Root canal filled versus non-root canal filled teeth: A retrospective comparison of survival times
Root canal filled versus non-root canal filled teeth: A retrospective comparison of survival times
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DOI：
10.1111/j.1752-7325.2005.tb02792.x
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发表时间：
2005-03-01
影响因子：
2.3
通讯作者：
White, BA
中科院分区：
文献类型：
--
作者：
Caplan, DJ;Cai, JW;White, BA
目的：这项匹配队列研究使用太平洋西北地区一家大型牙科 HMO 的数据来评估牙髓受累和随后的牙髓治疗对牙齿存活的影响程度。根管填充（RCF）牙齿被用作牙髓受累的指标。我们的假设是，在控制感兴趣的牙齿水平变量的情况下，RCF 牙齿比受试者内匹配的非 RCF 牙齿更早被拔除。方法：使用 HMO 的治疗数据库和随后的图表审核来确定 202 名符合条件的受试者，其中每人都有一颗牙齿在 1987-88 年接受过牙髓治疗，并且有一颗类似的对侧牙齿，当时非 RCF。对两颗牙齿进行从牙髓介入日期到拔牙日期、牙髓介入日期（对于最初非 RCF 牙齿）或 12131194（以最早者为准）的跟踪。进行事件时间分析，生成 Kaplan-Meier 曲线并拟合多变量边际比例风险回归模型来描述 RCF 状态对牙齿存活的影响。所有统计分析都考虑了生成数据集时使用的复杂采样策略。结果：牙齿随访长达八年（中位数 = 6.7）。 RCF 牙齿的存活率明显低于非 RCF 牙齿 (p < 0.001)，且 RCF 状态对磨牙的影响比非磨牙的影响更大。 RCF 丧失与非 RCF 磨牙和非磨牙相比的调整后风险比（95% 置信区间）分别为 7.4 (3.2-15.1) 和 1.8 (0.7-4.6)。结论：虽然牙髓治疗可以延长牙齿存活时间，但牙髓受累仍可能加速牙齿脱落，强调了预防龋齿和及时修复护理的重要性。
Objective: This matched cohort study used data from a large dental HMO in the Pacific Northwest to evaluate the degree to which pulpal involvement and subsequent endodontic therapy affects tooth survival. Root canal filled (RCF) teeth were used as an indicator of pulpal involvement Our hypothesis was that RCF teeth would be extracted sooner than non-RCF teeth matched within subjects, controlling for tooth-level variables of interest. Methods: The HMO's treatment databases and a subsequent chart audit were used to identify 202 eligible subjects, each of whom had one tooth endodontically treated in 1987-88 and a similar contralateral tooth that was non-RCF at that time. Both teeth were followed from the endodontic access date through the extraction date, the endodontic access date (for initially non-RCF teeth), or 12131194, whichever was earliest Time-to-event analyses were carried out, with Kaplan-Meier curves generated and multivariable marginal proportional hazards regression models fitted to describe the effect of RCF status on tooth survival. All statistical analyses accounted for the complex sampling strategy used in generating the dataset. Results: Teeth were followed for up to eight (median=6.7) years. RCF teeth had substantially worse survival than their non-RCF counterparts (p < 0.001), with a greater effect of RCF status evident among molars than nonmolars. Adjusted hazard ratios (95% confidence intervals) for loss of RCF versus non-RCF molars and non-molars were 7.4 (3.2-15.1) and 1.8 (0.7-4.6), respectively. Conclusion: Though endodontic therapy can prolong tooth survival, pulpal involvement still may hasten tooth loss, underscoring the importance of caries prevention and prompt restorative care.