Landys Borén Daniela, Jonasson Peter, Kvist Thomas
Department of Endodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Endodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Endod. 2015 Feb;41(2):176-81. doi: 10.1016/j.joen.2014.10.002. Epub 2014 Nov 25.
The long-term survival of endodontically treated teeth is an issue of high priority focus in modern restorative dentistry. In available literature, survival is generally high and comparable with implants. For more compromised teeth treated in a specialist clinic, survival rate may be lower. This retrospective study aimed to investigate the 10-year survival rate of teeth treated in a public endodontic specialist clinic.
From a database of 15,000 examined teeth, 420 teeth in 330 patients were randomly selected and included. Available potential preoperative, intraoperative, and postoperative prognostic factors were registered. Ten-year tooth survival was recorded by scrutinizing records and by contacting referring dentists and patients.
The overall Kaplan-Meier estimated 10-year survival rate was 81.5% (95% confidence interval [CI], 76.7%-85.5%). Placement of a crown, adjusted hazard ratio 0.27 (95% CI, 0.12-0.61), P = .0016, and age-adjusted hazard ratio 1.31 per 10 years (95% CI, 1.11-1.55), P = .0012, were significant independent predictors for estimated survival rate. Seventy-three teeth (17.4%) in 69 patients were extracted during the 10-year follow-up period. The declared reason for extraction was related to endodontic diagnoses in only 5 of the cases (6.8%).
Approximately 80% of the teeth treated at this specialist clinic in endodontics survived at least for 10 years. Teeth in young persons and teeth restored with a crown postoperatively survived significantly better. To further explore the importance of the postoperative restoration in endodontically treated teeth, randomized controlled trials need be carried out.
在现代修复牙科中，经牙髓治疗牙齿的长期存活是一个高度优先关注的问题。在现有文献中，存活率通常较高，与种植牙相当。对于在专科诊所治疗的情况更复杂的牙齿，存活率可能较低。这项回顾性研究旨在调查在一家公立牙髓专科诊所治疗的牙齿的10年存活率。
从15000颗检查牙齿的数据库中，随机选取并纳入了330例患者的420颗牙齿。记录了术前、术中和术后可用的潜在预后因素。通过仔细审查记录以及联系转诊牙医和患者来记录10年牙齿存活率。
总体Kaplan-Meier估计的10年存活率为81.5%（95%置信区间[CI]，76.7%-85.5%）。冠修复，校正风险比0.27（95%CI，0.12-0.61），P = 0.0016，以及年龄校正风险比每10年1.31（95%CI，1.11-1.55），P = 0.0012，是估计存活率的显著独立预测因素。在10年随访期内，69例患者的73颗牙齿（17.4%）被拔除。拔除的明确原因仅在5例（6.8%）中与牙髓诊断有关。
在这家牙髓专科诊所治疗的牙齿中，约80%至少存活了10年。年轻人的牙齿以及术后进行冠修复的牙齿存活情况明显更好。为了进一步探究术后修复在牙髓治疗牙齿中的重要性，需要开展随机对照试验。
