Valverde Haro Henry Paul, Rupaya Carmen Rosa Garcia, Alves Flávio R F
Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.
Postgraduate Program in Dentistry, Cayetano Heredia University, Lima, Peru.
Restor Dent Endod. 2024 Jun 24;49(3):e26. doi: 10.5395/rde.2024.49.e26. eCollection 2024 Aug.
This study aimed to investigate the frequency and type of endodontic procedural errors in cases indicated for retreatment through cone-beam computed tomography (CBCT) analysis.
The sample consisted of 96 CBCT scans, encompassing 122 permanent teeth with fully formed roots. Errors included perforation, instrument fracture, canal transportation, missed canals, and inadequate apical limit of filling. Additionally, potential risk factors were analyzed and subjected to statistical modeling.
The most frequent procedural error observed was the inadequate apical limit of filling, followed by canal transportation, perforation, missed canal, and instrument fracture. Statistically significant associations were identified between various procedural errors and specific factors. These include canal transportation and root canal wall, with the buccal wall being the most commonly affected; missed canal and tooth type, particularly the palatine and second mesiobuccal canal canals; inadequate apical limit of filling and root curvature, showing a higher deviation to the mesial direction in severely curved canals; inadequate apical limit of filling and the presence of calcifications, with underfilling being the most frequent; canal transportation and periapical lesion, notably with deviation to the buccal direction; and the direction of perforation and periapical lesion, most frequently occurring to buccal direction.
CBCT emerges as a valuable tool in identifying procedural errors and associated factors, crucial for their prevention and management.
本研究旨在通过锥形束计算机断层扫描（CBCT）分析，调查需要再治疗的病例中根管治疗程序错误的频率和类型。
样本包括96例CBCT扫描，涵盖122颗牙根完全形成的恒牙。错误包括穿孔、器械折断、根管偏移、遗漏根管以及根尖充填不足。此外，对潜在风险因素进行了分析并进行了统计建模。
观察到最常见的程序错误是根尖充填不足，其次是根管偏移、穿孔、遗漏根管和器械折断。在各种程序错误和特定因素之间发现了具有统计学意义的关联。这些关联包括根管偏移与根管壁，其中颊侧壁受影响最常见；遗漏根管与牙型，特别是腭侧根管和近中颊第二根管；根尖充填不足与牙根弯曲度，在严重弯曲的根管中向近中方向的偏差更大；根尖充填不足与钙化的存在，欠填最为常见；根管偏移与根尖周病变，尤其是向颊侧方向的偏移；以及穿孔方向与根尖周病变，最常发生在颊侧方向。
CBCT已成为识别程序错误及相关因素的重要工具，对预防和处理这些问题至关重要。
