牙周炎患者经非手术治疗的 2-3 级内牙周病变的预后因素：一项回顾性病例对照研究。
Prognostic Factors of Grade 2-3 Endo-Periodontal Lesions Treated Nonsurgically in Patients with Periodontitis: A Retrospective Case-Control Study.
机构信息
School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Disease, No. 117 Nanjing North St., Shenyang 110002, Liaoning Province, China.
Department of Stomatology, Dalian Stomatology Hospital, Dalian, Liaoning, China.
出版信息
Biomed Res Int. 2020 Feb 8;2020:1592910. doi: 10.1155/2020/1592910. eCollection 2020.
BACKGROUND
Endo-periodontal lesions are bacterial infectious diseases involving both the periodontal and pulp tissues with poor outcomes. It is hard for clinicians to predict their prognosis. The aim of this study is to investigate the factors affecting the prognosis of endo-periodontal lesions.
METHODS
A total of 140 teeth diagnosed with grade 2-3 endo-periodontal lesions in patients with periodontitis were recruited in this study. They were divided into high and low responder groups, according to the clinical symptoms and parameters of the teeth involved after nonsurgical treatment of both the endodontic and periodontal components. Clinical parameters and symptoms were compared before and after treatment, and gender, age, smoking, and all clinical parameters were compared between high and low responder groups using univariate analyses. Logistic regression was applied to evaluate the independent effects on endo-periodontal lesion prognosis.
RESULTS
Compared with the clinical parameters at baseline, the values of tooth mobility (TM), periapical index (PAI), and discomfort when chewing were decreased after endodontic therapy, and the values of periodontal probing depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI), TM, simplified oral hygiene index (OHI-S), full-mouth periodontitis severity, PAI, and discomfort when chewing were decreased after periodontal therapy. Univariate analysis revealed that smoking, PD, CAL, TM, PAI, clinical crown-root ratio (CR), full-mouth periodontitis severities, and the number of root canals were significantly different between the high and low responder groups ( < 0.05). The logistic regression analysis showed that smoking, PD, CAL, full-mouth periodontitis severities, and the number of root canals remained significantly associated with grade 2-3 endo-periodontal lesions in patients with periodontitis ( < 0.05). The logistic regression analysis showed that smoking, PD, CAL, full-mouth periodontitis severities, and the number of root canals remained significantly associated with grade 2-3 endo-periodontal lesions in patients with periodontitis (.
CONCLUSIONS
High PD and CAL, multirooted teeth, smoking, and serious full-mouth periodontitis indicated a poor prognosis for teeth with grade 2-3 endo-periodontal lesions.
背景
牙周牙髓联合病变是一种累及牙周和牙髓组织的细菌性传染病，预后较差。临床医生很难预测其预后。本研究旨在探讨影响牙周牙髓联合病变预后的因素。
方法
本研究共纳入 140 例牙周炎患者的 2-3 级牙周牙髓联合病变患牙，根据根管和牙周联合非手术治疗后牙齿的临床症状和参数，将其分为高反应组和低反应组。比较治疗前后的临床参数和症状，并采用单因素分析比较高、低反应组之间的性别、年龄、吸烟及所有临床参数。采用 Logistic 回归分析评价对牙周牙髓联合病变预后的独立影响。
结果
与基线时的临床参数相比，根管治疗后牙齿松动度（TM）、根尖指数（PAI）和咀嚼不适降低，牙周治疗后牙周探诊深度（PD）、临床附着丧失（CAL）、龈沟出血指数（SBI）、TM、简化口腔卫生指数（OHI-S）、全口牙周炎严重程度、PAI 和咀嚼不适降低。单因素分析显示，高、低反应组之间吸烟、PD、CAL、TM、PAI、临床冠根比（CR）、全口牙周炎严重程度和根管数量差异有统计学意义（<0.05）。Logistic 回归分析显示，吸烟、PD、CAL、全口牙周炎严重程度和根管数量与牙周炎患者 2-3 级牙周牙髓联合病变仍显著相关（<0.05）。
结论
高 PD 和 CAL、多根牙、吸烟和严重的全口牙周炎提示 2-3 级牙周牙髓联合病变患牙预后不良。
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