302例显微根尖手术的回顾性研究

doi:10.7518/hxkq.2021.04.013

华西口腔医学杂志 ›› 2021, Vol. 39 ›› Issue (4): 458-463.doi: 10.7518/hxkq.2021.04.013

302例显微根尖手术的回顾性研究

陈益燕(), Pradan Siras Prasad, 杨锦波()

口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院牙体牙髓病科，成都 610041

收稿日期:2020-10-21 修回日期:2021-02-19 出版日期:2021-08-01 发布日期:2021-08-10
通讯作者: 杨锦波 E-mail:995900181@qq.com;15884485592@163.com
作者简介:陈益燕，医师，硕士，E-mail：995900181@qq.com

A retrospective study of endodontic microsurgery about 302 patients

Chen Yiyan(), Pradan Siras Prasad, Yang Jinbo()

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2020-10-21 Revised:2021-02-19 Online:2021-08-01 Published:2021-08-10
Contact: Yang Jinbo E-mail:995900181@qq.com;15884485592@163.com

摘要/Abstract

摘要： 目的

探讨显微根尖手术的疗效及影响因素，并评估Kim和Kratchman显微根尖手术病例分类对疗效判断的价值。

方法

收集显微根尖手术病例（回访时间至少为1年）的临床资料及影像资料，并参照Kim and Kratchman显微根尖手术病例分类标准对病例进行分类，分析显微根尖手术的疗效及影响因素。

结果

研究共纳入302例患者的400颗患牙，显微根尖手术的成功率为94.25%。不同病损类型显微根尖手术疗效的差异有统计学意义（P<0.05），B、C类病例的显微根尖手术疗效优于D、E、F类病例（P<0.05）。不同牙位显微根尖手术疗效的差异有统计学意义（P<0.05）。前牙的疗效优于后牙，上颌牙的疗效优于下颌牙。根管充填质量及根尖再手术均对显微根尖手术的疗效无影响（P>0.05）。

结论

显微根尖手术具有较好的临床疗效，是保留患牙的有效方法；牙位和病损类型是显微根尖手术疗效的影响因素；Kim and Kratchman显微根尖手术病例分类可以帮助预测显微根尖手术的治疗效果。

关键词: 显微根尖手术, 疗效, 影响因素, 回顾性研究

Abstract: Objective

To investigate the outcome of endodontic microsurgery and analyze the potential prognostic factors, and to evaluate the value of surgical classification by Kim and Kratchman.

Methods

Collecting clinical examination and radiographical examination of endodontic microsurgery cases (which were followed up at least 1 year), which were classified according to Kim and Kratchman, and we analyzed the outcome of endodontic microsurgery and its potential prognostic factors.

Results

302 patients (400 teeth) who received endodontic microsurgery were included. The one year success rate of endodontic microsurgery was 94.25%. Different classification had significant influences on the outcome of endodontic microsurgery (P<0.05), and the success rate of class B and C were better than those of class D, E, and F. The position of teeth had significant influences on the outcome of endodontic microsurgery (P<0.05). The success rate of maxillary teeth was higher than that of mandibular teeth. The success rate of anterior teeth was higher than that of posterior teeth (P<0.05). The quality of root end filling and first or second surgery had no effect on the outcome (P>0.05).

Conclusion

Endodontic microsurgery is an effective treatment method for saving affected teeth, and it can get a good result. Tooth position and classification are the potential prognostic factors. The surgical classification of Kim and Kratchman can help to predict the outcome of endodontic microsurgery.

Key words: endodontic microsurgery, outcome, influence factor, retrospective study

中图分类号:

R 781.05

陈益燕, Pradan Siras Prasad, 杨锦波. 302例显微根尖手术的回顾性研究[J]. 华西口腔医学杂志, 2021, 39(4): 458-463.

Chen Yiyan, Pradan Siras Prasad, Yang Jinbo. A retrospective study of endodontic microsurgery about 302 patients[J]. West China Journal of Stomatology, 2021, 39(4): 458-463.

图/表 3

图 1

表 1

表 2

各因素对显微根尖手术疗效的影响

因素	n	成功	失败	成功率/%	$χ 2$ 值	P值
病损类型					47.57	0.000
A	0	0	0	-
B	219	215	4	98.17
C	131	128	3	97.71
D	12	9	3	75.00
E	30	20	10	66.67
F	8	5	3	62.50
根管充填长度					1.482	0.648
恰填	278	263	15	94.60
未填	10	9	1	90.00
超填	40	37	3	92.50
欠填	72	68	4	94.44
根管充填致密度					0.798	0.372
致密	299	280	19	93.65
稀疏	101	97	4	96.04
牙位					30.618	0.000
上颌前牙	256	249	7	97.27
下颌前牙	42	42	0	100.00
上颌前磨牙	24	22	2	91.67
下颌前磨牙	26	24	2	92.31
上颌磨牙	20	18	2	90.00
下颌磨牙	32	22	10	68.75
根尖再手术					0.000	1.000
是	12	11	1	91.67
否	388	366	22	94.33

表 2

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302例显微根尖手术的回顾性研究

A retrospective study of endodontic microsurgery about 302 patients

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部位	前牙	前磨牙	磨牙	合计
合计	298	50	52	400
上颌	256	24	20	300
下颌	42	26	32	100