根管治疗中根尖片使用的临床分析

Usage status of periapical films undertaking in root canal treatment

目的了解专科医生、全科医生、实习医生在根管治疗中使用根尖片的现状,分析根充质量与根尖片使用的关系。方法以在四川大学华西口腔医院门诊完成根管治疗的患者的患牙为调查对象,根据治疗医生的不同将调查对象分为专科医生组、全科医生组和实习医生组,对调查对象的根尖片应用情况进行问卷调查,并对术后根充片进行根充质量评价。采用卡方检验分析3组医生的根尖片使用频率,秩和检验分析根充质量与根尖片使用的关系。结果412例患者571颗牙的根管治疗中,专科医生组、全科医生组和实习医生组的术前片使用率分别为95.3%、89.5%和92.1%,初尖片使用率为5.2%、1.1%和5.8%,主尖片使用率为94.8%、72.1%和97.4%,根充片使用率为97.9%、76.3%和95.3%。3组初尖片、主尖片、根充片使用率均有统计学差异(P<0.05)。根充质量合格病例和不合格病例的根尖片使用张数分别为(3.14±0.639)和(2.84±0.736)张,二者之间有统计学差异(P<0.05)。结论专科医生和实习医生较全科医生更加规范使用根尖片。根尖片的使用频率与根充质量有关,规范化使用根尖片有利于提高根管治疗的质量。

Objective To determine the current radiographic practices of root canal treatment （RCT） undertaken by endodontists, general dentist practitioners （GDPs） and interns, and to analyze the relationship between the usage of periapieal films and the quality of RCT. Methods The patients who had received RCT treatment in West China College of Stomatology were investigated at random and were divided into three groups： Endodontists treating group, GDPs treating group and interns treating group according treating physician. The usage status of periapical film were investigated by the well designed questionnaires. The obturation quality of postoperative films were evaluated. Chisquare analysis was used to compare usage rates of periapical films of three groups. Mann-Whitney test was used to determine the relationship between the usage of periapical films and the quality of RCT. Results 571 teeth of 412 patients were investigated. In endodontists treating group, GDPs treating group and interns treating group, the usage rates of preoperative films were 95.3%, 89.5% and 92.1% respectively. The usage rates of working length films were 5.2%, 1.1% and 5.8% respectively. The usage of master point films was 94.8%, 72.1% and 97.4% respectively. The usage of postoperative films was 97.9%, 76.3% and 95.3% respectively. There were statistically significant differences among the working length films, master point films and postoperative films of three groups （P〈0.05）. The periapical films of adequate quality RCT and inadequate quality RCT were 3.14±0.639 and 2.84±0.736 respectively. There was statistically significant difference between periapical films of adequate quality RCT and inadequate quality RCT （P〈 0.05）. Conclusion Radiographic practices of endodontists and interns are more standardized than GDPs. Quality RCT is related to radiographic practices. Standard radiographic practices would be benefit to RCT.