根管治疗中不同冲洗消毒药物对牙周牙髓联合病变的疗效评价和对比观察

Efficacy evaluation and comparative observation on periodontal-endodontic combined lesions by different washing disinfection medicines in root canal therapy

目的：探究牙周牙髓联合病变的根管治疗中应用不同消毒药物对其临床治疗效果的影响。方法：随机抽取本院2011年～2013年收治牙周牙髓联合病变患牙68颗，根据冲洗消毒药物的不同将其分为A组与B组，每纽各有患牙34颗。A组患者应用替硝唑溶液超声荡洗，盐酸米诺环素消毒；B组患者应用次氯酸钠溶液超声荡洗，氢氧化钙消毒。除此两组均接受常规根管治疗和牙周系统治疗。记录两组患牙基线，对比治疗后4周、8周的菌斑指数（PLI）、临床附着水平（CAL）和患牙治疗总有效率。结果：两组患者在接受治疗后相对于基线，其PLI与CAL均有显著改善，差异有统计学意义（P〈0．05），两组患者4周与8周改善程度对比无统计学意义（P〉0．05），h组患者改善程度显著优于B组，差异有统计学意义（P〈0．05）；A组患者临床治疗总有效率为88．2％，显著优于B组临床治疗总有效率73．5％，差异有统计学意义（P〈0．05）。结论：相对于传统的消毒药物，替硝唑根管冲洗和盐酸米诺环素根管消毒在短期疗效方面更有优越性，值得临床推广。

Objective：To explore the clinical therapeutic effect on periodontal-endodontic combined lesions by different washing disinfection medicines in root canal therapy. Methods： 68 teeth with periodontal-endodontic combined lesions in our hospital from 2011 to 2013 were randomly selected and divided into group A and group B according to the different washing disinfection drugs, 34 teeth in each group. Patients in group A were washed by azole nitrate ultrasonic and disinfection of minocycline hydrochloride; patients in group B were washed by sodium hypochlorite solution ultrasonic and disinfection of calcium hydroxide. Except that, patients in the two groups were taken conventional root canal systematical treatment. The teeth baseline of the two groups were recorded, plaque index （PLI）, the clinical attachment level （CAL） and the total effective rate of teeth after 4 weeks, 8 weeks of treatment were compared. Results： Patients of two groups after treatment compared with the baseline, the PLI and CAL had improved significantly, the difference was statistically significant （P〈0.05）, the improvement of Group 2 after 4 weeks and 8 weeks had no statistical significance （P〉0.05）. Patients in group A improved significantly better than patients in group B with significant statistical difference （P〈0.05）; the total effective rate of Group A was 88.2%, significantly better than that of group B 73.5% with significant statistical difference （P〈0.05）. Conclusion： Compared with Traditional disinfection drugs, indications for washing and minocycline hydroehloride root canal disinfection have more advantages in the short term which is worthy of clinical promotion.