Sălceanu Mihaela, Melian Anca, Dascălu Cristina, Giuroiu Cristian, Concita Corina, Topoliceanu Claudiu, Melian Diana, Frumuzache Andreea, Solomon Sorina Mihaela, Mârţu Maria-Alexandra
Department of Odontology-Periodontology and Fixed Restorations, Faculty of Dental Medicine, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.
Discipline of Medical Informatics and Biostatistics, Faculty of Dental Medicine, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.
Diagnostics (Basel). 2025 Jun 30;15(13):1663. doi: 10.3390/diagnostics15131663.
The aim of this study was to identify and assess the independent risk factors and potential predictors for endo-periodontal lesions (EPLs) in endodontically treated teeth with periapical pathology. : The study group included 90 patients (35 men, 55 women; mean age 47.96 ± 13.495 years) with 126 endodontically treated teeth. Following clinical examinations and radiologic evaluation, 50 patients were diagnosed with endo-periodontal lesions (EPLs) in 64 molars (test group); the control group included 62 endodontically treated teeth without EPLs diagnosed in 40 patients. The independent variables were assessed as risk factors for EPLs. The relationship between patients' demographic and clinical features and endo-periodontal status was assessed using Chi-squared tests for categorical variables and Student's - or Mann-Whitney tests for continuous variables, depending on data distribution. The potential risk factors were characterized by calculating Odds Ratios (ORs) with 95% confidence intervals. The variables included in the multivariate logistic regression model were selected based on their clinical relevance and statistical significance in the univariate analysis. To evaluate the combined effect of the identified risk factors, a binary logistic regression model was constructed using the Enter method. Out of the 126 endodontically treated molars with periapical pathology, 64 teeth (50.8%) were diagnosed with endo-periodontal lesions (EPLs). Patients aged ≥60 years were significantly more represented in the EPL group (32.8%) compared to the control group (12.9%) ( = 0.024). Probing pocket depth ≥ 4 mm was present in 85.9% of teeth with EPLs versus only 30.6% in teeth without EPLs ( < 0.001). Probing pocket depth (PPD) ≥ 4 mm was the strongest predictor (OR = 13.830) and remained significant after adjustment in multivariate analysis (OR = 6.585). PPD ≥ 3.625 mm showed a strong association in univariate analysis (OR = 12.587) and preserved significance in the multivariate model (OR = 6.163). This study highlights age ≥ 60 years and PPD ≥ 4 mm as the most significant independent risk factors for EPLs, emphasizing the need for early periodontal assessment in endodontically treated teeth with periapical pathology. While PPD greater than 3.625 mm is a strong indicator of the presence of EPLs, other factors such as MBL (marginal bone loss) and occlusal considerations appear to have indirect roles in EPL development in endodontically treated teeth with periapical lesions.
本研究的目的是识别和评估患有根尖周病变的根管治疗牙齿发生牙髓牙周联合病变（EPLs）的独立危险因素和潜在预测因素。研究组包括90例患者（35名男性，55名女性；平均年龄47.96±13.495岁），共有126颗接受了根管治疗的牙齿。经过临床检查和影像学评估，50例患者的64颗磨牙被诊断为牙髓牙周联合病变（试验组）；对照组包括40例患者的62颗未诊断出牙髓牙周联合病变的根管治疗牙齿。将自变量评估为牙髓牙周联合病变的危险因素。根据数据分布情况，使用卡方检验分析分类变量，使用学生t检验或曼-惠特尼检验分析连续变量，评估患者的人口统计学和临床特征与牙髓牙周状况之间的关系。通过计算具有95%置信区间的优势比（ORs）来表征潜在危险因素。多变量逻辑回归模型中纳入的变量是根据其在单变量分析中的临床相关性和统计学意义来选择的。为了评估已识别危险因素的联合作用, 使用Enter方法构建二元逻辑回归模型。在126颗患有根尖周病变的根管治疗磨牙中，64颗牙齿（50.8%）被诊断为牙髓牙周联合病变（EPLs）。与对照组（12.9%）相比，牙髓牙周联合病变组中≥60岁的患者比例显著更高（32.8%）（P = 0.024）。牙髓牙周联合病变的牙齿中85.9%存在探诊深度≥4 mm，而无牙髓牙周联合病变的牙齿中这一比例仅为30.6%（P < 0.001）。探诊深度（PPD）≥4 mm是最强的预测因素（OR = 13.830），在多变量分析调整后仍具有显著性（OR = 6.585）。PPD≥3.625 mm在单变量分析中显示出强相关性（OR = 12.587），在多变量模型中仍具有显著性（OR = 6.163）。本研究强调≥60岁和PPD≥4 mm是牙髓牙周联合病变最显著的独立危险因素，强调了对患有根尖周病变的根管治疗牙齿进行早期牙周评估的必要性。虽然PPD大于3.625 mm是牙髓牙周联合病变存在的有力指标，但其他因素，如边缘骨丧失（MBL）和咬合因素，似乎在患有根尖周病变的根管治疗牙齿发生牙髓牙周联合病变的过程中起间接作用。
Zotero 插件
