Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, South Korea.
Department of Conservative Dentistry, College of Dentistry, Yonsei University, Seoul, South Korea.
Clin Oral Investig. 2018 May;22(4):1717-1724. doi: 10.1007/s00784-017-2265-1. Epub 2017 Nov 2.
The purpose of this retrospective clinical study was to evaluate the effect of lesion types related to endodontic microsurgery on the clinical outcome.
Patients who underwent endodontic microsurgery between March 2001 and March 2014 with a postoperative follow-up period of at least 1 year were included in the study. Survival analyses were conducted to compare the clinical outcomes between isolated endodontic lesion group (endo group) and endodontic-periodontal combined lesion group (endo-perio group) and to evaluate other clinical variables. To reduce the effect of selection bias in this study, the estimated propensity scores were used to match the cases of the endo group with those of the endo-perio group.
Among the 414 eligible cases, the 83 cases in the endo-perio group were matched to 166 out of the 331 cases in the endo group based on propensity score matching (PSM). The cumulated success rates of the endo and endo-perio groups were 87.3 and 72.3%, respectively. The median success period of the endo-perio group was 12 years (95% CI: 5.507, 18.498). Lesion type was found to be significant according to both Log-rank test (P = 0.002) and Cox proportional hazard regression analysis (P = 0.001). Among the other clinical variables, sex (female or male), age, and tooth type (anterior, premolar, or molar) were determined to be significant in Cox regression analysis (P < 0.05).
Endodontic-periodontal combined lesions had a negative effect on the clinical outcome based on an analysis that utilized PSM, a useful statistical matching method for observational studies.
Lesion type is a significant predictor of the outcome of endodontic microsurgery.
本回顾性临床研究旨在评估与根管显微手术相关的病变类型对临床疗效的影响。
纳入 2001 年 3 月至 2014 年 3 月期间接受根管显微手术且术后随访至少 1 年的患者。通过生存分析比较单纯根管病变组（endo 组）和根管牙周联合病变组（endo-perio 组）的临床疗效，并评价其他临床变量。为了减少本研究中选择偏倚的影响，使用估计倾向评分对 endo 组的病例与 endo-perio 组的病例进行匹配。
在 414 例合格病例中，基于倾向评分匹配（PSM），将 endo-perio 组的 83 例与 endo 组的 331 例中的 166 例进行匹配。endo 组和 endo-perio 组的累积成功率分别为 87.3%和 72.3%。endo-perio 组的中位成功期限为 12 年（95%CI：5.507，18.498）。Log-rank 检验（P=0.002）和 Cox 比例风险回归分析（P=0.001）均表明病变类型有显著意义。在其他临床变量中，性别（女性或男性）、年龄和牙齿类型（前牙、前磨牙或磨牙）在 Cox 回归分析中被确定为有统计学意义（P<0.05）。
基于利用 PSM 进行的分析，根管牙周联合病变对根管显微手术的临床疗效有负面影响，PSM 是一种用于观察性研究的有用的统计匹配方法。
病变类型是根管显微手术结果的重要预测指标。
