Discipline of Endodontology, Faculty of Dentistry, The University of Hong Kong, 34, Hospital Road, Sai Ying Pun, Hong Kong, Hong Kong.
Discipline of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, 34, Hospital Road, Sai Ying Pun, Hong Kong, Hong Kong.
Clin Oral Investig. 2020 Jan;24(1):25-36. doi: 10.1007/s00784-019-03076-8. Epub 2019 Nov 11.
This systematic review was undertaken to determine the oral health-related quality of life (OHRQoL) before and after endodontic treatment.
Based on the PRISMA guidelines, electronic databases (n = 7) were searched and from 1038 citations, 16 papers were included in this review. Information on study design, sample size, intervention/treatment modality, methods of assessing OHRQoL, and the key findings were extracted and analyzed.
Among the 16 studies, 3 were cross-sectional surveys, 9 were longitudinal studies, and 4 were randomized clinical trials. The cross-sectional studies reported improvements in OHRQoL following root canal treatment. Comparative longitudinal studies did not identify a significant association between improvements in OHRQoL and the method of root canal instrumentation or number of instruments used. Clinical trials found that improvements in OHRQoL were significantly associated with instrumentation technique, surgical-incision approach, and the application of platelet-concentrate during surgery. Several methods of assessing OHRQoL were employed with the most common being the Oral Health Impact Profile (OHIP), albeit using different versions.
The results of this systematic review indicate that the QoL of patients improved after endodontic treatment. Nevertheless, these results are limited to patients who seek endodontic treatment and cannot be generalized. The lack of well-designed observational studies with standardized assessment approaches, coupled with heterogeneity of study design and interventions, precluded quantitative synthesis.
Pragmatic clinical trials are more meaningful to understand patient-centered outcomes of treatment. This review shows that endodontic treatment does improve the QoL. However, future studies should use standardized tools and data reporting, which are critical to make meta-analyses possible.
本系统评价旨在确定根管治疗前后的口腔健康相关生活质量（OHRQoL）。
根据 PRISMA 指南，检索电子数据库（n=7），从 1038 条引文中，有 16 篇论文纳入本综述。提取并分析了研究设计、样本量、干预/治疗方式、OHRQoL 评估方法以及主要发现等信息。
在这 16 项研究中，有 3 项是横断面调查，9 项是纵向研究，4 项是随机临床试验。横断面研究报告根管治疗后 OHRQoL 有所改善。比较性纵向研究未发现 OHRQoL 改善与根管器械使用方法或使用器械数量之间存在显著关联。临床试验发现，OHRQoL 的改善与器械技术、手术切口方法以及手术中应用血小板浓缩物显著相关。评估 OHRQoL 的方法有几种，最常见的是口腔健康影响量表（OHIP），尽管使用的版本不同。
本系统评价的结果表明，根管治疗后患者的生活质量有所提高。然而，这些结果仅限于寻求根管治疗的患者，不能推广。缺乏设计良好的观察性研究，采用标准化评估方法，加上研究设计和干预措施的异质性，阻碍了定量综合。
实用临床试验更有助于理解以患者为中心的治疗结果。本综述表明根管治疗确实可以提高生活质量。然而，未来的研究应使用标准化工具和数据报告，这对于进行荟萃分析至关重要。
