根尖手术与根尖手术同时矫正再治疗:持续性根尖周围病变影响牙齿的前瞻性队列临床研究

IF 0.5 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Giornale Italiano di Endodonzia Pub Date : 2018-06-01 DOI:10.1016/j.gien.2018.03.001

Carlo Prati, Arash Azizi, Chiara Pirani, Fausto Zamparini, Francesco Iacono, Lucio Montebugnoli, Maria Giovanna Gandolfi

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引用次数: 2

摘要

目的本前瞻性临床研究通过临床和影像学标准分析常规根尖手术逆行硅酸钙骨水泥充填与根尖手术同时正位再治疗的24个月疗效。材料与方法本研究包括68例持续性根尖周病变患者的83颗牙齿。平均年龄52岁(中位数51岁;年龄范围19-81岁)。采用根尖手术治疗28例，根尖手术同时行正畸再治疗16例，既往牙行正畸再治疗39例作为对照组。根尖周指数评分(PAI)作为放射学标准。分别于6个月、1年和2年检查牙齿，根据影像学和临床标准分为愈合(无任何症状，PAI≤2)、愈合(无任何症状，PAI = 3)和病变(有症状，PAI≥4，无功能)。在24个月的评估中，治愈和愈合被认为是成功的，患病和骨折被认为是失败的。采用多水平GLM模型和有序逻辑回归作为统计分析，显著性水平设为p <0.05.结果6 ~ 9个月后，6颗牙(根尖手术3颗，同期治疗2颗，正畸再治疗1颗)因牙根骨折拔除。根尖手术组24个月成功率78% (n = 17)，根尖手术同时矫形再治疗81% (n = 10)，矫形再治疗成功率80% (n = 24)。两组在24个月时差异无统计学意义(p = 0.890)。结论两种手术技术均显示出较高的愈合率，与之前的研究报告相似。与对照组相比，根尖手术同时矫形再治疗在12个月后愈合更快。

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Apical surgery vs apical surgery with simultaneous orthograde retreatment: A prospective cohort clinical study of teeth affected by persistent periapical lesion

Aim

This prospective clinical study analyzed the 24-month outcome of conventional apical surgery retro-filled with calcium-silicate cement versus apical surgery with simultaneous orthograde retreatment by means of clinical and radiographic criteria.

Materials and methods

This study included 83 teeth affected by persistent periapical lesions in 68 patients. Mean age was 52 years (median = 51 years; range 19–81 years). Twenty-eight cases were treated with apical surgery, 16 cases with apical surgery with simultaneous orthograde retreatment and 39 cases with orthograde retreatment in previously treated teeth established as control group. Periapical index score (PAI) was used as radiographic criteria. Teeth were examined at 6 months, 1 and 2 years and classified as healed (without any symptoms and PAI ≤ 2), healing (without any symptoms and PAI = 3) or diseased (with symptoms or PAI ≥ 4 and not functional) on the basis of radiographic and clinical criteria. At 24 months evaluation, healed and healing were considered as success and diseased and fracture as failure. Multilevel GLM model and an ordered logistic regression as statistical analysis was made with level of significance set at p < 0.05.

Results

Total drop-out was 7% (n = 6). After 6–9 months, 6 teeth (3 from apical surgery, 2 from simultaneous treatment and 1 from orthograde retreatment) were extracted for root fracture. Twenty-four-month success rate of apical surgery group was 78% (n = 17), apical surgery with simultaneous orthograde retreatment presented 81% (n = 10) and orthograde retreatment success was 80% (n = 24). There was no statistically difference between the groups at 24 months (p = 0.890).

Conclusions

Both surgical techniques revealed a high percentage of healing, similar to that reported by previous studies. Apical surgery with simultaneous orthograde retreatment showed a faster healing after 12 months comparing to the control group.

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来源期刊

Giornale Italiano di Endodonzia DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

0.90

自引率

25.00%

发文量

审稿时长

24 weeks

期刊介绍： The Giornale Italiano di Endodonzia was founded in 1987 and is the official journal of the Italian Society of Endodontics (SIE). It is a peer-reviewed journal publishing original articles on clinical research and/or clinical methodology, case reports related to Endodontics. The Journal evaluates also contributes in restorative dentistry, dental traumatology, experimental pathophysiology, pharmacology and microbiology dealing with Endodontics.