The clinical outcomes of vital intact teeth close to large cystic lesions of endodontic origin: A prospective clinical study

IF 5.4 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE International endodontic journal Pub Date : 2024-02-27 DOI:10.1111/iej.14050

Francesco Erovigni, Ilaria Bosso, Mario Alovisi, Luca Mela, Lorenzo Bianchi, Ilaria Bobba, Giuseppe Migliaretti, Caterina Chiara Bianchi, Damiano Pasqualini

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Abstract

Aim

To evaluate the indication of the endodontic treatment for vital intact teeth with the root apex involved in large radicular cystic lesions of endodontic origin.

Methodology

This prospective cohort study enrolled healthy participants with radicular cysts of endodontic origin and with the root apex of vital intact teeth involved in the bone defect, as determined by cone beam computed tomography (CBCT). Thirty-two sound vital teeth were analysed by thermal (TPT) and electric pulp tests (EPT) before surgery (T0) and 1 week (T1), 2 weeks (T2), 3 months (T3) and 6 months (T4) post-surgery. Student's t-test (p < .05) was used to compare the EPT values at baseline and T4. anova (p < .05) was used to analyse the EPT variations for all maxillary and mandibular teeth. McNemar test (p < .05) was used to compare the results according to variation in EPT values gathering by variation, no variation and no response.

Results

At T1, 75 and 65.7% of teeth responded positively whilst 25 and 34.3% did not respond to EPT and TPT, respectively. The variation of the EPT values between T0 and T1 was observed for 50.0% of teeth, whilst no variation was noticed in 25.0% of teeth. At T4, 90.6 and 87.5% of teeth responded positively whilst 9.4 and 12.5% did not respond to EPT and TPT, respectively. At T4, variation of the EPT values between T0 and T4 was observed for 28.1%, whilst no variation was noticed in 62.5% of teeth. There were no statistical differences in EPT results between T0 and T4 (p > .05), but significant differences were observed for EPT values between T1 and T4 (p < .05), and between mandibular and maxillary teeth. The pulp sensibility of maxillary teeth worsened after surgery, before reverting progressively to T0 values, whilst no statistically significant differences were observed for mandibular teeth at the different time points.

Conclusions

These data support the inconsistence of the prophylactic endodontic treatment in healthy vital teeth with apex involvement in large cystic lesions of endodontic origin. Post-surgery follow-up with TPT and EPT is recommended to assess pulp status.

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接近牙髓源性大囊性病变的重要完好牙齿的临床结果：前瞻性临床研究。

目的：评估牙髓源性根尖囊肿病变累及根尖的重要完整牙齿的牙髓治疗适应症：这项前瞻性队列研究招募了患有根管源性根尖囊肿的健康参试者，根据锥形束计算机断层扫描（CBCT）确定，骨缺损涉及到了完整的重要牙齿的根尖。在手术前（T0）和手术后 1 周（T1）、2 周（T2）、3 个月（T3）和 6 个月（T4），对 32 颗完好无损的牙齿进行了热测试（TPT）和电髓测试（EPT）。学生 t 检验（P 结果：在 T1，分别有 75% 和 65.7% 的牙齿对 EPT 和 TPT 有积极反应，25% 和 34.3% 的牙齿没有反应。50.0% 的牙齿在 T0 和 T1 之间的 EPT 值有变化，而 25.0% 的牙齿没有变化。在 T4，分别有 90.6% 和 87.5% 的牙齿对 EPT 和 TPT 有积极反应，9.4% 和 12.5% 的牙齿没有反应。在 T4，28.1% 的牙齿在 T0 和 T4 之间的 EPT 值有变化，而 62.5% 的牙齿没有变化。T0 和 T4 之间的 EPT 结果没有统计学差异（p > .05），但 T1 和 T4 之间的 EPT 值有显著差异（p 结论：T1 和 T4 之间的 EPT 值不一致：这些数据支持对牙髓源性大囊性病变中累及顶端的健康活力牙进行预防性牙髓治疗的不一致性。建议使用 TPT 和 EPT 进行术后随访，以评估牙髓状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International endodontic journal 医学-牙科与口腔外科

CiteScore

10.20

自引率

28.00%

发文量

195

审稿时长

4-8 weeks

期刊介绍： The International Endodontic Journal is published monthly and strives to publish original articles of the highest quality to disseminate scientific and clinical knowledge; all manuscripts are subjected to peer review. Original scientific articles are published in the areas of biomedical science, applied materials science, bioengineering, epidemiology and social science relevant to endodontic disease and its management, and to the restoration of root-treated teeth. In addition, review articles, reports of clinical cases, book reviews, summaries and abstracts of scientific meetings and news items are accepted. The International Endodontic Journal is essential reading for general dental practitioners, specialist endodontists, research, scientists and dental teachers.