盐酸米诺环素辅助根管治疗牙周-牙髓联合病变的可行性分析

The feasibility analysis of minocycline hydrochloric acid assisted root canal therapy in the treatment of periodontal pulp combined lesions

目的探讨盐酸米诺环素辅助根管治疗牙周-牙髓联合病变的临床疗效。方法选择2014年7月~2017年4月在本院治疗牙周-牙髓联合病变的患者236例,按照随机数字表法分为两组,每组118例,对照组采用常规根管治疗并口服替硝唑片,观察组除上述治疗外,联合应用盐酸米诺环素。比较两组患者在治疗后1周,牙龈指数(GI)、牙龈出血指数(BI)、探诊深度(PD)和菌斑指数(PI)等临床指标,以及治疗后1个月的临床疗效、X线根尖片显示的根尖暗影(包括最大水平直径X和垂直方向的直径Y)和牙槽骨吸收(包括最大垂直高度H和最大水平宽度L)的情况、不良反应发生情况。结果治疗1周后,两组患者的GI、BI、PD和PI值均比治疗前明显下降,且观察组患者的下降程度显著大于对照组患者,以上各指标差异均有统计学意义(P<0.05);治疗1月后,观察组的总有效率92.37%(109/118)明显高于对照组的总有效率75.42%(89/118),差异具有统计学意义(P<0.05);观察组患者的X、Y、H和L的缩小程度均显著大于同期对照组患者,差异具有统计学意义(P<0.05)。而且对照组不良反应发生率4.24%略低于观察组不良反应发生率5.08%,但差异无统计学意义(P>0.05)。结论盐酸米诺环素辅助根管治疗牙周-牙髓联合病变的疗效显著,且不增加不良反应发生,具有良好的临床应用前景。

Objective To investigate the effect of minocycline hydroehloride-assisted root canal in the treatment of periodontal -endodonyic lesions. Methods Two hundred and thirty-six patients with periodontal - endodontic lesions from July 2014 to April 2017 in our hospital were selected and randomly divided into two groups, 118 cases in each group. The control group were treated with routine root canal therapy and oral for indications, in addition to the above treatment, the observation group were treated with combined with minocycline hydrochloride. One week after treatment, gingival index （GI）, gingival bleeding index （BI）, probing depth （PD） and plaque index （PI）, and the clinical curative effect of 1 month after treatment, apical shadow periapical X-ray display （including the maximum level of X diameter and vertical diameter Y） and alveolar bone resorption （including the maximum vertical height of H and the maximum horizontal width of L）, the incidence of adverse reactions were compared. Results One week after treatment, GI, BOP, PD and PI values of patients in two groups were significantly lower than before treatment, and the decrease degree of the patients in the observation group was significantly greater than that of the control group, and the differences of the above indexes were statistically significant （P 〈 0.05）. After 1 months of treatment, the total effective rate in the observation group was 92.37% （109/118）, which was significantly higher than that in the control group [75.42% （89/118）], and the difference was statistically significant （P 〈 0.05）. The degree of reduction of X, Y, H and L in the observation group were significantly greater than those in the control group, and the difference was statistically significant （P 〈 0.05）. The incidence of adverse reactions in the control group （4.24%） was slightly lower than the incidence of adverse reactions in the observation group （5.08%）, but the difference was not statistically significant （P 〉 0.05）. Conclusion Minocycline hydrochloride is effective in the treatment of combined periodontal endodontic lesions, and does not increase the incidence of adverse reactions. It has good clinical application prospects.