Charité - University Medical Center Berlin, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353, Berlin, Germany.
Department of Oral and Maxillofacial Surgery, Schleswig-Holstein University, Hospital Arnold-Heller-Straße 3, Haus 26, 24105, Kiel, Germany.
J Craniomaxillofac Surg. 2018 Nov;46(11):1934-1938. doi: 10.1016/j.jcms.2018.08.005. Epub 2018 Aug 21.
Oftentimes the discussion of long-term success rates and treatment modalities becomes a central issue in consultations with patients. The aim of this study was to retrospectively evaluate survival rates of teeth after apicoectomy in an established private practice for Oral and Maxillofacial Surgery in Kiel, Germany. All teeth treated with apicoectomy between 2001 and 2006 were included. Treatment success was previously defined as preservation of the tooth. Putative influence factors on success as kind and quality of endodontic treatment, additional intraoperative endodontic filling, inflammatory status, tooth mobility, and pre- and postoperative X-rays were further evaluated. A total of 149 teeth could be included. The mean observation period was 6.3 (SD: 4.4) years. In all, 48.3% of these teeth could be retained after a 10-year period. Teeth that received an additional retrograde root canal filling during surgery resulted in a significantly higher success rate (p = 0.0237) compared to those with orthograde root canal fillings or without additional endodontic treatment. The quality of endodontic treatment had no impact (p = 0.125). Our results suggest that apical surgery is a reliable procedure to treat and ensure the survival of symptomatic teeth in the posterior region for several years. A significant improvement was further determined for a retrograde filling.
在与患者的咨询中，长期成功率和治疗方式的讨论常常成为一个核心问题。本研究旨在回顾性评估德国基尔一家口腔颌面外科私人诊所中根尖切除术治疗后牙齿的存活率。纳入 2001 年至 2006 年间接受根尖切除术治疗的所有牙齿。先前将保留牙齿定义为治疗成功。进一步评估了对成功有潜在影响的因素，如牙髓治疗的类型和质量、术中额外的根管内填充、炎症状态、牙齿松动度以及术前和术后 X 光片。共纳入 149 颗牙齿。平均观察期为 6.3（SD：4.4）年。这些牙齿中有 48.3%在 10 年后仍保留。与进行顺行根管填充或未进行额外牙髓治疗的牙齿相比，术中进行额外逆行根管填充的牙齿的成功率显著更高（p=0.0237）。牙髓治疗的质量没有影响（p=0.125）。我们的结果表明，根尖手术是一种可靠的方法，可以治疗和确保后牙区有症状的牙齿在数年内的存活。进一步确定逆行填充有显著改善。
