New York University College of Dentistry, Department of Endodontics, New York, New York.
New York University College of Dentistry, Department of Endodontics, New York, New York.
J Endod. 2023 Oct;49(10):1269-1275. doi: 10.1016/j.joen.2023.07.020. Epub 2023 Jul 28.
This epidemiological analysis used procedure codes from dental insurance claims data to identify apexification cases and evaluate survival at the tooth-level.
Dental insurance claims data from New York State (2006-2019) and Massachusetts (2013-2018) were used in an observational, retrospective cohort study to evaluate the provision and treatment outcomes of apexification. Statistical analyses included Kaplan-Meier survival estimates and Cox proportional hazards regression. Cox proportional hazard regression was used to evaluate the hazard of adverse event occurrence by age, gender, tooth type, placement of permanent restoration, and dental provider type. A sensitivity analysis evaluated potential bias in the survival estimates and adjusted hazard ratios (aHRs) due to differential loss to follow-up. Robust standard errors were used to account for potential dependence between teeth within an individual.
The analytic cohort of 575 individuals included 632 teeth, with an average follow-up time of 64 months. The survival rates of apexification procedures were 95% at 1 year; 93% at 2 years; 90% at 3 years; and 86% at 5 years. Tooth retention following apexification was 98% at 1 year; 96% at 2 years; 95% at 3 years; and 90% at 5 years. Tooth type and subsequent placement of a permanent restoration were significant predictors of survival after apexification.
The procedural and tooth survival outcomes of apexification were high and comparable to studies that analyzed clinical data on tooth survival following apexification.
本项流行病学分析使用牙科保险理赔数据中的程序代码来识别根尖诱导成形术病例，并评估牙齿水平的生存情况。
本项观察性回顾性队列研究使用了来自纽约州（2006-2019 年）和马萨诸塞州（2013-2018 年）的牙科保险理赔数据，用以评估根尖诱导成形术的实施情况和治疗结果。统计分析包括 Kaplan-Meier 生存估计和 Cox 比例风险回归。Cox 比例风险回归用于评估年龄、性别、牙齿类型、永久性修复体的放置和牙科提供者类型对不良事件发生风险的影响。敏感性分析评估了由于随访丢失而导致的生存估计和调整后的危险比（aHR）的潜在偏差。稳健标准误差用于解释个体内牙齿之间潜在的依赖性。
分析队列包括 575 名个体的 632 颗牙齿，平均随访时间为 64 个月。根尖诱导成形术的 1 年生存率为 95%；2 年生存率为 93%；3 年生存率为 90%；5 年生存率为 86%。根尖诱导成形术后牙齿保留率为 1 年 98%；2 年 96%；3 年 95%；5 年 90%。牙齿类型和随后放置永久性修复体是根尖诱导成形术后生存的显著预测因素。
根尖诱导成形术的程序和牙齿生存率高，与分析根尖诱导成形术后牙齿生存率的临床数据的研究结果相当。
