Prevalencia de patología periapical en dientes endodonciados en pacientes con mieloma múltiple

Abstract

Introduction Numerous studies relate various systemic diseases with periapical pathology. Systemic pathology and periapical involvement share similar risk factors. Diseases such as diabetes, cardiovascular problems, high blood pressure or non-hodkin lymphoma, among others, have been studied in detail to confirm this association. Given that Multiple Myeloma is also a systemic condition, we could think that patients who have this condition may have a higher prevalence of periapical pathology, and higher failure rate with endodontic treatments. The aim of our study is to evaluate the prevalence of apical periodontitis in endodontically treated teeth in patients with multiple myeloma. Material and methods A total of 100 patients were included the study, 50 in the study group and 50 in the control group. Patients of the study group, according to the inclusion / exclusion criteria, should be at least 18 years old, with at least one endodontic treatment in the mouth, and be diagnosed with Multiple Myeloma. The patients belonging to the control group were older than 18 years, who had at least one endodontics, and who did not suffer from Multiple Myeloma. All the teeth present in each patient were analyzed by means of an orthopantomography, a diagnostic method from which we were able to apply the PAI index. Likewise, the quality of each endodontic treatment was evaluated using three variables: quality of the coronal restoration, quality of the filling of the canals and the length of the root filling. In our study, two observers were used to analyze each PAI index and the variables related to the quality of the endodontics. Once all the results were obtained, the descriptive and inferential studies were carried out using the statistical program SPSS, version 21.0-. Results The variables of the descriptive study were gender, group, bisphosphonate intake, age, age by intervals, the number of teeth present, the number of endodontically treated teeth, PAI, the quality of the coronal restoration, the quality of the filling of the canals and the length of the root filling. The results showed a positive association between PAI and the length of the root filling. However, although the literature consulted indicates that the quality of the endodontic filling influences the appearance of apical periodontitis, in our study the quality of the coronal restoration and the quality of the filling of the canals did not show statistically significant differences. Conclusion The conclusions of our study are: there are no statistically significant prevalence of PAI in endodontically treated teeth of patients with Multiple Myeloma in comparison with the control group; there is no greater prevalence of PAI in patients who are being treated with bisphosphonates; the prevalence of PAI is similar in men and women. In our study, detection of apical periodontitis is not related to the quality of the coronal restoration or to the filling of the canals, however, the results of our data did show a relation between PAI and the length of the obturation. More clinical studies are needed with larger samples to show an association between apical periodontitis and Multiple Myeloma.