Analysis Of Patients’ Treatment-seeking Behaviors With Dental Pulp Disease And The Difficulties Of Root Canal Therapy

Objective: The dental pulp disease is one of the most hospitalizing stomatology disease in our country.Root canal therapy is an important and effective treatment for pulpal and periapical disease.Based on evidence-based medicine system,some researchers develop an assessment criteria about technical specifications and effective results after root canal therapy though the long-term clinical studies.According to the criteria,stomatology workers can evaluate the teeth which need receptive root canal therapy and grade the difficulties of therapy,which makes it effective to project accurately treatment programs,estimate the cost and course of treatment,predict the prognosis and improve the hierarchical referral system of stomatology.However,prospective researches for patients’ treatment-seeking behaviors with dental pulp disease and decision-making researches for improving influence factors about subsequent treatment-seeking behaviors are deficient.There is lack of the assessment about the adding degree of root canal therapy difficulties.There is no study about the treatment-seeking behavior of pulp diseases,and there is no statistic about root canal therapy difficulties in our region either.This study is a retrospective study about 8041 cases of permanent teeth with dental pulp disease by conventional data analysis method in descriptive epidemiology method.The results of the study is used to descibe the distribution of pulp disease in permanent teeth,analyzed the traits of the first and subsequent treatment-seeking behavior and predicted the number of subsequent treatment-seeking,which is benefit to educate people about oral health prevention according to the consequence.In this study,we classify the difficulties of root canal therapy for permanent teeth with pulp disease by the evaluation standard for root canal anatomy risk factors and the marking table about the difficulties of root canal therapy,formula a logistics regression analysis model to analyze the root canal anatomy in 284 cases and evaluate the change of root canal therapy.All of our works is devoted to improvement of success rates,reducing doctor-patient disputes.Methods: 1.Collect the outpatients’ information from January 2016 to August 2017 in department of oral medicine of Grade Three First Class stomatology hospital of Si Chuan province.All the patients’ related clinical data about name,gender,age,married,clinical diagnosis,doctor’s name et al.is collected.All the original data is sorted and inputted in Excel.Analyze the data by SPSS 24.0(IBM SPSS Statistics).About the first-visit sample data,the mean is compared by t-test or non-parameters test,the percentage is compared by Pearson chi-square test.The subsequent-visit sample data is analyzed by Pearson chi-square test,then analyzed by Binary Logistic Analysis.2.Collect the patients’ information from January 2016 to August 2017 in department of oral medicine of Grade Three First Class stomatology hospital of Si Chuan province.All the outpatients’ related clinical data about name,gender,age,tooth position,working length,Calcification degrees,numbers of root canal,the history of root canal therapy is collected.All the original data is sorted by evaluation standard for root canal anatomy risk factors and inputted in Excel,then classify the difficulties by marking table about the difficulties of root canal therapy.3.Analyze the data by SPSS 24.0(IBM SPSS Statistics).Regard the difficulties of root canal theerapy as dependent factor,working length,Calcification degrees,numbers of root canal and the history of root canal therapy as risk factors or independent factors.Formulate the logistics regression analysis model.Evaluate how the difficulties changes when risk factors change.Results: 1.(1)At first visit,the patients’ age ranges from 5 to 96 years old.The 55.3% is older than 40 years old.The age between fifty to fifty-five is the treatment-seeking peak.(2)There are 4903 female outpatient cases which are1.56 times more than male,which is same as subsequent visit rates that the female outpatients have 51.70% for subsequent visit.(3)The detection cases of chronic pulpitis is 6703(83.4%),which has 4130 female cases and 2573 male cases.(4)The proportion of retrograde pulpitis of male ’s cases is 2.7%,more than female’s,whereas the proportion of chronic pulpitis is lower than female’s.(5)819 cases(10.2%)of the right mandibular first molar count to the largest number of all the sample,whereas the right mandibular lateral incisor is the smallest,only 13 cases.(6)Female(OR=0.860,P<0.05)、married(OR=0.853,P<0.05)、the doctor title(OR=0.871,P<0.05)and reversible pulpitis(OR=3.021,P < 0.05)is the influence factor to affect the pulp disease outpatients’ subsequent treatment-seeking behavior.Binary Logistic Analysis results indicate that the outpatients that is married male combine the doctor title which is below associate professor is more unwillingness to seek subsequent treatment.2.(1)284 cases is collected.Working length is ranged from 10.5 to25 mm.The curvature is range of 0～62 degree.The number of root canal is about 1～4,include root canal retreatment 12 cases(4.2%),C-shaped root canal10 cases,V-type root canal 2 cases.(2)Classifing the difficulty of root canal therapy,the normal level is 87 cases(30.6%),the special level is 71cases(25.0%),the highest level is 126 cases(44.4%).3.In the logistics regression analysis model,except some risk factors such as teeth position,and only is the working length range from 10.5 to 25 mm,when working length increase 1mm,the difficulty of root canal therapy is become 0.684 times as much as the former(P<0.001).When curvature of root canal increase 1 degree,the difficulty is 1.107 times than before(P < 0.001).The difficulty of classification one of root canal numbers is 0.009 times than class three(P<0.001),and the difficulty of classification two is 0.051 times than class three(P=0.011).The difficulty of classification one of calcification is 0.034 times than class three(P>0.05),and the difficulty of classification two is 0.300 times than class three(P>0.05).Conclusion: 1.It’s necessary to improve the education degree of oral health for male who is older than forty years old and improve the awareness rate of dental puple disease for grade three class first stomatology hospital.2.When dentists treat outpatients with puple diseases,they should consider about that the risk factors like gender、marital status、the doctor title influence the patient for subsequent treatment seeking.So,there is a way to improve subsequent treatment seeking rates by using different clinical reception tricks.3.In our region,we can use the evaluation standard for root canal anatomy risk factors and the marking table the difficulties of root canal therapy to classify the difficulty of root canal therapy.4.When root canal anatomy risk factors is changing,the difficulties are changed.The working length and the degree of calcification is the maximum risk factors which influences the difficulties of root canal therapy.number of difficulty of normal level accounts to 30.6%.Before doing root canal therapy,dentist should analyze from anatomy risk factors of root canal like working length,curvature,the number of root canal,calcification,which could improve the quality of treatment.