RESUMO
The primary objective of this retrospective study was to assess the correlation between treatment-related factors (resection angle, depth of retrograde filling, length of resected root and use of guided tissue regeneration-GTR) evaluated using cone-beam computed tomography (CBCT) scans and the treatment outcomes of endodontic microsurgery (EMS). The secondary purpose of this research was to evaluate the influence of the GTR technique on the radiographic healing state, taking into account the initial parameters of periapical lesions. In 161 cases, the local factors (volume of a lesion, bone destruction pattern, presence/absence of cortical bone destruction) were measured using preoperative CBCT images before undergoing EMS. At least one year after surgery, the outcome of EMS was classified as a success or a failure (based on radiographic and clinical criteria). Using postoperative CBCT, treatment-related factors (resection angle, depth of retrograde filling, and length of resected root) were measured. Additionally, the status of radiographic healing was evaluated (in accordance with modified PENN 3D criteria). Eighteen cases (11.18%) were classified as failures, and 143 were classified as successes (88.82%). Univariate analysis showed that there was no statistically significant influence of treatment-related factors on the healing outcome of EMS. An exact Fischer's test showed the significant impact of GTR on radiographic healing (P < 0.001) in apical lesions (P < 0.001), lesions with a volume between 100 mm3 and 450 mm3 (P < 0.009) and over 450 mm3 (P < 0.001), lesions with the destruction of one plate (P < 0.001), and lesions with the destruction of two plates (through and through) (P = 0.022). The use of GTR in apical lesions, lesions with volumes over 100 mm3, and lesions with the destruction of at least one plate is significantly associated with better radiographic healing.
RESUMO
The purpose of this retrospective study was to verify preoperative local parameters of periapical lesions evaluated on cone-beam computed tomography (CBCT) scans as a potential prognostic factor in endodontic microsurgery (EMS). Among 89 cases, local factors (dimensions of lesion, bone destruction pattern, presence/absence of cortical bone destruction, height of buccal bone plate, apical extend of root canal filling, presence/absence of communication with anatomical cavities, type of lesion restriction) were measured on preoperative CBCT images before EMS. At least one year after surgery, the outcome of EMS was classified as a success or a failure. Ten cases (11.24%) were classified as a failure and 79 as a success (88.76%). Symptomatic lesions (OR = 0.088 (95% CI 0.011-0.731); p = 0.024), apicomarginal lesions (OR = 0.092 (0.021-0.402); p = 0.001) and an association with molar teeth (OR = 0.153 (0.032-0.732); p = 0.019) were found as negative predictive factors in the univariate analysis, whereas large apicocoronal dimension (OR = 0.664 (0.477-0.926); p = 0.016), apicomarginal lesions (OR = 0.058 (0.006-0.55); p = 0.013), and an association with molar teeth (OR = 0.047 (0.003-0.869); p = 0.04) were identified as negative predictive factors in the multivariate analysis model. Symptomatic lesions, apicomarginal lesions, lesions associated with molar teeth and large apicocoronal dimensions are significantly associated with the failure of EMS.
RESUMO
The aim of the study was to analyse the oral health status of the fourth and fifth year dentistry students of Collegium Medicum of the Jagiellonian University in Cracow. The data were collected using the anonymous questionnaire concerning the general health, using medications, dietary habits, smoking and drinking alcohol, present and previous oral complaints and selected health behaviour patterns (follow-up examination of oral cavity, teeth brushing and other hygienic procedures, using dental floss). The oral cavity status was estimated by clinical examination conducted with the use of artificial lighting and basic diagnostic set: dental probe and dental mirror. The data for 120 persons were analysed: 75 (62.5%) fourth year students and 45 (37.5%) fifth year students aged 21-27 years (mean age 23.2). Among the examined persons 84.2% descended from cities and 15.8% from the villages. During the medical review it was stated that among chronic diseases allergies (27.5%) were on the first position, cardio-vascular diseases (8.33%) were on the second and respiratory system diseases were on the third position. The review about smoking and drinking alcohol stated that 71.7% never smoked cigarettes, 10% gave up smoking and 18.3% were daily smokers, 81.7% of students occasionally drink alcohol, mainly beer. The dental history stated that all of examined students (100%) were subjected to teeth caries treatment, 48.7% had endodontic treatment, 38.1% extraction (mainly for orthodontic reasons), 5.9% prosthetic, 3.9% apicoectomy, 0.8% had dental implant. The estimation of oral cavity hygiene (API index) and frequency of decay (DMF index-Decayed Missing Filling) was included in the examination. The mean value of DMF was 13.56, API 22.51 in the whole examined group. The assessment of periodontal tissues was made with the support of treatment needs: 60.0% of examined persons don't need any periodontal treatment, 14.17% need to improve their oral cavity hygiene and 25.83% require the dental calculus removal. The study revealed that 39.1% suffer from temporo-mandibular arthropathies. Normal occlusion is characteristic for 45.69% of examined students, small abnormalities for 48.28 and 6.03% have advanced malocclusion. The presented results are a part of examination performed in four Polish academic centres that estimates oral health status of students of dentistry in our country.