García-Guerrero Claudia, Parra-Junco Claudia, Quijano-Guauque Sara, Molano Nicolás, Pineda Gerardo A, Marín-Zuluaga Dairo J
Department of Endodontics, National University of Colombia, Bogotá, Colombia.
Endodontic Research Group (INVENDO), National University of Colombia, Bogotá, Colombia.
J Investig Clin Dent. 2018 Feb;9(1). doi: 10.1111/jicd.12273. Epub 2017 May 5.
The prevalence of vertical root fractures (VRF) ranges from 2% to 20%, and is associated with endodontically-treated teeth (ETT). The aim of the present study was to analyze clinically and radiographically, at different intervals of time, some of the risk factors present in ETT that developed VRF.
A classification model according to time measured the follow-up period of three groups. A match was made for times of occurrence (cases) and follow up (controls). An odds ratio (OR) test and a logistic regression model set at 95% confidence interval (CI) established the VRF probability when different clinical factors (patient, tooth, and endodontic or restorative treatment) were present.
The sample was composed of 197 ETT (41 cases and 156 controls). A classification model set the trend, thus defining three groups: group 1 (1-4 years of follow up): endodontic retreatment (OR: 8.01, 95% CI: 1.85-37.90, P=.0014), indirect restoration (OR: .202, 95% CI: .036-.979, P=.05); group 2 (5-8 years of follow up): primary treatment (OR: .052, 95% CI: .002-.680, P=.044) and the 'single tooth' category (OR: .042, 95% CI: .002-.453, P=.02) demonstrated a significant association with VRF; and group 3 (>9 years of follow up): no association.
Endodontic retreatment had the highest risk association for VRF after 1-8 years of follow up. Indirect and individual restorations were not significantly associated with VRF.
垂直根折(VRF)的患病率在2%至20%之间,且与根管治疗牙(ETT)相关。本研究的目的是在不同时间间隔对发生VRF的ETT中存在的一些风险因素进行临床和影像学分析。
根据时间的分类模型测量了三组的随访期。对发生时间(病例)和随访时间(对照)进行匹配。当存在不同临床因素(患者、牙齿以及根管或修复治疗)时,采用优势比(OR)检验和设定为95%置信区间(CI)的逻辑回归模型确定VRF概率。
样本由197颗ETT组成(41例病例和156例对照)。一个分类模型确定了趋势,从而定义了三组:第1组(随访1 - 4年):根管再治疗(OR:8.01,95%CI:1.85 - 37.90,P = 0.0014),间接修复(OR:0.202,95%CI:0.036 - 0.979,P = 0.05);第2组(随访5 - 8年):初次治疗(OR:0.052,95%CI:0.002 - 0.680,P = 0.044)和“单颗牙”类别(OR:0.042,95%CI:0.002 - 0.453,P = 0.02)与VRF有显著关联;第3组(随访>9年):无关联。
在随访1 - 8年后,根管再治疗与VRF的风险关联最高。间接修复和个别修复与VRF无显著关联。