Association between proximal caries and pulp canal obliteration in maxillary molars: A cone-beam computed tomography-based retrospective study

上颌磨牙邻面龋与牙髓腔闭锁的相关性:一项基于锥形束计算机断层扫描的回顾性研究

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Abstract

AIM: The aim of the study was to determine the correlation between proximal caries and pulp canal obliteration (PCO) in maxillary molars using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This retrospective observational study analyzed 162 CBCT scans of maxillary molars with proximal caries (mesial or distal) obtained from patients aged 18-49 years. Two calibrated endodontists independently assessed the mesiobuccal (MB), distobuccal (DB), and palatal roots for the presence of PCO in sagittal, coronal, and axial planes using CBCT (<0.2 mm voxel size). Inter- and intra-observer reliability was evaluated using Cohen's kappa. Associations between caries location and PCO were analyzed using Pearson's Chi-square test or Fisher's exact test and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated (P < 0.05). RESULTS: PCO was observed in 21.2% (n = 34/162) of maxillary molars. Root-wise prevalence was the highest in the DB root (42%), followed by the MB (19.8%) and palatal roots (1.9%). No statistically significant association was found between caries location and PCO (MB: OR = 0.88, 95% CI: 0.41-1.92, P = 0.757; DB: OR = 0.55, 95% CI: 0.29-1.04, P = 0.064; palatal: OR = 0.39, 95% CI: 0.03-4.43, P = 0.434). CONCLUSION: Within the limitations of the study, PCO was frequently observed in maxillary molars with proximal caries, predominantly affecting the DB root irrespective of caries location. Females had higher predilection compared to males.

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