联合应用不同根管充填糊剂治疗慢性根尖周炎疗效观察

The clinical effect of different root canal sealers in the treatment of chronic periapical periodontitis

目的观察联合应用不同根管充填糊剂治疗慢性根尖周炎的临床疗效。方法选取2007—2009年山东大学口腔医学院综合科门诊诊治的慢性根尖周炎患者298例(422颗牙),按患者就诊先后顺序随机分为4组。A组(AH Plus糊剂+Vitapex糊剂+牙胶尖)75例患者108颗牙,B组(AH Plus糊剂+牙胶尖)75例患者105颗牙,C组(Vitapex糊剂+牙胶尖)74例患者105颗牙,D组[氧化锌丁香油糊剂(ZOE)糊剂+牙胶尖]74例患者104颗牙。对4组术后7d、6个月、1年的临床疗效进行比较、分析。结果 298例患者根管充填7d后复查,A、C组术后反应轻,与B组比较,差异具有统计学差异(P<0.05);D组术后反应最重,与其他3组比较,差异均有统计学意义(均P<0.05)。根管充填6个月、1年后复查的结果没有差异(P>0.05),A组有效率最高,与其他3组比较,差异有统计学意义(P<0.05);D组有效率最低,与其他3组比较,差异有统计学意义(P<0.05)。结论 AH Plus糊剂+Vitapex糊剂+牙胶尖治疗慢性根尖周炎,既诱导了根尖周阴影区的骨质增生修复,又能使根尖孔形成完善的封闭,达到治愈根尖周炎、防止继发感染或复发的目的。

Objective To evaluate the clinical effect of AH Plus sealer and Vitapex sealer in the treatment of chronic periapical periodontitis.Methods A total of 422 teeth which needed root canal treatment were divided into four groups.Group A was treated with AH Plus,Vitapex and gutta-percha points;group B was treated with AH Plus and gutta-percha points;group C was treated with Vitapex and gutta-percha points;group D was treated with ZOE and gutta-percha points.The therapeutic effects were evaluated after 1 week,6 month and 1 year of treatment,respectively.Results We treated 298 patients and checked them after one week.The reaction of group A and C after treatment was light,and the differences with B and D were significant in statistics.The reaction of group D after treatment was the worst,the difference with the other three groups being significant.The results were similar when we checked at the sixth and twelfth month after the root canal filling.The treatment for group A was the best,and the differences with the other three groups were significant in statistics.The treatment for group B and group C was efficient,and the difference had no statistical significance.The treatment for group D was the worst,and the differences with the other three groups were significant in statistics.Conclusion The joint application of AH Plus sealer and Vitapex sealer in the treatment of chronic periapical periodontitis not only helps to restore hyperosteogeny in the area of the apical shadow,but also leads to a good closure of apical foramen.The therapy can effectively cure periapical periodontitis and prevent secondary infection recurrence.