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影响根管治疗后磨牙治疗决策和结局的因素:一项全国性研究。

Factors affecting treatment decisions and outcomes of root-resected molars: a nationwide study.

机构信息

Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.

出版信息

J Periodontol. 2013 Nov;84(11):1528-35. doi: 10.1902/jop.2013.120580. Epub 2013 Jan 17.

Abstract

BACKGROUND

Treatment of furcation-involved molars presents a clinical challenge. This study retrospectively investigates the demographic parameters affecting treatment decisions and outcomes of root-resected molars using a nationwide population-based dataset.

METHODS

De-identified data from 471 eligible patients were obtained from a representative cohort composed of 1 million of Taiwan's population. Demographic factors that influence treatment decisions and outcomes of root-resected teeth were examined. Cox regression was performed to statistically analyze the factors.

RESULTS

The overall survival rate for root-resected molars was 91.1%. The survival times of the extracted and surviving teeth were 303.0 ± 274.6 and 551.8 ± 327.2 days, respectively (P <0.001). The analyzed patient-related factors, such as living district, urbanization level, medical institution, and monthly income, have remarkable influence on treatment decisions; however, there is no statistically significant difference in survival rate between root-resected molars receiving flap surgery and those that do not (P = 0.504). After adjusting for other factors, patients aged >74 years have 3.33 times (hazard ratio = 3.33; 95% CI = 1.04 to 10.66; P = 0.043) higher rates of molar extraction than younger counterparts.

CONCLUSIONS

The overall survival rate of root-resected molars was satisfactory. Patients with advanced age (>74 years) had a higher risk of extraction occurrence on resected molars. Patient-related factors may influence the treatment decision of whether molars receive flap surgery. These findings suggest that demographic factors should be carefully evaluated before and after performing root-resection procedures because these factors may eventually impact the outcome of root-resected molars.

摘要

背景

涉及分叉的磨牙的治疗具有临床挑战性。本研究使用基于全国人口的数据集回顾性调查影响磨牙根管切除治疗决策和结果的人口统计学参数。

方法

从由 100 万台湾人口组成的代表性队列中获得了 471 名符合条件的患者的匿名数据。检查了影响根管切除牙齿治疗决策和结果的人口统计学因素。使用 Cox 回归对这些因素进行了统计学分析。

结果

磨牙根管切除的总生存率为 91.1%。拔牙和存活牙齿的生存时间分别为 303.0±274.6 和 551.8±327.2 天(P<0.001)。分析的患者相关因素,如居住地区、城市化水平、医疗机构和月收入,对治疗决策有显著影响;然而,接受瓣手术和未接受瓣手术的磨牙的生存率之间无统计学差异(P=0.504)。在调整其他因素后,年龄>74 岁的患者磨牙拔除的风险比年轻患者高 3.33 倍(危险比=3.33;95%CI=1.04 至 10.66;P=0.043)。

结论

磨牙根管切除的总生存率令人满意。年龄较大(>74 岁)的患者在接受磨牙根管切除后发生拔牙的风险更高。患者相关因素可能会影响是否对磨牙进行瓣手术的治疗决策。这些发现表明,在进行根管切除术前和术后都应仔细评估人口统计学因素,因为这些因素最终可能会影响根管切除磨牙的结果。

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