根尖截除与保留治疗牙根尖周病疗效比较分析

Comparative analysis of clinical effects of apical resection and apical retention in the treatment of periapical disease

目的评价牙根尖截除与保留两种不同的根尖手术方法治疗牙根尖周病的临床效果。方法选择2012年1月至2013年6月在佛山市禅城区向阳医院口腔科就诊的上、下前牙根尖周病患者30例（38颗患牙），随机分为根尖截除组与根尖保留组，每组15例。根尖截除组行根尖手术并截除牙根尖2—3mm，根尖保留组行根尖手术但保留牙根尖。术后3、6个月跟踪随访，通过检查牙松动度、瘘管出现以及测量牙槽骨骨密度和新生骨高度进行综合分析，比较两组术后临床效果。结果两组在代表复发指标的牙松动度和瘘管出现方面的差异均无统计学意义（均P〉0．05）；而在代表成骨指标的牙槽骨骨密度和新生骨高度上的差异均有统计学意义（均P〈0．05）。结论术者若能彻底去净病变组织，保留牙根尖的根尖外科治疗有较好的临床应用价值。

Objective To evaluate of clinical effects of apical resection and apical retention in the treatment of periapical disease. Methods Totally 38 maxillary and mandibular anterior teeth of 30 patients with periapical disease were chosen in Xiangyang Hospital of Chancheng District of Foshan City from January 2012 to June 2013. These patients were randomly divided into apical resection group and apical retention group（ 15 cases in each group）. The apical resection group underwent operation and the apical cut 2-3 ram, the apical retention group underwent operation but the apical retained. The patients were followed up for 3 and 6 months after operation, and through the examination of tooth mobility, fistula and measurement of alveolar bone density and bone height the analysis was made, and the clinical effects were compared between the two groups after operation. Results There was no statistical difference between the two groups in the tooth mobility and fistula which represented recurrence （P 〉 0.05）, while there was statistical difference in alveolar bone density and bone height which representde bone index （P 〈 0.05）. Conclusion If the lesion can be totally removed, the periapical surgery of retaining apical has better clinical application value.