基于CBCT的根管填充密度分级系统预测根尖周炎愈合效果的队列研究OA

Objective:To explore predictive value of a cone-beam computed tomography(CBCT)-based grading system for filling density of root canal on the healing effect of apical periodontitis.Methods:This study conducted a design of prospective cohort,and a total of 80 patients who were confirmed as chronic apical periodontitis at the department of stomatology,Beijing Rehabilitation Hospital,Capital Medical University between January 2023 and January 2025,were enrolled in this study.All patients underwent surgical treatment for root canal and CBCT examination.Based on the filling density,they were divided into a high-density group(n=40)and a low-density group(n=40).The scores of Visual Analog Scale(VAS)for pain,the scores of peri apical index(PAI),the measured values of filling density,the scores of patients for satisfaction,the clinical healing rate,and the incidence of complication of two groups were compared.The logistic regression analysis was performed to analyze the influence factors that affected the healing of apical periodontitis.Results:At the 12th month after surgery,the VAS pain score(1.2±0.8)and PAI score(1.8±0.6)of the high-density group were significantly lower than(3.5±1.1)and(3.2±0.9)of the low-density group,and the differences were significant(t=4.567,5.678,P<0.05).The filling density and satisfaction of patients of the former were significantly higher than those of the low-density group,and the differences were significant(t=6.789,3.456,P<0.05).The differences of clinical healing rate and incidence of complication between two groups were significant(x2=8.901,7.234,P<0.05).The results of multivariate logistic regression analysis revealed that filling density,VAS score and PAI score were independent influence factors for the healing of apical periodontitis(OR=1.131,0.791,0.708,P<0.001).Conclusion:The CBCT-based grading system for filling density of root canal can effectively predict the healing effect of apical periodontitis,which has higher clinical application value.