北京大学学报（医学版）2018，Vol.50Issue(1)：123-130,8.DOI:10.3969/j.issn.1671-167X.2018.01.021
牙髓根尖周病根管治疗疗效预测模型的建立
A prognostic model for assessment of outcome of root canal treatment in teeth with pulpitis or apical periodontitis
摘要
Abstract
Objective: To present a prognostic model for evaluating the outcome of root canal treatment in teeth with pulpitis or apical periodontitis 2 years after treatment. Methods: The implementation of this study was based on a retrospective study on the 2-year outcome of root canal treatment. A cohort of 360 teeth, which received treatment and review, were chosen to build up the total sample size. In the study, 143 teeth with vital pulp and 217 teeth with apical periodontitis were included. About 67％ of the samples were selected randomly to derive a training date set for modeling,and the others were used as validating date set for testing. Logistic regression models were used to produce the prognostic models. The dependent variable was defined as absence of periapical lesion or reduction of periapical lesion. The predictability of the models was evaluated by the area under the receiver-operating characteristic (ROC ) curve (AUC). Results: Four predictors were included in model one (absence of apical lesion): preoperative periapical radiolucency,canal curvature,density and apical extent of root fillings. The AUC was 0. 802 (95％ CI: 0. 744-0. 859). And the AUC of the testing date was 0. 688. Only the density and apical extent of root fillings were included to present model two (reduction of apical lesion). The AUC of training dates and testing dates were 0. 734 (95％ CI: 0. 612-0. 856) and 0. 681,respectively. As predicted by model one,the probability of absence of periapical lesion 2 years after endodontic treatment was 90％ in pulpitis teeth with sever root-canal curvature and adequate root canal fillings, but 51％ in teeth with apical periodontitis. When using prognostic model two for prediction, in teeth with apical periodontitis, the probability of detecting lesion reduction with adequate or inadequate root fillings was 95％ and 39％ 2 years after treatment. Conclusion: The pre-operative periapical status, canal curvature and quality of root canal treatment could be used to predict the 2-year outcome of root canal treatment.关键词
根管疗法/放射摄影术/治疗结果/预测模型Key words
Root canal therapy/Radiography/Treatment outcome/Prognostic model分类
医药卫生引用本文复制引用
张茗茗,郑迎东,梁宇红..牙髓根尖周病根管治疗疗效预测模型的建立[J].北京大学学报（医学版）,2018,50(1):123-130,8.基金项目
首都临床特色应用研究项目(Z131107002231045)资助 （Z131107002231045）
Supported by Clinical Characteristics and Application Research of Capital (Z131107002231045) （Z131107002231045）
