不同糊剂结合牙胶尖在根管治疗一次法充填疗效及并发症比较
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摘要
目的:对比ApexitPlus氢氧化钙糊剂和氧化锌碘仿糊剂结合牙胶尖在慢性牙髓炎患者根管治疗一次法中的临床应用价值差异。方法:选取110例(124颗)慢性牙髓炎患者为研究对象,在征询患者同意的前提下采用随机数字表法将其分成ApexitPlus氢氧化钙糊剂组(A组,n=55,63颗)和氧化锌碘仿糊剂组(B组,n=55,61颗)两组。两组患者均予以一次性根充疗法,行为期12-24个月随访,比对其术后根管填充效果及临床疗效差异,记录治疗前后疼痛评分及睡眠质量评分差异,分析术后急症反应发生情况。结果:(1)两组患者在根管填充效果对比上均无统计学意义(P>0.05);其中A组患者术后3个月内治疗成功率为100.0%,显著高于B组的91.8%(P<0.05);B组患者随访第24个月时治疗成功率为83.6%,显著低于A组的96.8%(P<0.05);(2)治疗后,两组患者视觉模拟评分法(VAS)及匹兹堡睡眠质量指数(PSQI)等治疗指标均较治疗前显著降低,其中A组降幅大于B组(P<0.05);(3)A组患者术后7 d内急症反应发生率为10.9%,显著低于B组的38.2%(P<0.05)。结论:对慢性牙髓炎患者以ApexitPlus氢氧化钙糊剂+牙胶尖为填充材料行一次性根充治疗,疗效确切且根充效果良好,可有效降低其术后急症反应发生风险,对提高治疗效果、改善患者预后质量等方面具有积极影响,值得临床推广。
Objective: To compare the differences in clinical application value of Apexit Plus calcium hydroxide paste and zinc oxide iodoform paste combined with gutta percha point in the one-visit root canal therapy for treating patients with chronic pulpitis. Methods:110 patients(124 teeth) with chronic pulpitis were selected as the research objects. On the premise of patients' agreement, the patients were divided into the Apexit Plus calcium hydroxide paste group(group A, n=55, 63 teeth) and the zinc oxide iodoform paste group(group B, n = 55, 61 teeth) of two groups according to the random number table method. The two groups of patients were given one-visit root canal therapy, with a period of 12 to 24 months of follow-up in behavior phase. The effect of root canal filling after operation and the clinical curative effect were compared. The differences in pain scores and sleep quality scores before and after the treatment were recorded and the incidence of postoperative emergency response was analyzed. Results: 1 There were no statistical significances in the effect of root canal filling between the two groups(P>0.05). The treatment success rate of group A in 3 months after operation(100.0%) was significantly higher than that of group B(91.8%)(P<0.05). The treatment success rate of group B at the 24 th month of follow-up(83.6 %)was significantly lower than that of group A(96.8 %)(P<0.05); 2After the treatment, the visual analgesia score(VAS), Pittsburg sleep quality index(PSQI) and other treatment indexes of the two groups were significantly lower than those before the treatment and the decline in group A was greater than that in group B(P<0.05); 3In 7d after operation, the occurrence rate of postoperative emergency response in group A(10.9 %) was significantly lower than that in group B(38.2%)(P<0.05). Conclusion: To treat patients who have chronic pulpitis with Apexit Plus calcium hydroxide paste and gutta percha point as the filling materials for one-visit root canal therapy,the curative effect is exact and the root filling effect is good, which can effectively reduce the risk of postoperative emergency response and have a positive impact on improving the therapeutic effect, the prognosis and quality of life of patients. It is worth clinical promotion.
Objective: To compare the differences in clinical application value of Apexit Plus calcium hydroxide paste and zinc oxide iodoform paste combined with gutta percha point in the one-visit root canal therapy for treating patients with chronic pulpitis. Methods:110 patients(124 teeth) with chronic pulpitis were selected as the research objects. On the premise of patients' agreement, the patients were divided into the Apexit Plus calcium hydroxide paste group(group A, n=55, 63 teeth) and the zinc oxide iodoform paste group(group B, n = 55, 61 teeth) of two groups according to the random number table method. The two groups of patients were given one-visit root canal therapy, with a period of 12 to 24 months of follow-up in behavior phase. The effect of root canal filling after operation and the clinical curative effect were compared. The differences in pain scores and sleep quality scores before and after the treatment were recorded and the incidence of postoperative emergency response was analyzed. Results: 1 There were no statistical significances in the effect of root canal filling between the two groups(P>0.05). The treatment success rate of group A in 3 months after operation(100.0%) was significantly higher than that of group B(91.8%)(P<0.05). The treatment success rate of group B at the 24 th month of follow-up(83.6 %)was significantly lower than that of group A(96.8 %)(P<0.05); 2After the treatment, the visual analgesia score(VAS), Pittsburg sleep quality index(PSQI) and other treatment indexes of the two groups were significantly lower than those before the treatment and the decline in group A was greater than that in group B(P<0.05); 3In 7d after operation, the occurrence rate of postoperative emergency response in group A(10.9 %) was significantly lower than that in group B(38.2%)(P<0.05). Conclusion: To treat patients who have chronic pulpitis with Apexit Plus calcium hydroxide paste and gutta percha point as the filling materials for one-visit root canal therapy,the curative effect is exact and the root filling effect is good, which can effectively reduce the risk of postoperative emergency response and have a positive impact on improving the therapeutic effect, the prognosis and quality of life of patients. It is worth clinical promotion.
引文
[1]贾建卫.体征不典型的急性牙髓炎临床分析[J].现代口腔医学杂志,2010,24(1):26-28Jia Jian-wei.Clinical analysis of atypical acute pulpitis[J].Journal of Modern Stomatology,2010,24(1):26-28
[2]万蕾,章锦才.牙周牙髓联合病变的研究进展[J].广东牙病防治,2011,19(11):612-614Wan Lei,Zhang Jin-cai.Research progress of combined periodontal and dental pulp lesions[J].Chinahealth Care&Nutrition,2011,19(11):612-614
[3]刘亚峰,刘欣.慢性牙髓炎一次法根管治疗术的研究[J].口腔医学,2012,32(3):147Liu Ya-feng,Liu Xin.A study of one-visit root canal therapy for chronic pulpitis[J].Stomatology,2012,32(3):147
[4]宁新丽,齐国海,张凤兰,等.一次性根管在急性牙髓炎急救治疗中的应用价值[J].河北医药,2012,34(23):3611-3612Ning Xin-li,Qi Guo-hai,Zhang Feng-lan,et al.The application value of one-visit root canal therapy in emergency treatment of acute pulpitis[J].Hebei Medical Journal,2012,34(23):3611-3612
[5]车彤.根管治疗中不同充填材料的应用效果及其生物相容性[J].中国组织工程研究与临床康复,2010,14(21):3927-3930Che Tong.Different filling materials in root canal therapy and their biocompatibility[J].Journal of Clnical Rehabilitative Tissue Engineering Research,2010,14(21):3927-3930
[6]樊明文.牙体牙髓病学[M].第4版.北京,人民卫生出版社.2012:259-262Fan Ming-wen.Endodontics[M].4 th Edition.Beijing:People's Medical Publishing House,2012:259-262
[7]朱珊.一次性根管治疗老年人慢性牙髓炎的临床疗效观察[J].临床口腔医学杂志,2014,30(8):491-492Zhu Shan.The study on the clinical efficacy of root canal treatment of elderly patients with chronic pulpitis[J].Journal of Clinical Stomatology,2014,30(8):491-492
[8]Mohd Sulong MZ.The incidence of postoperative pain after canal preparation of open teeth using two irrigation regimes[J].Int Endod J,1989,22(5):248
[9]杜小蓉,韦济琼.不同根充糊剂在乳牙慢性根尖周炎治疗中的应用效果比较[J].河北医学,2013,19(2):190-193Du Xiao-rong,Wei Ji-qiong.Treatment Comparison of Different Root Canal Filling in Primary Teeth with Chronic Apical Periodontitis[J].Hebei Medicine,2013,19(2):190-193
[10]路桃影,李艳,夏萍,等.匹兹堡睡眠质量指数的信度及效度分析[J].重庆医学,2014,32(3):260-263Lu Tao-ying,Li Yan,Xia Ping,et al.Analysis on reliability and validity of the Pittsburgh sleep quality index[J].Chongqing Medicine,2014,32(3):260-263
[11]孙静,高薇,刘永梅,等.546例学生口腔健康认知与行为调查分析[J].重庆医学,2015,32(7):952-954Sun Jing,Gao Wei,Liu Yong-mei,et al.A survey of oral health cognition and behavior in 546 cases of students[J].Chongqing Medicine,2015,32(7):952-954
[12]刘国慧,郑衍亮,徐霞,等.社区老年人口腔健康认知行为及影响因素[J].中华行为医学与脑科学杂志,2012,21(5):450-452Liu Guo-hui,Zheng Yan-liang,Xu Xia,et al.A survey of oral health cognitive behaviors and impact factors of the elderly people in Jining[J].Chinese Journal of Behavioral Medicine and Brain Science,2012,21(5):450-452
[13]季雪伟.一次性根管治疗老年人慢性牙髓炎的疗效观察[J].中国基层医药,2014,33(21):3287-3288,3289Ji Xue-wei.Effect of disposable root canal treatment for elderly patients with chronic pulpitis[J].Chinese Journal of Primary Medicine and Pharmacy,2014,33(21):3287-3288,3289
[14]漆梅,聂彬,张爱玲,等.热牙胶充填与冷牙胶侧方加压在根管充填中应用的临床效果比较[J].现代生物医学进展,2012,12(7):1289-1291Qi Mei,Nie Bin,Zhang Ai-ling,et al.Comparison of the clinical effect of warm gutta percha filling and cold gutta percha lateral pressurization in root canal filling[J].Progress in Modern Biomedicine,2012,12(7):1289-1291
[15]高开璇.两种根管糊剂在乳牙根管治疗中的疗效比较[J].中国医药导报,2011,08(20):235-236Gao Kai-xuan.Comparison of the curative effect of two root canal pastes in root canal therapy of deciduous teeth[J].China Medical Herald,2011,08(20):235-236
[16]毕维平.氢氧化钙碘仿糊剂用于根管内消毒90例[J].中国药业,2013,22(5):98-99Bi Wei-ping.Calcium hydroxide iodoform paste used for root canal disinfection in 90 cases[J].China Pharmaceuticals,2013,22(5):98-99
[17]李咏梅.氢氧化钙碘仿糊剂一次性根管充填治疗乳牙根尖周炎的临床观察[J].广西医学,2010,32(11):1381-1383Li Yong-mei.Clinical observation on calcium hydroxide iodoform paste used in one-visit root canal filling of periapical periodontitis of deciduous teeth[J].Guangxi Medical Journal,2010,32(11):1381-1383
[18]范素芳.碘仿氧化锌糊剂与干髓糊剂治疗乳牙根尖周炎疗效对比[J].中国误诊学杂志,2012,12(17):4554Fan Su-fang.Comparison of the curative effect of iodoform added with zinc oxide cataplasm and mummification paste in the treatment of periapical periodontitis of deciduous teeth[J].Chinese Journal of Misdiagnostics,2012,12(17):4554
[19]武张生.三种根充糊剂治疗老年牙隐裂伴窦道型慢性根尖周炎疗效比较[J].中国老年学杂志,2012,32(20):4552-4553Wu Zhang-sheng.Comparison of the curative effect of three kinds of root canal pastes in the treatment of senile cracked teeth with chronic periapical periodontitis of fistula[J].Chinese Journal of Gerontology,2012,32(20):4552-4553
[20]彭学生.2种根管糊剂在一次性根管治疗慢性根尖周炎中的疗效比较[J].安徽医学,2012,33(4):465-466Peng Xue-sheng.Clinical effect of two kinds of root paste fillers in one-visit root canal therapy on chronic periapical periodontitis[J].Anhui Medical Journal,2012,33(4):465-466
[2]万蕾,章锦才.牙周牙髓联合病变的研究进展[J].广东牙病防治,2011,19(11):612-614Wan Lei,Zhang Jin-cai.Research progress of combined periodontal and dental pulp lesions[J].Chinahealth Care&Nutrition,2011,19(11):612-614
[3]刘亚峰,刘欣.慢性牙髓炎一次法根管治疗术的研究[J].口腔医学,2012,32(3):147Liu Ya-feng,Liu Xin.A study of one-visit root canal therapy for chronic pulpitis[J].Stomatology,2012,32(3):147
[4]宁新丽,齐国海,张凤兰,等.一次性根管在急性牙髓炎急救治疗中的应用价值[J].河北医药,2012,34(23):3611-3612Ning Xin-li,Qi Guo-hai,Zhang Feng-lan,et al.The application value of one-visit root canal therapy in emergency treatment of acute pulpitis[J].Hebei Medical Journal,2012,34(23):3611-3612
[5]车彤.根管治疗中不同充填材料的应用效果及其生物相容性[J].中国组织工程研究与临床康复,2010,14(21):3927-3930Che Tong.Different filling materials in root canal therapy and their biocompatibility[J].Journal of Clnical Rehabilitative Tissue Engineering Research,2010,14(21):3927-3930
[6]樊明文.牙体牙髓病学[M].第4版.北京,人民卫生出版社.2012:259-262Fan Ming-wen.Endodontics[M].4 th Edition.Beijing:People's Medical Publishing House,2012:259-262
[7]朱珊.一次性根管治疗老年人慢性牙髓炎的临床疗效观察[J].临床口腔医学杂志,2014,30(8):491-492Zhu Shan.The study on the clinical efficacy of root canal treatment of elderly patients with chronic pulpitis[J].Journal of Clinical Stomatology,2014,30(8):491-492
[8]Mohd Sulong MZ.The incidence of postoperative pain after canal preparation of open teeth using two irrigation regimes[J].Int Endod J,1989,22(5):248
[9]杜小蓉,韦济琼.不同根充糊剂在乳牙慢性根尖周炎治疗中的应用效果比较[J].河北医学,2013,19(2):190-193Du Xiao-rong,Wei Ji-qiong.Treatment Comparison of Different Root Canal Filling in Primary Teeth with Chronic Apical Periodontitis[J].Hebei Medicine,2013,19(2):190-193
[10]路桃影,李艳,夏萍,等.匹兹堡睡眠质量指数的信度及效度分析[J].重庆医学,2014,32(3):260-263Lu Tao-ying,Li Yan,Xia Ping,et al.Analysis on reliability and validity of the Pittsburgh sleep quality index[J].Chongqing Medicine,2014,32(3):260-263
[11]孙静,高薇,刘永梅,等.546例学生口腔健康认知与行为调查分析[J].重庆医学,2015,32(7):952-954Sun Jing,Gao Wei,Liu Yong-mei,et al.A survey of oral health cognition and behavior in 546 cases of students[J].Chongqing Medicine,2015,32(7):952-954
[12]刘国慧,郑衍亮,徐霞,等.社区老年人口腔健康认知行为及影响因素[J].中华行为医学与脑科学杂志,2012,21(5):450-452Liu Guo-hui,Zheng Yan-liang,Xu Xia,et al.A survey of oral health cognitive behaviors and impact factors of the elderly people in Jining[J].Chinese Journal of Behavioral Medicine and Brain Science,2012,21(5):450-452
[13]季雪伟.一次性根管治疗老年人慢性牙髓炎的疗效观察[J].中国基层医药,2014,33(21):3287-3288,3289Ji Xue-wei.Effect of disposable root canal treatment for elderly patients with chronic pulpitis[J].Chinese Journal of Primary Medicine and Pharmacy,2014,33(21):3287-3288,3289
[14]漆梅,聂彬,张爱玲,等.热牙胶充填与冷牙胶侧方加压在根管充填中应用的临床效果比较[J].现代生物医学进展,2012,12(7):1289-1291Qi Mei,Nie Bin,Zhang Ai-ling,et al.Comparison of the clinical effect of warm gutta percha filling and cold gutta percha lateral pressurization in root canal filling[J].Progress in Modern Biomedicine,2012,12(7):1289-1291
[15]高开璇.两种根管糊剂在乳牙根管治疗中的疗效比较[J].中国医药导报,2011,08(20):235-236Gao Kai-xuan.Comparison of the curative effect of two root canal pastes in root canal therapy of deciduous teeth[J].China Medical Herald,2011,08(20):235-236
[16]毕维平.氢氧化钙碘仿糊剂用于根管内消毒90例[J].中国药业,2013,22(5):98-99Bi Wei-ping.Calcium hydroxide iodoform paste used for root canal disinfection in 90 cases[J].China Pharmaceuticals,2013,22(5):98-99
[17]李咏梅.氢氧化钙碘仿糊剂一次性根管充填治疗乳牙根尖周炎的临床观察[J].广西医学,2010,32(11):1381-1383Li Yong-mei.Clinical observation on calcium hydroxide iodoform paste used in one-visit root canal filling of periapical periodontitis of deciduous teeth[J].Guangxi Medical Journal,2010,32(11):1381-1383
[18]范素芳.碘仿氧化锌糊剂与干髓糊剂治疗乳牙根尖周炎疗效对比[J].中国误诊学杂志,2012,12(17):4554Fan Su-fang.Comparison of the curative effect of iodoform added with zinc oxide cataplasm and mummification paste in the treatment of periapical periodontitis of deciduous teeth[J].Chinese Journal of Misdiagnostics,2012,12(17):4554
[19]武张生.三种根充糊剂治疗老年牙隐裂伴窦道型慢性根尖周炎疗效比较[J].中国老年学杂志,2012,32(20):4552-4553Wu Zhang-sheng.Comparison of the curative effect of three kinds of root canal pastes in the treatment of senile cracked teeth with chronic periapical periodontitis of fistula[J].Chinese Journal of Gerontology,2012,32(20):4552-4553
[20]彭学生.2种根管糊剂在一次性根管治疗慢性根尖周炎中的疗效比较[J].安徽医学,2012,33(4):465-466Peng Xue-sheng.Clinical effect of two kinds of root paste fillers in one-visit root canal therapy on chronic periapical periodontitis[J].Anhui Medical Journal,2012,33(4):465-466