Influence of intracanal post on apical periodontitis identified by cone-beam computed tomography

ABSTRACT

The determination of the success of endodontic treatment has been often discussed based on outcome obtained by periapical radiography. The aim of this study was to verify the influence of intracanal post on apical periodontitis detected by cone-beam computed tomography (CBCT). A consecutive sample of 1020 images (periapical radiographs and CBCT scans) taken from 619 patients (245 men; mean age, 50.1 years) between February 2008 and September 2009 were used in this study. Presence and intracanal post length (short, medium and long) were associated with apical periodontitis (AP). Chi-square test was used for statistical analyses. Significance level was set at p<0.01. The kappa value was used to assess examiner variability. From a total of 591 intracanal posts, AP was observed in 15.06 percent, 18.78 percent and 7.95 percent using periapical radiographs, into the different lengths, short, medium and long, respectively (p=0.466). Considering the same posts length it was verified AP in 24.20 percent, 26.40 percent and 11.84 percent observed by CBCT scans, respectively (p=0.154). From a total of 1,020 teeth used in this study, AP was detected in 397 (38.92 percent) by periapical radiography and in 614 (60.19 percent) by CBCT scans (p<0.001). The distribution of intracanal posts in different dental groups showed higher prevalence in maxillary anterior teeth (54.79 percent). Intracanal posts lengths did not influenced AP. AP was detected more frequently when CBCT method was used.

RESUMO

O objetivo deste estudo foi determinar a influência de retentores intraradiculares na periodontite apical (PA), detectados por radiografia periapical (RP) e tomografia computadorizada de feixe cônico (TCFC). Um total de 1.020 imagens, tomadas de 619 pacientes (245 homens, idade média de 50,1 anos), entre Fevereiro de 2008 e Setembro de 2009, foram avaliadas. A presença e o comprimento de retentores intraradiculares (curto, médio e longo) foram associados com a PA. Os dados foram estatisticamente avaliados empregando-se os testes Qui-quadrado e o Kappa. Três observadores avaliaram todas as imagens, considerando-se a presença de retentor intraradicular, seu comprimento e a PA. De um total de 1.020 dentes analisados no estudo, a PA foi detectada em 397 (38,92 por cento) usando RP e em 614 (60,19 por cento) usando TCFC (p<0,001). Em 591 retentores intraradiculares, nos diferentes comprimentos (curto, médio, longo) foram observadas PA usando RP em 15,06 por cento; 18,78 por cento e 7,95 por cento, respectivamente (p=0,466). Considerando os mesmos comprimentos de retentores foram observados PA em 24,20 por cento; 26,40 por cento e 11,84 por cento por meio de TCFC, respectivamente (p=0,154). A distribuição de retentores nos diferentes grupos dentários mostrou elevada prevalência em dentes anteriores superiores (54,79 por cento). Os retentores intraradiculares não influenciaram a PA e as TCFC detectaram mais freqüentemente a periodontite apical.