A prospective study of the incidence of asymptomatic pulp necrosis following crown preparation
A prospective study of the incidence of asymptomatic pulp necrosis following crown preparation
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DOI：
10.1111/iej.12340
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发表时间：
2015-06-01
影响因子：
5
通讯作者：
Tzanetakis, G. N.
中科院分区：
文献类型：
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作者：
Kontakiotis, E. G.;Filippatos, C. G.;Tzanetakis, G. N.
目的探讨根管预备后无症状性牙髓坏死的发生率及电动牙髓试验的阳性预测值。根据术前牙冠状况分为2组(完全牙和有龋齿、修复体或牙冠)，按牙型分为4组(上颌前牙、上颌后牙、下颌前牙和下颌后牙)。实验牙和对照牙在治疗开始前(阶段0)、印模制作阶段(阶段1)和牙冠最终粘结之前(阶段2)在三个不同的场合进行了电动牙髓测试。被认为含有坏死牙髓的牙齿接受根管治疗。一旦进入，无出血被认为是牙髓坏死的确认。数据分析采用双变量(卡方)和多变量分析(Logistic回归)。所有报告的概率值(P值)都是基于双侧检验，并与5%的显着性水平进行比较。结果牙髓坏死的总发生率为9%。完整牙齿的牙髓坏死率(5%)明显低于术前结构受损牙齿(13%)[(OR：9.113，P=0.035)]。四组间牙型差异无统计学意义(P=0.923)。电动牙髓试验的阳性预测值为1.00。结论全冠预备后无症状性牙髓坏死的发生率值得关注。实验牙术前龋齿、修复体或牙冠的存在与牙髓坏死率显著升高相关。电动牙髓测试仍然是确定牙髓状况的一种有用的诊断工具。
AimTo determine the incidence of asymptomatic pulp necrosis following crown preparation as well as the positive predictive value of the electric pulp testing.MethodologyA total of 120 teeth with healthy pulps scheduled to receive fixed crowns (experimental teeth) were included. Teeth were divided into two groups according to the preoperative crown condition (intact teeth and teeth with preoperative caries, restorations or crowns) and into four groups according to tooth type (maxillary anterior teeth, maxillary posterior teeth, mandibular anterior teeth and mandibular posterior teeth). Experimental and control teeth were submitted to electric pulp testing on three different occasions before treatment commencement (stage 0), at the impression making session (stage 1) and just before the final cementation of the crown (stage 2). Teeth that were considered to contain necrotic pulps were submitted to root canal treatment. Upon access, absence of bleeding was considered as a confirmation of pulp necrosis. Data were analysed using bivariate (chi-square) and multivariate analysis (logistic regression). All reported probability values (P-values) were based on two-sided tests and compared to a significance level of 5%.ResultsThe overall incidence of pulp necrosis was 9%. Intact teeth had a significantly lower incidence of pulp necrosis (5%) compared with preoperatively structurally compromised teeth (13%) [(OR: 9.113, P=0.035)]. No significant differences were found amongst the four groups with regard to tooth type (P=0.923). The positive predictive value of the electric pulp testing was 1.00.ConclusionsThe incidence of asymptomatic pulp necrosis of teeth following crown preparation is noteworthy. The presence of preoperative caries, restorations or crowns of experimental teeth correlated with a significantly higher incidence of pulp necrosis. Electric pulp testing remains a useful diagnostic instrument for determining the pulp condition.