Int J Stomatol

Int J Stomatol ›› 2023, Vol. 50 ›› Issue (2): 166-171.doi: 10.7518/gjkq.2023029

• Original Articles • Previous Articles     Next Articles

Retrospective analysis of clinical data of 288 cases of endodontic microsurgery on anterior teeth

Liang Zhiying(),Zhao Yuanxi,Zhu Jiani,Su Qin.()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2022-07-20 Revised:2022-11-02 Online:2023-03-01 Published:2023-03-14
  • Contact: Qin. Su E-mail:812263017@qq.com;1176629149@qq.com
  • Supported by:
    Research and Develop Program, West China Hospital of Stomatology, Sichuan University(LCYJ2019-6);Chengdu Key Application Projects of Science and Technology(2021-YF09-00078-SN)

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Abstract:

Objective This study aims to analyze the clinical data of endodontic microsurgery on the anterior teeth for preventing the occurrence of refractory apical periodontitis. Methods The medical records and radiographic examination data of 288 patients (517 teeth) who received endodontic microsurgery on the anterior teeth in the hospital were collected and analyzed. Results The participants included more female patients than male patients, and the main age group was 20-29 years. Traumatic teeth accounted for the highest proportion (58.41%), followed by carious teeth (32.49%) and chronic abrasion teeth (6.58%). Anatomical abnormal teeth had the lowest proportion (2.51%). The constituent ratio of initial tooth hard tissue diseases had statistical difference between gender (P<0.05). About half of the teeth treated with first time root canal treatment had proper obturation (48.93%), with underfilling and overfilling rates of 38.24% and 12.83%, respectively. For the teeth with root canal retreatment, underfilling was 23.47% and overfilling was 33.67%. Statistical difference was found between the first time root canal treatment and the root canal retreatment in obturation quality at underfilling and overfilling (P<0.05). Although the radiographic examination showed that the teeth had right obturation, apical leakage was found by endodontic microsurgery exploration. The results of the evaluation of root canal filling quality by X-ray, cone beam computed tomography (CBCT), and surgical exploration had statistical difference (P<0.05). Conclusion Most patients who underwent endodontic microsurgery on anterior teeth were young people with traumatic tooth history. Teeth with refractory apical periodontitis mostly had underfilling, overfil-ling, missing root canals, and poorly apical sealing during the root canal treatment. Treatment of traumatic teeth should be standardized in clinical work, and the quality of root canal treatment should be improved to prevent the occurrence of refractory apical periodontitis on anterior teeth.

Key words: endodontic microsurgery, anterior teeth, refractory apical periodontitis, retrospective study

CLC Number: 

  • R 781.05

TrendMD: 

Tab 1

Distribution of the anterior teeth undergoing endodontic microsurgery in patients of different gender and age"

患者年龄段/岁男性女性χ2值P值
≤1932/14.1637/12.7110.2000.037
20~2997/42.92123/42.27
30~3939/17.2677/26.46a
40~4925/11.0616/5.50a
≥5033/14.6038/13.06
合计226/100291/100

Tab 2

Distribution of the initial causes of teeth in different gender and age groups"

分组因素牙外伤龋坏慢性磨损解剖结构异常不同性别合计χ2值P值
不同年龄段合计302/100168/10034/10013/100
性别男140/61.9559/26.1123/10.184/1.77226/10014.7020.002
女162/55.67109/39.46a11/3.78a9/3.09291/100
年龄段/岁≤1952/17.2213/7.74b0/0.00bc4/30.77bcd*0.000
20~29160/52.9849/29.17b8/23.53b3/23.08
30~3950/16.5658/34.52b4/11.764/30.77
40~4916/5.3014/8.3310/29.41bc1/7.69
≥5024/7.9534/20.24b12/35.29b1/7.69

Tab 3

Root canal filling quality in root canal treatment and root canal retreatment evaluated by X-ray n/%"

根管充填质量初次根管治疗根管再治疗χ2值P值
合计374/10098/100
恰填183/48.9342/42.8625.0660.000
欠填143/38.2423/23.47a
超填48/12.8333/33.67a

Tab 4

Evaluation of root canal filling quality by X-ray examination, CBCT and surgical exploration"

根管充填质量X线片CBCT术中探查χ2值P值
良好362/72.98364/73.39112/22.58ab344.2260.000
不佳134/27.02132/26.61384/77.42ab

Fig 1

Different of the evaluation of root canal filling quality by X-ray examination and surgical exploration"

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