Departments of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
Departments of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
J Endod. 2024 Oct;50(10):1381-1392. doi: 10.1016/j.joen.2024.07.013. Epub 2024 Aug 2.
This prospective study evaluated the effect of immediate functional loading (IFL) of a full-coverage prosthesis on the clinical and radiographic outcome of nonsurgical endodontic therapy (NSET) performed on mandibular molar teeth with pulp necrosis and asymptomatic apical periodontitis.
In 20 subjects, standardized 2-visit NSET was performed in bilateral mandibular first molar teeth (split-mouth model) with a diagnosis of pulp necrosis and asymptomatic apical periodontitis exhibiting a radiographic periapical index (PAI) score ≥3. In each subject, the nonvital bilateral mandibular first molar teeth were randomized to 1 of 2 groups: the IFL group or the functional loading after a time interval of 6 months group. Provisional full-coverage prostheses were provided within 7 days after the completion of endodontic therapy. The cases were followed up clinically and radiographically at 6 and 12 months. Radiographs were assessed for periapical healing based on PAI scores, which were dichotomized as healed (PAI score ≤2) or nonhealed (PAI score ≥3). The data were compared using chi-square and Fisher exact tests.
A recall rate of 100% was achieved at the end of 12 months. All teeth in the IFL group and the functional loading after a time interval of 6 months group were clinically asymptomatic. According to an intergroup comparison between the proportion of teeth healed and nonhealed (radiographic), there was a significant difference (P < .05).
IFL of a full-coverage prosthesis in endodontically treated mandibular molar teeth with pulp necrosis and asymptomatic apical periodontitis delayed periapical healing.
本前瞻性研究评估了即刻功能性负载（IFL）对牙髓坏死和无症状根尖周炎的下颌磨牙进行非手术根管治疗（NSET）的临床和放射学效果。
在 20 名受试者中，对双侧下颌第一磨牙（劈裂模型）进行了标准化的 2 次就诊 NSET，这些牙齿的诊断为牙髓坏死和无症状根尖周炎，表现出放射影像学根尖周指数（PAI）评分≥3。在每个受试者中，非活力的双侧下颌第一磨牙随机分为 2 组之一：IFL 组或在 6 个月时间间隔后进行功能性负载组。在根管治疗完成后 7 天内提供临时全冠修复体。在 6 个月和 12 个月时进行临床和放射学随访。根据 PAI 评分评估根尖愈合情况，PAI 评分≤2 为愈合，PAI 评分≥3 为未愈合。使用卡方和 Fisher 确切检验比较数据。
在 12 个月结束时达到了 100%的召回率。IFL 组和功能性负载后 6 个月组的所有牙齿均无临床症状。根据愈合（PAI 评分≤2）和未愈合（PAI 评分≥3）牙齿比例的组间比较，差异有统计学意义（P<.05）。
即刻负载全冠修复体延迟了牙髓坏死和无症状根尖周炎的下颌磨牙的根尖周愈合。
