Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Endodontist ve Çene Cerrahı Arasında Apikal Cerrahi Kararı: Retrospektif Bir Çalışma
Apical Surgery Decision Among Endodontist and Oral Surgeon: A-Retrospective-Study
Makbule Bilge AKBULUTa, Dilek MENZİLETOĞLUb, Arif Yiğit GÜLERb
aEndodonti ABD,
bAğız, Diş ve Çene Cerrahisi ABD, Konya Necmettin Erbakan Üniversitesi Diş Hekimliği Fakültesi, Konya, TÜRKİYE
Tur ki ye Kli nik le ri J Den tal Sci. 2019;25(3):263-9
doi: 10.5336/dentalsci.2018-63663
Article Language: TR
Full Text
ÖZET
 Amaç: Kök ucu cerrahisi, endodontik kaynaklı periapikal lezyonları iyileştirmek amacıyla hem endodonti uzmanları hem de çene cerrahisi uzmanları tarafından uygulanan önemli bir tedavi seçeneğidir. Bu çalışmda, kök ucu cerrahisi için yönlendirilen dişlerde endodonti uzmanı ve çene cerrahisi uzmanının tedavi kararlarının karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Bu retrospektif çalışmaya, Necmettin Erbakan Üniversitesi Diş Hekimliği Fakültesine 2014-2017 yılları arasında kök ucu cerrahisi amacıyla başvuran 72 hastanın 80 dişi dâhil edildi. Dişlerin radyografik incelemesi yapıldı. Bir endodonti ve bir çene cerrahisi uzmanı birbirinden bağımsız olarak panoramik ve periapikal radyografları değerlendirdi ve her bir hasta için uygun tedavi kodunu işaretledi. Tedavi kodları; 1. Hiçbir tedavi yapmamak, 2. 6-12 ay beklemek ve kontrol, 3. Kök kanal tedavisi, 4. Kök kanal tedavisinin yenilenmesi, 5. Kök ucu cerrahisi olarak belirlendi. Endodonti ve çene cerrahisi uzmanı arasındaki uyumluluğun derecesini değerlendirmek için Kappa (κ) testi kullanıldı. Bulgular: Kappa değeri (0,203) uzmanlar arasındaki uyumun zayıf olduğunu gösterdi. Endodonti uzmanı, hastaların %28,8'inde kök kanal tedavisinin yenilenmesi gerektiğini bildirirken, %40'ında kök ucu cerrahisinin gerekli olduğunu ifade etti. Çene cerrahisi uzmanında ise bu oranlar sırasıyla %11,3 ve %55 olarak bulundu. Endodonti uzmanı takip seçeneğini hastaların %26,3'ünde, çene cerrahisi uzmanı ise %33,8'inde uygun buldu. Sonuç: Bu çalışmanın bulgularına göre, endodontik kaynaklı periapikal lezyonların tedavi yaklaşımlarında, endodonti ve çene cerrahisi uzmanlarının farklı görüşlere sahip olduğu söylenebilir.

Anahtar Kelimeler: Apikoektomi; periapikal hastalıklar; tanı; yeniden tedavi
ABSTRACT
 Objective: Root-end surgery is an important treatment option which is performed by both endodontists and oral surgeons for endodontics related periapical lesions. The aim of this study was to compare clinical decision-making choices of endodontist and oral surgeon for roots referred to apical surgery. Material and Methods: Eighty roots of 72 patients referred to Necmettin Erbakan University, Dentistry Faculty for endodontic surgery during the years 2014-2017 were included in this retrospective study. The radiographic data of 80 teeth was examined. Endodontist and oral surgeon viewed the panoramic and periapical radiographs independently and checked the appropriate treatment code for each case. Treatment decision codes included 1. No treatment, 2. Wait 6-12 months and re-examine, 3. Endodontic treatment, 4. Retreatment, 5. Apical surgery. The Kappa (κ) test was used to measure the level of agreement between endodontist and oral surgeon. Results: A value of κ (0.203) showed low agreement between raters. Endodontist reported that 28.8% of cases required retreatment and apical surgery was justified in 40% of cases. For oral surgeon the figures were 11.3% and 55%, respectively. Endodontist reported 26.3% and oral surgeon reported 33.8 % for follow-up option. Conclusion: Based on the findings of this study, endodontist and oral surgeon have different treatment approaches for endodontically originated periapical lesions.

Keywords: Apicoectomy; periapical diseases; diagnosis; retreatment
REFERENCES:
  1. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 1965;20(3): 340-9. [Crossref] 
  2. Siqueira JF Jr, Araujo MC, Garcia PF, Fraga RC, Dantas CJ. Histological evaluation of the effectiveness of five instrumentation techniques for cleaning the apical third of root canals. J Endod. 1997;23(8):499-502. [Crossref] 
  3. Vieira AR, Siqueira JF Jr, Ricucci D, Lopes WS. Dentinal tubule infection as the cause of recurrent disease and late endodontic treatment failure: a case report. J Endod. 2012;38 (2):250-4. [Crossref]  [PubMed] 
  4. Gencoglu N, Pekiner FN, Gumru B, Helvacioglu D. Periapical status and quality of root fillings and coronal restorations in an adult Turkish subpopulation. Eur J Dent. 2010;4(1): 17-22. [Crossref]  [PubMed]  [PMC] 
  5. Moreno JO, Alves FR, Goncalves LS, Martinez AM, Rocas IN, Siqueira JF Jr. Periradicular status and quality of root canal fillings and coronal restorations in an urban Colombian population. J Endod. 2013;39(5):600-4. [Crossref]  [PubMed] 
  6. el-Swiah JM, Walker RT. Reasons for apicectomies. A retrospective study. Endod Dent Traumatol. 1996;12(4):185-91. [Crossref]  [PubMed] 
  7. Bigras BR, Johnson BR, BeGole EA, Wenckus CS. Differences in clinical decision making: a comparison between specialists and general dentists. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(1):139-44. [Crossref]  [PubMed] 
  8. Taha NA, Albashaireh ZS, Alfied RG. Endodontic decision making for asymptomatic root-filled teeth with apical periodontitis-a radiographic survey. Aust Endod J. 2018 2018 Mar 23. Doi: 10.1111/aej.12262. [Epub ahead of print]. [Crossref]  [PubMed] 
  9. von Arx T, Roux E, Burgin W. Treatment decisions in 330 cases referred for apical surgery. J Endod. 2014;40(2):187-91. [Crossref]  [PubMed] 
  10. Doornbusch H, Broersma L, Boering G, Wesselink PR. Radiographic evaluation of cases referred for surgical endodontics. Int Endod J. 2002;35(5):472-7. [Crossref]  [PubMed] 
  11. Mota de Almeida FJ, Huumonen S, Molander A, Ohman A, Kvist T. Computed tomography (ct) in the selection of treatment for root-filled maxillary molars with apical periodontitis. Dentomaxillofac Radiol. 2016;45(5):20150391. [Crossref]  [PubMed]  [PMC] 
  12. Abramovitz I, Better H, Shacham A, Shlomi B, Metzger Z. Case selection for apical surgery: a retrospective evaluation of associated factors and rational. J Endod. 2002;28(7):527-30. [Crossref]  [PubMed] 
  13. Dechouniotis G, Petridis XM, Georgopoulou MK. Influence of specialty training and experience on endodontic decision making. J Endod. 2010;36(7):1130-4. [Crossref]  [PubMed] 
  14. Wenteler GL, Sathorn C, Parashos P. Factors influencing root canal retreatment strategies by general practitioners and specialists in Australia. Int Endod J. 2015;48(5):417-27. [Crossref]  [PubMed] 
  15. Beckett H. Impact of a restorative dentistry service on the prescription of apical surgery in a district general hospital. Ann R Coll Surg Engl. 1996;78(4):369-71.
  16. European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the european society of endodontology. Int Endod J. 2006;39(12): 921-30. [Crossref]  [PubMed] 
  17. Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod. 2009;35(7):930-7. [Crossref]  [PubMed] 
  18. Rodriguez G, Abella F, Duran-Sindreu F, Patel S, Roig M. Influence of cone-beam computed tomography in clinical decision making among specialists. J Endod. 2017;43(2):194-9. [Crossref]  [PubMed] 

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