Department of Dental Hygiene, Wonkwang Health Science University, Jeollabuk-do, South Korea.
Division of Climate Change and Health Protection, Korea Disease Control and Prevention Agency, Chungcheongbuk-do, South Korea.
Eur Endod J. 2022 Mar;7(1):20-26. doi: 10.14744/eej.2021.86648.
This study examined the survival rate of root canal treatment (RCT) and identified the factors affecting the survival/failure of RCT with respect to the patient's demographic, socioeconomic and dental healthcare factors.
The data of patients with RCT were analyzed using the 2002 patient data of the Korean National Health Insurance Service (KNHIS). The analysis included 1,193,666 patients, with 1,414,715 targeted teeth. Survival analysis was performed using the Kaplan-Meier method based on the occurrence of the untoward event. The proportional hazard of failure of RCT was measured using the Cox proportional hazard model and considering variables were gender, age, income, type of dental healthcare, number of visits for RCT, and type of teeth.
The 11-year cumulative survival rate for non-surgical RCT teeth was 88.37%. The Cox proportional hazard model showed significantly lower females (HR 0.704; CI 1.022-1.079) than males. The hazard ratio (HR) of over 65 years (HR 2.959; CI 2.864-3.058) was higher than that of other groups. In addition, the HR varied according to the income level (medical beneficiary was the highest) and the type of dental healthcare (tertiary hospital was the lowest).
Performing RCT survival analysis using representative data revealed that the demographic and socioeconomic factors of the patients affect the failure of RCT. This study can serve as the basis for improving the survival trend in RCT and provide important implications in clinical decision-making in endodontics.
本研究旨在探讨根管治疗（RCT）的生存率，并确定与患者人口统计学、社会经济和牙科保健因素相关的 RCT 生存/失败的影响因素。
使用韩国国民健康保险服务（KNHIS）2002 年患者数据对接受 RCT 的患者数据进行分析。该分析共纳入 1193666 例患者，共涉及 1414715 颗目标牙齿。基于不良事件的发生情况，采用 Kaplan-Meier 方法进行生存分析。采用 Cox 比例风险模型测量 RCT 失败的比例风险，并考虑性别、年龄、收入、牙科保健类型、RCT 就诊次数以及牙齿类型等变量。
非手术 RCT 牙齿的 11 年累积生存率为 88.37%。Cox 比例风险模型显示女性（HR 0.704；CI 1.022-1.079）显著低于男性。65 岁以上人群的危险比（HR）高于其他组（HR 2.959；CI 2.864-3.058）。此外，HR 还根据收入水平（医疗受益人为最高）和牙科保健类型（三级医院为最低）而有所不同。
使用代表性数据进行 RCT 生存分析表明，患者的人口统计学和社会经济因素会影响 RCT 的失败。本研究可为改善 RCT 生存趋势提供依据，并为牙髓病学临床决策提供重要启示。
