Eight-Year Retrospective Study of the Critical Time Lapse between Root Canal Completion and Crown Placement: Its Influence on the Survival of Endodontically Treated Teeth
Eight-Year Retrospective Study of the Critical Time Lapse between Root Canal Completion and Crown Placement: Its Influence on the Survival of Endodontically Treated Teeth
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DOI：
10.1016/j.joen.2016.08.006
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发表时间：
2016-11-01
影响因子：
4.2
通讯作者：
Mickel, Andre
中科院分区：
文献类型：
--
作者：
Pratt, Isaac;Aminoshariae, Anita;Mickel, Andre
前言：本研究旨在探讨根管治疗（RCT）后不同冠状修复方式相关因素对根管治疗后牙（ETT）存活的影响，并评估RCT与RCT后置入冠间时间间隔的影响，形成牙丢失风险模型。方法：对2008 - 2016年在牙髓科研究生院接受后路随机对照试验的患者进行计算机化分析。收集的数据包括随机对照试验的日期、根管修复后的类型和拔牙的时间。RCT后接受冠的牙也分为2组：RCT后4个月和4个月接受冠。数据分析采用Kaplan-Meier log-rank检验，Cox回归模型（alpha = 0.05），采用SPPS Statistic 21。结果：RCT后修复类型对ETT存活有显著影响（P = 0.001）。采用复合/汞合金堆积物修复的ETT拔牙的可能性是采用冠修复的ETT的2.29倍（风险比为2.29；置信区间为1.29-4.06;P = 0.005）。RCT后冠放置时间与ETT成活率也有显著相关（P = 0.001）。RCT后4个月内接受冠的牙齿拔牙的可能性是RCT后4个月内接受冠的牙齿拔牙可能性的近3倍（风险比3.38；置信区间1.56 ~ 6.33;P = 0.002）。结论：RCT后及时放置牙冠可使患者受益，否则由于牙冠放置的延迟，患者可能会拔出牙列并更换种植体。
Introduction: The purpose of this study was to investigate the effects of factors associated with various coronal restorative modalities after root canal treatment (RCT) on the survival of endodontically treated teeth (ETT) and to assess the effect of time lapse between RCT and crown placement after RCT to form a tooth loss hazard model. Methods: Computerized analysis was performed for all patients who received posterior RCT from 2008 to 2016 in the graduate endodontic department. Data collected included dates of RCT, type of post-endodontic restoration, and time of extraction if extracted. Teeth that received crown after RCT were also divided into 2 groups: receiving crown before 4 months and after 4 months after RCT. Data were analyzed by using Kaplan-Meier log-rank test and Cox regression model (alpha = 0.05) by using SPPS Statistic 21. Results: Type of restoration after RCT significantly affected the survival of ETT (P = .001). ETT that received composite/amalgam buildup restorations were 2.29 times more likely to be extracted compared with ETT that received crown (hazard ratio, 2.29; confidence interval, 1.29-4.06; P = .005). Time of crown placement after RCT was also significantly correlated with survival rate of ETT (P = .001). Teeth that received crown 4 months after RCT were almost 3 times more likely to get extracted compared with teeth that received crown within 4 months of RCT (hazard ratio, 3.38; confidence interval, 1.56-6.33; P = .002). Conclusions: Patients may benefit by maintaining their natural dentition by timely placement of crown after RCT, which otherwise may have been extracted and replaced by implant because of any delay in crown placement.