根管治疗后三年疗效评价及影响因素分析

目的评价根管治疗的疗效及其影响因素。方法回访检查根管治疗后3年患牙的临床状况和根尖周X线片表现,对根管治疗的疗效及可能的影响因素进行分析。结果695颗患牙根管治疗后3年的治愈率为75．1％,有咀嚼功能的占96．0％。单因素分析发现,前牙、活髓牙、术前根尖周组织正常、适充及牙体修复完好的患牙治愈率较高;回归分析表明,无根尖周病变、适充及牙体修复完好的患牙比术前有根尖周病变、欠充及根充物暴露的患牙治愈率分别高2倍、3倍和1．6倍。结论患牙有无根尖周病变、根管充填质量和牙体修复的完好程度均可对根管治疗的疗效产生影响。

Analysis on results of endodontic treatment and influncing factors

OBJECTIVE: To assess the clinical outcome of root canal therapy (RCT) and the various factors that may influence the outcome of RCT. METHODS: A total of 695 teeth from 357 patients were retrospectively studied three years after endodontic treatment. Pre- and intra-operative information was collected from the original patient records. The post-operative sign or symptom, periapical status and coronal restoration integrity were examined 3 years after obturation. Data were subjected to bivariate and multivariate analysis. RESULTS: The cure rate for 695 teeth was 75.1%, 96.0% of which was considered to be functional. The tooth group, pre-operative pulp and periapical status, quality of root filling and integrity of coronal restoration were revealed by means of bivariate analysis to exert a significant influence on treatment outcome. The logistic analysis indicated that the odds for cure in the teeth with pre-operative periapical radiolucency, underfilling and "open" coronal restoration were significantly lower by 2 folds, 3 folds and 1.6 folds than their counterparts, respectively. CONCLUSIONS: The pre-operative periapical status, quality of root filling and the integrity of coronal restoration are main predictors of outcome in RCT.