The tooth survival of non-surgical root-filled posterior teeth and the associated prognostic tooth-related factors: A systematic review and meta-analysis

IF 5.4 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE International endodontic journal Pub Date : 2024-07-01 DOI:10.1111/iej.14116

S. R. Patel, F. Jarad, E. Moawad, A. Boland, J. Greenhalgh, Maria Liu, Michelle Maden

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Abstract

Background

Analysis of the survival of root-filled posterior teeth and the associated prognostic tooth-related factors will enable clinicians to predict the outcome of root canal treatment.

Objectives

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.

Registration

PROSPERO Registration: CRD42021227213.

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非手术根充后牙的牙齿存活率及相关预后因素：系统回顾和荟萃分析。

背景：分析根充后牙的存活率以及与预后相关的牙齿因素将有助于临床医生预测根管治疗的结果：调查(i)根充盈后牙的存活率和(ii)可能影响其存活率的牙齿相关因素：截至 2023 年 1 月，通过对以下数据库的电子检索，确定了评估根充盈后牙存活率的随机对照试验、比较研究和观察性研究，随访期至少为 4 年：Cochrane 对照试验中央注册中心、通过 PubMed 进行的 Medline、Cochrane 系统性综述数据库、Embase、Web of Science 和 NIHR 综述和传播中心。两名审稿人（SP 和 ML）根据预先确定的纳入标准独立筛选出最终研究。采用纽卡斯尔-渥太华量表（Newcastle Ottawa Scale）和科克伦随机试验偏倚风险工具（Cochrane Risk of Bias Tool for Randomized Trials）评估偏倚风险。采用随机效应荟萃分析模型，使用 DerSimonean 和 Laird 方法对汇总加权生存率进行分析。对描述任何与牙齿预后相关因素的研究进行了描述性分析：在确定的 72 项研究中，有 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 项研究为回顾性研究，7 项为前瞻性研究，1 项为随机对照试验。不考虑牙齿类型，根充后牙 4-7 年和 8-20 年的总生存率分别为 91% (95% CI, 0.85; 0.95) 和 87% (95% CI, 0.77; 0.93)。纳入研究中提到的与牙齿预后相关的因素有：(i) 剩余冠状牙齿结构；(ii) 卡环；(iii) 冠根比；(iv) 牙齿类型和位置；(v) 牙周病；(vi) 近端接触；(vii) 裂缝：荟萃分析表明，根管治疗的中长期生存率较高。叙述性总结确定了影响牙齿存活率的 7 个因素。然而，目前证据不足，需要在这一领域开展更多研究：注册：PROSPERO 注册：CRD42021227213。

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来源期刊

International endodontic journal 医学-牙科与口腔外科

CiteScore

10.20

自引率

28.00%

发文量

195

审稿时长

4-8 weeks

期刊介绍： The International Endodontic Journal is published monthly and strives to publish original articles of the highest quality to disseminate scientific and clinical knowledge; all manuscripts are subjected to peer review. Original scientific articles are published in the areas of biomedical science, applied materials science, bioengineering, epidemiology and social science relevant to endodontic disease and its management, and to the restoration of root-treated teeth. In addition, review articles, reports of clinical cases, book reviews, summaries and abstracts of scientific meetings and news items are accepted. The International Endodontic Journal is essential reading for general dental practitioners, specialist endodontists, research, scientists and dental teachers.