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牙髓治疗的结果:对一位专家进行的2000例病例的回顾性研究。

The outcome of endodontic treatment: a retrospective study of 2000 cases performed by a specialist.

作者信息

Imura Noboru, Pinheiro Ericka T, Gomes Brenda P F A, Zaia Alexandre A, Ferraz Caio C R, Souza-Filho Francisco J

机构信息

Piracicaba Dental School, State University of Campinas, UNICAMP, Piracicaba, Sao Paulo, Brazil.

出版信息

J Endod. 2007 Nov;33(11):1278-82. doi: 10.1016/j.joen.2007.07.018. Epub 2007 Sep 19.

Abstract

The purpose of this study was to evaluate the treatment outcome of initial endodontic treatment and nonsurgical retreatment performed by an endodontic specialist in his private office. A total of 2,000 teeth were examined clinically and radiographically and the results were analyzed statistically by Pearson or Fisher's Exact test and multivariate logistic regression. The multivariate analysis evaluated joint associations among various factors, using logistic regression models. The dependent variable for this analysis was the dichotomous outcome: healed versus disease. The overall endodontic success rate was 91.45%, and the healed rate was significantly higher for initial endodontic treatments than for nonsurgical retreatments; teeth without lesion than for those with lesions; teeth treated without complications than for those with complications; recall period of 18-24 months than for other periods, and teeth with final coronal restoration than for those without. Of the 1376 teeth treated in the initial endodontic treatment sample, the success rate was 94.0%. Multivariate analysis identified the presence of procedural complications (file breakage, perforation and flare-up), as well as the absence of the restorations at follow-ups as the significant predictors of outcome, showing lower rates of success. Of the 624 teeth in the nonsurgical retreatment sample, 85.9% were successful. Stepwise logistic regression analysis revealed that preoperative radiolucency was a strong statistically significant factor to determine lower rates of success than in its absence. Two additional variables (age and tooth type) were found to have a significant influence on the outcome of the retreatment sample. A higher healed rate was observed for the 50-59 years age groups than others, while multirooted (molars) teeth revealed a significantly lower percentage of success than pre-molars and anterior teeth.

摘要

本研究的目的是评估牙髓病专科医生在其私人诊所进行的初始根管治疗和非手术再治疗的治疗效果。对总共2000颗牙齿进行了临床和影像学检查,并通过Pearson检验或Fisher精确检验以及多变量逻辑回归进行统计学分析。多变量分析使用逻辑回归模型评估各种因素之间的联合关联。该分析的因变量是二分结果:愈合与患病。总体根管治疗成功率为91.45%,初始根管治疗的愈合率显著高于非手术再治疗;无病变牙齿的愈合率高于有病变牙齿;无并发症治疗的牙齿愈合率高于有并发症治疗的牙齿;随访期为18 - 24个月的牙齿愈合率高于其他时期,有最终冠修复的牙齿愈合率高于无冠修复的牙齿。在初始根管治疗样本中的1376颗牙齿中,成功率为94.0%。多变量分析确定操作并发症(锉折断、穿孔和疼痛发作)的存在以及随访时无修复体是结果的显著预测因素,成功率较低。在非手术再治疗样本的624颗牙齿中,85.9%治疗成功。逐步逻辑回归分析显示,术前存在透射区是一个在统计学上具有显著意义的因素,表明其成功率低于无透射区的情况。另外两个变量(年龄和牙齿类型)被发现对再治疗样本的结果有显著影响。50 - 59岁年龄组的愈合率高于其他年龄组,而多根牙(磨牙)的成功率显著低于前磨牙和前牙。

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