Effect of the Time Interval of Functional Loading on the Periapical Healing of Endodontically Treated Mandibular Molar Teeth with Pulp Necrosis and Asymptomatic Apical Periodontitis: A Split-mouth Randomized Clinical Study

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics Pub Date : 2024-10-01 DOI:10.1016/j.joen.2024.07.013

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Abstract

Introduction

This prospective study evaluated the effect of immediate functional loading (IFL) of a full-coverage prosthesis on the clinical and radiographic outcome of nonsurgical endodontic therapy (NSET) performed on mandibular molar teeth with pulp necrosis and asymptomatic apical periodontitis.

Methods

In 20 subjects, standardized 2-visit NSET was performed in bilateral mandibular first molar teeth (split-mouth model) with a diagnosis of pulp necrosis and asymptomatic apical periodontitis exhibiting a radiographic periapical index (PAI) score ≥3. In each subject, the nonvital bilateral mandibular first molar teeth were randomized to 1 of 2 groups: the IFL group or the functional loading after a time interval of 6 months group. Provisional full-coverage prostheses were provided within 7 days after the completion of endodontic therapy. The cases were followed up clinically and radiographically at 6 and 12 months. Radiographs were assessed for periapical healing based on PAI scores, which were dichotomized as healed (PAI score ≤2) or nonhealed (PAI score ≥3). The data were compared using chi-square and Fisher exact tests.

Results

A recall rate of 100% was achieved at the end of 12 months. All teeth in the IFL group and the functional loading after a time interval of 6 months group were clinically asymptomatic. According to an intergroup comparison between the proportion of teeth healed and nonhealed (radiographic), there was a significant difference (P < .05).

Conclusions

IFL of a full-coverage prosthesis in endodontically treated mandibular molar teeth with pulp necrosis and asymptomatic apical periodontitis delayed periapical healing.

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功能负荷时间间隔对牙髓坏死和无症状根尖牙周炎下颌磨牙根管治疗后根尖周愈合的影响：分口随机临床研究。

导言：这项前瞻性研究评估了对牙髓坏死和无症状根尖牙周炎的下颌第一磨牙进行非手术牙髓治疗（NSET）后，全覆盖修复体的即刻功能性加载（IFL）对临床和影像学结果的影响：在 20 名受试者中，对诊断为牙髓坏死和无症状根尖牙周炎的双侧下颌第一磨牙（分口模型）进行了两次标准化的非手术根管治疗（NSET），其放射根尖周指数（PAI）得分≥3。每名受试者的双侧下颌第一磨牙均无髓质，随机分为两组，即 IFL 组（即刻功能负荷）或 NFL 组（间隔 6 个月后功能负荷）。牙髓治疗完成后七天内提供临时全覆盖修复体。分别在 6 个月和 12 个月后对病例进行临床和影像学随访。根据 PAI 评分评估根尖周愈合情况，并将其分为愈合（PAI 评分≤2）和未愈合（PAI 评分≥3）两种。数据比较采用卡方检验（Chi-square）和费舍尔精确检验（Fischer's exact tests）：结果：12 个月后的复诊率为 100%。IFL 组和 NFL 组的所有牙齿均无临床症状。在组间比较中，痊愈和未痊愈的牙齿比例（影像学）有显著差异（p）：对牙髓坏死和无症状根尖牙周炎的下颌磨牙进行根管治疗后，全覆盖修复体的即刻功能性加载延迟了根尖周愈合。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of endodontics 医学-牙科与口腔外科

CiteScore

8.80

自引率

9.50%

发文量

224

审稿时长

42 days

期刊介绍： The Journal of Endodontics, the official journal of the American Association of Endodontists, publishes scientific articles, case reports and comparison studies evaluating materials and methods of pulp conservation and endodontic treatment. Endodontists and general dentists can learn about new concepts in root canal treatment and the latest advances in techniques and instrumentation in the one journal that helps them keep pace with rapid changes in this field.