Chotvorrarak Kanet, Suksaphar Warattama, Banomyong Danuchit
Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
Department of Endodontics, College of Dental Medicine, Rangsit University, Pathum Thani, Thailand.
Restor Dent Endod. 2021 May 6;46(2):e29. doi: 10.5395/rde.2021.46.e29. eCollection 2021 May.
This study was conducted to compare the post-fracture survival rate of endodontically treated molar endodontically treated teeth (molar ETT) restored with resin composites or crowns and to identify potential risk factors, using a retrospective cohort design.
Dental records of molar ETT with crowns or composite restorations (recall period, 2015-2019) were collected based on inclusion and exclusion criteria. The incidence of unrestorable fractures was identified, and molar ETT were classified according to survival. Information on potential risk factors was collected. Survival rates and potential risk factors were analyzed using the Kaplan-Meier log-rank test and Cox regression model.
The overall survival rate of molar ETT was 87% (mean recall period, 31.73 ± 17.56 months). The survival rates of molar ETT restored with composites and crowns were 81.6% and 92.7%, reflecting a significant difference ( < 0.05). However, ETT restored with composites showed a 100% survival rate if only 1 surface was lost, which was comparable to the survival rate of ETT with crowns. The survival rates of ETT with composites and crowns were significantly different (97.6% vs. 83.7%) in the short-term (12-24 months), but not in the long-term (> 24 months) (87.8% vs. 79.5%).
The survival rate from fracture was higher for molar ETT restored with crowns was higher than for ETT restored with composites, especially in the first 2 years after restoration. Molar ETT with limited tooth structure loss only on the occlusal surface could be successfully restored with composite restorations.
本研究采用回顾性队列设计，比较用树脂复合材料或全冠修复的牙髓治疗后磨牙牙髓治疗牙（磨牙ETT）的骨折后生存率，并确定潜在风险因素。
根据纳入和排除标准收集2015 - 2019年有全冠或复合修复体的磨牙ETT的牙科记录。确定无法修复骨折的发生率，并根据生存率对磨牙ETT进行分类。收集潜在风险因素的信息。使用Kaplan-Meier对数秩检验和Cox回归模型分析生存率和潜在风险因素。
磨牙ETT的总体生存率为87%（平均回顾期，31.73±17.56个月）。用复合材料和全冠修复的磨牙ETT的生存率分别为81.6%和92.7%，差异有统计学意义（<0.05）。然而，如果仅一个面缺失，用复合材料修复的ETT显示出100%的生存率，这与有全冠的ETT的生存率相当。在短期（12 - 24个月），用复合材料和全冠修复的ETT的生存率有显著差异（97.6%对83.7%），但在长期（>24个月）则无显著差异（87.8%对79.5%）。
用全冠修复的磨牙ETT的骨折生存率高于用复合材料修复的ETT，尤其是在修复后的头两年。仅咬合面牙齿结构损失有限的磨牙ETT可用复合修复体成功修复。
