Kirkevang L-L, Ørstavik D, Wenzel A, Vaeth M
Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Section of Oral Radiology, Department of Dentistry, Health, Aarhus University, Aarhus, Denmark.
Int Endod J. 2015 Nov;48(11):1051-8. doi: 10.1111/iej.12402. Epub 2014 Nov 24.
To evaluate whether the full-scale Periapical Index (PAI) can predict the periapical status over time in nonroot filled and root filled teeth.
Full-mouth radiographic surveys of a random sample from a general population were performed in 1997, 2003 and 2008. The present investigation included 330 persons who participated in all three examinations and 143 persons who participated in the first and second examination. At each examination, the presence or absence of a tooth and of a root filling was recorded, and a PAI score (1-5) was assigned to all teeth. Retreatment of a root filling was recorded for root filled teeth. Statistical analysis was carried out using ordinal logistic regression and logistic regression and computed as Wald's tests.
At baseline, nonroot filled teeth had lower PAI scores than root filled teeth (P < 0.0001). A high baseline PAI increased the risk of extraction for both root filled (P < 0.001) and nonroot filled teeth (P < 0.001). At 5-year follow-up, PAI scores were higher when baseline PAI scores had been higher. The overall pattern for root filled and nonroot filled teeth was similar, however, the differences were statistically significant (P < 0.001). In particular, the follow-up PAI score for nonroot filled teeth with baseline PAI score 1 or 2 was significantly lower than that of root filled teeth (P < 0.001). For root filled teeth with baseline PAI score 3, 4 or 5, the trend was reversed as they overall had slightly lower PAI scores at follow-up (P = 0.023).
Repeated radiographic assessments of teeth using the full-scale PAI reveal that each of the five scores had distinct prognostic value for the course of periapical disease over a 5-year period for both nonroot filled and root filled teeth.
评估全口根尖指数（PAI）能否预测未进行根管充填和已进行根管充填牙齿随时间变化的根尖周状况。
于1997年、2003年和2008年对来自普通人群的随机样本进行全口放射学检查。本研究纳入了330名参加了所有三次检查的人员以及143名参加了第一次和第二次检查的人员。每次检查时，记录牙齿的有无以及根管充填情况，并为所有牙齿分配一个PAI评分（1 - 5分）。记录已进行根管充填牙齿的根管再治疗情况。采用有序逻辑回归和逻辑回归进行统计分析，并计算为Wald检验。
在基线时，未进行根管充填的牙齿PAI评分低于已进行根管充填的牙齿（P < 0.0001）。高基线PAI增加了已进行根管充填牙齿（P < 0.001）和未进行根管充填牙齿（P < 0.001）拔除的风险。在5年随访时，基线PAI评分较高时，PAI评分也较高。已进行根管充填和未进行根管充填牙齿的总体模式相似，然而，差异具有统计学意义（P < 0.001）。特别是，基线PAI评分为1或2的未进行根管充填牙齿的随访PAI评分显著低于已进行根管充填的牙齿（P < 0.001）。对于基线PAI评分为3、4或5的已进行根管充填牙齿，趋势相反，因为它们在随访时总体PAI评分略低（P = 0.023）。
使用全口PAI对牙齿进行重复放射学评估表明，对于未进行根管充填和已进行根管充填的牙齿，在5年期间，五个评分中的每一个对于根尖周疾病的病程都具有独特的预后价值。
