Jansson L, Ehnevid H, Lindskog S, Blomlöf L
Department of Periodontology, Public Dental Service at Skanstull, Sweden.
J Clin Periodontol. 1995 Oct;22(10):729-34. doi: 10.1111/j.1600-051x.1995.tb00254.x.
The purpose of the present investigation was to determine magnitude and rate of proximal radiographic attachment loss in relation to endodontic infection in periodontally involved teeth. The investigation was conducted as a retrospective longitudinal study on a periodontitis-prone randomly selected referral population, including 175 single-rooted, root-filled teeth in 133 patients. An observation period of at least 3 years was required. Periapical conditions of the selected sample at baseline and re-examination were evaluated on radiographs, independently by 3 investigators. Each single-rooted, root-filled tooth of the sample was given a score according to the combined registrations. Radiographic attachment level was measured as the distance between the most coronal point of the alveolar bone and the apex at the mesial and distal sides of the tooth, and expressed as relative radiographic attachment level (RRAL) (radiographic attachment level at baseline/root length) at proximal sites for every tooth. Multiple regression analysis was used to study change in RRAL over time. Teeth in periodontitis-prone patients with progressing periapical pathology indicating a continuous root canal infection were found to lose comparatively more radiographic attachment than teeth with no signs of periapical pathology or teeth with an established periapical destruction which subsided during the observation period. An approximate 3-fold amplification of the rate of marginal proximal radiographic bone loss by endodontic infection in periodontitis-prone patients was found with an average 0.19 mm/year, while 0.06 mm/year was lost for teeth without endodontic infection or subsiding endodontic involvement.
本研究的目的是确定牙周受累牙齿中根尖部影像学附着丧失的程度和速率与牙髓感染的关系。该研究是对一组随机选取的易患牙周炎的转诊人群进行的回顾性纵向研究，包括133例患者的175颗单根根管充填牙。要求观察期至少为3年。由3名研究人员独立在X线片上评估所选样本在基线和复查时的根尖周情况。根据综合记录，给样本中的每颗单根根管充填牙打分。影像学附着水平测量为牙槽骨最冠方点与牙齿近中及远中侧根尖之间的距离，并表示为每颗牙齿近中部位的相对影像学附着水平（RRAL）（基线时的影像学附着水平/根长）。采用多元回归分析研究RRAL随时间的变化。结果发现，在易患牙周炎的患者中，根尖周病变进展提示存在持续性根管感染的牙齿，其影像学附着丧失相对比无根尖周病变迹象的牙齿或在观察期内根尖周破坏已消退的牙齿更多。在易患牙周炎的患者中，牙髓感染使近中边缘影像学骨丧失速率大约增加了3倍，平均每年丧失0.19 mm，而无牙髓感染或牙髓受累已消退的牙齿每年丧失0.06 mm。
