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根管治疗和手术牙髓治疗后的 PROMs。

PROMs Following Root Canal Treatment and Surgical Endodontic Treatment.

机构信息

Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.

Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; Department of Dental Surgery, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.

出版信息

Int Dent J. 2023 Feb;73(1):28-41. doi: 10.1016/j.identj.2022.06.015. Epub 2022 Jul 21.

Abstract

The FDI is currently working on developing a tool to encompass patient-reported outcome measures (PROMs) within the overall assessment of outcomes of endodontic treatment. The outcome of endodontic treatment has traditionally been determined by various clinical and radiographic criteria. However, these parameters do not address the impact of treatment on a patient's oral health-related quality of life (OHRQoL). OHRQoL, a crucial PROM, can be used to understand treatment outcome from a patient-centred perspective, thus improving clinician-patient communication whilst guiding decision-making. This focussed review aims to recount the OHRQoL of patients following nonsurgical root canal treatment and surgical endodontic treatment, with a specific focus on the minimal important difference (MID; the minimum score changes of an outcome instrument for a patient to register a clinically significant change in their OHRQoL and/or oral condition) and the methods used to determine it. The current evidence indicates that the OHRQoL of patients requiring root canal treatment is poorer than those without such need. Accordingly, the literature suggests that OHRQoL improves following nonsurgical or surgical endodontic treatment. However, study methodologies vary widely, and conclusions cannot be drawn with high confidence, nor can MID recommendations be provided. Well-designed clinical studies with baseline measurements and appropriate follow-up time frames are therefore needed. Despite that the literature is rife with outcome studies, research on PROMs is an area that deserves greater attention, particularly in relation to the MID. Determining the MID will facilitate the understanding of changes in outcome scores from the patients' perspective, thus allowing for more informed decision-making in clinical practice.

摘要

国际牙医联盟目前正在开发一种工具,将患者报告的结果测量(PROMs)纳入根管治疗结果的整体评估中。根管治疗的结果传统上是通过各种临床和放射学标准来确定的。然而,这些参数并不能解决治疗对患者口腔健康相关生活质量(OHRQoL)的影响。OHRQoL 作为一种重要的 PROM,可以从患者为中心的角度来理解治疗结果,从而改善医患沟通,指导决策。本次重点综述旨在回顾非手术根管治疗和手术根管治疗后患者的 OHRQoL,并特别关注最小重要差异(MID;结果工具的最小评分变化,患者在其 OHRQoL 和/或口腔状况方面登记出临床显著变化)以及用于确定 MID 的方法。目前的证据表明,需要根管治疗的患者的 OHRQoL 比不需要此类治疗的患者差。因此,文献表明,非手术或手术根管治疗后 OHRQoL 会有所改善。然而,研究方法差异很大,不能得出高可信度的结论,也不能提供 MID 建议。因此,需要进行设计良好的临床研究,包括基线测量和适当的随访时间框架。尽管文献中充满了结果研究,但 PROM 研究是一个值得更多关注的领域,特别是在 MID 方面。确定 MID 将有助于从患者的角度理解结果评分的变化,从而使临床实践中能够做出更明智的决策。

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PROMs Following Root Canal Treatment and Surgical Endodontic Treatment.根管治疗和手术牙髓治疗后的 PROMs。
Int Dent J. 2023 Feb;73(1):28-41. doi: 10.1016/j.identj.2022.06.015. Epub 2022 Jul 21.

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