Department of Dentistry and School of Dentistry, National Taiwan University Hospital and National Taiwan University Medical College, Taipei, Taiwan.
Department of Dentistry, Show Chwan Memorial Hospital, Chang Hua, Taiwan.
J Formos Med Assoc. 2019 Jun;118(6):1055-1061. doi: 10.1016/j.jfma.2018.10.019. Epub 2018 Nov 16.
BACKGROUND/PURPOSE: Apical surgery is an option for management of endodontically-treated tooth with persistent periapical lesions or symptom and sign. The objective of this study was to investigate the correlation between the demography, preoperative, postoperative factors and healed rate of apical surgery.
Subjects were retrospectively collected from patients who received apical surgery/apicoectomy at the Endodontic Department, National Taiwan University Hospital from January 2013 to June 2015. The standard apical surgery procedures were performed. The demography, preoperative clinical and radiographic examination data as well as postoperative variables were collected. The outcome assessment was carried out after surgery. Statistical analysis was performed by chi square test to evaluate the potential outcome predictors.
Total 187 patients and 234 teeth receiving apical surgery were included. 53 male and 134 female patients were collected. The age was ranged between 17 and 89 years old and the mean age was 43.64 years old. Better healed rate with significant differences were observed in female patient (p < 0.05), age ≤60 years old (p < 0.01), preoperative root canal filling material >2 mm short of apex (p < 0.01), lesion size from ≤2 mm to ≤12 mm (p < 0.05) and follow-up period ≧12 months (p < 0.01) groups.
Gender, age, preoperative root canal filling material extent, lesion size and follow-up period may affect the outcome of apical surgery. Tooth type, post, prosthesis, and lesion area showed no marked effect on apical healing. These results provide more detailed information for the clinical practitioners to make treatment plans and are important for clinical endodontic practices.
背景/目的：根尖手术是治疗有持续性根尖病变或症状和体征的根管治疗后牙齿的一种选择。本研究旨在探讨患者人口统计学、术前、术后因素与根尖手术愈合率之间的相关性。
本研究回顾性收集了 2013 年 1 月至 2015 年 6 月期间在国立台湾大学医院牙髓病科接受根尖手术/根尖切除术的患者。采用标准根尖手术程序。收集患者的人口统计学、术前临床和影像学检查数据以及术后变量。术后进行疗效评估。采用卡方检验评估潜在的疗效预测因素。
共纳入 187 例患者，234 颗接受根尖手术的患牙。其中男性 53 例，女性 134 例。患者年龄 17-89 岁，平均年龄 43.64 岁。女性（p<0.05）、年龄≤60 岁（p<0.01）、术前根管充填材料距根尖 2mm 以上（p<0.01）、病变大小≤2mm-≤12mm（p<0.05）和随访时间≥12 个月（p<0.01）组愈合率较好，差异有统计学意义。
性别、年龄、术前根管充填材料长度、病变大小和随访时间可能影响根尖手术的疗效。牙位、桩、修复体和病变面积对根尖愈合无明显影响。这些结果为临床医生制定治疗计划提供了更详细的信息，对临床牙髓病学实践具有重要意义。
