Seçilmiş bir Genç Türk Popülasyonunun Molar Dişlerinde Apikal Periodontitis Prevalansı ve Kanal Tedavisi Kalitesinin Değerlendirilmesi

Year 2020, Volume: 2 Issue: 2, 52 - 58, 31.10.2020

Merve Akbaş , Makbule Bilge Akbulut

Abstract

Amaç: Bu retrospektif çalışmanın amacı 2019 yılında Necmettin Erbakan Üniversitesi Diş Hekimliği Fakültesi Endodonti bölümüne başvuran 20-30 yaş aralığında rastgele seçilmiş hastaların molar dişlerindeki apikal periodontitis prevalansının ve mevcutsa kök kanal dolgularının teknik kalitesini ortopantomograf filmleri aracılığı ile belirlemektir.
Gereç ve Yöntemler: Bütün birinci ve ikinci büyük azı dişleri ağzında bulunan ve rastgele seçilen 400 hasta (200 kadın, 200 erkek) çalışmaya dahil edildi. Molar dişlerin periapikal durumu periapikal indeks skorlama sistemi kullanılarak değerlendirildi. Endodontik tedavinin kalitesi ve kök kanal tedavisinin dansitesi bir araştırmacı tarafından kaydedildi. Tüm radyografiler aynı gözlemci tarafından değerlendirildi. Kök kanal tedavisi kalitesi ve dişlerin periapikal durumu arasındaki ilişkiyi belirlemek için ki kare testi kullandı. Gözlemci içi tekrarlanabilirliği değerlendirmek için korelasyon analizi yapıldı. P <0.05 değerleri anlamlı kabul edildi.
Bulgular: İncelenen bütün molar dişlerin yaklaşık %10’u kanal tedavilidir. Hastaların tamamı değerlendirildiğinde en fazla kanal tedavisi uygulanan diş sol alt birinci molar diş iken en az kanal tedavisi uygulanan dişler ise sağ ve sol üst ikinci molar dişlerdir. PAI ölçümleri açısından gözlemci-içi uyumluluk yüksek bulunmuştur. Değerlendirilen dişlerin ortalama %12,43’ünde apikal periodontitis tespit edilmiştir. Kök kanal tedavisi yapılan dişlerin %54,1’i yetersiz kök kanal tedavisine sahip iken %45,9’u yeterli kök kanal tedavisine sahiptir. Yetersiz kök kanal tedavili dişlerin %19,3’ü sağlıklı olarak değerlendirilirken, %80,7’sinde apikal periodontitis tespit edilmiştir.
Sonuç: Sonuç olarak, fakültemize başvuran 20-30 yaş arası popülasyonun yetersiz kök kanal tedavili dişlerinin büyük çoğunluğunda apikal periodontitis mevcuttur. Bu çalışmanın bulguları, yetersiz kök kanal tedavisi ve apikal periodontitis arasında sıkı bir ilişki olduğunu göstermektedir.

Keywords

apikal periodontitis, kök kanal tedavisi, panoramik radyografi

References

• 1.Siqueira JF Jr, Rocas IN. Bacterial pathogenesis and mediators in apical periodontitis. Braz Dent J. 2007; 18(4): 267-80.
• 2.Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposure of dental pulps in germ-free and convenciona laboratory rats. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1965; 20: 340-49.
• 3.Moller AJ, Fabricius L, Dahlen G, Sundqvist G, Happonen RP. Apical periodontitis development and bacterial response to endodontic treatment. Experimental root canal infections in monkeys with selected bacterial strains. Eur J Oral Sci. 2004; 112: 207-15.
• 4.Kirkevang LL, Vaeth M, Horsted-Bindslev P, Bahrami G, Wenzel A. Risk factors for developing apical periodontitis in a general population. Int Endod J. 2007; 40: 290-9.
• 5.Al-Omari MA, Hazaa A, Haddad F. Frequency and distribution of root filled teeth and apical periodontitis in a Jordanian subpopulation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 111: 59-65.
• 6.Bender IB. Factors influencing the radiographic appearance of bony lesions. J Endod. 1982; 8: 161–70.
• 7.Van der Stelt PF. Experimentally produced bone lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1985; 59: 306 –12.
• 8.Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone I. J Am Dent Ass. 1961; 62: 152– 60.
• 9.Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone II. J Am Dent Ass. 1961; 62: 708 –16.
• 10.Ridao‑Sacie C, Segura‑Egea JJ, Fernandez‑Palacin A, Bullon‑Fernandez P, Rios‑Santos JV. Radiological assessment of periapical status using the periapical index: Comparison of periapical radiography and digital panoramic radiography. Int Endod J. 2007; 40: 433‑40.
• 11.Kaffe I, Gratt BM. Variations in the radiographic interpretation of the periapical dental region. J Endod. 1988; 14: 330‑5.
• 12.Huumonen S, Orstavik D. Radiological aspects of apical periodontitis. Endod Topics. 2002; 1: 3‑25.
• 13.Kamberi B, Hoxha V, Stavileci M, Dragusha E, Kuçi A, Kqiku L. Prevalence of apical periodontitis and endodontic treatment in a Kosovar adult population. BMC Oral Health 2011; 11: 32.
• 14.European Society of Endodontology. Quality guide lines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2006; 39: 921-30.
• 15.Kirkevang LL, Horsted-Bindslev P, Ørstavik D, Wenzel A. Frequency and distribution of endodontically treated teeth and apical periodontitis in an urban Danish population. Int Endod J. 2001; 34: 198–205.
• 16.Eriksen HM, Kirkevang LL, Petersson K. Endodontic epidemiology and treatment outcome: general considerations. Endod Topics. 2002; 2: 1–9.
• 17. Boucher Y, Matossian L, Rilliard F, Machtou P. Radiographic evaluation of the prevalence and technical quality of root canal treatment in a French subpopulation. Int Endod J. 2002; 35: 229‑38.
• 18.Gunduz K, Avsever H, Orhan K, Demirkaya K. Cross‑sectional evaluation of the periapical status as related to quality of root canal fillings and coronal restorations in a rural adult male population of Turkey. BMC Oral Health. 2011; 11:20.
• 19.Alkis H T, Kustarci A. Radiographic assessment of the relationship between root canal treatment quality, coronal restoration quality, and periapical status. Niger J Clin Pract. 2019; 22: 1126-31.
• 20.Gencoglu N, Pekiner FN, Gumru B, Helvacioglu D. Periapical status and quality of root fillings and coronal restorations in an adult Turkish subpopulation. Eur J Dent. 2010; 4: 17-22.
• 21.Tavares PB, Bonte E, Boukpessi T, Siqueira JF, Lasfargues JJ. 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. 2009; 35: 810‑3.
• 22.Dugas NN, Lawrence HP, Teplitsky PE, Pharoah MJ, Friedman S. Periapical health and treatment quality assessment of root-filled teeth in two Canadian populations. Int Endod J. 2003; 36: 181-92.
• 23.Orstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol. 1986; 2:20-34.
• 24.De Cleen MJ, Schuurs AH, Wesselink PR, Wu MK. Periapical status and prevalence of endodontic treatment in an adult Dutch population. Int Endod J. 1993; 26: 112-9.
• 25.Aeılqwıst M, Halung A, Hollender L. Rotational panoramic radiography in epidemiological studies of dental health. Swed Dent J 1986; 10: 73-84.
• 26.Molander B, Ahlqwist M, Grondahl HG, Hollender L. Comparison of panoramic and intraoral radiography for the diagnosis of caries and periapical pathology. Dentomaxillofac Radiol. 1993; 22, 28-32.
• 27.Nardi C, Calistri L, Pietragalla M, Vignoli C, Lorini C, Berti V et al. Electronic processing of digital panorami radiography for the detection of apical periodontitis. Radiol Med. 2020; 125: 145–54.
• 28.Rohlin M, Kullendorff B, Ahlqwist M, Stenström B. Observer performance in the assessment of periapical pathology: a comparison of panoramic with periapical radiography. Dentomaxillofac Radiol. 1991; 20: 127–31.
• 29.LeQuire AK, Cunningham CJ, Pelleu GB. Radiographic interpretation of experimentally produced osseous lesions of the human mandible. J Endod. 1977; 3: 274–6.
• 30.Harris D, Horner K, Groendahl K, Jacobs R, Helmrot E, Benic G et al. E.A.O. guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European Association for Osseointegration at the Medical University of Warsaw. Clin Oral Implants Res. 2012; 23: 1243–53.
• 31.Kayahan MB, Malkondu O, Canpolat C, Kaptan F, Bayirli G, Kazazoglu E. Periapical health related to the type of coronal restorations and quality of root canal fillings in a Turkish subpopulation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105: 58‑62.
• 32.Yildirim D, Aydın U, Gormez O, Yilmaz H, Bozdemir E, Aglarci O et al. Endodontically related lesions on panoramic radiographs in a turkish subpopulation. J Oral Maxillofac Radiol. 2013; 1: 8-12.
• 33.Ureyen Kaya B, Kececi AD, Guldas HE, Orhan H. A Retrospective Radiographic Study of Coronal-Periapical Status and Root Canal Filling Quality in a Selected Adult Turkish Population. Med Princ Pract. 2013; 22: 334–9.
• 34.Lupi-Pegurier L, Bertrand MF, Muller-Bolla M, Rocca JP, Bolla M. Periapical status, prevalence and quality of endodontic treatment in an adult French population. Int Endod J. 2002; 35: 690-7.
• 35.Cotton TP, Geisler TM, Holden DT, Schwartz SA, Schindler WG. Endodontic applications of cone-beam volumetric tomography. J Endod. 2007; 33: 1121–32.
• 36.Lofthag-Hansen S, Hummonen S, Grondahl K, Grondahl HG. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103: 114–9.
• 37.Nardi C, Talamonti C, Pallotta S, Saletti P, Calistri L, Cordopatri C et al. Head and neck effective dose and quantitative assessment of image quality: a study to compare cone beam CT and multislice spiral CT. Dento maxillofac Radiol. 2017; 46:20170030.
• 38.Kruse C, Spin-Neto R, Wenzel A, Kirkevang LL. Cone beam computed tomography and periapical lesions: a systematic review an alysing studies on diagnostic efficacy by a hierarchical model. Int Endod J. 2015; 48: 815–28.
• 39.American Association of Endodontists, American Academy of Oral and Maxillofacial Radiology. Use of conebeam CT in endodontics: 2015/2016 update. Available at: https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/ 06/conebeamstatement.pdf.
• 40.Loftus JJ, Keating AP, McCartan BE. Periapical status and quality of endodontic treatment in an adult Irish population. Int Endod J. 2005; 38: 81–86.
• 41.Orstavik D. Reliability of the periapical index scoring system. Scand J Dent Res. 1988; 96: 108‑11.