Centre for Oral, Clinical & Translational Sciences, King's College London Dental Institute, London, UK.
Ministry of Health, Kuwait City, Kuwait.
Int Endod J. 2019 Oct;52(10):1403-1409. doi: 10.1111/iej.13142. Epub 2019 Jun 17.
To assess the effectiveness of the Dental Practicality Index (DPI) in predicting the outcome of root canal retreatment in posterior teeth.
One hundred and thirty-seven posterior teeth with symptoms and/or signs of post-treatment endodontic disease requiring root canal retreatment and previously included in a clinical trial were selected. Clinical and radiographic examinations including digital periapical and cone beam computed tomography (CBCT) were obtained pre-treatment and 1-year postoperatively from a previous study. Two calibrated and trained assessors who were unaware of the treatment outcome assessed the pre-treatment clinical records of these cases using the DPI. The DPI score was then compared to the outcome of the root canal retreatment. A Chi-square/Fisher's exact test was used to establish a relationship between categorical variables, the total score of DPI vs outcome.
Retreated teeth with DPI scores equal to 6 or above had an unfavourable outcome of 50% vs 14% of teeth with DPI below 6. Teeth with DPI score equal to 3 or above had an unfavourable outcome of 23% versus 2%, for teeth below 3. Molar teeth with a DPI score below 3 had a favourable outcome percentage of 96%.
This study highlighted that using the DPI gave a good outcome prediction for root canal retreatments. However, further research, including the prospective assessment of a wider range of cases undertaken by a larger group of examiners is needed to further validate the DPI.
评估牙科操作性指数（DPI）在预测后牙根管再治疗效果的有效性。
选择 137 颗因治疗后出现牙髓病或根尖周病的症状和/或体征，需要进行根管再治疗的后牙，这些牙齿之前都包含在一项临床试验中。从之前的研究中获取了临床和放射学检查，包括数字化根尖片和锥形束 CT（CBCT）。两名经过校准和培训的评估员在不知道治疗结果的情况下，使用 DPI 评估这些病例的治疗前临床记录。然后将 DPI 评分与根管再治疗的结果进行比较。使用卡方/Fisher 精确检验来确定分类变量之间的关系，即 DPI 总分与结果之间的关系。
DPI 评分等于或大于 6 的再治疗牙齿的不良结局率为 50%，而 DPI 评分低于 6 的牙齿的不良结局率为 14%。DPI 评分等于或大于 3 的牙齿的不良结局率为 23%，而 DPI 评分低于 3 的牙齿的不良结局率为 2%。DPI 评分低于 3 的磨牙的良好结局率为 96%。
本研究表明，使用 DPI 可以对根管再治疗的效果进行良好的预测。然而，需要进一步的研究，包括更广泛的病例的前瞻性评估和更多评估员的参与，以进一步验证 DPI。
