de Chevigny Cristian, Dao Thuan T, Basrani Bettina R, Marquis Vincent, Farzaneh Mahsa, Abitbol Sarah, Friedman Shimon
Discipline of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
J Endod. 2008 Mar;34(3):258-63. doi: 10.1016/j.joen.2007.10.017. Epub 2007 Dec 21.
Outcome 4-6 years after initial treatment was assessed for Phase 4 (2000-2001) of the Toronto Study. Of 582 teeth treated, 430 were lost to follow-up (99 discontinuers, 331 dropouts), 15 were extracted, and 137 (32% recall minus 15 extracted teeth) were examined for outcome: healed (no apical periodontitis, signs, symptoms) or diseased. When pooled with Phases 1-3, 439 of 510 teeth (86%) were healed. Logistic regression identified 2 significant (P < or = .05) preoperative outcome predictors: radiolucency (odds ratio [OR], 2.86; confidence interval [CI], 1.56-5.24; healed: absent, 93%; present, 82%) and number of roots (OR, 2.53; CI, 1.25-5.13; healed: single, 93%; multiple, 84%). In teeth with radiolucency, intraoperative complications (OR, 2.27; CI, 1.05-4.89; healed: absent, 84%; present, 69%) and root-filling technique (OR, 1.89; CI, 1.01-3.53; healed: lateral, 77%; vertical, 87%) were additional outcome predictors. A better outcome was suggested for teeth without radiolucency, with single roots, and without mid-treatment complications. The predictive value of root-filling technique in teeth with radiolucency requires validation from randomized controlled trials.
对多伦多研究第4阶段（2000 - 2001年）初始治疗后4至6年的结果进行了评估。在接受治疗的582颗牙齿中，430颗失访（99例中断治疗者，331例退出者），15颗被拔除，137颗（召回率32%减去15颗拔除牙齿）接受了结果检查：愈合（无根尖周炎、体征、症状）或患病。与第1 - 3阶段合并后，510颗牙齿中有439颗（86%）愈合。逻辑回归确定了2个显著（P≤0.05）的术前结果预测因素：透射区（优势比[OR]，2.86；置信区间[CI]，1.56 - 5.24；愈合：无，93%；有，82%）和牙根数量（OR，2.53；CI，1.25 - 5.13；愈合：单根，93%；多根，84%）。在有透射区的牙齿中，术中并发症（OR，2.27；CI，1.05 - 4.89；愈合：无，84%；有，69%）和根管充填技术（OR，1.89；CI，1.01 - 3.53；愈合：侧方充填，77%；垂直充填，87%）是额外的结果预测因素。对于无透射区、单根且无治疗中并发症的牙齿，结果较好。根管充填技术在有透射区牙齿中的预测价值需要随机对照试验进行验证。
