不同经验口腔医师应用新型镍钛器械根管治疗质量及疗效的回顾性分析  

Influence of operator′s experience on the quality and success rate of root canal treatment with new nickel-titanium instruments

作　　者：邵彤菲 张茹 关蕊[1] 张琛[1] 侯本祥[2] Shao Tongfei;Zhang Ru;Guan Rui;Zhang Chen;Hou Benxiang(Department of Endodontics,School of Stomatology,Capital Medical University,Beijing 100050,China;Center for Microscope Enhanced Dentistry,School of Stomatology,Capital Medical University,Beijing 100162,China)

机构地区：[1]首都医科大学口腔医学院牙体牙髓科,北京100050 [2]首都医科大学口腔医学院口腔显微诊疗中心,北京100162

出　　处：《中华口腔医学杂志》2024年第11期1126-1131,共6页Chinese Journal of Stomatology

基　　金：北京市科学技术委员会科技计划(Z191100006619037)。

摘　　要：目的分析工作经验对新型镍钛器械根管治疗质量及疗效的影响,为新型镍钛器械根管治疗成功率提供依据。方法收集2020年9月至2021年8月于首都医科大学口腔医学院牙体牙髓科就诊,由工作经验1~3年的住院医师和工作经验5~7年的牙髓专科主治医师使用机用镍钛通畅锉及控制记忆完成锉进行根管治疗和非手术根管再治疗,且在术后6~12个月复查的病例(分别为住院医师组和专科医师组),分析两组医师治疗的患者根管治疗并发症、根管充填质量及根管治疗成功率的差异及影响因素。结果共纳入263例患者的277颗根管治疗和非手术根管再治疗患牙,分别由24名住院医师和3名专科医师完成治疗,住院医师组169颗,专科医师组108颗。住院医师组诊间急症发生率[3.6%(6/169)]显著高于专科医师组[0(0/108)](P=0.048);两组台阶、根尖偏移、根管穿孔、器械分离的发生率差异均无统计学意义(P>0.05)。住院医师组根管充填良好率[62.7%(106/169)]显著低于专科医师组[86.1%(93/108)](P<0.05)。住院医师组与专科医师组根管治疗成功率[分别为91.7%(155/169)和94.4%(102/108)]差异无统计学意义(χ^(2)=0.73,P=0.392)。根管治疗并发症和根管充填质量显著影响根管治疗成功率(P<0.05)。结论住院医师和牙髓专科医师使用机用镍钛通畅锉及控制记忆完成锉根管治疗成功率均较高。Objective To analyze the influence of operator′s experience on the quality and success rate of root canal treatment with new nickel-titanium instruments,providing support for improving the success rate of root canal treatment with new nickel-titanium instruments in clinic.Methods Cases of root canal treatment and non-surgical root canal retreatment with 6-12 months recall performed by residents(resident group)with experience of 1-3 years and endodontic specialists(specialist group)with experience of 5-7 years were collected from the electronic medical system of the Department of Endodontics,School of Stomatology,Capital Medical University,from September 2020 to August 2021.All cases were prepared by engine-driven glide path files and controlled memory nickel-titanium finishing files.Chi-square test and logistic regression were used to analyze the differences and influencing factors of complications,filling quality and success rate of root canal treatment between the two groups.Results A total of 277 cases performed by 24 residents and 3 specialists were included,169 in the resident group and 108 in the specialist group.The clinical incidence of flare-ups was significantly higher in the resident group[3.6%(6/169)]than in the specialist group[0(0/108)](P=0.048).There were no significant differences in ledges,root canal transportations,perforations,or instrument separations between the two groups(P>0.05).The prevalence of satisfactory fillings was 62.7%(106/169)in the resident group,which was significantly lower than that in the specialist group[86.1%(93/108)](P<0.05).The success rate of root canal treatment was 91.7%(155/169)and 94.4%(102/108)in the resident group and the specialist group,respectively,with no significant differences(χ^(2)=0.73,P=0.392).Multivariate analysis showed that the success rate of root canal treatment was related to complications and quality of root fillings(P<0.05).Conclusions Higher success rate of root canal treatment could be achieved by residents and endodontic specialists with engi

关 键 词：根管充填 牙科器械 根管预备 根管治疗成功率 工作经验 

分 类 号：R781.05[医药卫生—口腔医学]