子宮頸部外反症-治療成績と決定要因。最大10年間の追跡調査を行ったレトロスペクティブ・コホート研究

External cervical resorption - Treatment outcomes and determinants: A retrospective cohort study with up to 10 years of follow-up.

抄録

目的:

長期的な子宮頸部外反症（ECR）治療成績を、局所的および治療関連の決定要因の両方と関連して評価すること。

AIM: To assess long-term external cervical resorption (ECR) treatment outcomes in relation to both local and treatment-related determinants.

方法:

ブリティッシュ・コロンビア大学大学院歯内療法クリニックで2008年から2018年の間にECRと診断された76人（98歯）の情報が入手できた。ECR患者をフォローアップし、臨床検査とX線検査を実施した。カイ二乗検定により，異なるサブグループ間で失敗率を比較した．生存分析により、いくつかの局所的および治療関連の決定因子との関連で、全体のECR生存/失敗率を評価した。

METHODOLOGY: Information was available for 76 patients (98 teeth) who were diagnosed with ECR during the period from 2008 to 2018 at the University of British Columbia graduate endodontics clinic. The ECR patients were followed up, and a clinical and radiographic examination was conducted. Chi-square test compared failure rates amongst different subgroups. The survival analysis was used to evaluate the overall ECR survival/failure rates in relation to several local and treatment-related determinants.

結果:

全体で67人(89歯)の患者がフォローアップされた。平均追跡期間は3.9年であり、最短期間は1年であった。24本の歯が破損し（19本抜歯、5本機能せず）、全体の破損確率は診断から8年後に50.0％であった。局所的なECRの有意な決定要因は，歯の位置とHeithersay分類であり，治療に関する決定要因は，根管治療（RCT）とRCTと併用したECR修復であった．治療成績は，Heithersay分類が1，2の症例が3，4の症例よりも良好であった．

RESULTS: Overall, 67 patients (89 teeth) were followed up. The mean follow-up time was 3.9 years, and the minimum was 1 year. Twenty-four teeth failed (19 extracted, 5 not functional), and the overall probability of failure was 50.0% 8 years after the diagnosis. Significant (p < .05) local ECR determinants were tooth location and the Heithersay classification, and treatment-related determinants were root canal treatment (RCT) and the ECR repair combined with RCT. Treatment outcomes for Heithersay class 1 and 2 cases were better than for class 3 and 4 cases.

結論:

後方歯部およびHeithersay classが高いほど失敗率は高く，RCTおよびRCTと併用したECR修復は失敗率が低いことが示唆された．

CONCLUSIONS: Higher failure rates were associated with posterior tooth location and higher Heithersay class, whilst RCT and ECR repair combined with RCT were associated with lower failure rates.