Cousson Pierre-Yves, Nicolas Emmanuel, Hennequin Martine
CROC-EA 4847, Clermont Université, Université d'Auvergne, BP 10448, 63000, Clermont-Ferrand, France.
Service d'Odontologie, Unité Fonctionnelle de soins spécifiques, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France.
Clin Oral Investig. 2014 May;18(4):1155-1163. doi: 10.1007/s00784-013-1090-4. Epub 2013 Sep 1.
A previous study considered whether the proportions of clinically satisfactory root canal treatments (RCT) done under general anaesthesia (GA) or under local anaesthesia were equivalent, but the proportion of treatment with long-term satisfactory endodontic outcomes remains unknown. Moreover, no evaluation of pulpotomies performed under GA has been reported.
From 614 endodontic treatments (ETs) performed on permanent teeth under GA, 225 [193 RCT and 32 pulpotomies (P)] were examined after follow-up periods of 1-6 months (71 cases), 6-24 months (77 cases) and over 2 years (77 cases). Changes in the periapical index between the treatment date (T0) and the control time (T1) allowed the treatment to be classified as "success," "uncertain outcome" or "failure." Explicative variables for success of ET were the duration of follow-up and tooth-related criteria expected to affect the outcomes of endodontic treatment.
Overall, 87 % of ETs were scored as "success," while 9 % were uncertain and 4 % were failures. There was no difference in the distribution of success in relation with the type of tooth, the pulpal status, the level of endodontic difficulty, the periapical status or the technical quality of RCT. The proportion of endodontic cases with high level of difficulties was higher in the P group than in the RCT group.
Longer follow-ups and higher numbers of cases are needed to analyse the factors affecting success and failure in endodontic treatments performed under GA.
The relatively high rates of success of pulpotomies and RCT support undertaking endodontic treatment under GA.
先前一项研究探讨了在全身麻醉（GA）或局部麻醉下进行的临床满意的根管治疗（RCT）比例是否相当，但长期牙髓治疗效果满意的治疗比例仍不清楚。此外，尚未有关于在GA下进行的牙髓切断术的评估报告。
从在GA下对恒牙进行的614次牙髓治疗（ET）中，在1 - 6个月（71例）、6 - 24个月（77例）和超过2年（77例）的随访期后检查了225例[193例RCT和32例牙髓切断术（P）]。治疗日期（T0）和对照时间（T1）之间根尖指数的变化使治疗可分为“成功”、“结果不确定”或“失败”。ET成功的解释变量为随访时间和预期影响牙髓治疗结果的牙齿相关标准。
总体而言，87%的ET被评为“成功”，9%结果不确定，4%为失败。在成功分布方面，与牙齿类型、牙髓状态、根管治疗难度水平、根尖周状态或RCT的技术质量无关。牙髓切断术组中高难度牙髓病例的比例高于RCT组。
需要更长的随访时间和更多病例来分析影响GA下牙髓治疗成功和失败的因素。
牙髓切断术和RCT相对较高的成功率支持在GA下进行牙髓治疗。
