A Cone Beam CT Study on the Correlation between Crestal Bone Loss and Periapical Disease

Abstract

The aim of this study was to determine whether the degree of bone loss around teeth can be linked to the loss of vitality of adjacent teeth and periapical disease, which necessitates root canal treatments. Three hundred and twenty-one full maxilla cone-beam computed tomography scans were examined. The parameters investigated included the degree of crestal bone loss in relation to the cementoenamel junction, the presence/absence of apical periodontitis, and the presence/absence of root canal treatments. Out of the 2001 teeth examined, 696 (34.8%) showed evidence of crestal bone loss. The degree of crestal bone loss was classified as mild, moderate, or severe. A significant association (p < 0.001) was found between the presence of crestal bone loss around a tooth and root canal treatment of that tooth. It was found that it is more likely for teeth with crestal bone loss to be root canal treated compared to teeth with existing root canal treatment and healthy crestal bone levels. Furthermore, teeth with buccal or lingual crestal bone loss were significantly associated with a higher rate of periapical disease than teeth without crestal bone loss (p < 0.001). CBCT identified the severity of bone loss on all surfaces of the teeth, and the most common presentation was bone loss to the mid-root level. Teeth with crestal bone loss were significantly more likely to be associated with a higher rate of periapical disease. Teeth with crestal bone loss were more likely to be root treated than teeth with healthy crestal bone levels.

Analyze the clinical effect of YAG laser combined with sodium hypochlorite in root canal treatment of pulpitis

“…Bergmans et al showed that the dentin disc with a thickness of 1 mm was inoculated with actinomyces and streptococcus in the same proportion, and after three times of irradiation with 1.5w Nd: YAG laser, it was found that the morphology of bacteria gradually changed with the increase of irradiation times, and finally the bacteria were completely destroyed 22 . The pulp tissue and periodontal tissue are anatomically communicating with each other, and there are mixed infections dominated by anaerobic bacteria in both the periodontal pocket and the infected pulp 23 . The inflammation and immune response caused by them are similar.…”

“… 22 The pulp tissue and periodontal tissue are anatomically communicating with each other, and there are mixed infections dominated by anaerobic bacteria in both the periodontal pocket and the infected pulp. 23 The inflammation and immune response caused by them are similar. In this study, after laser‐assisted root canal cleaning, the periodontal index of patients, including PLI, BI, GI, and the levels of inflammatory indicators IL‐6, TNF‐α, and CRP, were all lower than those of the 1% NaClO group, which further indicating that the periodontal recovery and inflammation inhibition of patients after laser‐assisted root canal therapy were better than those in 1% NaClO alone.…”