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影响磨牙牙根切除术治疗效果的因素:一项10年回顾性研究

Factors influencing the outcome of root-resection therapy in molars: a 10-year retrospective study.

作者信息

Park Shin-Young, Shin Seung-Yun, Yang Seung-Min, Kye Seung-Beom

机构信息

Department of Periodontics, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

J Periodontol. 2009 Jan;80(1):32-40. doi: 10.1902/jop.2009.080316.

Abstract

BACKGROUND

Root resection is one treatment option for preserving molars with furcation involvement. This study evaluated the prognosis of root-resection therapy retrospectively and examined the factors influencing the survival rate of resected molars.

METHODS

Root-resection therapy was performed on 691 molars in 579 patients. The associated factors were examined from 342 of 402 molars that had been followed up for >1 year. Survival analysis was used to statistically analyze the factors.

RESULTS

Over the past 10 years, 102 of 342 cases (29.8%) failed. The factors were classified into four groups and analyzed to determine their influence on the survival rate of the resected molars. Regarding the resection-related factors, the molars resected because of periodontal problems had a higher survival rate than those resected because of non-periodontal problems (tooth fracture, dental caries, and endodontic problems; P = 0.0097). Patient- and tooth-related factors had no effect on the survival rates. Among the site-related factors, only the amount of bone support of the remaining roots at the time of surgery had a significant effect on the survival rate in the group of molars with periodontal problems (P = 0.0269).

CONCLUSIONS

Root resection to treat periodontal problems had a better prognosis than for non-periodontal problems. To achieve a good result, it was important that the remaining roots had >50% bone support. This guideline may help to improve the predictability of root-resection therapy.

摘要

背景

牙根切除术是保留存在根分叉病变磨牙的一种治疗选择。本研究回顾性评估了牙根切除治疗的预后,并探讨了影响切除磨牙存活率的因素。

方法

对579例患者的691颗磨牙实施了牙根切除术。从402颗随访时间超过1年的磨牙中的342颗中检查相关因素。采用生存分析对这些因素进行统计学分析。

结果

在过去10年中,342例患者中有102例(29.8%)治疗失败。将这些因素分为四组并进行分析,以确定它们对切除磨牙存活率的影响。关于切除相关因素,因牙周问题而切除的磨牙的存活率高于因非牙周问题(牙齿折断、龋齿和牙髓问题)而切除的磨牙(P = 0.0097)。患者和牙齿相关因素对存活率没有影响。在部位相关因素中,仅手术时剩余牙根的骨支持量对存在牙周问题的磨牙组的存活率有显著影响(P = 0.0269)。

结论

治疗牙周问题的牙根切除术比治疗非牙周问题的预后更好。为取得良好效果,重要的是剩余牙根要有>50%的骨支持。本指南可能有助于提高牙根切除治疗的可预测性。

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