镍钛机动器械与根管超声仪对一次和多次根管治疗疗效的影响

Clinical efficacy of one-visit versus two-visit endodontic treatment with nickel-titanium rotary instruments and ultrasonic irrigation unit

目的:使用镍钛机动器械与根管超声仪清理根管,对1次和2次根管治疗的短期疗效比较研究。方法:选择309名患者338颗患牙,依据症状与病史诊断为牙髓炎、尖周炎和未感染患牙3类,使用镍钛机动器械与根管超声仪清理根管,根管治疗时随机分成2组:1次组和2次组,在3d、1周、1、3个月从临床体征与X线片比较观察2个治疗组在炎症发展的不同阶段和程度下短期疗效。结果:1次和2次根管治疗在牙髓炎、尖周炎和未感染患牙短期疗效肯定,临床症状、X线片上有改善;经统计学分析,在炎症发展各阶段,2组间的疗效无统计学差异,1次组术后短时间(3d)内在疼痛程度重于2次组、疼痛率约高于2次组;但术后疼痛在结合口服抗炎药物于1周内缓解。结论:掌握好适应证情况下运用镍钛机动器械与根管超声仪清理根管,根管治疗1次组和2次组的疗效没有明显差异,1次根管治疗有缩短治疗时间,疗效稳定的特点,值得临床上开展运用。

Objective：To study clinical efficacy of one-visit versus two-visit root canal therapy for pulpitis, apical periodontitis and taintless teeth with nickel-titanium rotary instruments and ultrasonic irrigation unit. Methods： A total of 309 patients with 338 teeth were selected. The teeth were classified into pulpitis group, apical periodontitis group and taintless teeth group. Patients were randomly assigned to either the one-visit or two-visit root canal therapy, the treatment effects were evaluated with clinical trial and radiography after 3 days, 1 week, 1 month and 3 months. Results： The short-term outcome was changes in apical bone density by using the periapical index （PAI）, long-term outcome exhibited equally improvement in clinical curative effect in both groups. Although one-visit root treatment could cause more intensive postoperative pain than that of two-visit eudodontic treatment during 1-3 days, the indisposition could be eliminated by using medicine. Conclusion： By using of the nickel-titanium rotary instruments and canal ultrasonic irrigation unit, the cnre rate of root canal therapy of one-visit and two-visit endodontic treatment has been improved, with no significant difference between two groups, so that one-visit root treatment can be used in clinic.