Objectives: To investigate the outcome of endodontic microsurgery and analyze the potential prognostic factors, and to evaluate the value of surgical classification by Kim and Kratchman.
Methods: Collecting clinical examination and radiographical examination of endodontic microsurgery cases (which were followed up at least 1 year), which were classified according to Kim and Kratchman, and we analyzed the outcome of endodontic microsurgery and its potential prognostic factors.
Results: 302 patients (400 teeth) who received endodontic microsurgery were included. The one year success rate of endodontic microsurgery was 94.25%. Different classification had significant influences on the outcome of endodontic microsurgery (P<0.05), and the success rate of class B and C were better than those of class D, E, and F. The position of teeth had significant influences on the outcome of endodontic microsurgery (P<0.05). The success rate of maxillary teeth was higher than that of mandibular teeth. The success rate of anterior teeth was higher than that of posterior teeth (P<0.05). The quality of root end filling and first or second surgery had no effect on the outcome (P>0.05).
Conclusions: Endodontic microsurgery is an effective treatment method for saving affected teeth, and it can get a good result. Tooth position and classification are the potential prognostic factors. The surgical classification of Kim and Kratchman can help to predict the outcome of endodontic microsurgery.
目的: 探讨显微根尖手术的疗效及影响因素，并评估Kim和Kratchman显微根尖手术病例分类对疗效判断的价值。方法: 收集显微根尖手术病例（回访时间至少为1年）的临床资料及影像资料，并参照Kim and Kratchman显微根尖手术病例分类标准对病例进行分类，分析显微根尖手术的疗效及影响因素。结果: 研究共纳入302例患者的400颗患牙，显微根尖手术的成功率为94.25%。不同病损类型显微根尖手术疗效的差异有统计学意义（P<0.05），B、C类病例的显微根尖手术疗效优于D、E、F类病例（P<0.05）。不同牙位显微根尖手术疗效的差异有统计学意义（P<0.05）。前牙的疗效优于后牙，上颌牙的疗效优于下颌牙。根管充填质量及根尖再手术均对显微根尖手术的疗效无影响（P>0.05）。结论: 显微根尖手术具有较好的临床疗效，是保留患牙的有效方法；牙位和病损类型是显微根尖手术疗效的影响因素；Kim and Kratchman显微根尖手术病例分类可以帮助预测显微根尖手术的治疗效果。.
Keywords: endodontic microsurgery; influence factor; outcome; retrospective study.