근관치료적 이유로 치과대학병원으로 의뢰된 치아들의 특성
Characteristics of teeth referred to a dental university hospital for endodontic reason
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목적: 이번 연구의 목적은 치과대학병원 보존과로 근관치료적으로 의뢰된 환자들과 치아들의 특성을 진료기록을 통해살펴보고 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 토대로구분하여 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.
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.
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