nach oben

Clinical Oral Investigations

Erschienen in:

15.07.2019 | Original Article

Quality of root canal fillings and prevalence of apical radiolucencies in a German population: a CBCT analysis

verfasst von: Sebastian Bürklein, Edgar Schäfer, Hans-Peter Jöhren, David Donnermeyer

Erschienen in: Clinical Oral Investigations | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Abstract

Objectives

The aim of this study was to determine the frequency and quality of root canal fillings (RCF) and the prevalence of apical radiolucency (AR) in a German population.

Material and methods

Five hundred randomly selected full-size CBCT images (Planmeca ProMax 3D, FOV = 8 × 8 cm, voxel size 160 μm or 200 μm) were obtained from German patients (40.6% = ♂; 59.4% = ♀; mean age = 50.21 ± 12.45 years). A total of 8254 teeth were examined for pathology (AR, widened periodontal ligament). The relationship between AR and existing RCF and the quality of RCF were documented. Frequency and correlations between the left and right sides and gender distribution were analyzed statistically using the chi-square test.

Results

The overall prevalence of AR was 3.8%, whereas for teeth with RCF, it was 42.5%. Patients had approximately 1.4 root canal–filled teeth (8.2% of all teeth). RCF terminated more than 2 mm short of the radiological apex in 31.2%, 5.1% reached beyond the apex, 8.1% were associated with extruded sealer, and 5.3% presented untreated root canals. Odds ratio of having an AR was highest in teeth with RCF beyond the apex (OR = 27.0) followed by RCF <2 mm short of the apex (OR = 4.4), untreated root canals (OR = 2.9), and inhomogeneity of RCF (OR = 1.2). Extrusion of sealer was least associated with AR. Molars were most frequently associated with AR (P < 0.05). Root canal–filled teeth showed significantly more AR in men compared with women (P < 0.05).

Conclusions

About 42.5% of root canal–filled teeth were associated with AR, and in about one-third of these teeth, the RCF terminated more than 2 mm short of the apex.

Clinical relevance

Each step in root canal therapy influences treatment outcome and prevalence of periapical radiolucencies. Determination of the working length is still one of the key points to achieve predictable periapical healing, and homogenous root canal filling reaching the foramen major seems to be essential.

Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR (2008) Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod 34:273–279. https://doi.org/10.1016/j.joen.2007.11.023 CrossRefPubMed

Nair PN (2006) On the causes of persistent apical periodontitis: a review. Int Endod J 39:249–281. https://doi.org/10.1111/j.1365-2591.2006.01099.x CrossRefPubMed

Pak JG, Fayazi S, White SN (2012) Prevalence of periapical radiolucency and root canal treatment: a systematic review of cross-sectional studies. J Endod 38:1170–1176. https://doi.org/10.1016/j.joen.2012.05.023 CrossRefPubMed

Kanagasingam S, Lim CX, Yong CP, Mannocci F, Patel S (2017) Diagnostic accuracy of periapical radiography and cone beam computed tomography in detecting apical periodontitis using histopathological findings as a reference standard. Int Endod J 50:417–426. https://doi.org/10.1111/iej.12650 CrossRefPubMed

de Paula-Silva FW, Wu MK, Leonardo MR, da Silva LA, Wesselink PR (2009) Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard. J Endod 35:1009–1012. https://doi.org/10.1016/j.joen.2009.04.006 CrossRefPubMed

Dutta A, Smith-Jack F, Saunders WP (2014) Prevalence of periradicular periodontitis in a Scottish subpopulation found on CBCT images. Int Endod J 47:854–863. https://doi.org/10.1111/iej.12228 CrossRefPubMed

Van der Veken D, Curvers F, Fieuws S, Lambrechts P (2017) Prevalence of apical periodontitis and root filled teeth in a Belgian subpopulation found on CBCT images. Int Endod J 50:317–329. https://doi.org/10.1111/iej.12631 CrossRefPubMed

Lemagner F, Maret D, Peters OA, Arias A, Coudrais E, Georgelin-Gurgel M (2015) Revalence of apical bone defects and evaluation of associated factors detected with cone-beam computed tomographic images. J Endod 41:1043–1047. https://doi.org/10.1016/j.joen.2015.03.011 CrossRefPubMed

De Moor RJ, Hommez GM, De Boever JG, Delmé KI, Martens GE (2000) Periapical health related to the quality of root canal treatment in a Belgian population. Int Endod J 33:113–120. https://doi.org/10.1046/j.1365-2591.2000.00295.x CrossRefPubMed

10.

Loftus JJ, Keating AP, McCartan BE (2005) Periapical status and quality of endodontic treatment in an adult Irish population. Int Endod J 38:81–86. https://doi.org/10.1111/j.1365-2591.2004.00902.x CrossRefPubMed

11.

Siqueira JF Jr, Rôças IN, Alves FR, Campos LC (2005) Periradicular status related to the quality of coronal restorations and root canal fillings in a Brazilian population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 100:369–374. https://doi.org/10.1016/j.tripleo.2005.03.029 CrossRefPubMed

12.

Tavares PB, Bonte E, Boukpessi T, Siqueira JF Jr, Lasfargues JJ (2009) Prevalence of apical periodontitis in root canal-treated teeth from an urban French population: influence of the quality of root canal fillings and coronal restorations. J Endod 35:810–813. https://doi.org/10.1016/j.joen.2009.03.048 CrossRefPubMed

13.

Kalender A, Orhan K, Aksoy U, Basmaci F, Er F, Alankus A (2013) Influence of the quality of endodontic treatment and coronal restorations on the prevalence of apical periodontitis in a Turkish Cypriot population. Med Princ Pract 22:173–177. https://doi.org/10.1159/000341753 CrossRefPubMed

14.

Di Filippo G, Sidhu SK, Chong BS (2014) Apical periodontitis and the technical quality of root canal treatment in an adult sub-population in London. Br Dent J 216:E22. https://doi.org/10.1038/sj.bdj.2014.431 CrossRefPubMed

15.

Strindberg LZ (1956) The dependence of the results of pulp therapy on certain factors. An analytic study based on radiographic and clinical follow-up examination. Acta Odontol Scand 14:Suppl. 21

16.

Wu MK, Shemesh H, Wesselink PR (2009) Limitations of previously published systematic reviews evaluating the outcome of endodontic treatment. Int Endod J 42:656–666. https://doi.org/10.1111/j.1365-2591.2009.01600.x CrossRefPubMed

17.

López FU, Kopper PM, Cucco C, Della Bona A, de Figueiredo JA, Vier-Pelisser FV (2014) Accuracy of cone-beam computed tomography and periapical radiography in apical periodontitis diagnosis. J Endod 40:2057–2060. https://doi.org/10.1016/j.joen.2014.09.003 CrossRefPubMed

18.

Al-Nuaimi N, Patel S, Davies A, Bakhsh A, Foschi F, Mannocci F (2018) Pooled analysis of 1-year recall data from three root canal treatment outcome studies undertaken using cone beam computed tomography. Int Endod J 51(Suppl 3):e216–e226. https://doi.org/10.1111/iej.12844 CrossRefPubMed

19.

Patel S, Dawood A, Mannocci F, Wilson R, Pitt Ford T (2009) Detection of periapical bone defects in human jaws using cone beam computed tomography and intraoral radiography. Int Endod J 42:507–515. https://doi.org/10.1111/j.1365-2591.2008.01538.x CrossRefPubMed

20.

Weissman J, Johnson JD, Anderson M, Hollender L, Huson T, Paranjpe A, Patel S, Cohenca N (2015) Association between the presence of apical periodontitis and clinical symptoms in endodontic patients using cone-beam computed tomography and periapical radiographs. J Endod 41:1824–1829. https://doi.org/10.1016/j.joen.2015.06.004 CrossRefPubMed

21.

Kruse C, Spin-Neto R, Wenzel A, Kirkevang LL (2015) Cone beam computed tomography and periapical lesions: a systematic review analysing studies on diagnostic efficacy by a hierarchical model. Int Endod J 48:815–828. https://doi.org/10.1111/iej.12388 CrossRefPubMed

22.

Torabinejad M, Rice DD, Maktabi O, Oyoyo U, Abramovitch K (2018) Incidence and size of periapical radiolucencies using cone-beam computed tomography in teeth without apparent intraoral radiographic lesions: a new periapical index with a clinical recommendation. J Endod 44:389–394. https://doi.org/10.1016/j.joen.2017.11.015 CrossRefPubMed

23.

Leonardi Dutra K, Haas L, Porporatti AL, Flores-Mir C, Nascimento Santos J, Mezzomo LA, Corrêa M, De Luca CG (2016) Diagnostic accuracy of cone-beam computed tomography and conventional radiography on apical periodontitis: a systematic review and meta-analysis. J Endod 42:356–364. https://doi.org/10.1016/j.joen.2015.12.015 CrossRefPubMed

24.

European Society of Endodontology, Patel S, Durack C, Abella F, Roig M, Shemesh H, Lambrechts P, Lemberg K (2014) European Society of Endodontology position statement: the use of CBCT in endodontics. Int Endod J 47:502–504. https://doi.org/10.1111/iej.12267 CrossRef

25.

Venskutonis T, Plotino G, Tocci L, Gambarini G, Maminskas J, Juodzbalys G (2015) Periapical and endodontic status scale based on periapical bone lesions and endodontic treatment quality evaluation using cone-beam computed tomography. J Endod 41:190–196. https://doi.org/10.1016/j.joen.2014.10.017 CrossRefPubMed

26.

Schulze R, Heil U, Gross D, Bruellmann DD, Dranischnikow E, Schwanecke U, Schoemer E (2011) Artefacts in CBCT: a review. Dentomaxillofac Radiol 40:265–273. https://doi.org/10.1259/dmfr/30642039 CrossRefPubMedPubMedCentral

27.

Sjögren U, Hägglund B, Sundquist G, Wing K (1990) Factors affecting the long-term results of endodontic treatment. J Endod 16:498–504. https://doi.org/10.1016/S0099-2399(07)80180-4 CrossRefPubMed

28.

Nascimento EHL, Gaêta-Araujo H, Andrade MFS, Freitas DQ (2018) Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis. Clin Oral Investig 22:2495–2503. https://doi.org/10.1007/s00784-018-2344-y CrossRefPubMed

29.

Peng L, Ye L, Tan H, Zhou X (2007) Outcome of root canal obturation by warm gutta-percha versus cold lateral condensation: a meta-analysis. J Endod 33:106–109. https://doi.org/10.1016/j.joen.2006.09.010 CrossRefPubMed

30.

Gomes AC, Nejaim Y, Silva AI, Haiter-Neto F, Cohenca N, Zaia AA, Silva EJ (2015) Influence of endodontic treatment and coronal restoration on status of periapical tissues: a cone-beam computed tomographic study. J Endod 41:1614–1618. https://doi.org/10.1016/j.joen.2015.07.008 CrossRefPubMed

31.

Ricucci D, Rôças IN, Alves FR, Loghin S, Siqueira JF Jr (2016) Apically extruded sealers: fate and influence on treatment outcome. J Endod 42:243–249. https://doi.org/10.1016/j.joen.2015.11.020 CrossRefPubMed

32.

Ng YL, Mann V, Gulabivala K (2011) A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J 24:610–625. https://doi.org/10.1111/j.1365-2591.2011.01873.x CrossRef

33.

Dalopoulou A, Economides N, Evangelidis V (2017) Extrusion of root canal sealer in periapical tissues - report of two cases with different treatment management and literature review. Balk J Dent Med 21:12–18. https://doi.org/10.1515/bjdm-2017-0002 CrossRef

34.

Petersson K, Håkansson R, Håkansson J, Olsson B, Wennberg A (1991) Follow-up study of endodontic status in an adult Swedish population. Endod Dent Traumatol 7:221–225. https://doi.org/10.1111/j.1600-9657.1991.tb00440.x CrossRefPubMed

35.

Paes da Silva Ramos Fernandes LM, Ordinola-Zapata R, Húngaro Duarte MA, Alvares Capelozza AL (2013) Prevalence of apical periodontitis detected in cone beam CT images of a Brazilian subpopulation. Dentomaxillofac Radiol 42:80179163. https://doi.org/10.1259/dmfr/80179163 CrossRefPubMedPubMedCentral

36.

Nur BG, Ok E, Altunsoy M, Ağlarci OS, Çolak M, Güngör E (2014) Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT. J Appl Oral Sci 22:502–508. https://doi.org/10.1590/1678-775720140110 CrossRefPubMed

37.

Bartley EJ, Fillingim RB (2013) Sex differences in pain: a brief review of clinical and experimental findings. Br J Anaesth 111:52–58. https://doi.org/10.1093/bja/aet127 CrossRefPubMedPubMedCentral

38.

Fillingim RB, Maixner W (1995) Gender differences in the responses to noxious stimuli. Pain Forum 4:209–221CrossRef

39.

European Commission; Directorate General Health and Consumers. European Special Eurobarometer 330. Oral Health Report (2010) http://ec.europa.eu/commfrontoffice/publicopinion/archives/ebs/ebs_330_en.pdf

Titel: Quality of root canal fillings and prevalence of apical radiolucencies in a German population: a CBCT analysis
verfasst von: Sebastian Bürklein
Edgar Schäfer
Hans-Peter Jöhren
David Donnermeyer
Publikationsdatum: 15.07.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 3/2020
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-02985-y

Neu im Fachgebiet Zahnmedizin

19.04.2024 | Vorhofflimmern | Nachrichten

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Quality of root canal fillings and prevalence of apical radiolucencies in a German population: a CBCT analysis

Abstract

Objectives

Material and methods

Results

Conclusions

Clinical relevance

Neu im Fachgebiet Zahnmedizin

Parodontalbehandlung verbessert Prognose bei Katheterablation

Invasive Zahnbehandlung: Wann eine Antibiotikaprophylaxe vor infektiöser Endokarditis schützt

Zell-Organisatoren unter Druck: Mechanismen des embryonalen Zahnwachstums aufgedeckt

Die Oralprophylaxe & Kinderzahnheilkunde umbenannt

Newsletter

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Objectives

Material and methods

Results

Conclusions

Clinical relevance

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2020

Optimizing mandibular sagittal split of large maxillomandibular advancements for obstructive sleep apnea: patient and surgical factors

A 2-year clinical evaluation of direct and semi-direct resin composite restorations in non-carious cervical lesions: a randomized clinical study

Twenty-four-month clinical performance of a glass hybrid restorative in non-carious cervical lesions of patients with bruxism: a split-mouth, randomized clinical trial

Evaluation of palatal support tissues for placement of orthodontic mini-implants in mouth breathers with high-narrow palates versus nose breathers with normal palates: a retrospective study

Second primary molar hypomineralisation and drugs used during pregnancy and infancy. A systematic review

The effects of intraperitoneal metoprolol administration on healing of bone defects in rat tibia: a pilot study

Neu im Fachgebiet Zahnmedizin

Parodontalbehandlung verbessert Prognose bei Katheterablation

Invasive Zahnbehandlung: Wann eine Antibiotikaprophylaxe vor infektiöser Endokarditis schützt

Zell-Organisatoren unter Druck: Mechanismen des embryonalen Zahnwachstums aufgedeckt

Die Oralprophylaxe & Kinderzahnheilkunde umbenannt

Newsletter