Nd:YAP激光在牙髓血运重建中的应用效果评价

Application of Nd:YAP laser in dental pulp revascularization

目的 :比较Nd:YAP激光与三联抗生素糊剂在牙髓血运重建治疗中根管消毒的效果,为牙髓血运重建术中根管内消毒方法提供参考。方法:选择诊断为急性或慢性根尖周炎的年轻恒牙40颗,记录根尖周病变和牙根发育状况。患牙分为三联抗生素糊剂封药消毒的对照组和Nd:YAP激光消毒的实验组,每组均20颗患牙,均行牙髓血运重建术。术后对每颗患牙行临床检查和X线评价。采用SPSS19.0软件包对数据进行χ2检验。结果:治疗后1周,对照组和实验组分别有2颗和4颗患牙存在症状;治疗后2周,对照组患牙临床症状均消失,而实验组则有1颗患牙仍有临床症状,差异无显著性(P>0.05)。随访18个月,结果表明,对照组和实验组分别有2颗和3颗患牙临床症状复发,分别有12颗和10颗患牙X线片上表现为牙根继续发育,分别有3颗和4颗患牙X线片上未观察到明显的牙根继续发育。对照组和实验组结果差异无显著性(P>0.05)。结论:Nd:YAP激光可进行有效的根管消毒,且对牙髓血运重建术的预后无明显影响。

PURPOSE： To compare the effect of Nd：YAP laser and Hoshino＇s triple antibiotic paste on root canal disinfection in the treatment of pulp revascularization, and to provide reference for root canal disinfection in dental pulp revascularization. METHODS： Forty immature permanent teeth diagnosed as acute or chronic periapical periodontitis were included. The periapical lesions and root development were recorded. The cases were divided into 2 groups： the control group and the Nd：YAP laser disinfection experimental group. Clinical examination and X-ray evaluation of each case were performed after treatment. Statistical analysis was performed using SPSS 19.0 software package. RESULTS： Two cases showed symptoms in control group 1 week after treatment, while 4 cases had symptoms in the experimental group. The clinical symptoms disappeared in the control group 2 weeks after treatment, while 1 case still had symptoms in the experimental group. There was no significant difference between the two groups （P〉0.05）. Clinical evaluation at 18 months of follow-up showed that 2 and 3 cases had recurrent symptoms in the control group and the experimental group, respectively; continuous development of the root was noted in 12 and 10 cases on X-ray film in the control and experimental group, respectively, while 3 and 4 teeth had no obvious root development in the control and experimental group, respectively. There was no significant difference between the control group and the experimental group （P〉0.05）. CONCLUSIONS： Nd：YAP laser can be used for effective root canal disinfection without obvious effect on the prognosis of dental pulp revascularization.