Lewusz-Butkiewicz Katarzyna, Kaczor-Wiankowska Kinga, Kulas-Bałaban Aleksandra, Kubala Elżbieta, Nowicka Alicja
Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, Poland.
Pol J Radiol. 2024 Aug 16;89:e391-e401. doi: 10.5114/pjr/190412. eCollection 2024.
The purpose of this study was a retrospective cross-sectional study of the Polish subpopulation, performed to evaluate the quality of endodontic treatment (ET) and the condition of the periapical tissues of permanent teeth based on cone-beam computed tomography (CBCT) images.
The retrospective study included a group of patients who underwent CBCT at the University Dental Clinic of the Pomeranian Medical University in Szczecin. An endodontically treated tooth index (ETTI) was used to evaluate ET. Once apical periodontitis was recognised, the size, extent, and ratio of adjacent anatomical structures were assessed using the complex periapical index (COPI).
Analysis of the CBCT images showed that ET was performed in 9.9% of the teeth examined, of which 52.7% of the canals were treated correctly, while 28.1% of the root canals were found to be underfilled, 6.8% were overfilled, 9.3% of the root canals were not obturated at all, and in 3.1% of the teeth examined, the filling material was only visible in the pulp chamber. Apical periodontitis was observed in 6% of all teeth examined, while the percentage of teeth following ET was 38.5%.
The quality of the ET provided to the Polish subpopulation is unsatisfactory. Lack of root canal filling homogeneity is a significant risk factor for ET failure. Improper ET and poor quality of crown restoration after ET have an impact on the increased risk of occurrence, size, degree of root coverage, and extent of inflammatory periapical lesions in relation to adjacent anatomical structures.
本研究旨在对波兰亚人群进行回顾性横断面研究，通过锥形束计算机断层扫描（CBCT）图像评估恒牙根管治疗（ET）的质量和根尖周组织状况。
回顾性研究纳入了在什切青波美拉尼亚医科大学牙科诊所接受CBCT检查的一组患者。采用根管治疗牙齿指数（ETTI）评估根管治疗情况。一旦识别出根尖周炎，使用复杂根尖指数（COPI）评估相邻解剖结构的大小、范围和比例。
CBCT图像分析显示，在所检查的牙齿中，9.9%进行了根管治疗，其中52.7%的根管治疗正确，而28.1%的根管充填不足，6.8%的根管充填过度，9.3%的根管根本未充填，在3.1%的检查牙齿中，充填材料仅见于髓腔。在所有检查牙齿中，6%观察到根尖周炎，而根管治疗后的牙齿比例为38.5%。
为波兰亚人群提供的根管治疗质量不令人满意。根管充填缺乏均匀性是根管治疗失败的一个重要危险因素。不当的根管治疗和根管治疗后冠修复质量差会增加根尖周炎性病变发生的风险、大小、牙根覆盖程度以及与相邻解剖结构相关的范围。
