White Shane N, Miklus Vetea G, Potter Karen S, Cho Jason, Ngan Amanda Y W
UCLA School of Dentistry, Los Angeles, CA, USA.
J Evid Based Dent Pract. 2006 Mar;6(1):101-9. doi: 10.1016/j.jebdp.2005.12.013.
Dentists may be faced with the choice to retain a tooth by performing endodontic therapy and restoration or to extract the tooth and replace it with an implant and restoration. The purpose of this study was to catalog areas where implant and endodontic therapies differ so as to assist dentists in making treatment decisions and in identifying areas deserving of future research. Differences in diagnostic procedures and prognostic indicators were listed. With respect to treatment outcomes, study designs, success criteria, treatment results, systematic reviews, complications, clinician expertise, and the use of patient-based measures were discussed. The need for clinically applicable consensus statements and treatment protocols was noted. It was concluded that at this time, choices between implant and endodontic therapies cannot be solely based on outcomes measurement evidence; that different modes of outcome measure frustrate direct comparison; that endodontic and implant therapies profoundly differ in many ways; that although rigorous and clearly defined outcome measures have been proposed for use in endodontic and implant outcomes studies, they are very rarely used; that long-term, large, clearly defined studies, with simple and clear outcome measures, for example survival in combination with defined treatment protocols, are needed to measure the clinical performance of endodontic and implant therapies; and it was recognized that broad outcomes data may not be sufficiently specific to directly impact clinical decision making.
通过进行牙髓治疗和修复来保留牙齿，或者拔除牙齿并用种植体和修复体进行替代。本研究的目的是梳理种植治疗和牙髓治疗存在差异的方面，以帮助牙医做出治疗决策，并确定值得未来研究的领域。列出了诊断程序和预后指标的差异。讨论了治疗结果、研究设计、成功标准、治疗结果、系统评价、并发症、临床医生专业知识以及基于患者的测量方法的使用。指出了制定临床适用的共识声明和治疗方案的必要性。得出的结论是，目前，种植治疗和牙髓治疗之间的选择不能仅仅基于结果测量证据；不同的结果测量模式阻碍了直接比较；牙髓治疗和种植治疗在许多方面存在深刻差异；尽管已经提出了严格且明确界定的结果测量方法用于牙髓治疗和种植治疗结果研究，但它们很少被使用；需要进行长期、大规模、明确界定的研究，采用简单明了的结果测量方法，例如结合明确治疗方案的生存率，来衡量牙髓治疗和种植治疗的临床效果；并且认识到广泛的结果数据可能不够具体，无法直接影响临床决策。
