Pre and intraoperative factors impact on periapical healing of endodontically treated molars: a multicentric observational study

IF 4.8 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-06-10 DOI:10.1016/j.jdent.2025.105903

Carolina Bender Hoppe , Pauline Mastella Lang , Lara Dotto , Roberta Kochenborger Scarparo , Matheus Silveira Martins Hartmann , Maximiliano Schunke Gomes , Fabiana Soares Grecca

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引用次数: 0

Abstract

Introduction

Pre and intraoperative clinical variables of endodontic procedures are diverse among operators and schools, which may adopt different guidelines. Thus, it is challenging to establish comparisons regarding differences which can potentially influence the desired periapical healing. Thus, this study aimed to evaluate the influence of operative factors on the clinical and radiographic success of root canal treatment between two postgraduation centers.

Methods

The treatment outcome of 134 molars was assessed. Besides preoperative data, variations between treatment protocols were also collected. The root canal treatment was classified as ‘success’ or ‘failure' according to the Periapical Index score. Participants were followed-up for up to 48 months. Bi and multivariate models, using Poisson regression with robust variance, were used.

Results

The overall success rate of the root canal treatment was 79.9 %. Preoperative apical periodontitis was significantly associated with a poorer success rate (P = 0.007) of 71.6 % whereas when apical periodontitis was absent, the success rate raised to 90 %. The strength of this association was held even when the model is adjusted for age, sex, treatment protocol, tooth location, obturation level, and recall period. Hydraulic vertical condensation filling technique was associated with a 4-fold rate of overextension (P < 0.001). None of the other technical variables affected the outcome of endodontic treatment.

Conclusion

The presence of apical periodontitis is highly associated with worse endodontic prognostic, despite the guideline adopted by the postgraduation center.

Clinical relevance

Meaningful further development and research must provide innovative tools and techniques for endodontists, focusing mainly on anatomical complexity challenges. In this sense, a substantial increase in endodontic success rates in high complexity teeth treatment, such as molars, could be expected.

查看原文本刊更多论文

术前和术中因素对根管治疗后磨牙根尖周愈合的影响：一项多中心观察研究。

导言：不同术者和学校的牙髓治疗术前和术中临床变量不同，可能采用不同的指导方针。因此，建立可能影响预期根尖周愈合的差异的比较是具有挑战性的。因此，本研究旨在评估手术因素对两个研究生中心根管治疗临床和影像学成功的影响。方法：对134磨牙的治疗效果进行评价。除术前数据外，还收集了治疗方案之间的差异。根据根尖周指数评分将根管治疗分为“成功”或“失败”。研究人员对参与者进行了长达48个月的随访。使用Bi和多元模型，使用具有稳健方差的泊松回归。结果：根管治疗总成功率为79.9%。术前根尖牙周炎患者的成功率较低（P = 0.007），为71.6%，而无根尖牙周炎患者的成功率可达90%。即使模型考虑了年龄、性别、治疗方案、牙齿位置、封闭水平和回忆期等因素，这种关联的强度仍然存在。水力垂直冷凝填充技术与4倍的过伸率相关（P < 0.001）。其他技术变量均不影响根管治疗的结果。结论：根尖牙周炎的存在与较差的根管预后高度相关，尽管研究生中心采用了指导方针。临床相关性：有意义的进一步发展和研究必须为牙髓医生提供创新的工具和技术，主要关注解剖复杂性的挑战。从这个意义上说，可以预期在高复杂性牙齿治疗（如磨牙）中牙髓治疗成功率的大幅增加。

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 dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.