PDF(Pubmed)
Abstract：
OBJECTIVE: To assess the effectiveness of a self-constructed modified apical negative pressure irrigation (ANPI) system employing commonly used clinical instruments in nonsurgical root canal therapy (NSRCT) for large cyst-like periapical lesions (LCPLs).
METHODS: From 2017 to 2022, 35 patients diagnosed with LCPLs (5-15 mm) via preoperative clinical and radiographic evaluations of endodontic origin underwent NSRCT combined with ANPI. These patients were subjected to postoperative clinical and radiographic follow-up at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years, with a CBCT scan specifically conducted at 6-month follow-up. Through the reconstruction of three-dimensional cone beam computed tomography (CBCT) data, an early prognosis was facilitated by monitoring changes in lesion volume. Various treatment predictors-including sex, type of treatment, lesion size, preoperative pain, jaw, type of teeth involved, sealer extrusion, and the number of root canals-were meticulously analyzed. The evaluation of post-treatment outcomes leveraged both clinical observations and radiographic data collected during the follow-up periods. The Kruskal‒Wallis test and one-way ANOVA were also conducted to determine the independent factors influencing treatment outcomes. A significance level of 5% was established.
RESULTS: Thirty-five teeth from 35 patients with a median age of 28 years (range 24-34) were treated; the median follow-up duration was 19 months (range 12-26). The overall success rate was 91.4%, with a median lesion reduction of 77.0% (range 54.2-96.4%) at 6 months. Patients under 30 years of age exhibited a significantly greater success rate than older patients did (100.0% vs. 80.0%, p = 0.037). Other factors, such as sex, jaw, treatment type, preoperative pain, cyst size, tooth location, sealer extrusion, and the number of roots, did not significantly impact treatment outcomes.
CONCLUSIONS: Despite limitations related to the observational case-series study design and relatively small sample size, our findings suggest that utilizing the ANPI in the NSRCT for LCPLs may hold promise. The notably higher success rate in patients younger than 30 years is worth noting.
METHODS: From 2017 to 2022, 35 patients diagnosed with LCPLs (5-15 mm) via preoperative clinical and radiographic evaluations of endodontic origin underwent NSRCT combined with ANPI. These patients were subjected to postoperative clinical and radiographic follow-up at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years, with a CBCT scan specifically conducted at 6-month follow-up. Through the reconstruction of three-dimensional cone beam computed tomography (CBCT) data, an early prognosis was facilitated by monitoring changes in lesion volume. Various treatment predictors-including sex, type of treatment, lesion size, preoperative pain, jaw, type of teeth involved, sealer extrusion, and the number of root canals-were meticulously analyzed. The evaluation of post-treatment outcomes leveraged both clinical observations and radiographic data collected during the follow-up periods. The Kruskal‒Wallis test and one-way ANOVA were also conducted to determine the independent factors influencing treatment outcomes. A significance level of 5% was established.
RESULTS: Thirty-five teeth from 35 patients with a median age of 28 years (range 24-34) were treated; the median follow-up duration was 19 months (range 12-26). The overall success rate was 91.4%, with a median lesion reduction of 77.0% (range 54.2-96.4%) at 6 months. Patients under 30 years of age exhibited a significantly greater success rate than older patients did (100.0% vs. 80.0%, p = 0.037). Other factors, such as sex, jaw, treatment type, preoperative pain, cyst size, tooth location, sealer extrusion, and the number of roots, did not significantly impact treatment outcomes.
CONCLUSIONS: Despite limitations related to the observational case-series study design and relatively small sample size, our findings suggest that utilizing the ANPI in the NSRCT for LCPLs may hold promise. The notably higher success rate in patients younger than 30 years is worth noting.
摘要：
目的：评估在非手术根管治疗（NSRCT）中采用常用临床仪器的自行构建的改良根尖负压冲洗（ANPI）系统的有效性。
方法：2017年至2022年，35例通过术前临床和影像学评估牙髓起源诊断为LCPL（5-15mm）的患者接受了NSRCT联合ANPI治疗。这些患者在术后3个月接受临床和影像学随访，6个月,1年,2年,3年,4年,在6个月随访时进行CBCT扫描。通过重建三维锥束CT(CBCT)数据,监测病变体积的变化有助于早期预后.各种治疗预测因素-包括性别，治疗类型,病变大小,术前疼痛,下巴,涉及的牙齿类型，密封剂挤出，并对根管的数量进行了细致的分析。对治疗后结果的评估利用了随访期间收集的临床观察和影像学数据。还进行了Kruskal-Wallis检验和单向方差分析以确定影响治疗结果的独立因素。建立了5%的显著性水平。
结果：35例患者的35颗牙齿接受了治疗，中位年龄为28岁（范围24-34）；中位随访时间为19个月（范围12-26）。总体成功率为91.4%,6个月时，中位病变减少77.0%（范围54.2-96.4%）。30岁以下患者的成功率明显高于老年患者（100.0％vs.80.0%,p=0.037)。其他因素,比如性，下巴,治疗类型,术前疼痛,囊肿大小,牙齿位置,密封剂挤出，和根的数量，对治疗结果无显著影响.
结论：尽管与观察性病例系列研究设计相关的局限性和相对较小的样本量，我们的研究结果表明，在NSRCT中利用ANPI进行LCPL可能是有希望的。值得注意的是，30岁以下患者的成功率明显更高。
方法：2017年至2022年，35例通过术前临床和影像学评估牙髓起源诊断为LCPL（5-15mm）的患者接受了NSRCT联合ANPI治疗。这些患者在术后3个月接受临床和影像学随访，6个月,1年,2年,3年,4年,在6个月随访时进行CBCT扫描。通过重建三维锥束CT(CBCT)数据,监测病变体积的变化有助于早期预后.各种治疗预测因素-包括性别，治疗类型,病变大小,术前疼痛,下巴,涉及的牙齿类型，密封剂挤出，并对根管的数量进行了细致的分析。对治疗后结果的评估利用了随访期间收集的临床观察和影像学数据。还进行了Kruskal-Wallis检验和单向方差分析以确定影响治疗结果的独立因素。建立了5%的显著性水平。
结果：35例患者的35颗牙齿接受了治疗，中位年龄为28岁（范围24-34）；中位随访时间为19个月（范围12-26）。总体成功率为91.4%,6个月时，中位病变减少77.0%（范围54.2-96.4%）。30岁以下患者的成功率明显高于老年患者（100.0％vs.80.0%,p=0.037)。其他因素,比如性，下巴,治疗类型,术前疼痛,囊肿大小,牙齿位置,密封剂挤出，和根的数量，对治疗结果无显著影响.
结论：尽管与观察性病例系列研究设计相关的局限性和相对较小的样本量，我们的研究结果表明，在NSRCT中利用ANPI进行LCPL可能是有希望的。值得注意的是，30岁以下患者的成功率明显更高。
