背景:牙髓治疗旨在根除根管空间以及牙齿根尖周(PA)区域内的微生物感染和炎症过程。为了实现这一点,运河应该清理干净,shaped,消毒,并封闭到适当的工作长度。临床上,工作长度被描述为从冠状参考点到位于根尖孔的生理顶点的测量值。在现有文献中,电子根尖定位器(EAL)与根尖(PA)X线照片是最可靠和精确的工具,用于确定工作长度在常规根管治疗。因此,这项回顾性临床研究的目的是评估与标准临床测量方法相比,锥形束计算机断层扫描(CBCT)在测量牙髓工作长度方面是否可靠和准确.
方法:确定符合纳入标准的患者。一位研究生牙髓住院医师对锥形束计算机断层扫描扫描结果视而不见,治疗了需要牙髓治疗的视野中的所有牙齿。使用JMoritaRootZXII根尖定位器确定根管长度(JMoritaCorp.,京都,日本)和根尖X射线照片。牙科放射学专家解释预先存在的锥形束计算机断层扫描(CBCT)扫描图像并确定工作长度。EAL和CBCT的工作长度测量的统计比较在验证正态后使用配对样本t检验进行。
结果:除仅腭管外,所有运河的工作长度均无统计学意义(t=2.16,p=0.034),表明EAL和CBCT之间的测量结果一致。
结论:在需要牙髓治疗的牙齿中,在确定工作长度时,预先存在的锥形束计算机断层扫描扫描图像作为电子顶点定位器是准确的。这项研究的局限性在于,它仅包含有限数量的样本,并且受操作员变化的影响。
BACKGROUND: Endodontic treatment aims to eradicate both microbial infection and inflammatory processes within the root canal space as well as in the periapical (PA) region of the tooth. To achieve this, the canals should be cleaned, shaped, disinfected, and obturated to the proper working length. Clinically, the working length is described as the measurement from the coronal reference point to the physiological apex located at the apical foramen. In the available literature, electronic apex locators (EAL) with periapical (PA) radiographs are the most reliable and precise tools for determining the working length in routine root canal treatment. Therefore, the aim of this retrospective clinical
study is to evaluate if cone beam computed tomography (CBCT) scans are reliable and accurate in measuring endodontic working length compared to standard clinical measurement methods.
METHODS: Patients who fit the inclusion criteria were identified. A postgraduate endodontic resident blinded to the cone beam computed tomography scan results treated all teeth in the field of view that needed endodontic treatment. The root canal length was determined using J Morita Root ZX II apex locator (J Morita Corp., Kyoto, Japan) and periapical radiographs. The dental radiology specialist interpreted the pre-existing cone beam computed tomography (CBCT) scan images and determined the working length. Statistical comparisons of the working length measurements of EAL and CBCT were performed using paired sample t-tests after verifying normality.
RESULTS: No statistically significant differences in the working lengths were found in all canals with the exception of the palatal canal only (t=2.16, p=0.034), suggesting consistent measurements between EAL and CBCT.
CONCLUSIONS: In teeth requiring endodontic treatment, pre-existing cone beam computed tomography scan images are accurate as electronic apex locators when determining the working length. A limitation of this
study is that it only includes a limited number of samples and is affected by operator variation.