Metapex糊剂超填对根尖周病损疗效的影响

Influense of Metapex Extruding into the Periapical Lesions

目的：对Matepex糊剂超填和Ca（OH）2根管内消毒治疗根尖周病损的疗效进行比较,并分析治疗方法和暗影大小对疗效的影响。方法：对满足纳入标准的患者根据暗影大小分两类,一类暗影范围为≤5 mm,另一类〉5mm。采用随机数字表法将每一类患者分入A组和B组进行治疗,共收集到89名患者,暗影最大径3~15 mm,随访1~2年。结果：A组和B组患者暗影消失时间有统计学差异（p〈0.05）。A组暗影≤5 mm与暗影〉5 mm的消失时间有统计学差异（p〈0.05）;B组暗影≤5 mm与暗影〉5 mm的消失时间无统计学差异。对于暗影≤5 mm的患者,A组治疗方法与B组治疗方法之间无统计学差异。暗影〉5 mm,A组治疗方法与B组治疗方法有统计学差异（p〈0.05）。用Cox回归模型进行分析,发现暗影大小的回归系数为-0.476,治疗手段的回归系数为0.587,治疗手段和暗影大小标准化回归系数的绝对值分别为0.472和0.528。结论：当不分暗影大小时,A组暗影消失所需时间较B组长。A组用于暗影≤5 mm的患者效果优于暗影〉5 mm的患者,而B组与暗影大小无关。当暗影≤5mm时,A组与B组疗效相当;当暗影〉5 mm时,A组疗效不及B组。随暗影的增大，暗影消失的危险度越小，即暗影消失的时间越长；B组方法治疗暗影消失的危险度较A组大，即B组方法治疗暗影消失的时间短；暗影大小较治疗手段而言对暗影消失时间的影响更大。

Objective： To evaluate the outcome of periapical lesions when using Matepex extruding into the apical area and Ca（OH）2 within the root canal.Methods： 89 patients with periapical lesions ranging in size from 3 to 15 mm in diameter were included in this study.The patients were classified by their lesion size.one was the diameter≤5 mm,and the other was＆gt;5 mm.They were then divided into two treatments,group A was with Metapex and group B with Ca（OH）2.All cases were followed up for a period of 1-2 years. Results： 1 ） The survival time of group A is significantly longer than group B （P 〈 0.05） 2） The outcome was analyzed according to the diameter of the radiolucence. To group A, the survival time was significantly different （ P 〈 0.05 ）. To group B, the survival time had no significant difference . 3 ） The outcome was analyzed according to the different treatments. When the periapical lesion ≤5 mm, the survival time had no significant difference. If the periapical lesion 〉 5 ram, the survival time was significantly different （P 〈 0.05 ）. 4 ）The influent factors were analyzed by Cox＇s proportional hazards regression model. Conclusion： 1 ）Overally, the efficacy of group A is not as good as group B. 2 ） When the outcome was analyzed according to the diameter of the radiolucence, in Group A ,the effect was better if the periapical lesion was ≤5 mm; in group B, the size of the periapical lesion had no effect on the outcome. 3 ）When the outcome was analyzed according to the treated methods, to the periapical lesion ≤5 ram, the effect of group A and group B had no difference, to the periapical lesion 〉 5mm, the effect of group B was better than group A . 4）The bigger the radiolucent diameter, the longer the time required for the periapical lesion to disappear. The radiolucent diameter had more influence on survival time than the treatment methods.