歯内療法的治療を受けた歯の周縁状態と歯根充填および冠状修復物の技術的品質との関係

Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration.

• H A Ray
• M Trope

抄録

本研究の目的は、歯内治療を受けた歯のレントゲン撮影時の歯周状態と冠状修復物の質と根管閉塞の関係を評価することであった。テンプル大学歯学部で無作為に選択された新患フォルダからの全口腔X線写真を調査した．永久修復物で修復された最初の歯内療法的治療を受けた1010本の歯を2人の検査員が独立して評価した．ポスト型およびコア型修復物は除外した。事前に設定された標準的なレントゲン撮影基準に従って、各歯の歯根充填の技術的品質を良好（GE）または不良（PE）とし、冠状修復物の品質を同様に良好（GR）または不良（PR）と採点した。次に、歯根の先端1/3とその周囲の構造をX線写真で評価し、歯根周囲の状態を(a)歯根周囲炎の欠如(API)または(b)歯根周囲炎の存在(PPI)に分類した。歯内療法で治療されたすべての歯のAPIの割合は61.07%であった。GRはGEよりもAPI症例が80％対75.7％と有意に多かった。PRはPEよりもPPIの症例数が有意に多く、30.2％対48.6％であった。GRとGEの組み合わせは91.4%と最も高いAPI率を示し、PRとPEのAPI率18.1%よりも有意に高かった。

The purpose of this study was to evaluate the relationship of the quality of the coronal restoration and of the root canal obturation on the radiographic periapical status of endodontically treated teeth. Full-mouth radiographs from randomly selected new patient folders at Temple University Dental School were examined. The first 1010 endodontically treated teeth restored with a permanent restoration were evaluated independently by two examiners. Post and core type restorations were excluded. According to a predetermined radiographic standard set of criteria, the technical quality of the root filling of each tooth was scored as either good (GE) or poor (PE), and the quality of the coronal restoration similarly good (GR) or poor (PR). The apical one-third of the root and surrounding structures were then evaluated radiographically and the periradicular status categorized as (a) absence of periradicular inflammation (API) or (b) presence of periradicular inflammation (PPI). The rate of API for all endodontically treated teeth was 61.07%. GR resulted in significantly more API cases than GE, 80% versus 75.7%. PR resulted in significantly more PPI cases than PE, 30.2% versus 48.6%. The combination of GR and GE had the highest API rate of 91.4%, significantly higher than PR and PE with a API rate of 18.1%.