Ku Jeong-Kui, Jeon Woo-Young, Ko Seung-O, Yoon Ji-Young
Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.
J Korean Assoc Oral Maxillofac Surg. 2024 Jun 30;50(3):140-145. doi: 10.5125/jkaoms.2024.50.3.140.
The necessity of retrograde filling after apicoectomy is controversial in cases of non-inflammatory cysts as opposed to bacteria-related periapical abscesses. This study aims to investigate whether the presence or absence of retrograde filling during apicoectomy has differential long-term prognostic implications between inflammatory and non-inflammatory cysts.
This retrospective study included patients who underwent tooth apicoectomy during jaw cyst enucleation between 2013 and 2022, and who underwent follow-up cone-beam computed tomography for at least 6 months. The prognosis of the tooth was evaluated during the follow-up period according to the cyst type, the presence or absence of retrograde filling, mandible or maxilla, and location.
A total of 147 teeth was included in this study. All the operated teeth underwent preoperative root canal treatment by an endodontic specialist. Apicoectomy was performed for 119 inflammatory cysts and 28 non-inflammatory cysts. Retrograde filling was performed on 22 teeth with inflammatory cysts and 3 teeth with non-inflammatory cysts. All teeth survived the 3.5-year follow-up (range, 1.0-9.1 years). However, 1 tooth with an inflammatory cyst developed complications 1 year after surgery that required re-endodontic treatment.
The prognosis of a tooth treated by apicoectomy without retrograde filling during cyst enucleation is favorable, regardless of the cyst type.
与细菌相关的根尖周脓肿不同，在非炎性囊肿病例中，根尖切除术后进行逆行充填的必要性存在争议。本研究旨在调查根尖切除术中是否进行逆行充填在炎性和非炎性囊肿之间是否具有不同的长期预后影响。
这项回顾性研究纳入了2013年至2022年间在颌骨囊肿摘除术期间接受牙齿根尖切除术且接受了至少6个月的锥形束计算机断层扫描随访的患者。在随访期间，根据囊肿类型、是否进行逆行充填、下颌骨或上颌骨以及位置对牙齿的预后进行评估。
本研究共纳入147颗牙齿。所有手术牙齿均由牙髓专科医生进行术前根管治疗。对119个炎性囊肿和28个非炎性囊肿进行了根尖切除术。对22个炎性囊肿牙齿和3个非炎性囊肿牙齿进行了逆行充填。所有牙齿均在3.5年的随访期内存活（范围为1.0 - 9.1年）。然而，1颗炎性囊肿牙齿在术后1年出现并发症，需要再次进行根管治疗。
在囊肿摘除术中未进行逆行充填的情况下，根尖切除术治疗牙齿的预后良好，无论囊肿类型如何。
