乳牙根管充填程度及牙体修复材料与根管治疗成功率的关系

Relationship of root filling extent and material of restoration with the successful rate of root canal therapy

目的研究乳牙根管充填程度和牙体修复材料与根管治疗成功率的关系。方法处于乳牙牙根稳定期、患牙髓炎或根尖周炎的乳牙255颗,其中前牙178颗,后牙77颗。常规开髓拔髓根管预备;以Vitapex糊剂作根管充填材料,摄X线片观察根管充填程度;分别以银汞合金、复合体(登士柏)或氧化锌黏固粉作为牙体充填材料。跟踪观察,每次复诊结果以临床检查及X线片为准。结果根管充填程度与成功率的关系:适填的平均成功率最高(98.7%),超填次之(93.4%),欠填最低(86.4%),三者间的差异均有统计学意义(P值均<0.05)。牙体修复材料与成功率的关系:银汞合金成功率最高(97.3%),复合体次之(85.4%),氧化锌黏固粉最低(26.7%),三者间的差异均有统计学意义(P值均<0.05)。结论根管充填程度及牙体修复材料与根管治疗的成功率有密切关系,根管充填以适填、牙体修复以溶解性小的材料的成功率最高。

Objective To investigate the relationship of root filling extent and material of repair with the successful rate of root canal therapy （RCT）. Methods Two hundred and fifty-five primary teeth （178 front teeth and 77 posterior teeth） with pulpitis and periapical periodontitis during the stable phase of the roots were included in this study. After routine root canal preparation, the root canal was filled with vitapex cataplasm. The extent of root filling was observed by X-ray. The body of the teeth was filled with silver amalgam, composite resin （Densply）, or zinc oxide-eugenol cement for restoration. The restoration outcomes were evaluated by clinical examination and radiograph. Results The successful rate was 98.7% for flat filling, 93.4M for over-filling, and 86.4M for under filling; there were significant differences between the 3 groups （all P〈0. 05）. Silver amalgam filling achieved highest successful rate （97.3%）, followed by composite resin （85.4%） and zinc oxide-eugenol cement （26.7 %）; there were significant differencse between the 3 groups （all P〈0.05）. Conclusion The successful rate of RCT of the primary is closely associated with the root filling extent and the materials for restoration. Flush filling and material with low solubility have the highest successful rates.