Santo Tomás University, Faculty of Dentistry. Bucaramanga, Colombia.
Private practice, Bucaramanga, Colombia.
Acta Odontol Latinoam. 2024 Apr;37(1):59-67. doi: 10.54589/aol.37/1/59.
A high prevalence of post-treatment apical periodontitis associated to variables such as endodontic treatment quality and missed canals has been reported.
The aim of this study was to evalúate the quality of endodontic treatment and the frequency of missed canals associated with teeth with apicalperiodontitis (AP) through CBCTin a Colombian sub-population.
This was a cross-sectional study assessing 318 cone beam computed tomography (CBCT) scans of endodontically treated teeth from Colombian individuals. The scans were taken using J Morita X550 (J Morita Corporation, Osaka, Japan), with voxel size 0.125 to 0.20 mm. All endodontically treated teeth were assessed for quality of treatment, presence of missed canals and AP. Allsamples were analyzed bytwo endodontics specialists and an radiology specialist. Chi-square or Fisher 's test and odds ratio were calculated to identify the association and risk relationship between the presence of AP and the study variables.
Missed canals were found in 18.61% (86/462), and 95.3% were associated with AP. The frequency of AP was 62.34% (288/462) for all the evaluated teeth. AP was found in 27.43 % (79/288) of the teeth with adequate endodontic treatment, in contrast to 72.57% (209/288) of the teeth with inadequate treatment (P<0.01). The frequency of missed canals was highest in maxillary molars, with 55.23% (58/105), with 96.55% presenting AP. The second mesiobuccal canal wasthe most frequently missed canal, 88.52%o(54/61), with AP in 90.74% (49/54) of the cases.
CONCLUSIÓN: There was a high frequency of teeth with missed canals and PA. More than half of the teeth with missed canals were maxillary molars, with MB2 being the most common canal, commonly presenting apical periodontitis.
本研究旨在通过 CBCT 评估在哥伦比亚亚人群中与根尖周炎（AP）相关的根管治疗质量和遗漏根管的频率。
这是一项横断面研究，评估了来自哥伦比亚个体的 318 例根管治疗后牙齿的锥形束 CT（CBCT）扫描。扫描使用 J Morita X550（J Morita Corporation，大阪，日本）进行，体素大小为 0.125 至 0.20 毫米。所有根管治疗后的牙齿均评估治疗质量、遗漏根管和 AP 的存在。所有样本均由两位牙髓病专家和一位放射科专家进行分析。采用卡方检验或 Fisher 确切概率法和优势比计算来确定 AP 的存在与研究变量之间的关联和风险关系。
发现遗漏根管的发生率为 18.61%（86/462），其中 95.3%与 AP 相关。所有评估牙齿的 AP 发生率为 62.34%（288/462）。在所有治疗充分的牙齿中，AP 的发生率为 27.43%（79/288），而治疗不充分的牙齿中，AP 的发生率为 72.57%（209/288）（P<0.01）。上颌磨牙的遗漏根管发生率最高，为 55.23%（58/105），其中 96.55%存在 AP。第二近中颊根管是最常遗漏的根管，发生率为 88.52%（54/61），其中 90.74%（49/54）的病例存在 AP。
存在高频率的牙齿存在遗漏根管和 AP。超过一半的遗漏根管的牙齿是上颌磨牙，其中 MB2 是最常见的根管，通常存在根尖周炎。
