アピカルマイクロサージェリー後の恒常的な周縁部病変の評価と歯内療法の失敗との関連性

Assessment of Constant Periapical Lesions and Their Connection with Endodontic Failures after Apical Microsurgery.

抄録

背景:

根管治療を受けた歯には、歯周病が見られ、合併症を引き起こす可能性がある。確定診断のためには，X線撮影と組織学的評価が重要である．

Background: Periapical lesions can be appreciated in the teeth that have underwent root canal treatment leading to more complications. Radiographic as well as histological evaluation is important for definitive diagnosis.

目的:

本研究の目的は、根管治療を受けた歯に見られる一定の歯周部X線透過性病変の組織学的所見を調べ、組織学的所見とX線写真上の病変の大きさおよびX線不透過性のlaminaの有無との関連性を明らかにすることである。

Aim: The aim of this study was to examine the histology of constant periapical radiolucent lesions that are associated with root canal treated teeth and also to find association between histological findings and radiographic size of lesion as well as existence or nonappearance of a radiopaque lamina.

材料と方法:

本研究では、60本の切歯と犬歯を対象とした。2名の観察者が、歯根部のX線透過性病変の直径とX線不透過性ラミナの有無を調査した。アピカルマイクロサージェリー中に生検標本を採取し，組織処理後，口腔病理医が標本を光学顕微鏡で観察した。検体の組織学的特徴が考慮され、膿瘍、嚢胞、肉芽腫、瘢痕組織の診断が下された。Pearsonのカイ二乗検定を用いて、組織学的診断と病変の大きさとの間に成立する関係を調べた。

Materials and Methods: The study included 60 incisors and canines allotted for apical microsurgery. Two observers studied the diameter of periapical radiolucent lesions and the existence or nonappearance of radiopaque lamina. During apical microsurgery, biopsy specimens were collected and after tissue processing oral pathologist examined the specimen under a light microscope. Histological features of the specimen were taken into consideration, and the diagnosis of abscess, cyst, granuloma, and scar tissue were given. Pearson's chi-square test was used to study the established relationship between histological diagnosis and lesion size.

結果:

その結果、68.33％が肉芽腫、23.33％が嚢胞、5％が膿瘍、3.33％が瘢痕組織であった。

Results: Results indicated that 68.33% of lesions were granulomas, 23.33% were cysts, 5% were abscesses, and 3.33% were scar tissue.

結論:

組織学的結果によると、本研究の病変の多くは肉芽腫であり、次いで嚢胞であった。膿瘍や瘢痕組織はまれであった。

Conclusion: According to histological results, most of the lesions in this study were granulomas, followed by cysts. Abscesses and scar tissues were rare.