el-Swiah J M, Walker R T
Leeds Dental Institute/Division of Restorative Dentistry, UK.
Endod Dent Traumatol. 1996 Aug;12(4):185-91. doi: 10.1111/j.1600-9657.1996.tb00512.x.
A retrospective study was carried out to evaluate the clinical factors involved in deciding to perform apicectomies. Five hundred and seventeen teeth from 392 patients (211 women and 181 men) that had undergone apicectomy during the period from September, 1990 to December, 1992 were assessed using the patients' clinical records. The information recorded included the source of referral, the quality of preoperative root canal filling, the size of periradicular lesion, the type of the lesion (for biopsed lesions), the type of coronal and radicular restorations, and the different factors that influenced the decision to perform an apicectomy for each tooth. These factors were classified into technical and biological, and when they occurred together they were classified as combined. The decisions to perform apicectomies most commonly involved combined technical and biological factors. Biological factors alone only amounted to 35% of the total. Technical factors alone amounted to only 3% of the total. When all factors were considered, biological factors constituted 60%, whilst technical factors constituted 40%, of the total. The most common biological factors were persistent symptoms (54%), and continuing presence of a periradicular lesion (44%). The most common technical factors were post crown (60%) and crowned teeth without posts (31%). This study emphasised the need for a high standard of conventional root canal treatment in order to avoid surgical treatment.
开展了一项回顾性研究，以评估决定实施根尖切除术的临床相关因素。利用患者的临床记录，对1990年9月至1992年12月期间接受根尖切除术的392例患者（211名女性和181名男性）的517颗牙齿进行了评估。记录的信息包括转诊来源、术前根管充填质量、根尖周病变大小、病变类型（活检病变）、冠部和根部修复体类型以及影响每颗牙齿根尖切除术决策的不同因素。这些因素分为技术因素和生物学因素，当它们同时出现时则归类为综合因素。实施根尖切除术的决策最常涉及技术和生物学综合因素。单纯生物学因素仅占总数的35%。单纯技术因素仅占总数的3%。综合考虑所有因素时，生物学因素占总数的60%，而技术因素占总数的40%。最常见的生物学因素是持续性症状（54%）和根尖周病变持续存在（44%）。最常见的技术因素是桩冠（60%）和无桩冠修复牙（31%）。本研究强调需要高标准的传统根管治疗以避免手术治疗。
