Epidemiological evaluation of the outcomes of nonsurgical root canal treatment in a large cohort of insured dental patients
Epidemiological evaluation of the outcomes of nonsurgical root canal treatment in a large cohort of insured dental patients
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DOI：
10.1097/00004770-200112000-00021
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发表时间：
2001-12-01
影响因子：
4.2
通讯作者：
Hargreaves, KM
中科院分区：
文献类型：
--
作者：
Lazarski, MP;Walker, WA;Hargreaves, KM
采用保险公司数据库，对由牙髓科医生及其推荐的普通牙医完成的110,766例非手术根管治疗（NSRCT）的初步非手术根管治疗（NSRCT）后选定的结果进行回顾性评估。在44,613例病例中，最小随访时间为2年，拔牙、再治疗和根周手术的发生率分别为5.56%、2.47%和1.41%。后续拔牙的发生率随患者年龄的增加而增加。根管治疗后未修复的牙齿比修复后的牙齿更容易进行拔牙。尽管与普通牙医相比，牙髓医生的臼齿比例明显较高（多48%；p < 0.001），前牙比例较低（少43%；p < 0.001），但两组医生的不良事件发生率相当。这些数据有力地支持了这样的假设，即即使在治疗明显更复杂的NSRCT病例时，专家实践与其他提供者相比，提供了相似的临床成功率。总的来说，在平均3.5年的随访时间里，94.44%的非手术根管治疗的牙齿仍然保持功能。这些结果是一个重要的迹象，表明在牙髓科医生及其转诊的普通牙医的综合卫生保健服务系统中提供牙髓治疗的好处。
Selected outcomes following initial nonsurgical root canal treatment (NSRCT) procedures were retrospectively assessed using an insurance company database of 110,766 nonsurgical root canal procedures that were completed by endodontists and their referring general dentists. A subset of 44,613 cases, with a minimum required follow-up time of 2 yr, showed incidences of extraction, retreatment and periradicular surgery equal to 5.56%, 2.47%, and 1.41%, respectively. The incidence of subsequent extraction increased with patient age. Teeth that were not restored after root canal therapy were significantly more likely to undergo extraction than restored teeth. Although the practice pattern for endodontists consisted of a significantly higher proportion of molars (48% more; p < 0.001) and a smaller proportion of anterior teeth (43% less; p < 0.001) than general dentists, both groups of providers had comparable rates of untoward events. These data strongly support the hypothesis that the specialist practice provides similar rates of clinical success compared with other providers, even when treating significantly more complex NSRCT cases. Overall, 94.44% of nonsurgical root canal treated teeth remained functional over an average follow-up time of 3.5 yr. These results are an important indication of the benefits of endodontic treatment when provided in an integrated health care delivery system of endodontists and their referring general dentists.