评估影响根管治疗后牙齿根尖周炎放射学检测的治疗质量风险因素：一项回顾性 CBCT 分析。

Assessment of Treatment Quality Risk Factors Influencing the Radiographic Detection of Apical Periodontitis in Root-Filled Teeth: A Retrospective CBCT Analysis.

机构信息

College of Dentistry, University of Baghdad, Department of Aesthetic and Restorative Dentistry, Baghdad, Iraq.

UCL Eastman Dental Institute, University College London, Faculty of Endodontology, Department of Restorative Dentistry, London, UK.

出版信息

Eur Endod J. 2024 Aug 22;9(3):252-259. doi: 10.14744/eej.2024.03371.

DOI:10.14744/eej.2024.03371

PMID:39102664

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11413595/

Abstract

OBJECTIVE

This study aimed to assess the treatment quality factors associated with the risk of radiographic detection of apical periodontitis (AP) in root-filled teeth (RFT) on CBCT images.

METHODS

Two hundred eighty-five CBCT scans of patients (range 18-60, mean 35.1) years old were selected from a pool of CBCT scans which were taken from 2016-2022. Gender and age were recorded. The presence/absence of AP, unfilled canal, perforation, zipping and ledge and homogenous/nonhomogeneous root canal filling (RCF), adequate/inadequate coronal restoration and under/over filled RCF and those within 0-2 mm from the radiographic apex were recorded for RFTs. Kappa was used to assess intra-consensus reliability. Chi-square and Binary logistic regression were used to assess and predict risk factors related to the detection of AP. A significant difference was set at p<0.05.

RESULTS

AP was present in 81.5% of RFTs. No significant difference was present in the AP prevalence in RFT between males and females, maxilla and mandible, right and left sides, RFT with adequate and inadequate coronal restoration and RFT with/without zipping and ledge and between RFT with overfilled and those with RCF end within 0-2 mm from the radiographic apex (p>0.05), respectively. Significantly higher AP prevalence was present in RFT with unfilled canal, perforations, non-homogenous and underfilled RCF (p<0.05), respectively. The odds of AP detection were 2.02, 5.5, 2 and 1.98 times higher in RFT with unfilled canal, perforations, non-homogenous and underfilled RCF, respectively. Intra-consensus reliability was (0.98, 0.95, 0.85, 0.81, 0.88, 0.85 and 0.92) for AP, unfilled canal, perforation, zipping and ledge, homogeneity of RCF, coronal restoration and length of RCF, respectively.

CONCLUSION

The vast majority of teeth with previous root fillings presented with AP. AP detection risk was significantly higher in root-filled teeth with perforation, non-homogeneous, and underfilled root canal filling. Other factors do not influence the radiographic detection of AP in CBCT images. (EEJ-2024-02-042).

摘要

目的

本研究旨在评估与 CBCT 图像中根管填充后牙齿（RFT）根尖周病（AP）放射检测相关的治疗质量因素。

方法

从 2016 年至 2022 年拍摄的 CBCT 扫描中选择了 285 名患者（18-60 岁，平均 35.1 岁）的 CBCT 扫描。记录性别和年龄。记录 RFT 中是否存在 AP、未填充根管、穿孔、拉链和龈下、根管填充均匀/不均匀（RCF）、冠部修复是否充分/不充分以及 RCF 是否在根尖 0-2mm 以内。评估 RFT 中 AP、未填充根管、穿孔、拉链和龈下、RCF 均匀性、冠部修复和 RCF 长度与根管填充的一致性。卡帕用于评估内部一致性。卡方检验和二元逻辑回归用于评估和预测与 AP 检测相关的风险因素。设定显著差异为 p<0.05。

结果

81.5%的 RFT 存在 AP。男性和女性、上颌和下颌、右侧和左侧、冠部修复充分和不充分、是否存在拉链和龈下以及 RCF 过度填充和根尖 0-2mm 内 RCF 之间，RFT 中 AP 的患病率无显著差异（p>0.05）。未填充根管、穿孔、非均匀和未填充 RCF 的 RFT 中 AP 患病率显著较高（p<0.05）。未填充根管、穿孔、非均匀和未填充 RCF 的 RFT 中 AP 检测的几率分别高出 2.02、5.5、2 和 1.98 倍。AP、未填充根管、穿孔、拉链和龈下、RCF 均匀性、冠部修复和 RCF 长度的内部一致性分别为（0.98、0.95、0.85、0.81、0.88、0.85 和 0.92）。