初次根管治疗愈合率和影响因素分析

目的评价进行初次根管治疗的患牙的愈合率,分析影响初次根管治疗愈合的因素。方法选取2005年1月-2007年12月接受初次根管治疗的296例患者的371颗患牙,采用冠向下技术进行根管治疗,随访2年。依据临床检查和X线片评判治疗效果,并分析牙根数目、牙髓活力、根管充填情况、根尖周病变对治疗效果的影响。结果296例患者（371颗牙）中143例患者（176颗牙）参与了回访。复诊病例中有152颗（86.36%）患牙评定为愈合（无临床症状、无根尖周病变）;24颗为病变,其中12颗被拔除,12颗进行再治疗。活髓牙的根管治疗愈合率（95.38%）明显高于死髓牙（81.08%）,根尖周无病变患牙的愈合率（95.24%）明显高于有病变的患牙（73.24%）;单根牙的愈合率与多根牙无明显差异,不同根管充填情况（适充或充填不完善）患牙的愈合率也无明显差异（P>0.05）。结论牙髓和根尖周状况对初次根管治疗的成功率有着较明显的影响。

Analysis of initial endodontic treatment outcome and relevant factors

Objective To assess the two-year outcome of initial endodontic treatment and evaluate the relationship between the treatment outcome and relevant factors.Methods A total of 296 patients with 371 teeth received ini-tial endodontic treatment between January 2005 and December 2007 were included in the study.The teeth were treated using crown down technique,and followed for two years.The outcome was examined clinically and radiographically.The relevant factors,including pulp vitality,apical periodontitis,the number of tooth root,and state of root canal obturation,were analyzed.Results 143(176 teeth) from 296 patients(371 teeth) were followed for two years.152 teeth(86.36%) with normal limits were assessed as "healed"(no apical periodontitis,no signs or symptoms).24 teeth were assessed as "disease",12 teeth were extracted and 12 teeth were retreated.The healing rate(HR) was statistically higher for vital teeth(95.38%) than that for devital teeth(81.08%).The HR of teeth without apical periodontitis(95.24%) was significantly higher than that with apical periodontitis(73.24%).Other factors were associated with different HR, but no statistical significance(P>0.05).Conclusion Apical periodontitis and pulp vitality may be prognostic factors for outcome of initial endodontic treatment.