Assessment of the periapical and clinical status of crowned teeth over 25 years
Assessment of the periapical and clinical status of crowned teeth over 25 years
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DOI：
10.1016/s0300-5712(96)00008-5
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发表时间：
1997-03-01
影响因子：
4.4
通讯作者：
Norheim, PW
中科院分区：
文献类型：
--
作者：
Valderhaug, J;Jokstad, A;Norheim, PW
目的：本研究的目的是观察25年来根尖周状态的放射学变化，并比较25年来用全冠和桥固位体修复的活髓和根充牙的临床状况。方法：1967/68年间，114名患者接受了奥斯陆牙科学院大四学生的口腔修复治疗。总共用158个修复体修复了291颗活髓牙和106颗根充填牙。所有根管充填的牙齿均用铸造桩核修复。铸件由3型金合金制成，并用磷酸锌粘固剂粘结。全冠修复46颗，桥固位体修复351颗。分别于术前、骨水泥固定后即刻和每五年拍一次X光片。两名独立观察者根据PAI指数评估X线片上的根尖周状态。在25年的检查中，32名患者(28%)101颗修复牙(24%)仍在研究中。用Kaplan-Meyer非参数统计方法估计修复牙和修复牙的存活率。结果：13颗活髓牙和4颗根管充填牙的根尖周状态的PAI评分恶化。固定修复体的存活率不受基线时修复牙牙髓活力的影响。活髓修复的牙齿和根管充填的牙齿存活率相似。大约三分之一的修复牙齿有临床失败的记录。牙齿失败的主要原因是龋病(12%)，活髓的牙齿也有牙髓恶化(10%)。5年后、10年后、20年后和25年后，根尖周病变的发生率分别为98%、92%、87%和83%。结论：在25年的观察中，根尖周病变的发生率较低。经过高质量的牙髓治疗和桩核形态优化的根管充填冠牙，其存活率与牙髓有活力的冠牙相似。在25年的时间里，大部分牙髓活跃的冠牙将不会出现牙髓恶化的迹象和症状。(C)1997年爱思唯尔科学有限公司。
Objectives: The purpose of this study was to examine radiographically changes in the periapical status and compare the clinical status of teeth with a vital pulp and root-filled teeth restored with crowns and bridge retainers during 25 years.Methods: During 1967/68, 114 patients received prosthodontic treatment by senior dental students at the Oslo Dental Faculty. In all, 291 teeth with a vital pulp and 106 root-filled teeth were restored with 158 prostheses. All root-filled teeth were restored with a cast dowel and core. The casts were made in a type-3 gold alloy, and cemented with zinc phosphate cement. Forty-six teeth were restored with crowns and 351 teeth with bridge retainers. Radiographs were taken preoperatively, immediately after cementation, and every fifth year. Two independent observers assessed the periapical status on the radiographs according to the PAI-index. At the 25 years examination, 32 patients (28%) with 101 restored teeth (24%) remained in the study. Survival rates of the prostheses and of the restored teeth were estimated using Kaplan-Meyer non-parametric statistics.Results: The PAI-score of the periapical status deteriorated in 13 vital and four root-filled teeth. The survival rates of the fixed prostheses were not influenced by the pulp vitality of the restored tooth at the baseline. The survival rates of the restored teeth with a vital pulp and of the root-filled teeth were similar. Clinical failures were recorded on approximately one-third of the restored teeth. The main reason for tooth failure was caries (12%), and for the teeth with a vital pulp also pulpal deterioration (10%). Estimates of the proportions of crowned teeth with a vital pulp that will remain free from signs and symptoms of pulpal deterioration were 98% after five years, 92% after 10 years, 87% after 20 years and 83% after 25 years.Conclusions: The incidence of periapical lesions on radiographs of crowned teeth was low during 25 years observation. Crowned, root-filled teeth with a high quality endodontic treatment and an optimal morphology of the dowel and core have a similar survival rate as crowned teeth with a vital pulp. A high proportion of crowned teeth with a vital pulp will remain free from signs and symptoms of pulpal deterioration over 25 years. (C) 1997 Elsevier Science Ltd.