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