A prognostic model for assessment of the outcome of endodontic treatment:: Effect of biologic and diagnostic variables

被引:116
作者
Chugul, NM
Clive, JM
Spångberg, LSW
机构
[1] Univ Calif Los Angeles, Sch Dent, Sect Endodont, Los Angeles, CA 90095 USA
[2] Univ Connecticut, Ctr Hlth, Off Biostat Consultat, Farmington, CT USA
[3] Univ Connecticut, Ctr Hlth, Dept Endodontol, Sch Dent Med, Farmington, CT USA
来源
ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTICS | 2001年 / 91卷 / 03期
关键词
D O I
10.1067/moe.2001.113106
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Objective. Many biological variables, endodontic treatment factors, and restorative considerations have been suggested in the literature to affect the outcome of endodontic treatment. However, few attempts have been made recently to study these variables further. The purpose of this study was to identify the biologic and endodontic treatment-associated variables that are most predictive of treatment outcome for conventional endodontic therapy and to determine the magnitude of risk these variables pose on the outcome. Study design. The population of this historical prospective cohort study comprised a total of 200 teeth with 441 root canals. Diagnostic and treatment information was abstracted from the original patient records. An endodontic follow-up examination was conducted 4 +/- 0.5 years after obturation. Each tooth/root was analyzed according to 3 indices of periradicular status at 2 time points. The main outcome measure was the presence of apical periodontitis. The criteria used for evaluation of the outcome were modified from Strindberg. Data were subjected to univariate and multivariate analysis. Logistic regression models were fit by using various clinical measures to determine which combination of biologic and treatment-associated factors best predicted treatment outcome. Results. The preoperative pulp diagnosis, the periapical diagnosis, the preoperative periapical radiolucency size, and the sex of the patients were revealed, by means of univariate analysis, to exert a significant influence on endodontic treatment outcome (P < .05). In the logistic regression model, the strongest effect on postoperative healing was the presence and magnitude of preoperative apical periodontitis. In the presence of this variable, no other factor contributed value to the prediction. The correct prediction of this model was 74.7% (P<.05). Conclusion. The major biologic factors influencing the outcome of endodontic treatment appear to be the extent of microbiological insult to the pulp and periapical tissue, as reflected by the periapical diagnosis and the magnitude of periapical pathosis.
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页码:342 / 352
页数:11
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