应用显微超声技术治疗老年钙化根管的临床效果
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摘要
目的评价显微镜超声技术治疗老年钙化闭锁根管的作用及效果。方法选取2016年10月至2018年4月在承德市口腔医院口腔内科就诊的老年患者159例(264个钙化根管)作为研究对象,按患者治疗意愿分为实验组95例(152个钙化根管)和对照组64例(112个钙化根管)。实验组在显微镜下结合超声技术疏通根管,对照组仅凭手动C锉结合机用扩孔钻完成钙化根管的探查及疏通,2组患者均镍钛根管预备,热牙胶根充,完成根管治疗。比较2组患者治疗后的钙化根管疏通情况。采用SPSS 23.0软件对数据进行分析,根据数据类型,组间比较采用t检验或χ~2检验。结果实验组钙化闭锁根管成功疏通率86.18%(131/152),对照组钙化根管成功疏通率54.46%(61/112)。与对照组比较,实验组不同牙位及不同钙化根管的疏通率均明显升高,疏通时间显著下降,差异有统计学意义(P<0.05)。对照组未疏通的51例患牙经显微镜超声技术治疗后,疏通39例,疏通率达76.5%。结论显微超声技术对老年钙化根管的探查及疏通具有更明显的效果,也大大提高了治疗的成功率。
Objective To evaluate the role and efficacy of scanning acoustic microscopy(microscopic ultrasound) in the treatment of calcified atresia root canal in elderly patients. Methods A total of 264 calcified root canals from 159 elderly patients admitted in the Department of Oral Medicine of our hospital from October 2016 to April 2018 were subjected into this study. They were divided into experimental(n=95, 152 calcified root canals) and control groups(n=64, 112 calcified root canals) according to their own wills. In the experimental group, the calcified root canals were treated with microscopy combined with ultrasound technology, while for the control group, manual C file and hole drilling were used for probing and dredging of calcified root canals. The patients of both groups were prepared with nickel-titanium root canal, filled with hot gum root, and treated with root canal therapy. The dredging situation after treatment was compared between the 2 groups. SPSS statistics 23.0 was used for statistical analysis. Student′s t test or Chi-square test was employed for comparison of different data types. Results The success rate of root canal dredging was 86.18%(131/152) in the experimental group and 54.46%(61/112) in the control group. Compared with the control group, the dredging rates of different tooth positions and different calcified root canals were significantly higher, while the dredging time was shorter obviously in the experimental group, both with significant differences(P<0.05). In the control group, 51 cases of undredged teeth were further treated by micro-ultrasonic technique, and finally 39 cases were dredged, with a dredging rate of 76.5%. Conclusion Micro-ultrasonic technique is quite effective in probing and dredging the calcified root canals in the elderly, and it also improves the success rate of the treatment.
Objective To evaluate the role and efficacy of scanning acoustic microscopy(microscopic ultrasound) in the treatment of calcified atresia root canal in elderly patients. Methods A total of 264 calcified root canals from 159 elderly patients admitted in the Department of Oral Medicine of our hospital from October 2016 to April 2018 were subjected into this study. They were divided into experimental(n=95, 152 calcified root canals) and control groups(n=64, 112 calcified root canals) according to their own wills. In the experimental group, the calcified root canals were treated with microscopy combined with ultrasound technology, while for the control group, manual C file and hole drilling were used for probing and dredging of calcified root canals. The patients of both groups were prepared with nickel-titanium root canal, filled with hot gum root, and treated with root canal therapy. The dredging situation after treatment was compared between the 2 groups. SPSS statistics 23.0 was used for statistical analysis. Student′s t test or Chi-square test was employed for comparison of different data types. Results The success rate of root canal dredging was 86.18%(131/152) in the experimental group and 54.46%(61/112) in the control group. Compared with the control group, the dredging rates of different tooth positions and different calcified root canals were significantly higher, while the dredging time was shorter obviously in the experimental group, both with significant differences(P<0.05). In the control group, 51 cases of undredged teeth were further treated by micro-ultrasonic technique, and finally 39 cases were dredged, with a dredging rate of 76.5%. Conclusion Micro-ultrasonic technique is quite effective in probing and dredging the calcified root canals in the elderly, and it also improves the success rate of the treatment.
引文
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[2] 毛学理, 凌均棨, 林正梅, 等. 锥形束CT结合显微超声技术处理钙化根管的效果评价[J]. 中华口腔医学研究杂志(电子版), 2011, 5(6): 594-599. DOI: 10.3877/cma.j.issn.1674-1366.2011.06.007. Mao XL, Ling JQ, Lin ZM, et al. Evaluation of cone beam com-puted tomography combining with dental microscopy and ultrasonic instrument in the treatment of canal calcification[J]. Chin J Stomatol Res (Electron Ed), 2011, 5(6): 594-599. DOI: 10.3877/cma.j.issn.1674-1366.2011.06.007.
[3] 吴杉杉, 张茹, 侯本祥. 钙化根管的诊断与治疗[J]. 国际口腔医学杂志, 2017, 44(3): 279-283. DOI: 10.7518/gjkq.2017.03.006. Wu SS, Zhang R, Hou BX. Diagnosis and therapy for calcified root canals[J]. Int J Stomatol, 2017, 44(3): 279-283. DOI: 10.7518/gjkq.2017.03.006.
[4] 侯本祥. 显微根管治疗技术的要点解析[J]. 中华口腔医学志, 2016, 51(8): 455-459. DOI: 10.3760/cma.j.issn.1002-0098.2016.08.003. Hou BX. Analysis of the key points in the micro-endodontic treatment[J]. Chin J Stomatol, 2016, 51(8): 455-459. DOI: 10.3760/cma.j.issn.1002-0098.2016.08.003.
[5] Tomczyk J, Komamrnitki J, Zalewska M, et al. The prevalence of pulp stones in historical populations from the middle Euphrates valley(Syria)[J]. Am J Phys Anthropol, 2014, 153(1): 103-115. DOI: 10.1002/ajpa.22414.
[6] Shetly PP, Aslekar MS, Jain A, et al. Maxillary firgtmolar with two palatal roots located under dental operating microscope[J]. Chn Prael, 2012, 2(1): 26-30. DOI: 10.4081/cp.2012.e26.
[7] 董丽平, 储冰峰. 钙化根管辅助诊疗方法应用概况[J]. 中华老年口腔医学杂志, 2016, 14(1): 58-62. DOI: 10.3969/j.issn.1672-2973.2016.01.015. Dong LP, Chu BF. Auxiliary diagnosis and treatment methods of calcified root canal[J]. Chin J Geriatr Dent, 2016, 14(1): 58-62. DOI: 10.3969/j.issn.1672-2973.2016.01.015.
[8] 田锐. 牙科显微镜联合超声技术治疗钙化根管的处理方法[J]. 实用临床医药杂志, 2017, 21(3): 151-152. DOI : 10.7619/jcmp.201703049. Tian R. Treatment of calcified root canal by dental microscope combined with ultrasound[J]. J Pract Clin Med, 2017, 21(3): 151-152. DOI : 10.7619/jcmp.201703049.
[9] 朱小军, 杨立群. 显微超声技术治疗老年钙根管的临床疗效观察[J]. 世界最新医学信息文摘, 2015, 15(56): 109-110. DOI: 10.3969/j.issn.1671-3141.2015.56.089. Zhu XJ, Yang LQ. Clinical observation on treatment of senile calcium root canal by microultrasound[J]. World Latest Med Inf, 2015, 1(56): 109-110. DOI: 10.3969/j.issn.1671-3141.2015.56.089.
[10] 徐西红, 冯颖, 郭蕾, 等. 锥形束CT结合显微超声技术诊治老年钙化根管的应用[J]. 中华老年口腔医学杂志, 2016, 14(5): 276-278. DOI: 10.3969/j.issn.1672-2973.2016.05.005. Xu XH, Feng Y, Guo L, et al. Use of cone-beam CT and micro-ultrasound in treating calcified root canal in aged people[J]. Chin J Geriatr Dent, 2016, 14(5): 276-278. DOI: 10.3969/j.issn.1672-2973.2016.05.005.
[11] Ee J, Fayad MI, Johnson BR. Comparison of endodontic diagnosis and treatment planning decisions using cone-beam volumetric tomography versus periapical radiography[J]. J Endod, 2014, 40(7): 910-916. DOI: 10.1016/j.joen.2014.03.002.
[12] 郭冬梅, 张卫平. 锥形束CT结合显微超声技术治疗老年钙化根管[J]. 临床误诊误治, 2013, 26(4): 89-91. DOI: 10.3969/j.issn.1002-3429.2013.04.038. Guo DM, Zhang WP. Cone beam CT combined with dental operating microscope and ultrasonic technique in treatment of elderly patients with calcified canais[J]. Clin Misdiagn Mistherapy, 2013, 26(4): 89-91. DOI: 10.3969/j.issn.1002-3429.2013.04.038.
[13] Biswas M, Mazumdar D, Neyogi A.Non surgical pedoration repair by mineral trioxide aggregate under dental operating microscope[J]. J Conserv Dent, 2011, 14(1): 83-85. DOI: 10.4103/0972-0707.80729.
[14] 韩宁, 孙克勤. 显微超声技术应用于钙化根管治疗的相关研究[J]. 国际口腔医学杂志, 2015, 42(4): 453-457. DOI: 10.7518/gjkq.2015.04.021. Han N, Sun KQ.Correlative research on dental operating microscope and ultrasonic instruments in the treatment of calcified root canals[J]. Int J Stomatol, 2015, 42(4): 453-457. DOI: 10.7518/gjkq.2015.04.021.
[15] Wu D, Shi W, Wu J, et al. The clinical treatment of complicated root canal with the aid of a dental operating microscope[J]. Int Dent J, 2011, 61(5): 261-266. DOI: 10.1111/j.1875-595X.2011.00070.x.
[16] 凌均棨, 韦曦, 高燕. 应用根管显微镜和超声器械处理阻塞根管的效果评价[J].中华口腔医学杂志, 2003, 38(5): 324-326. DOI: 10.3760/j.issn:1002-0098.2003.05.002. Ling JQ, Wei X, Gao Y. Evaluation of the use of dental operating microscope and ultrasonic instruments in the management of blocked canals[J]. Chin J Stomatol, 2003, 38(5): 324-326. DOI: 10.3760/j.issn:1002-0098.2003.05.002.
[2] 毛学理, 凌均棨, 林正梅, 等. 锥形束CT结合显微超声技术处理钙化根管的效果评价[J]. 中华口腔医学研究杂志(电子版), 2011, 5(6): 594-599. DOI: 10.3877/cma.j.issn.1674-1366.2011.06.007. Mao XL, Ling JQ, Lin ZM, et al. Evaluation of cone beam com-puted tomography combining with dental microscopy and ultrasonic instrument in the treatment of canal calcification[J]. Chin J Stomatol Res (Electron Ed), 2011, 5(6): 594-599. DOI: 10.3877/cma.j.issn.1674-1366.2011.06.007.
[3] 吴杉杉, 张茹, 侯本祥. 钙化根管的诊断与治疗[J]. 国际口腔医学杂志, 2017, 44(3): 279-283. DOI: 10.7518/gjkq.2017.03.006. Wu SS, Zhang R, Hou BX. Diagnosis and therapy for calcified root canals[J]. Int J Stomatol, 2017, 44(3): 279-283. DOI: 10.7518/gjkq.2017.03.006.
[4] 侯本祥. 显微根管治疗技术的要点解析[J]. 中华口腔医学志, 2016, 51(8): 455-459. DOI: 10.3760/cma.j.issn.1002-0098.2016.08.003. Hou BX. Analysis of the key points in the micro-endodontic treatment[J]. Chin J Stomatol, 2016, 51(8): 455-459. DOI: 10.3760/cma.j.issn.1002-0098.2016.08.003.
[5] Tomczyk J, Komamrnitki J, Zalewska M, et al. The prevalence of pulp stones in historical populations from the middle Euphrates valley(Syria)[J]. Am J Phys Anthropol, 2014, 153(1): 103-115. DOI: 10.1002/ajpa.22414.
[6] Shetly PP, Aslekar MS, Jain A, et al. Maxillary firgtmolar with two palatal roots located under dental operating microscope[J]. Chn Prael, 2012, 2(1): 26-30. DOI: 10.4081/cp.2012.e26.
[7] 董丽平, 储冰峰. 钙化根管辅助诊疗方法应用概况[J]. 中华老年口腔医学杂志, 2016, 14(1): 58-62. DOI: 10.3969/j.issn.1672-2973.2016.01.015. Dong LP, Chu BF. Auxiliary diagnosis and treatment methods of calcified root canal[J]. Chin J Geriatr Dent, 2016, 14(1): 58-62. DOI: 10.3969/j.issn.1672-2973.2016.01.015.
[8] 田锐. 牙科显微镜联合超声技术治疗钙化根管的处理方法[J]. 实用临床医药杂志, 2017, 21(3): 151-152. DOI : 10.7619/jcmp.201703049. Tian R. Treatment of calcified root canal by dental microscope combined with ultrasound[J]. J Pract Clin Med, 2017, 21(3): 151-152. DOI : 10.7619/jcmp.201703049.
[9] 朱小军, 杨立群. 显微超声技术治疗老年钙根管的临床疗效观察[J]. 世界最新医学信息文摘, 2015, 15(56): 109-110. DOI: 10.3969/j.issn.1671-3141.2015.56.089. Zhu XJ, Yang LQ. Clinical observation on treatment of senile calcium root canal by microultrasound[J]. World Latest Med Inf, 2015, 1(56): 109-110. DOI: 10.3969/j.issn.1671-3141.2015.56.089.
[10] 徐西红, 冯颖, 郭蕾, 等. 锥形束CT结合显微超声技术诊治老年钙化根管的应用[J]. 中华老年口腔医学杂志, 2016, 14(5): 276-278. DOI: 10.3969/j.issn.1672-2973.2016.05.005. Xu XH, Feng Y, Guo L, et al. Use of cone-beam CT and micro-ultrasound in treating calcified root canal in aged people[J]. Chin J Geriatr Dent, 2016, 14(5): 276-278. DOI: 10.3969/j.issn.1672-2973.2016.05.005.
[11] Ee J, Fayad MI, Johnson BR. Comparison of endodontic diagnosis and treatment planning decisions using cone-beam volumetric tomography versus periapical radiography[J]. J Endod, 2014, 40(7): 910-916. DOI: 10.1016/j.joen.2014.03.002.
[12] 郭冬梅, 张卫平. 锥形束CT结合显微超声技术治疗老年钙化根管[J]. 临床误诊误治, 2013, 26(4): 89-91. DOI: 10.3969/j.issn.1002-3429.2013.04.038. Guo DM, Zhang WP. Cone beam CT combined with dental operating microscope and ultrasonic technique in treatment of elderly patients with calcified canais[J]. Clin Misdiagn Mistherapy, 2013, 26(4): 89-91. DOI: 10.3969/j.issn.1002-3429.2013.04.038.
[13] Biswas M, Mazumdar D, Neyogi A.Non surgical pedoration repair by mineral trioxide aggregate under dental operating microscope[J]. J Conserv Dent, 2011, 14(1): 83-85. DOI: 10.4103/0972-0707.80729.
[14] 韩宁, 孙克勤. 显微超声技术应用于钙化根管治疗的相关研究[J]. 国际口腔医学杂志, 2015, 42(4): 453-457. DOI: 10.7518/gjkq.2015.04.021. Han N, Sun KQ.Correlative research on dental operating microscope and ultrasonic instruments in the treatment of calcified root canals[J]. Int J Stomatol, 2015, 42(4): 453-457. DOI: 10.7518/gjkq.2015.04.021.
[15] Wu D, Shi W, Wu J, et al. The clinical treatment of complicated root canal with the aid of a dental operating microscope[J]. Int Dent J, 2011, 61(5): 261-266. DOI: 10.1111/j.1875-595X.2011.00070.x.
[16] 凌均棨, 韦曦, 高燕. 应用根管显微镜和超声器械处理阻塞根管的效果评价[J].中华口腔医学杂志, 2003, 38(5): 324-326. DOI: 10.3760/j.issn:1002-0098.2003.05.002. Ling JQ, Wei X, Gao Y. Evaluation of the use of dental operating microscope and ultrasonic instruments in the management of blocked canals[J]. Chin J Stomatol, 2003, 38(5): 324-326. DOI: 10.3760/j.issn:1002-0098.2003.05.002.