School of Dental Medicine, University of Zagreb, Croatian Dental Society - Croatian Medical Association
Abstract
Svrha ovoga rada bila je procijeniti povezanost kakvoće restaurativnoga poslijeendodontskoga nadomjestka zuba i kakvoće ispuna korijenskoga kanala s periapeksnim statusom liječenoga zuba temeljem radiografske raščlambe. Pregledavani su ortopani slučajno izabranih pacijenata Zavoda za bolesti zubi te Zavoda za parodontologiju Stomatološkog fakulteta u Zagrebu. Dva su ispitivača neovisno jedan od drugoga procijenili 696 endodontski liječenih zubi s 265 ortopana. Prema unaprijed dogovorenim radiografskim kriterijima tehnička kakvoća punjenja kanala (PK) procijenjena je kao dobra ili kao loša, a isto tako i kakvoća poslijeendodontskoga nadomjestka (PEN). Apeksna trećina korijena s okolnim strukturama radiografski je proučena te je periapeksni status kategoriziran kao nepostojanje periradikularne upale (NPU) ili kao postojanje periradikularne upale (PPU). Pojavnost NPU-a u ispitanim endodontski liječenim zubima bila je 45%. Dobro punjenje kanala rezultiralo je sa statistički znatno više NPU slučajeva (89%), za razliku od dobre kakvoće PEN-a (68%). Loš PK imalo je nešto višu pojavnost PPU-a (81%) u usporedbi s lošim PEN-om (79%). Kombinacija dobar PK/dobar PEN pokazala je najviše NPU slučajeva (94%), a skupina loš PK/ loš PEN najmanje (14%). Razlike između pojedinih skupina s obzirom na kakvoću ispuna kanala i kakvoću nadomjestka zuba statistički su znatne (p< 0,05).The purpose of this study was to evaluate the relationship of the quality of the postendodontic restoration and root canal obturation on the radiographic periapical status of endodontically treated teeth. Panoramic adiographs of randomly selected patients from the Department of Endodontics and Restorative Dentistry and the Department of Periodontology, School of Dental Medicine in Zagreb, were examined. Six hundred and ninety-six endodontically treated teeth from 265 panoramic radiographs were evaluated independently by two examiners. According to a predetermined radiographic set of criteria, the technical quality of the root filling of each tooth was scored as either good or poor, and the quality of the postendodontic restoration similarly good or poor. The apical one-third of the root and surrounding structures were then evaluated radiographically and the periapical status categorized as absence (API) or presence (PPI) of periradicular inflammation. The rate of API for all endodontically treated teeth was 45%. Good endodontic filling (GE) resulted in significantly more API cases than good postendodontic restoration (GR), 89% versus 68%. Poor endodontic filling (PE) resulted in slightly more PPI cases than poor postendodontically restoration (PR), 81% versus 79%. The combination of GE and GR had the highest API rate of 94%, significantly higher than PE and PR, with API rate of 14%. Differences among groups regarding the technical quality of the root filling, and the quality of the postendodontic restoration were statistically significant (p< 0.05)
