Department of Oral and Maxillofacial Diseases, University of Helsinki, P.O. Box 41, FI-00014, Helsinki, Finland.
Department of Social Services and Health Care, Oral Health Care, P.O. Box 6000, FI-00099, City of Helsinki, Finland.
Clin Oral Investig. 2019 Nov;23(11):4011-4018. doi: 10.1007/s00784-019-02832-0. Epub 2019 Feb 2.
We assessed the impact of type of tooth on the outcome of root canal treatment (RCT) according to factors potentially weakening the prognosis such as preoperative apical periodontitis (AP) and treatment modality (primary or secondary RCT).
We scrutinized patient documents including pre- and postoperative radiographs of 640 permanent teeth receiving non-surgical RCT at Helsinki University Clinic in 2008-2011. Of teeth, 44% were molars, 32% premolars, and 24% anterior teeth. Patients' mean age was 51.5 years; 51% were male. AP was present in 60.5% of teeth preoperatively. We used the periapical index (PAI) to assess the radiographs and defined radiographically "healthy" and "healing" cases as successful. Statistical evaluation included chi-squared tests, Fisher's exact tests, t tests, and logistic regression modeling.
The overall success rate (SR) was 84.1%; 88.3% for primary and 75.5% for secondary RCT (p < 0.001). The SRs for anterior teeth, premolars and molars were 85.6%, 88.8%, and 79.7%, respectively. Teeth with and without AP had SRs of 77.3% and 94.5%, respectively (p < 0.001). The RCTs were more likely to succeed in anterior teeth and premolars than in molars (OR 1.7; 95% CI 1.1-2.7) and in females than in males (OR 1.9; 95% CI 1.2-3.1).
Apart from existing AP and retreatment scenario, also, the type of tooth and gender had a significant influence on the outcome of RCT in this study.
The prognosis of RCT varies by type of tooth; special attention should be given to RCT of molar teeth.
根据可能削弱预后的因素，如术前根尖周炎（AP）和治疗方式（初次或二次根管治疗[RCT]），评估不同类型牙齿对 RCT 治疗效果的影响。
我们仔细检查了 2008-2011 年在赫尔辛基大学诊所接受非手术 RCT 的 640 颗恒牙的患者病历和术前术后的 X 光片。这些牙齿中，磨牙占 44%，前磨牙占 32%，前牙占 24%。患者的平均年龄为 51.5 岁，其中 51%为男性。术前 60.5%的牙齿存在 AP。我们使用根尖指数（PAI）来评估 X 光片，并将影像学上“健康”和“愈合”的病例定义为成功。统计评估包括卡方检验、Fisher 确切检验、t 检验和逻辑回归模型。
总体成功率（SR）为 84.1%；初次 RCT 的成功率为 88.3%，二次 RCT 的成功率为 75.5%（p<0.001）。前牙、前磨牙和磨牙的 SR 分别为 85.6%、88.8%和 79.7%。有 AP 和无 AP 的牙齿的 SR 分别为 77.3%和 94.5%（p<0.001）。与磨牙相比，前牙和前磨牙的 RCT 更有可能成功（OR 1.7；95%CI 1.1-2.7），女性比男性更有可能成功（OR 1.9；95%CI 1.2-3.1）。
除了存在 AP 和再治疗情况外，本研究还发现牙齿类型和性别对 RCT 治疗效果也有显著影响。
RCT 的预后因牙齿类型而异；对于磨牙的 RCT，应特别注意。
