正畸治疗对根管治疗后牙齿疗效的影响：锥形束 CT 分析。

Effect of Orthodontic Treatment on the Outcomes of Endodontically Treated Teeth: A Cone-Beam Computed Tomography Analysis.

机构信息

Department of Stomatology, Peking University Third Hospital, Beijing, China.

Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.

出版信息

J Endod. 2024 Aug;50(8):1091-1099. doi: 10.1016/j.joen.2024.05.002. Epub 2024 May 18.

DOI:10.1016/j.joen.2024.05.002

PMID:38763483

Abstract

INTRODUCTION

Often there is the need of moving endodontically treated teeth. Orthodontic movement may have no effect on the prognosis of teeth with root canal treatment (RCT). To verify this subject, we evaluated the effect of orthodontic movement on the prognosis of RCT teeth using cone-beam computed tomography (CBCT) and further explored the influence of orthodontic movement on the prognosis of RCT teeth with and without apical periodontitis (AP).

METHODS

This retrospective study was conducted by evaluating 169 RCT teeth of 100 patients who had undergone fixed orthodontic treatment. AP was assessed and classified using the CBCT periapical index. Univariate analysis of RCT outcome was performed for the total RCT group, RCT without AP group and RCT with AP group. Multivariate logistic regression was performed for the total RCT group and RCT without AP group, respectively, but not for the RCT with AP group. Variables related to the prognosis of RCT were included, such as age, gender, tooth position, RCT quality, coronal restoration quality, periodontal condition, orthodontic traction distance, and orthodontic rotation angle.

RESULTS

The orthodontic traction distance and rotation angle were not significantly correlated to the RCT outcomes, regardless of the presence of AP. Among the total RCT group, teeth with unqualified RCT (odds ratio = 3.42, P = .004) and inadequate coronal restoration (odds ratio = 4.40, P = .031) had a lower success rate. Of the 97 RCT teeth without AP, unqualified RCT was a risk factor for treatment failure (odds ratio = 3.55, P = .041). Of the 72 RCT teeth with AP, the univariate analysis showed that RCT quality were significantly related to the outcome (P = .042).

CONCLUSIONS

Orthodontic movement had no effect on the prognosis of RCT teeth regardless of the presence of AP.

摘要

简介

临床上经常需要移动根管治疗后的牙齿。正畸移动对根管治疗（RCT）后的牙齿预后没有影响。为了验证这一观点，我们使用锥形束 CT（CBCT）评估了正畸移动对 RCT 牙齿预后的影响，并进一步探讨了正畸移动对有和无根尖周炎（AP）的 RCT 牙齿预后的影响。

方法

本回顾性研究评估了 100 名接受固定正畸治疗的患者的 169 颗 RCT 牙。使用 CBCT 根尖周指数评估和分类 AP。对总 RCT 组、无 AP 的 RCT 组和有 AP 的 RCT 组进行 RCT 结果的单因素分析。对总 RCT 组和无 AP 的 RCT 组分别进行多变量逻辑回归分析，但不对有 AP 的 RCT 组进行分析。纳入与 RCT 预后相关的变量，如年龄、性别、牙齿位置、RCT 质量、冠部修复质量、牙周状况、正畸牵引距离和正畸旋转角度。

结果

无论是否存在 AP，正畸牵引距离和旋转角度与 RCT 结果均无显著相关性。在总 RCT 组中，RCT 质量不合格（比值比=3.42，P=.004）和冠部修复不充分（比值比=4.40，P=.031）的牙齿成功率较低。在 97 颗无 AP 的 RCT 牙中，RCT 质量不合格是治疗失败的危险因素（比值比=3.55，P=.041）。在 72 颗有 AP 的 RCT 牙中，单因素分析显示 RCT 质量与结果显著相关（P=.042）。