- 期刊
Molar Root Separation and Resection Treatment: A Retrospective Study
摘要
Objective: The purpose of this study was to evaluate the outcomes of resected molar teeth and the factors affected the lifespan of teeth. Materials and Methods: This article reviewed 184 root resected teeth in our department of dentistry from 2006 to 2018. Radiography and dental history were recorded under regular recall. Kaplan-Meier survival analysis and multiple Cox's regression analysis were performed. Results: Sixty-four of 184 teeth were exclusive due to loss to follow-up and death. Fifty-seven teeth were extracted by the time of recall (1-10year post-resection). Ten-year cumulative survival rate is 39.5%. Using multiple Cox's regression analysis to explore the factors affecting root resection survival rate. Bone level >50% is the most important factor, with hazard ratio of 6.48. The tooth type is also the factor, with hazard ratio of 2.69. Conclusion: Reduced pre-operative bone height around remained roots increases the risk of tooth loss. Long term survival rate can still achieve by careful case selection. Harmful masticatory habits and parafunction still need to be controlled to avoid root fracture. If patient want to retain tooth as long as possible due to financial or personal consideration, root resection is still a reliable choice.
並列摘要
研究目的：評估切根治療應用於大臼齒一或多根預後不良牙根切除的存活率，及其相關影響存活的因子。材料與方法：此篇回溯研究本院從2006～2018年共184顆進行切根的大臼齒，經過根尖片與牙科病史的紀錄及定期回診追蹤檢查，利用存活分析與多元迴歸分析的結果。結果：184顆進行切根的大臼齒，排除64顆喪失追蹤與死亡的病例，剩下120個病例中有57顆牙齒於追蹤一到十年內陸續被拔除。十年累積存活率為39.5%。利用多元迴歸分析評估影響切根牙齒存活率的相關因素，以切根當時齒槽骨存留高度是否超過50%為最重要的影響因子，風險比達6倍之多。而第二大臼齒切根風險為第一大臼齒的2.96倍。結論：長期的存活率仍可以藉由嚴謹的病人選擇而達成，同時也需要評估病人的飲食及咀嚼習慣，排除過大咬力避免切根後牙齒又遭遇斷裂的情形。如果病人因為經濟或個人因素希望接受以保留牙齒為主的治療，切根治療仍然是一個可信賴的選擇。