牙周牙髓联合病变患牙预后观察的回顾性研究  

Prognostic Effect of Combined Periodontal-endodontic Lesions:A Retrospective Study

作　　者：周伟[1] 汤雅 李厚轩[1] 陈斌[1] 闫福华[1] ZHOU Wei;TANG Ya;LI Houxuan;CHEN Bin;YAN Fuhua(Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China)

机构地区：[1]南京大学医学院附属口腔医院·南京市口腔医院牙周病科,江苏南京210008

出　　处：《口腔医学研究》2021年第9期825-829,共5页Journal of Oral Science Research

基　　金：江苏省医学创新团队(编号:CXTDB2017014);江苏省临床医学科技专项(编号:BL2013002);南京口腔疾病临床医学研究中心项目(编号:2019060009)。

摘　　要：目的:观察牙周源性牙周-牙髓联合病变患牙的预后效果。方法:回顾性分析南京大学医学院附属口腔医院牙周病科2013~2015年同一医师治疗完成的74颗牙周-牙髓联合病变患牙临床资料,按牙齿存留与否分为A、B两组,根据年龄、性别、随访次数、基线及治疗后5年时牙周临床检查指数等分析影响预后的可能因素,采用Kaplan-Meier法和Log-rank法评估患牙的生存率。结果:74颗牙齿总的生存率为44.1%,5年生存率为52.5%。男性与女性、牙弓和牙位生存率无明显差异,随访次数两组比较差异有统计学意义;基线时平均探诊深度(PD)、附着丧失值(AL)及最大AL值两组有显著差异,平均PD≤5 mm和PD>5 mm以及平均AL≤6 mm和AL>6 mm患牙生存率有统计学差异,A组患牙松动度(TM)、龈沟出血指数(SBI)、平均PD值、最大PD值及最大AL值与基线时相比差异有统计学意义。结论:对于牙周源性的牙周牙髓联合病变,短期效果尚可,长期预后不良,初诊牙周基线时支持组织破坏程度和患者依从性是影响患牙存留时间的重要因素。Objective:To observe the prognostic factors of periodontal-derived combined periodontal-endodontic lesions.Methods:A retrospective analysis was used to analyze the clinical trial data of 74 teeth with combined periodontal-endodontic lesions treated by the same physician in the Periodontology Department of Nanjing Stomatological Hospital in China from 2013 to 2015.The teeth were divided into two groups according to tooth retention.Age,sex,follow-up time,periodontal clinical examination index at baseline and 5-year follow-up,and other factors affecting prognosis were analyzed.The Kaplan-Meier test and log-rank method were used to evaluate the survival rate of teeth.Results:The overall survival rate of 74 teeth was 44.1%,and the 5-year survival rate was 52.5%.There was no significant difference in survival rates between gender,dental arch,and tooth position.There were significant differences between two groups in the follow-up times,mean probing depth(PD),mean attachment loss(AL),and maximum AL at baseline.The tooth survival rate between cases with average PD≤5 mm and PD>5 mm,and cases with average AL≤6 mm and AL>6 mm were statistically different.There were statistical differences regarding teeth mobility(TM),sulcus bleeding index(SBI),average PD value,maximum PD value,and maximum AL value at 5-year follow-up compared to the baseline.Conclusion:For periodontal-derived combined periodontal-endodontic lesions,the short-term effect is predictable,but the long-term prognosis is poor.The average damage of periodontal supporting tissues and patient compliance are important factors that affect the survival time of teeth.

关 键 词：牙周牙髓联合病变 牙周治疗 预后 生存率 

分 类 号：R78[医药卫生—口腔医学]