基线特征作为 3 年预测牙齿断裂和裂纹进展的指标：来自全国牙科实践为基础的研究网络的发现。
Baseline characteristics as 3-year predictors of tooth fracture and crack progression: Findings from The National Dental Practice-Based Research Network.
出版信息
J Am Dent Assoc. 2021 Feb;152(2):146-156. doi: 10.1016/j.adaj.2020.09.023. Epub 2020 Dec 24.
BACKGROUND
The authors of this practice-based study estimated the risk of experiencing tooth fractures and crack progression over 3 years and correlated baseline patient-, tooth-, and crack-level characteristics with these outcomes.
METHODS
Two-hundred-and-nine National Dental Practice-Based Research Network dentists enrolled a convenience sample of 2,601 participants with a cracked vital posterior tooth that had been examined for at least 1 recall visit over 3 years. Data were collected at the patient, tooth, and crack levels at baseline, annual follow-up visits, and any interim visits. Associations between these characteristics and the subsequent same-tooth fractures and crack progression were quantified.
RESULTS
Of the 2,601 teeth with a crack or cracks at baseline, 78 (3.0%; 95% confidence interval, 2.4% to 3.7%) subsequently developed a fracture. Of the 1,889 patients untreated before year 1, 232 (12.3%; 95% confidence interval, 10.9% to 13.8%) had some type of crack progression. Baseline tooth-level characteristics associated with tooth fracture were the tooth was maxillary and had a wear facet through enamel and a crack was detectable with an explorer, on the facial surface, and in a horizontal direction. Crack progression was associated with males and teeth with multiple cracks at baseline; teeth with a baseline facial crack were less likely to show crack progression. There was no commonality between characteristics associated with tooth fracture and those associated with crack progression.
CONCLUSIONS
Development of tooth fractures and crack progression over 3 years were rare occurrences. Specific characteristics were associated with the development of tooth fracture and crack progression, although none were common to both.
PRACTICAL IMPLICATIONS
This information can aid dentists in assessing factors that place posterior cracked teeth at risk of experiencing adverse outcomes.
背景
本基于实践的研究的作者估计了在 3 年内经历牙齿折裂和裂纹进展的风险，并将基线患者、牙齿和裂纹水平特征与这些结果相关联。
方法
209 名国家牙科实践研究网络牙医纳入了 2601 名患有有裂纹的活髓后牙的便利样本，这些牙齿在 3 年内至少进行了 1 次随访检查。数据在基线、每年随访和任何中间随访时在患者、牙齿和裂纹水平上收集。在这些特征与随后的同一牙齿折裂和裂纹进展之间进行了相关性的量化。
结果
在基线时存在裂纹或多条裂纹的 2601 颗牙齿中，有 78 颗（3.0%；95%置信区间，2.4%至 3.7%）随后发生了折裂。在 1 年内未接受治疗的 1889 名患者中，有 232 名（12.3%；95%置信区间，10.9%至 13.8%）出现了某种类型的裂纹进展。与牙齿折裂相关的基线牙齿水平特征是牙齿位于上颌，有一个通过牙釉质的磨损面，并且可以用探针探测到裂纹，位于颊面且呈水平方向。裂纹进展与男性和基线时存在多条裂纹的牙齿相关；基线时有颊面裂纹的牙齿不太可能出现裂纹进展。与牙齿折裂相关的特征与与裂纹进展相关的特征之间没有共同之处。
结论
在 3 年内发生牙齿折裂和裂纹进展的情况很少见。具体特征与牙齿折裂和裂纹进展的发生相关，尽管两者都没有共同之处。
实用意义
这些信息可以帮助牙医评估使后牙有裂纹的牙齿面临不良结果风险的因素。
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