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Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT.

Nur BG, Ok E, Altunsoy M, Ağlarci OS, Çolak M, Güngör E - J Appl Oral Sci (2014 Nov-Dec)

Bottom Line: Statistical analysis was performed using percentages and chi-square test.Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth].The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics.

View Article: PubMed Central - PubMed

Affiliation: Department of Pedodontics, Faculty of Dentistry, Şifa University, Izmir, Turkey.

ABSTRACT

Objective: This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation.

Material and methods: The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test.

Results: The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth].

Conclusions: The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics.

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A-E) Insufficient (underfilled) root canal filling; B) undetected canals; C,G) Apical lesion; F) Overfilled root filling and instrument fracture I); Apical resorption H,J); Sufficient root filling
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f01: A-E) Insufficient (underfilled) root canal filling; B) undetected canals; C,G) Apical lesion; F) Overfilled root filling and instrument fracture I); Apical resorption H,J); Sufficient root filling

Mentions: The CBCT images were obtained using a CBCT scanner (I-CAT Vision TM Imaging Science International, Hatfield, USA, 2008) at 120 kVp, 18.54 mA, with an exposure time of 8-9 s. The voxel size of the images was 0.3 mm. The acquisition process was performed by an experienced radiologist according to the recommendations of the manufacturer, with the minimum exposure necessary for adequate image quality. Intraexaminer calibration of the CBCT images was first performed to evaluate the reliability of the assessment. All images were assessed separately two times by two examiners (an endodontist and a maxillofacial radiologist) with a 2-week interval between the assessments. In the case of disagreements between the pair, these were discussed with another radiologist until a consensus was reached. The following factors were assessed in all images: sex, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion, type and quality of the coronal structure and sufficient (overfilled) and insufficient (underfilled) root canal filling (RF) (Figure 1). The criteria used for the examination were slightly modified from those described by De Moor, et al.4 (2000): sufficient RF was defined as a root canal space that was completely filled, ending 1–2 mm from the apex, and with no voids; insufficient RF was defined as a root canal space that was poorly condensed, ending more than 2 mm from the apex, and with voids. Additionally, the quality of coronal restoration was assessed according to any permanent restoration, radiographic signs of recurrent caries, open margins or presence of temporary coronal restorations or no restoration (Figure 2).


Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT.

Nur BG, Ok E, Altunsoy M, Ağlarci OS, Çolak M, Güngör E - J Appl Oral Sci (2014 Nov-Dec)

A-E) Insufficient (underfilled) root canal filling; B) undetected canals; C,G) Apical lesion; F) Overfilled root filling and instrument fracture I); Apical resorption H,J); Sufficient root filling
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4307763&req=5

f01: A-E) Insufficient (underfilled) root canal filling; B) undetected canals; C,G) Apical lesion; F) Overfilled root filling and instrument fracture I); Apical resorption H,J); Sufficient root filling
Mentions: The CBCT images were obtained using a CBCT scanner (I-CAT Vision TM Imaging Science International, Hatfield, USA, 2008) at 120 kVp, 18.54 mA, with an exposure time of 8-9 s. The voxel size of the images was 0.3 mm. The acquisition process was performed by an experienced radiologist according to the recommendations of the manufacturer, with the minimum exposure necessary for adequate image quality. Intraexaminer calibration of the CBCT images was first performed to evaluate the reliability of the assessment. All images were assessed separately two times by two examiners (an endodontist and a maxillofacial radiologist) with a 2-week interval between the assessments. In the case of disagreements between the pair, these were discussed with another radiologist until a consensus was reached. The following factors were assessed in all images: sex, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion, type and quality of the coronal structure and sufficient (overfilled) and insufficient (underfilled) root canal filling (RF) (Figure 1). The criteria used for the examination were slightly modified from those described by De Moor, et al.4 (2000): sufficient RF was defined as a root canal space that was completely filled, ending 1–2 mm from the apex, and with no voids; insufficient RF was defined as a root canal space that was poorly condensed, ending more than 2 mm from the apex, and with voids. Additionally, the quality of coronal restoration was assessed according to any permanent restoration, radiographic signs of recurrent caries, open margins or presence of temporary coronal restorations or no restoration (Figure 2).

Bottom Line: Statistical analysis was performed using percentages and chi-square test.Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth].The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics.

View Article: PubMed Central - PubMed

Affiliation: Department of Pedodontics, Faculty of Dentistry, Şifa University, Izmir, Turkey.

ABSTRACT

Objective: This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation.

Material and methods: The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test.

Results: The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth].

Conclusions: The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics.

Show MeSH
Related in: MedlinePlus