Üst Büyük Azı Dişlerinin Endodontik Tedavi Kalitelerinin ve Periapikal Sağlık Durumlarının Konik Işınlı Bilgisayarlı Tomografi ile Değerlendirilmesi

Abstract

ÖZET Amaç: Bu çalışmanın amacı, retrospektif konik ışınlı bilgisayarlı tomografi (KIBT) görüntülerinde endodontik tedavi görmüş üst büyük azı dişlerinin endodontik tedavi kalitelerinin ve periapikal bölge sağlıklarının, periapikal ve endodontik durum indeksi (PEDİ) kullanılarak değerlendirilmesidir. Gereç ve Yöntem: Çalışmaya endodontik tedavi görmüş 80 adet üst büyük azı dişine (47 birinci, 33 ikinci azı) ait toplam 240 kök dahil edilmiştir. Endodontik tedavi kalitesi ve periapikal bölgenin sağlık durumu değerlendirilmiştir. Veriler istatistiksel olarak analiz edilmiştir (p<0.05). Bulgular: Çalışma grubuna dahil olan dişlerin %77.5’inde (n=62) AP tespit edilmiştir. AP en çok üst birinci büyük azı dişlerinde (n=39) gözlenirken, dişler arasında AP görülmesi açısından anlamlı bir farklılık bulunmamıştır (p>0.05). Kökler içerisindei se AP en çok meziobukkal kökte tespit edilmiştir. Dişlerin büyük bir çoğunluğunda AP’nin anatomik yapılar ile ilişkili (D2) olduğu (%53.2n=33) gözlenmiştir. Kök kanal dolgusu normal sınırlardan eksik (L2) veya taşkın (L3) olduğunda AP görülmesi anlamlı derecede yüksek bulunmuştur (p=0.001). Distal ve palatinal köklerde yetersiz obtürasyon (H2) ile AP varlığı arasında anlamlı ilişki gözlenmiştir (p=0.001). Dişlerin %16.2’sinde (n=13) komplikasyona rastlanırken, bunlar içerisinde en sık apikal rezorpsiyon (CF5) (n=59) ve tedavi edilmemiş kanal (CF2) (n=17) tespit edilmiştir. Sonuç: Kanal tedavili üst büyük azı dişlerinde AP yüksek oranda saptanmıştır. İncelenen kökler içerisinde AP en çok, kompleks bir anatomik yapı sergileyen meziobukkal kökte tespit edilmiştir. Eksik, taşkın ve/veya homojen olmayan kanal dolumları AP oluşumunda etkili olabilecek faktörler olarak tespit edilmiştir.

Keywords

• Apikal periodontitis
• Kanal tedavisi
• Konik ışınlı bilgisayarlı tomografi
• Tedavi kalitesi

Evaluation of Endodontic Treatment Quality and Periapical Health Status of Maxillary Molars Using Cone-Beam Computed Tomography

Abstract

Objectives: The aim of this retrospective study was to evaluate the endodontic treatment quality and periapical health status of endodontically treated maxillary molars in retrospective cone beam computed tomography (CBCT) images using the periapical and endodontic status scale (PESS). Materials and Methods: A total of 240 roots of 80 endodontically treated maxillary molars (47 first, 33 second) were included in the study. The quality of endodontic treatment and the health status of the periapical region were evaluated. Data were statistically analyzed (p<0.05). Results: Apical Periodontitis (AP) was detected in 77.5% (n=62) of the study group. Although AP was mostly observed in the maxillary first molars (n=39), no significant difference was found between the molars (p>0.05). Among the roots, AP was mostly detected in the mesiobuccal root. In majority of the teeth (53.2%, n=33), AP was in contact with anatomical structures (D2). AP was found to be significantly higher when canal filling was shorter than normal (L2) or overfilling (L3) (p=0.001). A significant correlation was observed between insufficient obturation (H2) and the presence of AP (p=0.001) in distal and palatal roots. Complications were encountered in 16.2% (n=13) of the study group and apical resorption (CF5) (n=59) and untreated canal (CF2) (n=17)were the most common. Conclusion: A high rate of AP was detected in endodontically treated maxillary molars. AP was primarily observed in the mesiobuccal root which is exhibiting complex anatomy. Underfilled, overfilled and/or inhomogeneous canal fillings were determined as factors that may be effective in the formation of AP.

Keywords

• Apical periodontitis
• Cone-beam computed tomography Root canal treatment
• Treatment quality

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