A recent cross-sectional study published in BMC Oral Health has shed light on the potential risks associated with the use of intraradicular posts (IRPs) in endodontically treated teeth (ETTs). The research, conducted in Saudi Arabia, found that ETTs with IRPs were more than three times as likely to develop periapical radiolucent lesions (PRLs), which are areas of bone loss that can indicate inflammation or infection.
The study, led by Badi Alotaibi and colleagues from the Department of Conservative Dental Sciences at Qassim University, aimed to assess the relationship between the presence of IRPs and the prevalence of PRLs. Using cone-beam computed tomography (CBCT), the researchers examined teeth with at least 2 mm of remaining gutta-percha apical to the post-end. The results revealed that while factors like the type of IRP and the length of remaining gutta-percha did not show a significant impact, the presence of IRPs significantly increased the likelihood of PRLs (Odds Ratio: 3.670).
PRLs around the root apex can complicate the treatment and restoration of root canal-treated teeth, potentially leading to restoration failure. Despite conflicting findings in previous literature regarding the relationship between IRPs and PRLs, this study offers strong evidence of a correlation between the two.
The study’s methodology included the use of a stepwise backward binomial logistic regression model to evaluate predictors of PRL formation, including age, gender, tooth position, arch location, and the presence of IRPs. Among these factors, only the presence of IRPs was found to be statistically significant in increasing the risk of PRL formation.
The regression model explained 14.5% of the variance in PRL occurrence, with the model showing a sensitivity of 54.5%, specificity of 75.4%, and a positive predictive value (PPV) of 58.3%. The findings suggest that clinicians should carefully weigh the benefits and risks of using IRPs during ETT restorations.
The researchers concluded that given the study’s limitations, clinicians should be cautious when considering the use of IRPs in endodontic treatments, advising a thorough evaluation of potential risks and benefits before deciding on their use.
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