Prevalencia del segundo conducto en el primer premolar mandibular en pacientes tratados en la clínica odontológica Universidad Andrés Bello Concepción 2013-2015
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2015
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Profesor/a Guía
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es
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Universidad Andrés Bello
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Licencia CC
Licencia CC
Resumen
Antecedentes:
Los primeros premolares mandibulares presentan la mayor tasa de fracaso endodóntico [6], producto del desconocimiento de sus variaciones anatómicas. Normalmente son considerados como un diente simple, por lo cual es habitual que sean tratados por odontólogos generales aumentando la probabilidad de riesgo en el tratamiento. Justificación:
No existen estudios que describan las variaciones anatómicas de este diente en población chilena. Por lo que resulta necesario conocer la prevalencia y características de éstas variaciones. De este modo el clínico podrá manejar los conocimientos de morfología canalicular para realizar un adecuado diagnóstico y plan de tratamiento, asegurando la eficacia terapéutica con el menor riesgo de fracaso.
Objetivo:
Conocer la prevalencia del segundo conducto radicular en primeros premolares mandibulares, identificando características biológicas asociadas a su presencia. Material y métodos:
Estudio cuantitativo, cuyo diseño fue: observacional, transversal y analítico. Se analizaron un total de 109 tomografías volumétricas de haz cónico (CBCT) tomadas con equipo GX CB-50 pertenecientes al mismo total de pacientes tratados en la Clínica Odontológica Universidad Andrés Bello Concepción durante el período 2013-2015, lo que constituyó la muestra del estudio. Cada tomografía se revisó mediante software i-Cat Vision, analizándose vistas axiales con la finalidad de describir características morfológicas y biológicas. Para evaluar la calidad del examen se realizó un test de concordancia interobservadores con un R=0,80. Los resultados de las mediciones fueron analizados con el software estadístico SPSS versión 22. Se evaluó normalidad en la distribución de las variables numéricas y de acuerdo a la presencia o no de éstas se aplicó test Anova para evaluación de las diferencias promedio entre dos o más grupos. Para evaluar asociaciones estadísticas se utilizó el test de Chi cuadrado. Los resultados de las mediciones fueron tabulados y calculados con medidas de frecuencia y asociación. Resultados:
Los tipos de conductos según la clasificación de Vertucci para el diente 3.4 (primer premolar inferior izquierdo) correspondieron a un 77,1% para el tipo I, un 4,6% para el tipo III y un 6,4% para el tipo V. En el caso del diente 4.4 (primer premolar mandibular derecho) se obtuvo un 84,4% para el tipo I, un 1,8% para el tipo III y un 0,9% para el tipo V. No existió una asociación estadísticamente significativa entre el sexo y el tipo de conductos, sin embargo, los pacientes de sexo femenino tuvieron una mayor tendencia a presentar dos conductos radiculares. No existió una diferencia estadísticamente significativa entre la edad y el tipo de conductos, aun cuando, los pacientes de edades más avanzadas presentaron una mayor tendencia de conductos tipo III.
Conclusiones:
La prevalencia del segundo conducto radicular en los primeros premolares mandibulares correspondió a un 11% en el caso del primer premolar mandibular izquierdo (3.4) y de un 2,7% en el caso del primer premolar mandibular derecho (4.4).
La edad no logró asociarse con la presencia del segundo conducto radicular, sin embargo existió una mayor tendencia de conductos tipo III en los pacientes que eran de edades más avanzadas.
El sexo no logró asociarse con la presencia de segundo conducto radicular, aun cuando se puede evidenciar que existe una tendencia hacia el sexo femenino.
La variante anatómica encontrada con mayor frecuencia correspondió a la tipo I encontrándose en un 77,1% para el diente 3.4 y en un 84,4% para el diente 4.4.
Background: As a product of ignorance in anatomical variations the mandibular first premolars showed the highest rate of endodontic failure [6]. They are usually considered a simple tooth, which is usually treated by general dentists increasing the likelihood of risk in treatment. Justification: There are no studies that describe the anatomical variations of this tooth in Chilean population, so it is necessary to know the prevalence and characteristics of these variations. In this way the clinician can handle radicular morphology knowledge to make a proper diagnosis and treatment plan, ensuring the therapeutic efficacy with lower risk of failure. Purpose: Knowing the prevalence of the second root canal in mandibular first premolars, identifying biological characteristics associated with their presence. Material and methods: Quantitative study, whose design was observational, cross-sectional and analytical. A total of 109 volumetric cone-beam CT (CBCT) taken with equipment GX CB-50 belonging to the same total number of patients treated at the Andres Bello University Dental Clinic Concepción during 2013-2015 period were analyzed, which constituted the study sample. Each tomography was revised by i-Cat Vision software, axial views were analyzed in order to describe morphological and biological characteristics. To evaluate the quality of the examinations, an interobserver concordance test was performed, which result was R = 0.80. The measurement results were analyzed with SPSS statistical software version 22. Anova test was used to evaluate the average difference between two or more groups. To evaluate statistical associations Chi-square test was used. The results of frequency and association measurements were tabulated and calculated using frequency and association measurements. Results: The types of root canal classified by Vertucci`s for tooth 3.4 (lower left first premolar) corresponded to: 77,1% for type I, 4,6% for type III and 6,4% for type V. In the case of tooth 4.4 (first right mandibular premolar): 84,4% for type I, 1,8% for type III and 0,9% for type V. There was no significant statistically association between sex and type of root canal, however, female patients were more likely to have two root canals. There was no significant statistically association between age and type of root canal, though, older patients had a higher tendency of type III root canal. Conclusions: The prevalence of the second root canal in mandibular first premolars corresponded to 11% for the mandibular left first premolar (3.4) and 2,7% for the first right mandibular premolar (4.4). Age failed to associate with the presence of the second root canal, however there was a tendency in older patients to present type III root canal. Sex failed to associate with the presence of a second root canal, although there is a trend towards females. The anatomical variant most frequently found corresponded to the type I which was found in 77, 1% in the case of 3.4 tooth and 84,4% in the case of 4.4 tooth.
Background: As a product of ignorance in anatomical variations the mandibular first premolars showed the highest rate of endodontic failure [6]. They are usually considered a simple tooth, which is usually treated by general dentists increasing the likelihood of risk in treatment. Justification: There are no studies that describe the anatomical variations of this tooth in Chilean population, so it is necessary to know the prevalence and characteristics of these variations. In this way the clinician can handle radicular morphology knowledge to make a proper diagnosis and treatment plan, ensuring the therapeutic efficacy with lower risk of failure. Purpose: Knowing the prevalence of the second root canal in mandibular first premolars, identifying biological characteristics associated with their presence. Material and methods: Quantitative study, whose design was observational, cross-sectional and analytical. A total of 109 volumetric cone-beam CT (CBCT) taken with equipment GX CB-50 belonging to the same total number of patients treated at the Andres Bello University Dental Clinic Concepción during 2013-2015 period were analyzed, which constituted the study sample. Each tomography was revised by i-Cat Vision software, axial views were analyzed in order to describe morphological and biological characteristics. To evaluate the quality of the examinations, an interobserver concordance test was performed, which result was R = 0.80. The measurement results were analyzed with SPSS statistical software version 22. Anova test was used to evaluate the average difference between two or more groups. To evaluate statistical associations Chi-square test was used. The results of frequency and association measurements were tabulated and calculated using frequency and association measurements. Results: The types of root canal classified by Vertucci`s for tooth 3.4 (lower left first premolar) corresponded to: 77,1% for type I, 4,6% for type III and 6,4% for type V. In the case of tooth 4.4 (first right mandibular premolar): 84,4% for type I, 1,8% for type III and 0,9% for type V. There was no significant statistically association between sex and type of root canal, however, female patients were more likely to have two root canals. There was no significant statistically association between age and type of root canal, though, older patients had a higher tendency of type III root canal. Conclusions: The prevalence of the second root canal in mandibular first premolars corresponded to 11% for the mandibular left first premolar (3.4) and 2,7% for the first right mandibular premolar (4.4). Age failed to associate with the presence of the second root canal, however there was a tendency in older patients to present type III root canal. Sex failed to associate with the presence of a second root canal, although there is a trend towards females. The anatomical variant most frequently found corresponded to the type I which was found in 77, 1% in the case of 3.4 tooth and 84,4% in the case of 4.4 tooth.
Notas
Tesis (Cirujano Dentista, Grado de Magíster en Ciencias Odontológicas)
Palabras clave
Endodoncia, Diente Premolar, Tomografía Computarizada de Haz Cónico