Ebrahimi Rayan, Khajeh Samira, Paik Hanieh, Moradi Masoud, Rastegar Khosravi Mohammad
Dentist, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Iran Endod J. 2024;19(3):150-157. doi: 10.22037/iej.v19i3.42440.
Untreated canals represent the primary cause of treatment failure in molars and the second leading cause in other dental groups. This study determined the prevalence of untreated canals and their relationship with periapical periodontitis using cone-beam computed tomography (CBCT) images.
385 CBCT images with at least one treated canal were selected from the oral and maxillofacial radiology center. The number of roots and canals, presence, and size of periapical pathology, and presence of untreated canals were recorded. The study used descriptive statistics and Chi-square, Fisher's exact, and odds ratio tests to analyze data.
Of the 2053 teeth examined, 14.9% had at least one untreated canal. Untreated canals in teeth increase the chance of having a periapical lesion, raising the prevalence by 11 times. Of these, 91.8% had both untreated canals and periapical lesions. This was more than teeth without untreated canals (35.8%). Most untreated canals were in maxillary molars (65.3%), and mandibular molars (12.54%). There was a statistically significant relationship (<0.001) between the number of roots, canals, expansion, destruction, and jaw type with the prevalence of untreated canals. The maxillary first molar (68.66%) and second mesiobuccal (MB2) canal (63.27%) had the highest percentages of untreated canals.
The MB2 had the highest prevalence of untreated canals. The presence of untreated canals significantly increased the risk of expansion and/or destruction. Therefore, identifying these conditions can also be useful in diagnosing untreated canals. Dentists should assess the anatomy of the tooth and the structure of the root canal to minimize the possibility of an untreated canal. CBCT can assist in this process.
未经处理的根管是磨牙治疗失败的主要原因，也是其他牙组治疗失败的第二大原因。本研究利用锥形束计算机断层扫描（CBCT）图像确定未经处理的根管的患病率及其与根尖周炎的关系。
从口腔颌面放射中心选取385张至少有一条已治疗根管的CBCT图像。记录牙根和根管的数量、根尖病变的存在情况和大小以及未经处理的根管的存在情况。本研究使用描述性统计以及卡方检验、费舍尔精确检验和比值比检验来分析数据。
在检查的2053颗牙齿中，14.9%至少有一条未经处理的根管。牙齿中未经处理的根管会增加出现根尖病变的几率，患病率提高11倍。其中，91.8%既有未经处理的根管又有根尖病变。这一比例高于没有未经处理根管的牙齿（35.8%）。大多数未经处理的根管位于上颌磨牙（65.3%）和下颌磨牙（12.54%）。牙根数量、根管数量、扩张、破坏情况与颌骨类型和未经处理的根管患病率之间存在统计学显著关系（<0.001）。上颌第一磨牙（68.66%）和第二近中颊根（MB2）根管（63.27%）未经处理的根管比例最高。
MB2根管未经处理的患病率最高。未经处理的根管的存在显著增加了扩张和/或破坏的风险。因此，识别这些情况也有助于诊断未经处理的根管。牙医应评估牙齿的解剖结构和根管结构，以尽量减少出现未经处理的根管的可能性。CBCT可协助这一过程。
