Faculty of Dentistry, University of Toronto, Toronto, Ontario.
Faculty of Dentistry, University of Toronto, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Department of Dentistry, Mount Sinai Hospital, Toronto, Ontario.
J Endod. 2023 Oct;49(10):1289-1298. doi: 10.1016/j.joen.2023.07.012. Epub 2023 Jul 22.
There is considerable variation in the reporting of treatment outcomes in endodontics. Patient-centered outcomes are often inadequately reported in endodontic outcome studies. This paper explores patients' expectations and reported outcomes in nonsurgical root canal treatment (NS-RCT), nonsurgical root canal retreatment (NS-ReTx), and endodontic microsurgery (EMS).
We used a qualitative description approach and conducted telephone and virtual semi-structured interviews with participants who had the following treatments within the preceding 3-12 months: NS-RCT (n = 10), NS-ReTx (n = 10), or EMS (n = 10). Half of these treatments were performed by senior endodontic residents in an academic setting and the other half by a community-based endodontist at a private practice.
Participants identified several outcomes that were important to them and integral to treatment success, such as tooth survival, resolution of symptoms, aesthetics, and radiographic healing. Process-related factors were as important as treatment outcomes for participants. Communicating with and educating patients during treatment increased participants' satisfaction and lowered their stress. Dissatisfaction was linked to the lack of a comprehensive treatment and follow-up plan. Thorough planning ensured that patients were fully informed and had a structured approach to achieving their desired outcomes.
This study provides a list of outcomes that are important for patients undergoing NS-RCT, NS-ReTx, and EMS. These outcomes should be considered when developing a core outcome set related to endodontic treatments. Additionally, this study reports patients' expectations regarding process-related factors that are essential for providing patient-centered care and improving patient experience.
牙髓治疗结局的报告存在很大差异。在牙髓治疗结局研究中，患者为中心的结局往往没有得到充分报告。本文探讨了非手术根管治疗（NS-RCT）、非手术根管再治疗（NS-ReTx）和牙髓显微手术（EMS）患者的期望和报告结局。
我们采用定性描述方法，对在过去 3-12 个月内接受以下治疗的参与者进行了电话和虚拟半结构化访谈：NS-RCT（n=10）、NS-ReTx（n=10）或 EMS（n=10）。这些治疗中有一半是由学术环境中的高级牙髓住院医师进行的，另一半是由社区-based 牙髓医生在私人诊所进行的。
参与者确定了一些对他们很重要且是治疗成功的重要组成部分的结局，如牙齿存活、症状缓解、美观和放射学愈合。对于参与者来说，治疗过程相关的因素与治疗结局同样重要。在治疗过程中与患者进行沟通和教育增加了参与者的满意度并降低了他们的压力。不满意与缺乏全面的治疗和随访计划有关。彻底的计划确保患者得到充分的信息并采取一种结构化的方法来实现他们期望的结果。
本研究提供了一组对接受 NS-RCT、NS-ReTx 和 EMS 治疗的患者很重要的结局。在制定与牙髓治疗相关的核心结局集时，应考虑这些结局。此外，本研究报告了患者对治疗过程相关因素的期望，这些因素对于提供以患者为中心的护理和改善患者体验至关重要。
