重症牙周炎牙周牙髓联合治疗临床观察
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摘要
目的重度牙周炎属于牙周相关疾病中的难治性疾病之一,临床治疗效果不理想,为提高重度牙周炎的治疗效果,本研究主要探讨牙周牙髓联合治疗的临床价值。方法选取2016-02-01-2017-09-30河南省淅川县中医院收治的重度牙周炎患者80例(患牙80颗),按照治疗方法不同分为两组,各40例(40颗)。观察组实施牙周牙髓联合治疗,对照组则单纯实施牙周相关治疗。对所有患者随访3个月,比较两组干预前后牙周袋探诊深度及附着丧失指标,统计干预后釉牙骨质界至骨缺陷底和牙槽嵴顶距离及整体临床有效率。结果干预前两组牙周袋探诊深度比较,差异无统计学意义,t=0.000,P=1.000;干预后观察组牙周袋探诊深度为(3.0±0.1)mm,小于对照组的(3.5±0.2)mm,t=14.142,P<0.001。干预前两组附着丧失指标比较,差异无统计学意义,t=0.894,P=0.374;干预后观察组附着丧失指标为(9.8±0.7)mm,小于干预后对照组的(11.6±0.8)mm,t=10.709,P<0.001。干预后观察组釉牙骨质界至骨缺陷底距离为(8.3±0.1)mm,小于对照组的(8.7±0.2)mm,t=11.314,P<0.001;观察组牙槽嵴顶距离为(5.7±0.2)mm,小于对照组(6.5±0.2)mm,t=17.889,P<0.001。观察组有效率为97.5%,显著高于对照组的75.0%,χ~2=6.746,P=0.009。结论牙周牙髓联合治疗慢性牙周炎,可减轻机体炎症反应,减少骨质破坏,稳定患牙,从而提高治疗效果。
OBJECTIVE Severe periodontitis is one of the refractory diseases associated with periodontal disease.The clinical treatment effect is not ideal.In order to improve the therapeutic effect of severe periodontitis,this study mainly explores the clinical value of periodonto-endodontic combined treatment.METHODS 80 cases with severe periodontitis admitted in department of stomatology in Xichuan county hospital of Traditional Chinese Medicine from February 1,2016 to September 30,2017 were enrolled.All cases were divided into two group according to different treatment method,and each group had 40 cases.The observation group was given combined periodonto-endodontic treatment and the control group was treated with periodontal treatment alone.All patients were followed up for 3 months.Then the depth of probing and the loss of attachment of the periodontal pockets before and after treatment were compared.The distance between the enamel bone boundary to the bone defect,the alveolar crest and the overall clinical effective rate were statistically analyzed.RESULTS There was no significant difference in the depth of probing between the two groups before the intervention,t=0.000,P=1.000.After the treatment,the depth of probing of the periodontal pocket of the observation group was(3.0±0.1)mm,which was smaller than that of the control group(3.5±0.2)mm,t=14.142,P<0.001.There was no significant difference in the attachment loss index in two groups before the intervention,t=0.894,P=0.374.The postoperative attachment loss index was(9.8±0.7)mm in the observation group,which was less than(11.6±0.8)mm in the control group,t=10.709,P<0.001.After intervention,the distance from the enamel bone boundary to the bone defect of the observation group was(8.3±0.1)mm,which was smaller than that of the control group(8.7±0.2)mm,t=11.314,P<0.001.The alveolar crest distance of the observation group was(5.7±0.2)mm,which was smaller than that of the control group(6.5±0.2)mm,t=17.889,P<0.001.The effective rate of the observation group was 97.5%,which was significantly higher than 75.0% of the control group,χ~2=6.746,P=0.009.CONCLUSIONS The combined periodontoendodontic treatment with chronic periodontitis can reduce the inflammatory response,reduce bone destruction,stabilize the teeth,and improve the treatment effect.
OBJECTIVE Severe periodontitis is one of the refractory diseases associated with periodontal disease.The clinical treatment effect is not ideal.In order to improve the therapeutic effect of severe periodontitis,this study mainly explores the clinical value of periodonto-endodontic combined treatment.METHODS 80 cases with severe periodontitis admitted in department of stomatology in Xichuan county hospital of Traditional Chinese Medicine from February 1,2016 to September 30,2017 were enrolled.All cases were divided into two group according to different treatment method,and each group had 40 cases.The observation group was given combined periodonto-endodontic treatment and the control group was treated with periodontal treatment alone.All patients were followed up for 3 months.Then the depth of probing and the loss of attachment of the periodontal pockets before and after treatment were compared.The distance between the enamel bone boundary to the bone defect,the alveolar crest and the overall clinical effective rate were statistically analyzed.RESULTS There was no significant difference in the depth of probing between the two groups before the intervention,t=0.000,P=1.000.After the treatment,the depth of probing of the periodontal pocket of the observation group was(3.0±0.1)mm,which was smaller than that of the control group(3.5±0.2)mm,t=14.142,P<0.001.There was no significant difference in the attachment loss index in two groups before the intervention,t=0.894,P=0.374.The postoperative attachment loss index was(9.8±0.7)mm in the observation group,which was less than(11.6±0.8)mm in the control group,t=10.709,P<0.001.After intervention,the distance from the enamel bone boundary to the bone defect of the observation group was(8.3±0.1)mm,which was smaller than that of the control group(8.7±0.2)mm,t=11.314,P<0.001.The alveolar crest distance of the observation group was(5.7±0.2)mm,which was smaller than that of the control group(6.5±0.2)mm,t=17.889,P<0.001.The effective rate of the observation group was 97.5%,which was significantly higher than 75.0% of the control group,χ~2=6.746,P=0.009.CONCLUSIONS The combined periodontoendodontic treatment with chronic periodontitis can reduce the inflammatory response,reduce bone destruction,stabilize the teeth,and improve the treatment effect.
引文
[1]程贵梅.重度牙周炎采用牙周牙髓联合治疗与单纯牙周治疗临床效果对比分析[J].全科口腔医学电子杂志,2018,5(27):26,28.
[2] Castelo-Baz P,Ramos-Barbosa I,Martin-Biedma B,et al.Combined endodontic-periodontal treatment of a palatogingival groove[J].J Endod,2015,41(11):1918-1922.
[3]李晓敏,陈蕾,张治勇,等.3种不同口腔慢性炎症引起牙源性上颌窦炎的锥形束CT比较[J].分子影像学杂志,2018,41(2):137-141.
[4]覃聪琦,邓雪莲,卢文卿.牙周牙髓联合治疗重度牙周炎患者的1年临床疗效随访分析[J].解放军医药杂志,2018,30(3):105-108.
[5]刘畅,王家凤,张志民.Toll样受体的免疫调节在口腔疾病中的研究进展[J].口腔生物医学,2018,9(1):45-48.
[6]李瑞兰.牙神经病变与慢性牙周炎的相关因素临床分析[J].医药论坛杂志,2018,39(1):94-95.
[7]张璇.牙周-牙髓联合治疗与单纯牙周治疗重度牙周炎的疗效比较研究[J].临床合理用药杂志,2018,11(3):34-35.
[8]臧运华.盐酸米诺环素缓释剂联合Vitapex治疗老年慢性牙周炎合并牙髓病变的疗效[J].中国老年学杂志,2018,38(1):191-193.
[9]张秀,苗磊,罗文琼,等.重度慢性牙周炎牙周与种植联合治疗1例报告[J].中国实用口腔科杂志,2017,10(11):701-704.
[10]刘宇明,段昌华,翟炜东.盐酸米诺环素缓释剂联合Vitapex治疗老年慢性牙周炎合并牙髓病变疗效分析[J].中国实用口腔科杂志,2017,10(8):480-483.
[11]王银平.重度牙周炎采用牙周牙髓联合治疗与单纯牙周治疗临床疗效对比[J].全科口腔医学电子杂志,2017,4(6):13-14.
[12]谭葆春,肖健平,闫福华,等.牙周牙髓联合治疗与单纯牙周治疗对重度牙周炎疗效的临床对比研究[J].华西口腔医学杂志,2016,34(6):600-605.
[13]沈玥,古丽努尔·阿吾提.影响牙周-牙髓联合病变预后的相关因素研究进展[J].口腔医学,2016,36(8):765-768.
[14]潘克清,张朋梅,邓婧,等.OPG/RANK/RANKL在牙周炎联合血管钙化大鼠牙髓组织中的表达及意义[J].上海口腔医学,2016,25(4):391-395.
[15]刘震宇,张静东,张林,等.盐酸米诺环素缓释剂联合Vitapex治疗老年慢性牙周炎合并牙髓病变疗效分析[J].上海口腔医学,2016,25(4):465-468.
[16]赵兵,和明春,蔡春江,等.葛根芩连汤在牙周疾病治疗中的应用[J].中国中西医结合耳鼻咽喉科杂志,2016,24(3):238-239.
[17]管海洁.研究牙周牙髓联合病变的治疗方法[J].中国现代药物应用,2016,10(9):101-102.
[18]谭葆春,钟泉,闫福华.重度牙周炎的牙髓治疗研究进展[J].中国实用口腔科杂志,2016,9(4):205-208.
[2] Castelo-Baz P,Ramos-Barbosa I,Martin-Biedma B,et al.Combined endodontic-periodontal treatment of a palatogingival groove[J].J Endod,2015,41(11):1918-1922.
[3]李晓敏,陈蕾,张治勇,等.3种不同口腔慢性炎症引起牙源性上颌窦炎的锥形束CT比较[J].分子影像学杂志,2018,41(2):137-141.
[4]覃聪琦,邓雪莲,卢文卿.牙周牙髓联合治疗重度牙周炎患者的1年临床疗效随访分析[J].解放军医药杂志,2018,30(3):105-108.
[5]刘畅,王家凤,张志民.Toll样受体的免疫调节在口腔疾病中的研究进展[J].口腔生物医学,2018,9(1):45-48.
[6]李瑞兰.牙神经病变与慢性牙周炎的相关因素临床分析[J].医药论坛杂志,2018,39(1):94-95.
[7]张璇.牙周-牙髓联合治疗与单纯牙周治疗重度牙周炎的疗效比较研究[J].临床合理用药杂志,2018,11(3):34-35.
[8]臧运华.盐酸米诺环素缓释剂联合Vitapex治疗老年慢性牙周炎合并牙髓病变的疗效[J].中国老年学杂志,2018,38(1):191-193.
[9]张秀,苗磊,罗文琼,等.重度慢性牙周炎牙周与种植联合治疗1例报告[J].中国实用口腔科杂志,2017,10(11):701-704.
[10]刘宇明,段昌华,翟炜东.盐酸米诺环素缓释剂联合Vitapex治疗老年慢性牙周炎合并牙髓病变疗效分析[J].中国实用口腔科杂志,2017,10(8):480-483.
[11]王银平.重度牙周炎采用牙周牙髓联合治疗与单纯牙周治疗临床疗效对比[J].全科口腔医学电子杂志,2017,4(6):13-14.
[12]谭葆春,肖健平,闫福华,等.牙周牙髓联合治疗与单纯牙周治疗对重度牙周炎疗效的临床对比研究[J].华西口腔医学杂志,2016,34(6):600-605.
[13]沈玥,古丽努尔·阿吾提.影响牙周-牙髓联合病变预后的相关因素研究进展[J].口腔医学,2016,36(8):765-768.
[14]潘克清,张朋梅,邓婧,等.OPG/RANK/RANKL在牙周炎联合血管钙化大鼠牙髓组织中的表达及意义[J].上海口腔医学,2016,25(4):391-395.
[15]刘震宇,张静东,张林,等.盐酸米诺环素缓释剂联合Vitapex治疗老年慢性牙周炎合并牙髓病变疗效分析[J].上海口腔医学,2016,25(4):465-468.
[16]赵兵,和明春,蔡春江,等.葛根芩连汤在牙周疾病治疗中的应用[J].中国中西医结合耳鼻咽喉科杂志,2016,24(3):238-239.
[17]管海洁.研究牙周牙髓联合病变的治疗方法[J].中国现代药物应用,2016,10(9):101-102.
[18]谭葆春,钟泉,闫福华.重度牙周炎的牙髓治疗研究进展[J].中国实用口腔科杂志,2016,9(4):205-208.