Sim Irene G B, Lim Toh-Seong, Krishnaswamy Gita, Chen Nah-Nah
Department of Restorative Dentistry, National Dental Centre, Singapore.
Private Practice, Singapore.
J Endod. 2016 Feb;42(2):225-9. doi: 10.1016/j.joen.2015.11.011. Epub 2015 Dec 23.
The study aimed to investigate the 5-year survival of root-filled posterior cracked teeth and its related factors.
Two hundred patients who had root canal-treated posterior cracked teeth at the National Dental Centre were recalled for a 5-year review. Eighty-four patients who met the inclusion criteria were included in this study. The cases were managed following the treatment protocol for cracked teeth at the center. The data for analyses were obtained from the patients' clinical records. Statistical analyses were performed using SPSS 21.0 (SPSS Inc, Chicago, IL). The outcome measure was the presence of tooth at the time of the review.
At 5 years, 77 teeth "survived" (92%), and 7 teeth (8 %) were extracted. Patient demographics, tooth type and location, existing restoration, number and location of cracks, presence of pretreatment signs and symptoms, and initial pulpal and periapical diagnosis did not significantly affect the survival of the teeth. Univariate analysis showed that teeth with extension of the cracks onto the pulpal floor were more often extracted (odds ratio = 4.5, P = .07). Multivariable analyses found that extension of cracks onto the pulpal floor independently increased the odds of tooth loss by 11-fold (odds ratio = 11, P = .033), with other factors being held constant. The 5-year survival estimate in the absence and presence of crack extension onto the pulpal floor was 99% and 88%, respectively.
Coronal cracks may be predictably treated, whereas radicular cracks increased the odds of the tooth being extracted.
本研究旨在调查根管治疗后的后牙纵裂牙的5年生存率及其相关因素。
召回在国家牙科中心接受过根管治疗的后牙纵裂牙的200名患者进行为期5年的复查。符合纳入标准的84名患者纳入本研究。病例按照该中心纵裂牙的治疗方案进行处理。分析数据来自患者的临床记录。使用SPSS 21.0（SPSS公司，伊利诺伊州芝加哥）进行统计分析。观察指标为复查时牙齿的存留情况。
5年后，77颗牙齿“存活”（92%），7颗牙齿（8%）被拔除。患者人口统计学特征、牙齿类型和位置、现有修复体、裂纹数量和位置、治疗前体征和症状的存在情况以及初始牙髓和根尖周诊断对牙齿的生存率没有显著影响。单因素分析显示，裂纹延伸至髓室底的牙齿更常被拔除（比值比 = 4.5，P = .07）。多变量分析发现，在其他因素保持不变的情况下，裂纹延伸至髓室底会使牙齿缺失的几率独立增加11倍（比值比 = 11，P = .033）。裂纹未延伸至髓室底和延伸至髓室底时的5年生存率估计分别为99%和88%。
冠部裂纹可能可以得到可预测的治疗，而根部裂纹会增加牙齿被拔除的几率。
