根管充填と治療成績の関連性

The association between root canal filling and treatment outcome.

抄録

本研究の目的は、スウェーデンのカロリンスカ研究所（ストックホルム）の大学院生が2008年から2011年の間に行った歯内療法の技術的な質を評価し、治療結果を評価することであった。また、治療成績に影響を及ぼす可能性のある因子を分析した。2008年から2011年の間に歯内療法を受けたすべての上顎第一大臼歯を研究対象とした．治療前，治療後，経過観察のX線写真を収集し，根尖状態（PAI-score），根管治療の質（RCT），治療成績について評価した．根管治療の質およびその他の影響しうる変数と治療結果の関連性をChi2またはFisher's Exact testで分析し，統計的有意性をP<0.05とした．合計73本の歯が研究に含まれた。そのうち，RCT実施時に根尖病変を有していたのは63歯（86.3％）であった．根管治療は46本（63 %）に実施され，27本（37 %）が再治療された．治療成績は59例（81％）で成功した．RCTの品質と治療成績の間には、有意ではないものの関連性が認められた（P =0.066）。結論として，根充の質と治療成績との関連は統計的有意差をもって検証されなかったが，満足できる根充は良好な治療成績と関連するという傾向を示している．この研究は，レトロスペクティブな性質と比較的小さなサンプルサイズによって制限されている．

The aim of the study was to evaluate the technical quality of endodontic treatment per- formed by postgraduate students in Karolinska Institutet, Stockholm, Sweden during the years (2008-2011) and to evaluate the treatment outcome. In addition, possible influencing factors to treatment outcome were analyzed. All maxillary first molars that received endo- dontic treatment between 2008 and 2011 were included in the study. Pre, post and follow up radiographs were collected.The apical status (PAI-score),the quality of the root canal treat- ment (RCT) and the treatment outcome were assessed. Analysis of the treatment outcome in relation to the quality of root canal treatment and other possible influencing variables was performed by Chi2 or Fisher's Exact test, and the statistical significance was set at P<0.05. A total of 73 teeth were included in the study. Out of these, sixty-three teeth (86,3 %) had periapical lesions at the time for RCT. An initial root canal treatment was performed in 46 teeth (63 %) and 27 teeth (37 %) were retreated.There was no significant as- sociation between the outcome and the type of treatment.The majority of the RCT's (58 %) had good seal and correct length. In total, the treatment outcome was successful in 59 (81 %) of the cases. The success rate was 88% in cases with high quality root fillings, compared to 71% in cases with less good quality.There was a non- significant trend (P =0.066) of an association between RCT quality and treatment outcome. In conclusion the association between the quality of the root filling and the treatment outcome was not verified with statistical significance, but the results indicate a trend that satisfactory root fillings are associated with a favorable outcome.This study was limited by its retrospective nature and a relatively small sample size.