【作者】 周艳勤； 钟晓波；

【Author】 Zhou Yanqin,Zhong xiao-bo.(The affiliated hospital of stomatology,Chongqin Medical University)

【机构】 重庆医科大学附属口腔医院牙体牙髓科；

【摘要】 目的:建立适合医疗质量分级控制的根管治疗难度系数体系,建立分级控制的基线资料。方法:收集连续3个月内5位牙体牙髓科住院医师根管治疗的病例共计89例(排除上颌磨牙),依据根管治疗难度的4级评判标准对术前片进行评价,并结合病历对根管预备过程中的难度进行评价,计算二者的符合率。根据术后片对根管充填效果进行评价,计算不同等级根管治疗难度的根管充填合格率。结果:术前X线片根管治疗难度评价与根管预备难度评价相同的共计62例,占70%;其中磨牙难度评价相同的共计23例,符合率为72%;前磨牙难度评价相同的共计28例,符合率为82%;前牙难度评价相同的共计1 1例,符合为48%。其中前牙难度的符合率较低,可能的原因有:①、前牙例数较少。②、术前片看似难,但操作容易。对磨牙、前磨牙、前牙的符合率进行X2检验,三者符合率有统计学意义(p<0.05),两两间进行比较,磨牙与前磨牙的符合率认为没有统计学意义(p>0.05),而磨牙与前牙,前磨牙与前牙的符合率均有统计学意义(p<0.05)。评价为4级者的根管充填合格率为73%,评价为3级者的根管充填合格率为79%,评价为2级者的根管充填合格率为83%,评价为1级者的根管充填合格率为90%。四个等级的根管充填合格率进行X2检验,1、2、3、4级的根管充填成功率有差异,且差异有统计学意义(p<0.05)。对四个等级与根管充填合格率进行Spearman相关性分析,可以认为等级与根管充填合格率是线性相关的且呈负相关关系。结论:根管治疗难度术前评估与根管预备难度存在差异,且有统计学意义。根管充填合格率与根管治疗难度系数呈负相关关系,难度系数越大,根管充填率越低。更多还原

【Abstract】 PURPOSE:The purpose of this study was to establish root canal therapy difficulty coefficient system that suit hierarchical control of medical quality,establishing hierarchical control of baseline information.METHODS:to analyse 89 cases(excepting maxillary molars)of 5 residents of dental endodontics within 3months.Evaluate the preoperative films based on 4 criteria and the difficulty in root canal preparation,and calculate the coincidence rate between the two.Assess the root canal filling according to postoperative films,and calculate passing rate of the root canal filling with different levels of root canal therapy difficulty.RESULTS:X-ray evaluation of root canal therapy difficulty and difficulty of root canal preparation with the same total of 62 patients evaluated,70%: including 23 molars,its compliance rate is 72%;28 premolars,82%;and 11 anterior teeth, 48%.The compliance rate of anterior teeth seems lower,possible reasons are:①,fewer cases of anterior teeth.②,preoperative assessment seemingly difficult,but easy to operate.On the molar,premolar,anterior teeth meet the rate of chi-square test,the three found statistically significant rate(p<0.05),compared between two,molar and premolar compliance rate that was not statistically significant(p>0.05),while the molar and anterior teeth,premolar and anterior teeth in line with the previous rate was statistically significant (p<0.05).Root canal preparation evaluated for 4,pass rate of root canal filling is 73%; those evaluated for 3,79%;the evaluation for 2,83%,the evaluation for 1,90%.Four levels of root canal filling chi-square test pass rates,1,2,3,4-level success rate of root canal filling is different,and the difference was statistically significant(p<0.05).Four levels of compliance with the rate of root canal filling Spearman correlation analysis,that the level of compliance with the root canal filling and the rate is linearly related to the negative correlation.CONCLUSION:Root canal therapy difficulty with preoperative evaluation of differences in the difficulty of root canal preparation,with statistical significance.Passing rate of root canal filling and root canal treatment a positive correlation between degree of difficulty,the greater the degree of difficulty,the lower the rate of root canal filling.更多还原