活髓牙失活后根管治疗与拔髓后根管治疗的疗效对比

A comparative study of the clinical effects of the root canal therapy on the treatment of vital teeth after pulp extirpation and after pulp devitalization

目的观察比较活髓牙失活后根管治疗与拔髓后根管治疗的疗效,提高临床治疗水平。方法选取我院门诊2008年3月～2010年5月收治的250例急性牙髓炎患者按照治疗方法不同分为A组(失活后根管治疗组)130例和B组(拔髓后根管治疗组)120例,比较两组患者术中情况及术后治疗效果。结果①A组轻度疼痛2例,中度疼痛1例,疼痛发生率为2.31%;B组轻度疼痛5例,中度疼痛3例,重度疼痛1例,疼痛发生率为7.50%。两组患者疼痛发生率比较差异有统计学意义(P<0.01)。②A组急性反应阳性3例,B组急性反应阳性2例。两组患者急性反应发生率差异无统计学意义(P>0.05)。③A组患者成功126例,失败4例;B组患者成功117例,失败3例。两组患者远期疗效差异无统计学意义(P>0.05)。结论活髓牙失活后根管治疗与拔髓后根管治疗急性反应与远期疗效无明显差异,但前者术中疼痛可显著减轻。

Objective The purpose of the study was to compare the clinical effects of the root canal therapy on the treatment of vital teeth after pulp extirpation and after pulp devitalization and improve the clinical level. Methods 250 Cases of acute pulpitis were devided to two groups, including 130 in the group A who were treated with root canal therapy after pulp devitalization and 120 in the group B who were treated with root canal therapy after pulp extirpation. Then the clinical effects of the two groups were compared. Results （1）In group A , mild pain occured in 2 cases, moderate pain in 1 case, the incidence of pain was 2. 31% ; In group B , mild pain occured in five cases , moderate pain in 3 cases, severe pain in 1 case, the incidence of pain was 7.50 %. The incidence of pain between the two groups was significantly different （P 〈 0.01 ） , with statistical significance. （2）In group A acute reactions occured in 3 cases and 2 cases in group B. Significant differences were not obsered between the two groups of patients with acute reaction（P 〉0. 05 ）. （3）In group A 126 cases were suceessf and four cases failed; In group B 117 cases were successful and 3 cases failed. Significant differences were not observed in the long-term effects between the two groups（ P 〉 0.05 ）,with no statistical significance. Conclusion Significant differences were not observed of acute reactions and long-term effects between the two groups ,the teeth in goup A were treated by root canal therapy after pulp devitalization and those in group B were treated after pulp extirpation, but the incidence of the pain during the treatment in the former can be significantly reduced.