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根管治疗后的临床医生/患者报告结局及其关联

Clinician/Patient-Reported Outcomes and Their Association After Root Canal Treatment.

作者信息

Wong Jasmine, Cheng Lee Angeline Hui, Pan Cheung Gary Shun, McGrath Colman, Neelakantan Prasanna

机构信息

Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR.

Department of Dental Surgery, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.

出版信息

J Endod. 2024 Dec;50(12):1725-1733. doi: 10.1016/j.joen.2024.09.009. Epub 2024 Sep 28.

Abstract

INTRODUCTION

The relationship between clinician-reported outcome measures (CROM) and patient-reported outcome measures (PROM) after root canal treatment is poorly understood. Oral health-related quality of life (OHRQOL) is a crucial PROM. Determination of the minimal important difference (MID) is critical for determining patients' perspective of treatment effectiveness, but the MID required to perceive any meaningful change in the OHRQOL after root canal treatment remains unclear. The aim of this prospective study was to investigate the relationship between the clinical outcome and OHRQOL after root canal treatment and to determine the corresponding MID values.

METHODS

Patients (N = 64) requiring primary nonsurgical root canal treatment were recruited. Clinical and radiographic (cone-beam computed tomography) assessment of treatment outcomes was performed at the 12-month follow-up. OHRQOL and pain were evaluated preoperatively and at the 12-month follow-up using the Oral Health Impact Profile-14 and visual analog scale, respectively. P < .05 was considered statistically significant. MID was assessed using distribution- and anchor-based approaches.

RESULTS

The final analysis included 47 patients. The clinical outcome was favorable for 92.6% of teeth. OHRQOL and pain showed significant improvement after treatment (P < .001). No significant association was found between clinical outcome and OHRQOL (P > .05). The mean Oral Health Impact Profile-14 score change (ie, 13.6) was greater than the range of MID values determined.

CONCLUSIONS

Root canal treatment significantly improves OHRQOL. Improvement in the OHRQOL score was greater than the MID values determined, implying a clinically significant change. However, PROM (OHRQOL) does not appear to be correlated with CROM.

摘要

引言

根管治疗后临床医生报告的结局指标(CROM)与患者报告的结局指标(PROM)之间的关系尚不清楚。口腔健康相关生活质量(OHRQOL)是一项关键的PROM。确定最小重要差异(MID)对于确定患者对治疗效果的看法至关重要,但根管治疗后OHRQOL中能感知到任何有意义变化所需的MID仍不明确。这项前瞻性研究的目的是调查根管治疗后的临床结局与OHRQOL之间的关系,并确定相应的MID值。

方法

招募需要进行初次非手术根管治疗的患者(N = 64)。在12个月的随访中对治疗结局进行临床和影像学(锥形束计算机断层扫描)评估。分别在术前和12个月随访时使用口腔健康影响程度量表-14和视觉模拟量表评估OHRQOL和疼痛情况。P < 0.05被认为具有统计学意义。使用基于分布和锚定的方法评估MID。

结果

最终分析纳入47例患者。92.6%的牙齿临床结局良好。治疗后OHRQOL和疼痛情况有显著改善(P < 0.001)。未发现临床结局与OHRQOL之间存在显著关联(P > 0.05)。口腔健康影响程度量表-14的平均得分变化(即13.6)大于所确定的MID值范围。

结论

根管治疗可显著改善OHRQOL。OHRQOL得分的改善大于所确定的MID值,这意味着具有临床意义的变化。然而,PROM(OHRQOL)似乎与CROM不相关。

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