日本全科医疗中导致牙髓治疗失败的因素。
Factors that cause endodontic failures in general practices in Japan.
作者信息
Yamaguchi Mikiyo, Noiri Yuichiro, Itoh Yoshihiro, Komichi Shungo, Yagi Kyoko, Uemura Reo, Naruse Haruna, Matsui Saori, Kuriki Nanako, Hayashi Mikako, Ebisu Shigeyuki
机构信息
Osaka University Graduate School of Dentistry, Osaka, Japan.
出版信息
BMC Oral Health. 2018 Apr 27;18(1):70. doi: 10.1186/s12903-018-0530-6.
BACKGROUND
Bacterial biofilms that develop on root surfaces outside apical foramens have been found to be associated with refractory periapical periodontitis. However, several other factors cause endodontic failures apart from extraradicular biofilms. The aim of this study was to identify the factors causing endodontic failures in general practices in Japan.
METHODS
Patients diagnosed as having refractory periapical periodontitis by general practitioners and who requested endodontic treatment at Osaka University Dental Hospital were selected by checking medical records from April 2009 to March 2013. Factors causing endodontic failures were identified.
RESULTS
A total of 103 teeth were selected, and 76 teeth completed root-canal treatment. Tooth extractions were required for 18 teeth after or without endodontic treatment. Six teeth required apicoectomy after endodontic treatment. One tooth needed hemisection. One tooth needed intentional replantation. One tooth needed adhesion and replantation. The main causes of treatment failure were open apices (24 teeth), perforation (18 teeth), and root fracture (13 teeth). In six teeth with open apices that required apicoectomy or extraction, extraradicular biofilms may have been related to endodontic failure.
CONCLUSIONS
Most endodontic cases diagnosed with refractory periapical periodontitis by general practitioners were compromised by any other factors rather than extraradicular biofilms.
背景
已发现根尖孔外牙根表面形成的细菌生物膜与难治性根尖周炎有关。然而，除了根外生物膜外，还有其他一些因素会导致根管治疗失败。本研究的目的是确定日本全科医疗中导致根管治疗失败的因素。
方法
通过查阅2009年4月至2013年3月的病历，选择被全科医生诊断为难治性根尖周炎并在大阪大学牙科医院要求进行根管治疗的患者。确定导致根管治疗失败的因素。
结果
共选择了103颗牙齿，76颗牙齿完成了根管治疗。18颗牙齿在根管治疗后或未进行根管治疗的情况下需要拔牙。6颗牙齿在根管治疗后需要根尖切除术。1颗牙齿需要半切术。1颗牙齿需要有意再植。1颗牙齿需要粘结和再植。治疗失败的主要原因是根尖孔开放（24颗牙齿）、穿孔（18颗牙齿）和牙根折断（13颗牙齿）。在6颗需要根尖切除术或拔牙的根尖孔开放的牙齿中，根外生物膜可能与根管治疗失败有关。
结论
大多数被全科医生诊断为难治性根尖周炎的根管治疗病例是由根外生物膜以外的其他因素导致的。
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