Asociación entre la presencia de conductos no tratados y periodontitis apical en dientes con tratamiento endodóntico en una población colombiana

Abstract

Introduction: Persistent infection leads to the permanence of apical periodontitis and one of the causes may be the presence of untreated canals. Within the associated variables, the permanence of microorganisms, the quality of the endodontics, the quality of the coronal restoration, the previous pulp state, the anatomical variations and the presence of untreated canals. 2D radiographic images have some limitations for the identification or interpretation of the root anatomy, these have been overcome with CBCT due to its high sensitivity to observe three-dimensional changes in dental tissues and supporting structures, Abuabara et al. In 2013 reported that only 8% of MV2 conducts were identified using periapical radiographs, while 54% of MV2 conducts were identified with CBCT. Objective: To investigate the association between the frequency of untreated canals and apical periodontitis in teeth with endodontic treatment. Materials and methods: In 462 teeth by means of computerized axial tomography, each root was evaluated independently, centered and aligned in the three planes to identify the presence of untreated canals and apical periodontitis, which was measured in the sagittal and coronal cuts drawing a perpendicular from the root apex to the upper limit of the hypodense area in its greatest extension; the teeth were analyzed by two endodontists and a radiologist dentist. The kappa coefficient of agreement was ≥95% for both evaluators. Results: The frequency of untreated canals was 18.61%, and the prevalence of apical periodontitis was 95.3%. The upper molars exhibited the highest percentage of untreated canals in the vestibular mesial root with 55.23% and the vestibular mesial canal 2 was the most frequent untreated canal in 88.52%. Conclusion: The risk of developing apical periodontitis is 10.5 times higher when an untreated canal is present.