Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany.
Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland.
Gerodontology. 2019 Sep;36(3):267-275. doi: 10.1111/ger.12407. Epub 2019 Apr 26.
To assess the impact of non-endodontic factors like periodontitis and chronic disease medication (CDM) mostly affecting elderly people's health on the outcome of non-surgical root canal treatment (NSRCT).
An increasing number of elderly people with high prevalence of marginal periodontitis and CDM benefit from adequate endodontic therapy, if irreversible pulpitis or apical periodontitis occurs. Only few data exist about the relevance of those non-endodontic factors on healing of endodontic lesions in a population 60 years or more.
Of 177 patients aged 60 years or more with 212 NSRCTs performed between the year of 2010 and 2013, complete documentation was available for 112 teeth in 93 participants. Mean time between baseline and last follow-up was 38.93 months. The primary endodontic factors studied were the periapical index (PAI) of periapical health, quality of the root canal filling and of coronal restoration, periodontal probing depth (PPD, mm) and tooth mobility (TM, 0-3). Secondary non-endodontic factors included the presence of marginal periodontitis and CDM, in particular antidiabetics, antihypertensives and anticoagulants. Statistical analyses were performed using Chi-square test statistics and logistic regression analysis.
Periodontitis and CDM had no effect on endodontic outcome. Chronic intake of anticoagulants showed a significant association with endodontic outcome. Root-filled teeth with preoperative periapical lesions had a significantly higher rate of endodontic failure than those without preoperative lesion. The overall success rate of NSRCT was 87.1% with 81 healed teeth.
Periodontitis and CDM have no impact on the endodontic outcome of NSRCT in a population 60 years or more.
评估牙周炎和影响老年人健康的慢性疾病药物(CDM)等非牙髓因素对非手术根管治疗(NSRCT)结果的影响。
越来越多的患有高患病率边缘性牙周炎和 CDM 的老年人如果发生不可复性牙髓炎或根尖周炎,将从充分的牙髓治疗中获益。只有少数数据涉及这些非牙髓因素对 60 岁及以上人群牙髓病变愈合的相关性。
在 2010 年至 2013 年期间进行的 177 例 60 岁及以上患者的 212 例 NSRCT 中,有 93 名患者的 112 颗牙齿有完整的记录。基线和最后一次随访之间的平均时间为 38.93 个月。研究的主要牙髓因素包括根尖周健康的根尖周指数(PAI)、根管充填质量和冠部修复质量、牙周探诊深度(PPD,mm)和牙齿动度(TM,0-3)。次要非牙髓因素包括边缘性牙周炎和 CDM 的存在,特别是抗糖尿病药物、抗高血压药物和抗凝剂。统计分析采用卡方检验和逻辑回归分析。
牙周炎和 CDM 对牙髓治疗结果没有影响。慢性抗凝剂的使用与牙髓治疗结果有显著关联。术前有根尖周病变的根管充填牙的牙髓治疗失败率明显高于无术前病变的牙。NSRCT 的总体成功率为 87.1%,有 81 颗愈合的牙。
在 60 岁及以上人群中,牙周炎和 CDM 对 NSRCT 的牙髓治疗结果没有影响。