Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
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Characteristics of teeth referred to a dental university hospital for endodontic reason

근관치료적 이유로 치과대학병원으로 의뢰된 치아들의 특성

  • Jeon, Su-Jin (Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital) ;
  • Hwang, Soo-Jeong (Department of Dental Hygiene, College of Medical Science, Konyang University) ;
  • Seo, Min-Seock (Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital)
  • 전수진 (원광대학교 대전치과병원 치과보존과) ;
  • 황수정 (건양대학교 의과학대학 치위생학과) ;
  • 서민석 (원광대학교 대전치과병원 치과보존과)
  • Received : 2019.07.02
  • Accepted : 2019.08.20
  • Published : 2019.09.30
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Abstract

Purpose: The aim of this study is to investigate the characteristics of patients and teeth referred to a university dental hospital for endodontic problem. Materials and Methods: From January, 2017 to December, 2018, patients who were referred to a university dental hospital for endodontic problem were collected from clinical records. A total of 1171 patient records were analyzed. The status of the referred teeth was divided into three groups according to whether they were treated endodontically based on radiographs and clinical records at the time of referred visit. Results: 69.9% of the referred teeth were maxillary and mandibular first and second molars. The average time from referral to actual visit is 9.03 days and 65.6% of the case referred with referring letter. The most primary reasons of referral were persistent clinical symptom (pain, swelling, and sinus tract) (37.9%), diagnosis difficulty (16.7%), blockage of canal space (13.8%) and difficult tooth anatomy (11.4%). In the case of referral before endodontic treatment, the most primary reason of referral was failure to make a proper diagnosis. If the teeth were referred in the middle of endodontic treatment, the most primary reason of referral was persistent clinical symptom and blockage of canal space. In the case of referral after root canal filling, the most primary reason of referral was persistent clinical symptom. Conclusion: In the case of molars, the rate of persistent clinical symptom and blockage of canal space were the most primary reason of referral, and the rate of apical surgery and management of trauma was high in the case of anterior teeth.

목적: 이번 연구의 목적은 치과대학병원 보존과로 근관치료적으로 의뢰된 환자들과 치아들의 특성을 진료기록을 통해 살펴보고 영향을 미치는 요인을 분석하는 것이다. 연구 재료 및 방법: 2017년 1월부터 2018년 12월까지 한 치과대학병원 보존과에 내원한 환자들을 대상으로 환자의 진료기록을 통해 근관치료적으로 의뢰되었던 환자를 취합하였다. 총 1171명의 환자 기록을 분석하였다. 의뢰된 치아의 상태가 근관치료 전인지 근관치료 중인지 또는 근관 충전된 이후인지를 초진 당시의 방사선 사진과 진료기록 내용을 토대로 구분하여 3가지 군으로 정리해서 분석하였다. 결과: 의뢰된 치아들의 69.9%가 상, 하악 제1, 2대구치였다. 이전 기관에서 의뢰된 후 치과대학병원에 내원할 때까지 소요된 일수는 평균 9.03일이었고 의뢰서가 있는 경우가 65.6%였다. 주된 의뢰 이유로는 지속되는 임상 증상(통증, 종창, 누공)이 37.9%로 가장 많았으며 진단의 어려움 16.7%, 근관막힘 13.8%, 높은 해부학적 난이도 11.4% 순이었다. 세부적으로 근관치료 전에 의뢰된 경우에는 진단의 어려움이 많았고 근관치료 중에 의뢰된 경우에는 지속적인 임상 증상과 근관 막힘이 많았다. 근관 충전 후에 의뢰된 경우는 지속되는 임상 증상이 대부분이었다. 결론: 대구치인 경우 지속적인 임상 증상과 근관 막힘이 주된 이유인 비율이 높았고 전치의 경우 치근단 수술과 외상 치료의 비율이 높았다.

Keywords

References

  1. Harty FJ. A survey of endodontic procedures performed by practitioners in limited practice. Int Endod J 1992;25:25-8. https://doi.org/10.1111/j.1365-2591.1992.tb00945.x
  2. American Association of Endodontists. AAE Endodontic case difficulty assessment form and guidelines. Available from: https://www.aae.org/specialty/wpcontent/uploads/sites/2/2017/10/2006casedifficultya ssessmentformb_edited2010.pdf (updated 2019 Sep 4).
  3. Abbott JA, Wolcott JF, Gordon G, Terlap HT. Survey of general dentists to identify characteristics associated with increased referrals to endodontists. J Endod 2011;37:1191-6. https://doi.org/10.1016/j.joen.2011.06.029
  4. Barnes JJ, Patel S, Mannocci F. Why do general dental practitioners refer to a specific specialist endodontist in practice? Int Endod J 2011;44:21-32. https://doi.org/10.1111/j.1365-2591.2010.01791.x
  5. Ree MH, Timmerman MF, Wesselink PR. Factors influencing referral for specialist endodontic treatment amongst a group of Dutch general practitioners. Int Endod J 2003;36:129-34. https://doi.org/10.1046/j.1365-2591.2003.00641.x
  6. Messer HH. Clinical judgement and decision making in endodontics. Aust Endod J 1999;25:124-32. https://doi.org/10.1111/j.1747-4477.1999.tb00119.x
  7. Pothukuchi K. Case assessment and treatment planning: what governs your decision to treat, refer or replace a tooth that potentially requires endodontic treatment? Aust Endod J 2006;32:79-84. https://doi.org/10.1111/j.1747-4477.2006.00010.x
  8. Abbott PV. Analysis of a referral-based endodontic practice: Part 1. Demographic data and reasons for referral. J Endod 1994;20:93-6. https://doi.org/10.1016/S0099-2399(06)81190-8
  9. Toure B, Faye B, Kane AW, Lo CM, Niang B, Boucher Y. Analysis of reasons for extraction of endodontically treated teeth: a prospective study. J Endod 2011;37:1512-5. https://doi.org/10.1016/j.joen.2011.07.002
  10. Tzimpoulas NE, Alisafis MG, Tzanetakis GN, Kontakiotis EG. A prospective study of the extraction and retention incidence of endodontically treated teeth with uncertain prognosis after endodontic referral. J Endod 2012;38:1326-9. https://doi.org/10.1016/j.joen.2012.06.032
  11. Chrysanthakopoulos NA. Reasons for extraction of permanent teeth in Greece: a five-year followup study. Int Dent J 2011;61:19-24. https://doi.org/10.1111/j.1875-595X.2011.00004.x
  12. Kim S. Prevalence of referral reasons and clinical symptoms for endodontic referrals. Restor Dent Endod 2014;39:210-4. https://doi.org/10.5395/rde.2014.39.3.210
  13. Buckley M, Spangberg LS. The prevalence and technical quality of endodontic treatment in an American subpopulation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;79,92-100. https://doi.org/10.1016/S1079-2104(05)80081-2
  14. Weiger R, Hitzler S, Hermle G, Lost C. Periapical status, quality of root canal fillings and estimated endodontic treatment needs in an urban German population. Endod Dent Traumatol 1997;13:69-74. https://doi.org/10.1111/j.1600-9657.1997.tb00013.x
  15. Saunders WP, Saunders EM, Sadiq J, Cruickshank E. Technical standard of root canal treatment in an adult Scottish sub-population. Br Dent J 1997;10:382-6.
  16. de Moor RJ, Hommez GM, De Boever JG, Delme KI, Martens GE. Periapical health related to the quality of root canal treatment in a Belgian population. Int Endod J 2000;33:113-20. https://doi.org/10.1046/j.1365-2591.2000.00295.x
  17. Kirkevang LL, Horsted-Bindslev P, Orstavik D, Wenzel A. Frequency and distribution of endodontically treated teeth and periapical periodontitis in an urban Danish population. Int Endod J 2001;34:198-205. https://doi.org/10.1046/j.1365-2591.2001.00370.x
  18. Abbot PV. Analysis of a referral-based endodontic practice: Part 1. Demographic data and reasons for referral. J Endod 1994;20:93-6. https://doi.org/10.1016/S0099-2399(06)81190-8
  19. Hommez GM, De Moor RJ, Braem M. Endodontic treatment performed by Flemish dentists. Part 2. Canal filling and decision making for referrals and treatment of apical periodontitis. Int Endod J 2003;36:344-51. https://doi.org/10.1046/j.1365-2591.2003.00655.x
  20. Caplan DJ, Reams G, Weintraub JA. Recommendations for endodontic referral among practitioners in a dental HMO. J Endod 1999;25:369-75. https://doi.org/10.1016/S0099-2399(06)81174-X
  21. Sebring D, Dimenas H, Engstrand S, Kvist T. Characteristics of teeth referred to a public dental specialist clinic in endodontics. Int Endod J 2017;50:629-35. https://doi.org/10.1111/iej.12671
  22. Waldman HB, Feigen ME. Endodontists in a period of improving dental economics and changing realities of practice. J Endod 1990;16:179-81. https://doi.org/10.1016/S0099-2399(06)81967-9
  23. Unruh AM. Gender variation in clinical pain experience. Pain 1996;65:123-67. https://doi.org/10.1016/0304-3959(95)00214-6
  24. Cotti E, Zedda A, Deidda M, Piras A, Flore G, Ideo F, Madeddu C, Pau VM, Mercuro G. Endodontic infection and endothelial dysfunction are associated with different mechanisms in men and women. J Endod 2015;41:594-600. https://doi.org/10.1016/j.joen.2015.01.037