Weiger R, Hitzler S, Hermle G, Löst C
Department of Conservative Dentistry, University of Tübingen, Germany.
Endod Dent Traumatol. 1997 Apr;13(2):69-74. doi: 10.1111/j.1600-9657.1997.tb00013.x.
The objective of this study was to determine the periapical status and the quality of root canal fillings and to estimate the endodontic treatment needs in a German population. Clinical and radiographic data and the operative procedures performed were evaluated on 323 patients coming to a dental surgery in Stuttgart, Germany, in 1993. In 182 individuals at least one tooth exhibited a root canal filling, a necrotic pulp or an irreversible pulpitis. Out of the 7897 teeth examined, 215 (2.7%) had a root canal treatment (category A), 122 being non-endodontically treated (1.5%) did not respond to the sensitivity test (category B) and 53 (0.7%) were diagnosed as having irreversible inflamed pulp tissue (category C). The prevalence of teeth associated with radiographic signs of periapical pathosis was 61% in the group of root canal filled teeth and 88% in the group of pulpless and non-endodontically treated teeth. Using the level and the density of the root canal filling as criteria for evaluating the technical standard, only 14% of the endodontic treatments of non-apicectomized teeth were qualified as adequate. The minimal endodontic treatment need is 2.3% related to all examined teeth when the root canal filled teeth with clinical symptoms of periapical periodontitis (category A) and those of categories B and C are included. The real endodontic treatment need is suggested to be larger when considering that the technical quality of the obturation is poor in most symptomless endodontically treated teeth associated with a periapical lesion. In the case of retreatment of these teeth, the endodontic treatment need would then be calculated at 3.7%.
本研究的目的是确定根尖周状况和根管充填质量，并评估德国人群的牙髓治疗需求。对1993年来到德国斯图加特一家牙科诊所的323例患者的临床和影像学数据以及所实施的手术操作进行了评估。在182例个体中，至少有一颗牙齿存在根管充填、牙髓坏死或不可逆性牙髓炎。在检查的7897颗牙齿中，215颗（2.7%）接受了根管治疗（A类），122颗未经牙髓治疗（1.5%）对敏感性测试无反应（B类），53颗（0.7%）被诊断为患有不可逆性炎症牙髓组织（C类）。根管充填牙齿组中与根尖周病变影像学征象相关的牙齿患病率为61%，无牙髓且未经牙髓治疗的牙齿组中为88%。以根管充填的程度和密度作为评估技术标准的依据，未行根尖切除术的牙齿的根管治疗中只有14%被判定为合格。当将伴有根尖周炎临床症状的根管充填牙齿（A类）以及B类和C类牙齿包括在内时，与所有检查牙齿相关的最低牙髓治疗需求为2.3%。考虑到大多数与根尖周病变相关的无症状牙髓治疗牙齿的充填技术质量较差，实际的牙髓治疗需求可能更大。在对这些牙齿进行再治疗的情况下，牙髓治疗需求经计算将为3.7%。
