Kirkevang L-L, Ørstavik D, Bahrami G, Wenzel A, Vaeth M
Section of Oral Radiology, Department of Dentistry, Health, Aarhus University, Aarhus, Denmark.
Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Int Endod J. 2017 Jan;50(1):5-14. doi: 10.1111/iej.12581. Epub 2015 Dec 23.
To describe and analyse risk factors associated with prediction of periapical status, assessed using the full-scale Periapical Index (PAI) supplemented with extraction as outcome variable.
In 1997-1998, 616 randomly selected individuals from Aarhus County, Denmark, underwent a full-mouth radiographic survey. All 616 were re-invited in 2003-2004 and in 2008-2009, when 473 and 363 persons, respectively, consented and attended a new radiographic examination. The study population of the present investigation included 330 persons who had participated in all three examinations, and 143 persons who had participated in the first and second examination only. Using the full-mouth radiographic survey and interview information, the following variables were assessed: on person level - age, gender, smoking habits and number of teeth; on tooth level - presence of tooth, PAI, root filling, caries, marginal bone level, restoration, jaw and tooth group. The outcome variable was the 5 score PAI supplemented with extraction. The observation period was 5 years. Ordered logistic regression analyses were carried out for root filled and non-root filled teeth separately. The Regional Committee of Ethics approved the study.
For both root filled teeth and non-root filled teeth, the baseline PAI score was the most important predictive factor of periapical status and extraction (P < 0.0001). Non-root filled teeth had in general a better outcome than root filled teeth. However, in non-root filled teeth, several other factors had a significant influence on the outcome, and the risk estimates were larger and showed a more pronounced variation between the different categories of predictive factors. For root filled teeth few variables, other than baseline PAI score, influenced the outcome significantly.
The full-scale PAI was the strongest predictive factor of periapical status or extraction even when adjusted for additional factors, such as marginal bone level. A high baseline PAI score increased the risk for an impaired outcome. The large difference in risk estimates for non-root filled compared to root filled teeth documents the importance of separate analyses/studies for identification and quantification of predictive factors associated with periapical status and extraction of a tooth.
描述并分析与根尖周状况预测相关的风险因素，采用全口根尖周指数（PAI）并辅以拔牙作为结局变量进行评估。
1997年至1998年，从丹麦奥胡斯郡随机选取616名个体进行全口放射学检查。2003年至2004年以及2008年至2009年，再次邀请这616人，分别有473人和363人同意并参加了新的放射学检查。本研究的研究人群包括330名参加了所有三次检查的人，以及143名仅参加了第一次和第二次检查的人。利用全口放射学检查和访谈信息，评估了以下变量：个体层面——年龄、性别、吸烟习惯和牙齿数量；牙齿层面——牙齿的存在情况、PAI、根管充填、龋齿、边缘骨水平、修复情况、颌骨和牙组。结局变量是补充了拔牙情况的5分制PAI。观察期为5年。分别对根管充填牙和非根管充填牙进行有序逻辑回归分析。地区伦理委员会批准了该研究。
对于根管充填牙和非根管充填牙，基线PAI评分都是根尖周状况和拔牙的最重要预测因素（P<0.0001）。一般来说，非根管充填牙的结局比根管充填牙更好。然而，在非根管充填牙中，其他几个因素对结局有显著影响，风险估计值更大，且在不同类别的预测因素之间显示出更明显的差异。对于根管充填牙，除了基线PAI评分外，很少有变量对结局有显著影响。
即使对边缘骨水平等其他因素进行调整后，全口PAI仍是根尖周状况或拔牙的最强预测因素。高基线PAI评分会增加不良结局的风险。与根管充填牙相比，非根管充填牙风险估计值的巨大差异证明了分别进行分析/研究以识别和量化与根尖周状况及牙齿拔除相关的预测因素的重要性。
