗牙齿（50.73%）患有AP，在遗漏MB2根管的牙齿中观察到AP的比例为67.3%，而在治疗了MB2根管的牙齿中仅为14.3%。融合型MB2根管的牙齿中AP患病率为43.7%，分离型MB2根管的牙齿中为80.9%。
在所检查的上颌第一磨牙中，MB2根管的频率显著高于上颌第二磨牙。大多数接受根管治疗的牙齿遗漏了MB2根管。在根管治疗后遗漏MB2根管的上颌磨牙中，AP患病率相对较高。
