OBJECTIVE: To investigate (i) the survival of root-filled posterior teeth and (ii) the tooth-related factors that may affect their survival.
METHODS: Randomized controlled trials, comparative studies and observational studies assessing survival rates of root-filled posterior teeth with a minimum 4-year follow-up period were identified through an electronic search of the following databases up to January 2023: The Cochrane Central Register of Controlled Trials, Medline via PubMed, the Cochrane Database of Systematic Reviews, Embase, Web of Science and NIHR centre for reviews and dissemination. Two reviewers (SP and ML) independently selected the final studies based on pre-defined inclusion criteria. The Newcastle Ottawa Scale and the Cochrane Risk of Bias Tool for Randomized Trials were used to assess the risk of bias. Pooled weighted survival rates were analysed using a random effects meta-analysis model using DerSimonean and Laird methods. Descriptive analysis of studies describing any prognostic tooth-related factors was conducted.
RESULTS: Of the 72 studies identified, data from 20 studies were included in the survival meta-analysis, and data from 13 of these studies were included in the descriptive analysis of tooth-related factors; 12 studies were retrospective, 7 were prospective, and one was a randomized control trial. The pooled survival rates at 4-7 years and 8-20 years of root-filled posterior teeth regardless of tooth type was 91% (95% CI, 0.85; 0.95) and 87% (95% CI, 0.77; 0.93), respectively. The prognostic tooth-related factors mentioned in the included studies were (i) remaining coronal tooth structure, (ii) ferrule, (iii) crown-to-root ratio (iv) tooth type and location (v) periodontal disease (vi) proximal contacts and (vii) cracks.
CONCLUSIONS: The meta-analysis suggests that root canal treatment has a high medium to long term survival outcome. The narrative summary identified 7 factors that affect tooth survival. However, there is a paucity of evidence, and more research is needed in this area.
BACKGROUND: PROSPERO Registration: CRD42021227213.
目的:研究(i)充满牙根的后牙的存活率和(ii)可能影响其存活率的牙齿相关因素。
方法:随机对照试验,通过对截至2023年1月的以下数据库进行电子搜索,确定了评估至少4年随访期的充满根后牙生存率的比较研究和观察研究:Cochrane中央对照试验登记册,Medline通过PubMed,Cochrane系统评价数据库,Embase,WebofScience和NIHR中心进行审查和传播。两名评审员(SP和ML)根据预定义的纳入标准独立选择最终研究。使用纽卡斯尔渥太华量表和随机试验的Cochrane偏差风险工具评估偏差风险。使用DerSimonean和Laird方法,使用随机效应荟萃分析模型分析集合加权生存率。对描述任何预后牙齿相关因素的研究进行了描述性分析。
结果:在确定的72项研究中,来自20项研究的数据被纳入生存荟萃分析,其中13项研究的数据被纳入牙齿相关因素的描述性分析;12项研究是回顾性的,7是前瞻性的,一项是随机对照试验.无论牙齿类型如何,4-7年和8-20年的根充后牙的合并生存率分别为91%(95%CI,0.85;0.95)和87%(95%CI,0.77;0.93),分别。在纳入的研究中提到的预后牙齿相关因素是(i)剩余的冠状牙齿结构,(ii)套圈,(iii)冠根比(iv)牙齿类型和位置(v)牙周病(vi)近端接触和(vii)裂纹。
结论:荟萃分析表明,根管治疗具有较高的中长期生存结局。叙述性总结确定了影响牙齿存活的7个因素。然而,证据不足,在这方面需要更多的研究。
背景:PROSPERO注册:CRD42021227213。