Abstract：
BACKGROUND: This study reported on the outcome of the nonsurgical root canal treatment/retreatment of teeth with large apical periodontitis lesions. The influence of some variables on the prognosis was also evaluated.
METHODS: The study included 199 teeth with large apical periodontitis lesions from 184 patients, treated/retreated by a single operator. Most teeth were managed in a single visit using NaOCl irrigation. Cases were followed up periodically from >1 to 8 years. Treatment/retreatment outcome was evaluated by clinical and radiographic/tomographic criteria and categorized as healed, healing, or diseased. For statistical analysis, data were dichotomized in such a way that healing cases were considered as success in a loose criterion or failure in a rigid one.
RESULTS: Clinical/radiographic analyses revealed that 67% of the initial treatment cases were classified as healed, 22.5% as healing, and 11% as diseased. Treatment success rates were 89% (loose) and 67% (rigid). Variables that influenced the treatment outcome included previous abscess and antibiotic use, very large lesions (≥10 mm), and a sinus tract. The median follow-up time for treatment was 31.5 months. As for retreatment cases, 47% were healed, 32% were healing, and 21% were diseased. Retreatment success rates were 79% (loose) and 47% (rigid), in a median follow-up of 32 months. Cases evaluated by cone-beam computed tomography had lower healed rates.
CONCLUSIONS: Findings demonstrate that high favorable outcome rates can be achieved by nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions.
METHODS: The study included 199 teeth with large apical periodontitis lesions from 184 patients, treated/retreated by a single operator. Most teeth were managed in a single visit using NaOCl irrigation. Cases were followed up periodically from >1 to 8 years. Treatment/retreatment outcome was evaluated by clinical and radiographic/tomographic criteria and categorized as healed, healing, or diseased. For statistical analysis, data were dichotomized in such a way that healing cases were considered as success in a loose criterion or failure in a rigid one.
RESULTS: Clinical/radiographic analyses revealed that 67% of the initial treatment cases were classified as healed, 22.5% as healing, and 11% as diseased. Treatment success rates were 89% (loose) and 67% (rigid). Variables that influenced the treatment outcome included previous abscess and antibiotic use, very large lesions (≥10 mm), and a sinus tract. The median follow-up time for treatment was 31.5 months. As for retreatment cases, 47% were healed, 32% were healing, and 21% were diseased. Retreatment success rates were 79% (loose) and 47% (rigid), in a median follow-up of 32 months. Cases evaluated by cone-beam computed tomography had lower healed rates.
CONCLUSIONS: Findings demonstrate that high favorable outcome rates can be achieved by nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions.
摘要：
背景：这项研究报道了非手术根管治疗/再治疗患有大根尖周炎病变的牙齿的结果。还评估了一些变量对预后的影响。
方法：该研究包括184例患者的199颗具有大根尖周炎病变的牙齿，由单个操作员处理/后退。大多数牙齿在一次访问中使用NaOCl冲洗进行管理。对病例进行>1至8年的定期随访。治疗/再治疗结果根据临床和影像学/层析成像标准进行评估，并分类为已治愈，愈合，或患病。为了进行统计分析，数据被划分为这样一种方式，即治愈病例在宽松的标准中被认为是成功的，在严格的标准中被认为是失败的。
结果：临床/影像学分析显示，67%的初始治疗病例被归类为治愈，22.5％作为愈合，11%的人患病。治疗成功率分别为89％（松散）和67％（刚性）。影响治疗结果的变量包括既往脓肿和抗生素使用，非常大的病变（>10毫米），还有一个窦道.中位随访时间为31.5个月。至于再治疗病例，47%已痊愈,32%愈合，21%的人患病。退养成功率分别为79%(松散)和47%(刚性),中位随访时间为32个月。通过锥形束计算机断层扫描评估的病例的失败率较高。
结论：研究结果表明，通过非手术根管治疗或对患有大根尖周炎病变的牙齿进行再治疗可以获得较高的预后。
方法：该研究包括184例患者的199颗具有大根尖周炎病变的牙齿，由单个操作员处理/后退。大多数牙齿在一次访问中使用NaOCl冲洗进行管理。对病例进行>1至8年的定期随访。治疗/再治疗结果根据临床和影像学/层析成像标准进行评估，并分类为已治愈，愈合，或患病。为了进行统计分析，数据被划分为这样一种方式，即治愈病例在宽松的标准中被认为是成功的，在严格的标准中被认为是失败的。
结果：临床/影像学分析显示，67%的初始治疗病例被归类为治愈，22.5％作为愈合，11%的人患病。治疗成功率分别为89％（松散）和67％（刚性）。影响治疗结果的变量包括既往脓肿和抗生素使用，非常大的病变（>10毫米），还有一个窦道.中位随访时间为31.5个月。至于再治疗病例，47%已痊愈,32%愈合，21%的人患病。退养成功率分别为79%(松散)和47%(刚性),中位随访时间为32个月。通过锥形束计算机断层扫描评估的病例的失败率较高。
结论：研究结果表明，通过非手术根管治疗或对患有大根尖周炎病变的牙齿进行再治疗可以获得较高的预后。
