硅酸钙基生物材料用于根尖倒充填的临床研究——基于PSM分析的回顾性研究

目的 用倾向性分析的统计学方法比较和评价硅酸钙基生物陶瓷材料iRoot BP Plus或MTA作为根尖倒充填材料的临床疗效，并确定影响显微根尖手术成功率的预后因素。方法 检索2016—2018年在本院行显微根尖手术的病例。对使用iRoot BP Plus或MTA作为根管倒充填材料进行手术患者的年龄、性别、病变牙位、根管治疗类型、是否合并牙周病变5个变量采用最近邻匹配法进行1∶1倾向性评分匹配，分析其临床效果。采用多因素二元Logistic回归分析评价显微根尖手术的影响因素，并绘制森林图。结果 纳入患牙共179颗。所有协变量的绝对标准化差值均<0.1。iRoot BP Plus组和MTA组显微根尖外科手术的1年成功率分别为91.2%和89.7%(P=0.771)。PSM后多因素二元Logistic回归分析结果发现年龄、病变牙位、是否合并牙周病变对显微根尖手术预后具有显著影响。结论 MTA或者iRoot BP Plus作为根尖切除后的倒充填材料均可取得良好的临床效果。年龄、病变牙位、是否合并牙周病变是影响显微根尖手术临床疗效的显著因素。

Clinical research on calcium silicate based bio-materials for root-end filling: A retrospective study based on PSM analysis

Objective To compare and evaluate clinical efficacy of calcium silicate based bio-ceramic materials iRoot BP Plus and MTA as root-end filling materials and to determine prognostic factors affecting the outcome of endodontic microsurgery (EMS). Methods A clinical database was searched for EMS cases from 2016 to 2018. The nearest neighbor matching method was used to match age, gender, lesion location, root canal treatment type and whether the lesion complicated with periodontal desease of patients undergoing EMS using iRoot BP Plus or MTA as root-end filling materials with 1∶1 propensity score. Multifactor binary Logistics regression analysis was used to evaluate interfering factors of EMS and the forest plot was drawn. Results A total of 179 teeth were included. The absolute normalized differences of all co-variables were <0.1. One-year success rate of microapical surgery was 91.2% in iRoot BP Plus group and 89.7% in MTA group (P=0.771). Multivariate binary Logistic regression analysis after PSM showed that age, lesion location and whether the lesion complicated with periodontal desease had statistically significant effects on clinical efficacy and prognosis of microscopic apical surgery. Conclusion Microapical surgery has good clinical efficacy, and there is no significant difference in the success rate of microapical surgery with MTA or iRoot BP Plus as backfilling materials. Age, lesion location and whether the lesion complicated with periodontal desease are significant factors influencing the clinical effect of microapical surgery.