成人尼泊尔亚人群根管治疗牙发生根尖周炎的预测因素：一项横断面研究。

Predictors of apical periodontitis in root canal treated teeth from an adult Nepalese subpopulation: a cross-sectional study.

机构信息

Department of Conservative Dentistry & Endodontics, National Medical College, Birgunj, Nepal.

Department of Prosthodontics & Maxillofacial Prosthesis, National Medical College, Birgunj, Nepal.

出版信息

BMC Oral Health. 2024 Mar 29;24(1):400. doi: 10.1186/s12903-024-04139-3.

DOI:10.1186/s12903-024-04139-3

PMID:38553672

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10979567/

Abstract

BACKGROUND

Endodontic literature search revealed that no study has been conducted to evaluate the prevalence of apical periodontitis (AP) in root canal treated teeth from an adult Nepalese population of Madhesh Province. Consequently, little is known about the extent and risk factors associated with it. This study aimed to determine AP prevalence in root canal treated teeth from an adult Nepalese subpopulation and to analyze the related risk factors including age, sex, tooth type, type of coronal restoration and quality of root canal treatment and coronal restoration as predictors of AP.

METHODS

Digital panoramic radiographs were evaluated. Periapical status of 300 root canal-treated teeth was scored by using the periapical index. The quality of root canal treatment and coronal restorations were categorized as adequate or inadequate through radiographic and clinical evaluation. The data were analyzed using univariate and multivariate logistic regression models.

RESULTS

Prevalence of AP in the present study was 31.7%. In 45.7% of the treated teeth, quality of root canal treatment was adequate whereas 46% of the cases had adequate coronal restorations. Multivariate logistic regression analysis revealed statistically significant associations and remarkably increased risk for AP in teeth with inadequate root canal treatment (odds ratio [OR] = 7.92; 95% CI: 3.96-15.82; p < 0.001) whereas lower risk for AP was found in females (OR = 0.51; 95% CI: 0.28-0.90; p = 0.021) and in teeth restored with crown (OR = 0.22; 95% CI: 0.09-0.51; p < 0.001) and filling (OR = 0.18; 95% CI: 0.08-0.42; p < 0.001). Quality of coronal restoration, tooth type and age of the patient were not found to be the predictors of AP.

CONCLUSIONS

Within the limits of this study, a high prevalence of AP and poor overall quality of root canal treatment and coronal restoration was found in the subpopulation studied. Quality of root canal treatment, type of coronal restoration and sex of the patient are significant predictors of possible AP development in root canal treated teeth. Substantial efforts are needed to improve the endodontic treatment standards.

摘要

背景

牙髓学文献检索显示，尚无研究评估过尼泊尔马德西省成年人群中根管治疗牙的根尖周病（AP）患病率。因此，对于其严重程度和相关风险因素知之甚少。本研究旨在确定尼泊尔成年亚人群中根管治疗牙的 AP 患病率，并分析相关风险因素，包括年龄、性别、牙齿类型、冠部修复类型以及根管治疗和冠部修复的质量，作为 AP 的预测因子。

方法

评估数字化全景片。使用根尖指数对 300 颗根管治疗牙的根尖状态进行评分。通过影像学和临床评估将根管治疗和冠部修复的质量分类为充分或不充分。使用单变量和多变量逻辑回归模型进行数据分析。

结果

本研究中 AP 的患病率为 31.7%。在 45.7%的治疗牙中，根管治疗质量充分，而 46%的病例冠部修复充分。多变量逻辑回归分析显示，根管治疗不充分的牙齿发生 AP 的关联具有统计学意义，风险显著增加（比值比[OR] = 7.92；95%置信区间：3.96-15.82；p < 0.001），而女性（OR = 0.51；95%置信区间：0.28-0.90；p = 0.021）和用牙冠（OR = 0.22；95%置信区间：0.09-0.51；p < 0.001）和填充（OR = 0.18；95%置信区间：0.08-0.42；p < 0.001）修复的牙齿发生 AP 的风险较低。冠部修复质量、牙齿类型和患者年龄未被发现是 AP 的预测因子。