冷牙胶侧压充填一次法根管治疗牙髓炎的术后急症发生率及影响因素研究

The incidence and impact factors of IAE in single-visit root canal therapy for pulpitis by using a cold lateral condensation of gutta percha

目的：探讨一次法根管治疗牙髓炎的术后急症（ IAE）发生率以及影响因素。方法选取我院2011～2013年口腔科就诊的96例牙髓炎患者的120颗患牙，其中使用K锉一次法根管治疗23例（ C1组）， K锉多次法根管治疗25例（ C2组）；手用ProTaper一次法根管治疗23例（ E1组）；手用ProTaper多次法根管治疗25例（ E2组），四组根管填充法均为冷牙胶侧压填充。比较四组患者的IAE发生率及影响因素。结果 C1组与C2组II、III级疼痛分级、E1组和E2组II级疼痛分级组间比较差异均有统计学意义（ P＜0.05）；对照组（ C1、C2）与试验组（ E1、E2） IAE发生率组间比较差异有统计学意义（ P＜0.05）；C1和E1组间、C2和E2组间IAE发生率差异均有统计学意义（P＜0.05）；超填组IAE的发生率明显高于恰填组和欠填组（ P＜0.05）。影响术后IAE发生率的因素包括根管填充结果和根管填充次数。结论 ProTaper一次法根管治疗牙髓炎可减少术后IAE的发生率，值得临床推广应用。

Objective To investigate the incidence and impact factors of the endodontic interappointment emergencies（ IAE） in single-visit root canal therapy.Methods One hundred and twenty teeth of 96 pulpitis patients who need root canal treatment from 2011 to 2013 in our hospital were divided into four groups.One group（n =23）was treated with K-file single-visit root canal therapy （group C1）.One group（n =25）was treated with K-file multiple method（group C2）.The third group（n =23）was treated with hand ProTaper single-visit root canal therapy （ group E1 ） and the fourth group （ n =25 ） was treated with hand ProTaper multiple method （group E2）.The root canal filling method in all four groups was cold lateral condensation of gutta percha.The incidence of IAE and its impact factors were compared among the four groups.Results There were significant differences in II and III grade pain classification between the group C1 and C2 and II grade pain classification between the groups E1 and E2（P〈0.05）,respectively.The incidences of IAE between the groups C1/C2 and E1/E2 as well as between the groups C1 and E1 or between the groups C2 and E2 were significant-ly different（ all P 〈0.05） .The IAE incidence in patients with root canal overfilling was significantly higher than that in patients with root canal under-filling or just-filling（P〈0.05）.The impact factors of IAE included root canal filling results and times of filling.Con-clusion The hand ProTaper single-visit root canal therapy for pulpitis can decrease the incidence of IAE.It is worth of clinical applica-tion.