A range of procedural errors can occur when performing endodontic treatment on posterior teeth. These errors may decrease the success rate in endodontic practice. This study assessed the prevalence of procedural errors and the quality of endodontic treatments in maxillary molars and premolars using cone-beam computed tomography (CBCT). CBCT scans from two private radiology centers were assessed retrospectively to ensure the same calculated sample size of 327 teeth for each of the four maxillary posterior tooth types (a total of 1,308 endodontically treated teeth). Image sets were evaluated for procedural errors categorized as follows: obturation length (overfilling or underfilling by >2 mm short of the root apex), missed canals, perforations, strip perforations (with extrusion of material into the furcation area), separated instruments in the root canal space, and root fracture. Data were analyzed with SPSS version 20 (SPSS Inc., Chicago, IL, USA), and frequency data was assessed using the Monte Carlo test at the 0.05 level of significance. The procedural errors most commonly reported in the present study were from most frequent to least frequent: underfilled canals (50.0%), missed canals (27.5%), overfilled canals (12.5%), apical perforations (5.0%), separated instruments (3.1%), and root fractures (1.9%). No strip perforations (with extrusion of material into the furcation area) were seen in the study (0%). Underfilled and missed root canals were the most frequent procedural errors identified in the present study. These findings underline the importance of more consideration of critical working length management during all stages of root canal treatment, greater awareness of root canal anatomy, and the use of imaging and diagnostic devices that enhance the ability to identify and treat root canals both safely and effectively.

中文翻译：

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锥形束计算机断层扫描评估上颌后牙手术错误的发生率

对后牙进行牙髓治疗时可能会出现一系列程序错误。这些错误可能会降低牙髓治疗的成功率。本研究使用锥形束计算机断层扫描 (CBCT) 评估了上颌磨牙和前磨牙的手术错误发生率和牙髓治疗质量。对两个私人放射中心的 CBCT 扫描进行回顾性评估，以确保四种上颌后牙类型中每种类型的 327 颗牙齿的计算样本量相同（总共 1,308 颗经过牙髓治疗的牙齿）。对图像集的程序错误进行了评估，分类如下：闭塞长度（距根尖距离超过 2 毫米的过度填充或填充不足）、遗漏根管、穿孔、带状穿孔（材料挤压到分叉区域）、根管中分离的器械根管间隙和根折。使用 SPSS 20 版（SPSS Inc.，芝加哥，伊利诺伊州，美国）分析数据，并使用蒙特卡洛检验在 0.05 显着性水平下评估频率数据​​。本研究中最常报告的手术错误按最常见到最不常见的顺序排列：根管填充不足 (50.0%)、根管缺失 (27.5%)、根管填充过多 (12.5%)、根尖穿孔 (5.0%)、器械分离 (3.1%) %）和根部骨折（1.9%）。研究中未发现条带穿孔（材料被挤压到分叉区域）（0%）。根管填充不足和遗漏是本研究中发现的最常见的手术错误。这些发现强调了在根管治疗的各个阶段更多地考虑关键工作长度管理、提高对根管解剖学的认识以及使用成像和诊断设备来增强安全有效地识别和治疗根管的能力的重要性。