Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.
Studio Dentistico Vignoletti, Private practice, Verona, Italy.
Clin Oral Investig. 2023 Jun;27(6):3233-3244. doi: 10.1007/s00784-023-04938-y. Epub 2023 Mar 18.
The aims of the present longitudinal retrospective observational case series study were to investigate the survival and success rates of primary non-surgical endodontic therapy.
Patients with at least one endodontically treated tooth (ETT), with 5 years of follow-up and in compliance with the recall programme of at least 1 time per year in a private practice setting, were recruited. Kaplan-Meier survival analyses were performed considering (a) tooth extraction/survival and (b) endodontic success as the outcome variables. A regression analysis was performed to evaluate prognostic factors associated with tooth survival.
Three hundred twelve patients and 598 teeth were included. The cumulative survival rates showed 97%, 81%, 76% and 68% after 10, 20, 30 and 37 years, respectively. The corresponding values for endodontic success were 93%, 85%, 81% and 81%, respectively.
The study demonstrated high longevity in symptomless function as well as high success rates of ETT. The most significant prognostic factors associated with tooth extraction were the presence of deep (> 6 mm) periodontal pockets, the presence of pre-operative apical radiolucency and the lack of occlusal protection (no use of a night guard).
The favourable long-term (> 30 years) prognosis of ETT must encourage clinicians to rely on primary root canal treatment when taking the decision regarding whether a tooth with pulpal and/or periapical diseases should be saved or be extracted and replaced with an implant.
本纵向回顾性观察病例系列研究的目的是调查原发性非手术根管治疗的生存率和成功率。
本研究招募了在私人诊所环境中，至少有一颗接受过根管治疗的牙齿（ETT），且随访时间至少为 5 年，并每年至少按规定进行一次复诊的患者。采用 Kaplan-Meier 生存分析考虑（a）拔牙/生存和（b）根管成功作为结局变量。进行回归分析以评估与牙齿生存相关的预后因素。
共纳入 312 名患者和 598 颗牙齿。10、20、30 和 37 年后的累积生存率分别为 97%、81%、76%和 68%。相应的根管成功的比率分别为 93%、85%、81%和 81%。
本研究表明，无症状功能的持久性和 ETT 的高成功率。与拔牙最相关的显著预后因素是深牙周袋（> 6mm）的存在、术前根尖透影区的存在以及缺乏咬合保护（未使用夜磨牙垫）。
ETT 的良好长期（> 30 年）预后应鼓励临床医生在决定是否保留有牙髓和/或根尖周疾病的牙齿或拔牙并用种植体替代时，依靠主要的根管治疗。
