目的:评估使用矿物三氧化物聚集体(MTA;DentsplySirona,夏洛特,NC,美国),EndoSequence根修复材料(RRM腻子;Brasseler,萨凡纳,GA),和可注射生物陶瓷(BC)密封剂(BrasselerUSA),然后应用RRM腻子(盖子技术)作为根端填充材料。
方法:招募2016年至2020年在阿卜杜勒阿齐兹国王大学牙科医院接受EMS的110例患者,在至少1年后进行临床和影像学随访。使用根尖周X光片(PAs)和锥形束计算机断层扫描(CBCT)进行影像学评估。使用Amira软件进行根尖周放射透明度(PARL)的体积分析。
结果:79例患者(103颗牙齿:MTA组,n=28;RRM腻子,n=41;盖子技术,n=34),出席了后续访问,平均随访24个月(召回率=74.5%)。在103颗牙齿中,40人是先辈,24个是前磨牙,39颗是磨牙.所有三组逆行充填材料(MTA,RRM腻子,和盖子技术)在两个PA上都显示出较高的成功率(85.7、85.4、94.1%,分别)和CBCT成像(67.9、75.6、88.2%,分别),不同材料的成功率无明显差异。总的来说,PA和CBCT结果之间略有一致性,差异有统计学意义(P=0.029)。没有一个病人-,tooth-,或治疗相关因素显着影响EMS的结局。根管充填材料的足够密度与CBCT上完全愈合病例的高百分比显着相关(P=0.044)。EMS后随访1-4年,PARL体积显着减少(P<0.001)结论:当MTA时,EMS在PA和CBCT上显示出较高的成功率,RRM腻子或盖子技术被用作逆行填充材料。CBCT成像在检测EMS的愈合结果方面比PA更精确。
To evaluate the outcomes of endodontic microsurgery (EMS) using mineral trioxide aggregate (MTA; Dentsply Sirona, Charlotte, NC, USA), EndoSequence root repair material (RRM putty; Brasseler, Savannah, GA), and injectable Bioceramic (BC) sealer (Brasseler USA) followed by the application of RRM putty (lid technique) as root-end filling materials.
One hundred and ten patients who underwent EMS between 2016 and 2020 at King Abdulaziz University Dental Hospital were recruited for clinical and radiographic follow-up after a minimum of 1 year. Radiographic assessment was performed using periapical radiographs (PAs) and cone-beam computed tomography (CBCT). Volumetric analysis of periapical radiolucencies (PARLs) was performed using Amira software.
Seventy-nine patients (103 teeth: MTA group, n = 28; RRM putty, n = 41; lid technique, n = 34), attended the follow-up visit, with an average follow-up period of 24 months (recall rate = 74.5%). Of the 103 teeth, 40 were anteriors, 24 were premolars, and 39 were molars. All three groups of retrograde filling materials (MTA, RRM putty, and lid technique) showed high success rates on both PA (85.7, 85.4, 94.1%, respectively) and CBCT imaging (67.9, 75.6, 88.2%, respectively), without any significant difference among the success rates of different materials. Overall, a slight agreement was noted between the PA and CBCT outcomes, with a statistically significant difference (P = 0.029). None of the patient-, tooth-, or treatment-related factors significantly influenced the outcomes of EMS. Adequate density of root canal filling material was significantly associated with a high percentage of completely healed cases on CBCT (P = 0.044). PARL volumes were reduced significantly over 1-4 years follow-up after EMS (P < 0.001) CONCLUSIONS: EMS showed high success rates on both PA and CBCT when MTA, RRM putty or lid technique were used as retrograde filling materials. CBCT imaging is more precise than PA in detecting the healing outcomes of EMS.