未行冠修复的根管治疗牙冠折的影响因素分析

doi:10.19439/j.sjos.2026.03.010

摘要/Abstract

摘要： 目的: 探讨未行冠修复的根管治疗牙（endodontically treated teeth, ETT）冠折前的口内留存时间、冠折严重程度及相关影响因素,为临床预后评估与干预提供依据。方法: 选择2023年3月—2024年1月于上海交通大学医学院附属第九人民医院就诊的ETT冠折患者。通过病史采集与口腔检查,记录ETT口内留存时间、冠折后牙体缺损轴壁数量及患者临床基线资料。采用单因素与logistic多因素回归分析筛选影响ETT口内留存时间及冠折严重程度的独立危险因素。结果: 纳入146例患者,男87例,女59例,平均年龄（44.63±4.28）岁,上颌后牙51颗,下颌磨牙95颗。ETT平均口内留存时间为（8.27±3.57）年,平均缺损轴壁数量为（92.25±0.99）个。多因素分析显示,年龄、根管治疗原因、充填材料、颌位、牙位及牙周状况是ETT口内留存时间较短的独立危险因素（P<0.05）;根管治疗原因、颌位及牙位是 ETT 冠折严重程度（缺损轴壁数量）的独立危险因素（P<0.05）。结论: 患牙根管治疗后的存留时间与患者年龄、根管治疗的原因、患牙牙位和牙周状况具有相关性,老年患者、因牙外伤或牙隐裂进行根管治疗、下颌磨牙以及牙周状况差的患牙根管治疗后,不行冠修复的冠折风险较高。

关键词: 根管治疗牙, 冠折, 冠修复, 口内留存时间, 牙体缺损, 影响因素

Abstract: PURPOSE: To investigate the intraoral retention time before crown fracture, the severity of crown fracture, and related influencing factors in endodontically treated teeth (ETT) without crown restoration, and to provide evidence for clinical prognosis evaluation and intervention. METHODS: Patients with ETT crown fractures who visited Shanghai Ninth people's Hospital, Shanghai Jiao Tong University School of Medicine from March 2023 to January 2024 were selected. Through medical history collection and oral examination, the intraoral retention time of ETT, the number of missing axial walls after crown fracture, and patients' baseline clinical data were recorded. Univariate and multivariate logistic regression analyses were used to screen for independent risk factors affecting the intraoral retention time and the severity of crown fracture in ETT. RESULTS: A total of 146 patients were included, consisting of 87 males and 59 females, with an average age of (44.63±4.28) years. Among them, there were 51 maxillary posterior teeth and 95 mandibular molars. The average intraoral retention time of ETT was (8.27±3.57) years, and the average number of missing axial walls was (92.25±0.99). Multivariate analysis showed that age, reason for root canal treatment, filling material, jaw position, tooth position, and periodontal status were independent risk factors for shorter intraoral retention time of ETT (P<0.05). Reason for root canal treatment, jaw position, and tooth position were independent risk factors for the severity of ETT crown fracture (number of missing axial walls) (P<0.05). CONCLUSIONS: The retention time of teeth after root canal treatment is correlated with patients' age, reason for root canal treatment, tooth position, and periodontal status. Elderly patients, teeth undergoing root canal treatment due to dental trauma or cracked teeth, mandibular molars, and teeth with poor periodontal status have a higher risk of crown fracture without crown restoration after root canal treatment.

Key words: Endodontically treated teeth, Crown fracture, Crown restoration, Intraoral retention time, Tooth defect, Influencing factors

中图分类号:

R781.05

朱家骏, 汪轶, 杨娅. 未行冠修复的根管治疗牙冠折的影响因素分析[J]. 上海口腔医学, 2026, 35(3): 281-287.

Zhu Jiajun, Wang Yi, Yang Ya. Analysis of influencing factors on crown fracture in endodontically treated teeth without crown restorations[J]. Shanghai Journal of Stomatology, 2026, 35(3): 281-287.

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