根管超充引发急性根尖周炎的临床研究

Clinical study on acute periapical periodontitis caused by overfilling

目的探讨根管超充与引发急性根尖周炎的关系。方法收集根管充填后1周内出现急性根尖周炎的患者60例,拍摄X线牙片确定为根管糊剂或牙胶尖超充。根据临床症状将患者分为轻症和重症,测量超充部分的牙胶尖长度或糊剂面积。治疗时完全去除根管内充填物,必要时予以调,每日换药直至症状完全消失,记录所需时间。结果轻症和重症患者的牙胶尖平均超充长度分别为1.01mm和1.79mm,糊剂平均超充面积分别为2.45mm2和8.26mm2;牙胶尖超充组轻症和重症分别有13例和21例,糊剂超充组轻症和重症分别有18例和8例;牙胶尖超充组和糊剂超充组临床症状完全消失所需时间分别为3.56d和6.19d。以上数值组间均有统计学差异(P<0.05)。结论超充量较大则患者临床症状较重;牙胶尖超充患者的临床症状较重但症状完全消失所需的时间较短。

Objective To study the relation on overfilling with gutta-percha point or paste and acute periapical periedontitis. Methods Collected sixty cases of acute periapical periodontitis which had been filled with gutta-percha point and paste within 1 week, and took dental radiographs. The cases that dental radiographs showed only guttapereha point was overfilling were assigned to group A （34 cases）, and the cases that dental radiographs showed only paste was overfilling were assigned to group B （26 cases）. The cases that dental radiographs showed both gutta-percha point and paste were overfilling were excluded. Sixty cases were divided into light group and severe group according to clinical sign. Measured gutta-percha point length or paste areas over apex. Took out the obturation material completely, adjusted occlusion when necessary and changed root canal medicament every day until clinical sign disappeared completely. Recorded the time of clinical sign disappeared completely. Results In group A, gutta-percha point length over apex averaged 1.01 mm on light cases, and 1.79 mm on severe cases. In group B, the paste areas over apex averaged 2.45 mm^2 on light cases, and 8.26 mm^2 on severe cases. Group A had 13 light cases and 21 severe cases, and group B had 18 light cases and 8 severe cases. In group A, the average time of clinical sign disappeared completely was 3.56 days, and in group B the average time was 6.19 days. The statistical test showed there were significant differences among these four couples. Conclusion The more overfilling, the more severe clinical sign was. Clinical sign caused by gutta-percha point overfilling was more severe. The time of clinical sign which caused by gutta-percha point overfilling disappeared completely was shorter.