影響根管治療或植牙治療計畫因素之探討

Factors Influencing Treatment Planning Decisions of Implants Versus Root Canal Treatment

楊正媺(Cheng-Mei Yang) ； 陳獻仁(Hsien-Jeng Chen) ； 謝耀東(Yao-Dung Hsieh)

《中華民國家庭牙醫學雜誌》 4卷3期 (2009/12) Pp. 10-15

https://doi.org/10.6566/JFD/2009.4(3).10

摘要

根管治療或植牙是目前牙醫界爭議的話題。兩者都有不錯的成功率，但到底何者有較好的可預期效果，似乎很難比較。此篇文獻回顧的目的在提供臨床上醫師能經由實證醫學的觀點，並兼顧病患的需求以作成判斷。這些觀點包括適應症、成功率、病患本身的條件狀況、自然牙與植牙的差異等。許多主要的文獻都顯示根管治療和單顆植牙的成功率或存活率相當，因此其他準則如病患經濟及身心狀況、植牙區骨質、美觀的預期狀況可能影響更大。對大部份的病例而言，根管治療是可實行又經濟的保存自然牙的方式，若牙齒預後不好而須拔牙，則植牙是一良好的治療選項。

關鍵字

根管治療 ； 植牙 ； 成功率 ； 存活率

並列摘要

One of the major issues confronting the contemporary dental clinician is the treatment decision between extracting a tooth with placement of a dental implant or preserving the natural tooth by root canal treatment. Both treatments are highly predictable procedures. Arguments are often made that one treatment is more predictable than the other, but it is difficult to make an objective comparison. The aim of this review is to evaluate key factors allowing the clinician to make clinical decisions on the basis of the best evidence and in the patient's best interests. The major studies published to date indicate that there is no difference in long-term prognosis between single-tooth implants and restored root canal-treated teeth. Therefore, the decision to treat a tooth endodontically or to place a single-tooth implant should be based on other criteria such as prosthetic restorability of the tooth, quality of bone, esthetic demands, cost-effect ratio, systematic factors, and patient preferences. It can be concluded that endodontic treatment of teeth represents a feasible, practical, and economical way to preserve function in a vast amount of cases and the dental implants serve as a good alternative treatment options while the tooth prognosis is poor.

並列關鍵字

root canal treatment ； dental implant ； success ； prognosis