Periapikal sağlık üzerine koronal restorasyonun kalitesine karşı kök kanal tedavisinin kalitesinin etkisi: sistematik derleme ve meta-analiz

Amaç: Bu çalışmanın amacı, periapikal sağlık üzerine kök kanal dolgusunun kalitesine karşı koronal restorasyonun kalitesinin etkilerini karşılaştırmaktır. Gereç ve Yöntem: Literatür taraması “endodontics”, “periapical index”, “periapical status”, “quality of root canal treatment”, “root treatment”, “root canal treatment”, “coronal restoration”, “quality of root canal treatment”, “cone beam computed tomography” ve “restoration” arama terimleri kullanılarak yapıldı. Kök kanal dolgusunun ve koronal restorasyonun kalitesinin periapikal dokulara etkisini değerlendiren çalışmalar seçildi. Veriler, dâhil edilme ve hariç tutulma kriterlerine göre iki araştırmacı tarafından toplandı. Apikal periodontitisli dişlerin oranı her kategori için kaydedildi: iyi yapılmış kök kanal dolgusu (İE), kötü yapılmış kök kanal dolgusu (KE), iyi yapılmış koronal restorasyon (İR), kötü yapılmış koronal restorasyon (KR). Veriler, olasılık oranları için meta-analiz kullanılarak analiz edildi. Önem seviyesi α=0.05 olarak belirlendi. Bulgular: İE-KR ile İE-İR arasında [p=0.02 ve odds ratio (OR)=1.88, %95 güven aralığı (GA; 1.13-3.13)], KE-İR ile İE-İR arasında [p=0.006 ve OR=3.23 (1.41-7.39)], KE-KR ile İE-İR arasında [p<0.00001 ve OR=5.18 (2.62-10.23)], KE-İR ile İE- KR arasında [p=0.02 ve OR=1.48 (1.07-2.03)], KE-KR ile İE-KR arasında [p<0.0001 ve OR=2.44 (1.69-3.51)] ve KE-KR ile KE-İR arasında [p<0.00001 ve OR=1.80 (1.38-2.34)] istatistiksel olarak anlamlı bir fark vardı. Sonuç: Mevcut en iyi kanıtlara dayanarak, apikal periodontitisin iyileşme olasılığı hem yeterli kök kanal tedavisi hem de yeterli restoratif tedavi ile artar. İE-KR’ye karşı KE-İR değerlendirildiğinde kök kanal dolgusunun koronal restorasyona göre daha önemli olduğu ortaya çıkmıştır.

The effect of the quality of coronal restoration versus the quality of root canal filling on periapical health: systematic review and meta-analysis

Objective: The aim of this meta-analysis was to compare the impact of the quality of root canal treatment versus the quality of coronal restoration on periapical health. Materials and Method: A literature review was conducted using the search terms “endodontics”, “periapical index”, “periapical status”, “quality of root canal treatment”, “root treatment”, “root canal treatment”, “coronal restoration”, “quality of root canal treatment”, “cone beam computed tomography”, and “restoration”. The studies evaluating the effect of the quality of root canal filling and the quality of coronal restoration on periapical tissues were selected. Data were collected by two researchers according to the inclusion and exclusion criteria. The ratio of teeth with apical periodontitis was recorded for each category: adequate root canal treatment (AC), inadequate root canal treatment (IC), adequate restoration (AR), and inadequate restoration (IR). The data were analyzed using meta-analysis for odds ratios. The significance level was set at α=0.05. Results: There were statistically significant differences between AC-IR and AC-AR [p=0.02 and OR=1.88, 95% confidence interval (CI): 1.13-3.13], between IC-AR and AC-AR [p=0.006 and OR=3.23 (1.41-7.39)], between IC-IR and AC-AR [p<0.00001 and OR=5.18 (2.62-10.23)], between IC-AR and AC- IR [p=0.02 and OR=1.48 (1.07-2.03)], between IC-IR and AC-IR [p<0.0001 and OR=2.44 (1.69-3.51)], between IC-IR and IC-AR [p<0.00001 and OR=1.80 (1.38-2.34)] Conclusion: On the basis of the current best available evidence, the odds for the healing of apical periodontitis increases with both adequate root canal treatment and adequate restorative treatment. When AC-IR versus IC-AR was evaluated, it was revealed that root canal filling was more important than coronal restoration.

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