非手术根管治疗根尖大面积牙周炎病变牙齿的效果：一项回顾性研究。

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics Pub Date : 2024-10-01 DOI:10.1016/j.joen.2024.08.003

Liliana Artaza PhD , Andrea F. Campello PhD , Giuliana Soimu MS , Flávio R.F. Alves PhD , Isabela N. Rôças PhD , José F. Siqueira Jr. PhD

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引用次数: 0

摘要

导言：本研究报告了对根尖大面积牙周炎病变的牙齿进行非手术根管治疗/再治疗的结果，并评估了一些变量对预后的影响。研究还评估了一些变量对预后的影响：研究包括 184 名患者的 199 颗牙根尖大牙周炎病变牙齿，由一名操作员进行治疗/再治疗。大多数牙齿都是在一次就诊中使用 NaOCl 冲洗治疗的。对病例进行了 1 至 8 年的定期随访。治疗/再治疗结果根据临床和放射学/断层扫描标准进行评估，并分为痊愈、愈合或病变。在进行统计分析时，对数据进行了二分法处理，在宽松的标准下，痊愈病例被视为成功，在严格的标准下，痊愈病例被视为失败：临床/放射学分析显示，67%的初次治疗病例被归类为痊愈，22.5%为愈合，11%为病变。治疗成功率为 89%（松动）和 67%（僵硬）。影响治疗结果的变量包括：既往脓肿和抗生素使用情况、病变面积非常大（> 10 毫米）以及窦道。治疗的中位随访时间为 31.5 个月。至于再治疗病例，47%已经痊愈，32%正在愈合，21%仍有病变。中位随访时间为 32 个月，再治疗成功率为 79%（松动）和 47%（僵硬）。通过锥形束计算机断层扫描评估的病例失败率更高：研究结果表明，对根尖大面积牙周炎病变的牙齿进行非手术根管治疗或再治疗，可获得较高的成功率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Outcome of Nonsurgical Root Canal Treatment of Teeth With Large Apical Periodontitis Lesions: A Retrospective Study

Introduction

This study reported on the outcome of the nonsurgical root canal treatment/retreatment of teeth with large apical periodontitis lesions. The influence of some variables on the prognosis was also evaluated.

Methods

The study included 199 teeth with large apical periodontitis lesions from 184 patients, treated/retreated by a single operator. Most teeth were managed in a single visit using NaOCl irrigation. Cases were followed up periodically from >1 to 8 years. Treatment/retreatment outcome was evaluated by clinical and radiographic/tomographic criteria and categorized as healed, healing, or diseased. For statistical analysis, data were dichotomized in such a way that healing cases were considered as success in a loose criterion or failure in a rigid one.

Results

Clinical/radiographic analyses revealed that 67% of the initial treatment cases were classified as healed, 22.5% as healing, and 11% as diseased. Treatment success rates were 89% (loose) and 67% (rigid). Variables that influenced the treatment outcome included previous abscess and antibiotic use, very large lesions (≥10 mm), and a sinus tract. The median follow-up time for treatment was 31.5 months. As for retreatment cases, 47% were healed, 32% were healing, and 21% were diseased. Retreatment success rates were 79% (loose) and 47% (rigid), in a median follow-up of 32 months. Cases evaluated by cone-beam computed tomography had lower healed rates.

Conclusions

Findings demonstrate that high favorable outcome rates can be achieved by nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions.

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来源期刊

Journal of endodontics 医学-牙科与口腔外科

CiteScore

8.80

自引率

9.50%

发文量

224

审稿时长

42 days

期刊介绍： The Journal of Endodontics, the official journal of the American Association of Endodontists, publishes scientific articles, case reports and comparison studies evaluating materials and methods of pulp conservation and endodontic treatment. Endodontists and general dentists can learn about new concepts in root canal treatment and the latest advances in techniques and instrumentation in the one journal that helps them keep pace with rapid changes in this field.