歯内療法を行った歯の治療成績に及ぼす歯冠修復の影響

Influence of the coronal restoration on the outcome of endodontically treated teeth.

抄録

歯内療法を行うと硬組織が除去されるため、歯は弱くなります。多くの歯科医師は、根管治療（RCT）後に異なる歯冠修復物を選択することが困難であると感じています。研究により、歯冠修復物が歯内療法の予後に影響を与える可能性があることが示されている。この学生による研究は、3つの目的をもって行われた。(1) スカンジナビアの歯科大学で歯内療法を受けた歯の歯冠修復物の選択を検討する，(2) これらの修復物の生存率を検討する，(3) RCTの結果に歯冠修復物が与える影響を評価する． 127本の臼歯を対象に，X線撮影と臨床検査を実施した．根管治療の質および根尖周囲の状態（PAI-index）を評価した． 43.8%の歯が間接歯冠修復され，47.2%が直接歯冠修復された．根管治療終了から永久歯冠修復物装着までの期間は，間接修復の方が直接修復よりも有意に長かった．pulpectomy，necrotic pulp treatment，endodontic retreatmentの後にPAI scoreが1および2の治療を受けた歯は，それぞれ93.8％，82.6％，69.4％であった．冠状修復物の選択とPAI-scoreの間に有意な関連は認められなかった．

The tooth weakens due to removal of hard tissue during an endodontic procedure. Many dentists find it difficult to choose between different coronal restorations after root canal treatment (RCT). Studies show that the coronal restoration may affect the endodontic prognosis. This student-based study had three aims. (1) Examine the choice of coronal restoration of endodontically treated teeth at a Scandinavian dental school, (2) examine the survival of these restorations and (3) evaluate the influence of the coronal restoration on the outcome of the RCT. Radiographic and clinical examination was performed on 127 posterior teeth. The quality of the root canal treatment and the periapical status (PAI-index) were evaluated. 43.8% of the teeth were restored with an indirect coronal restoration and 47.2% with a direct coronal restoration. The period from finished root canal treatment until placement of a permanent coronal restoration was significantly longer for an indirect restoration than a direct restoration. The teeth treated with a PAI score of 1 and 2 following pulpectomy, necrotic pulp treatment and endodontic retreatment was 93.8%, 82.6% and 69.4%, respectively. There was no significant association between choice of coronal restoration and PAI-score.