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牙髓显微镜手术 10 年以上的结果及相关预后因素:一项回顾性队列研究。

Endodontic Microsurgery Outcomes over 10 Years and Associated Prognostic Factors: A Retrospective Cohort Study.

机构信息

Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea.

Division of Endodontics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada.

出版信息

J Endod. 2024 Jul;50(7):934-943. doi: 10.1016/j.joen.2024.04.009. Epub 2024 Apr 18.

Abstract

INTRODUCTION

This retrospective cohort study aimed to evaluate long-term healing outcomes (10-17.5 years) after contemporary endodontic microsurgery (EMS) and identify the associated prognostic factors.

METHODS

Clinical and radiographic data of an EMS cohort (2006-2013) from the electronic database of the dental hospital were reviewed retrospectively by 2 independent examiners to determine their survival and healing outcomes, and potential prognostic factors were analyzed by Cox proportional hazards regression and logistic regression (α = 0.05).

RESULTS

Through strict inclusion and exclusion criteria and 721 EMS-treated teeth in the cohort, 309 (42.9%) were included (male = 35.0%; female = 65.0%; age = 45.83 ± 15.53 years) with a mean final follow-up of 152.26 ± 26.37 months (range, 120-211 months; median = 148 months). Clinical and radiographic assessments found an 80.5% 10-year survival rate with 63.4% of success. Collectively, tooth type, tooth mobility, preoperative lesion size, clinical crown-to-root ratio, and crown restorations at follow-up were significantly associated with long-term success and survival over 10 years.

CONCLUSIONS

The preoperative status and condition of the tooth including its alveolar bone support and adequate full-crown restorations may be relevant prognostic determinants of success and survival after EMS over time.

摘要

简介

本回顾性队列研究旨在评估当代根管显微手术(EMS)后的长期愈合结果(10-17.5 年),并确定相关的预后因素。

方法

通过 2 名独立检查者对来自牙科医院电子数据库的 EMS 队列(2006-2013 年)的临床和放射学数据进行回顾性复查,以确定其生存和愈合结果,并通过 Cox 比例风险回归和逻辑回归分析潜在的预后因素(α=0.05)。

结果

通过严格的纳入和排除标准,对队列中的 721 颗接受 EMS 治疗的牙齿进行了筛选,其中 309 颗(男性=35.0%;女性=65.0%;年龄=45.83±15.53 岁)被纳入研究,平均最终随访时间为 152.26±26.37 个月(范围 120-211 个月;中位数=148 个月)。临床和放射学评估发现,10 年的生存率为 80.5%,成功率为 63.4%。总体而言,牙类型、牙齿松动度、术前病变大小、临床冠根比和随访时的冠修复与 10 年以上的长期成功率和生存率显著相关。

结论

术前牙齿的状况及其牙槽骨支持和充分的全冠修复可能是 EMS 后成功和生存的相关预后决定因素。

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