替硝唑联合地塞米松辅助根管治疗对牙周-牙髓联合病变相关牙周指数及血清炎性因子的影响

Effect of Tinidazole Combined with Root Canal Therapy with Dexamethasone on Related Periodontal Indexes and Serum Inflammatory Factors in Patients with Combined Periodontal-Endodontic Lesions

目的探讨替硝唑联合地塞米松辅助根管治疗对牙周-牙髓联合病变患者相关牙周指数及血清炎性因子的影响。方法选取湖北省宜昌市中心人民医院2017年1月至2018年1月就诊的牙周-牙髓联合病变患者250例(250颗患牙),按入院顺序随机分为试验组和对照组,各125例(125颗患牙)。两组患者根管预备后,分别予替硝唑-地塞米松糊剂根管内封药和甲醛甲酚(FC)根管内封药。结果治疗1个月后,试验组患者治疗总有效率为93. 60%,明显高于对照组的84. 80%(P <0. 05);两组患者牙周指数[菌斑指数(PLI)、牙周探诊深度(PD)、龈沟出血指数(SBI)、牙龈指数(GI)]分值均较治疗前明显下降(P <0. 05),且试验组显著优于对照组(P <0. 05);两组患者血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素1β(IL-1β)、超敏C反应蛋白(hs-CPR)]水平均较治疗前明显降低(P <0. 05),且试验组患者显著低于对照组(P <0. 05);封药后48 h,试验组患者诊间痛发生率为9. 60%(12/125),对照组为25. 60%(32/125),两组差异显著(χ2=11. 033,P <0. 05);治疗期间,两组患者均未出现消化系统、神经系统损伤等严重不良反应。试验组患者气味不适感发生率明显低于对照组(P <0. 05)。结论替硝唑联合地塞米松辅助根管治疗牙周-牙髓联合病变可提高疗效,改善牙周状况,缓解炎性反应。

Objective To investigate the effect of tinidazole combined with root canal therapy with dexamethasone on related periodontal indexes and serum inflammatory factors in patients with combined periodontal-endodontic lesions. Methods Totally 250 patients( 250 affected teeth) with combined periodontal-endodontic lesions treated in Yichang Central People’s Hospital from January 2017 to January 2018 were selected and randomly divided into the experimental group and the control group according to the order of admission,125 cases( 125 affected teeth) in each group. After root canal preparation,the patients in the experimental group were given tinidazole-dexamethasone paste for intracanal medicament,while the patients in the control group were given formaldehyde cresol( FC) for intracanal medicament. Results After one month of treatment,the total effective rate of the experimental group was 93. 60%,which was significantly higher than 84. 80% of the control group( P < 0. 05). The periodontal indexes [ plaque index( PLI),periodontal probing depth( PD),sulcus bleeding index( SBI),gingival index( GI)] in the two groups were significantly lower than those before treatment( P < 0. 05),and those in the experimental group were significantly better than those in the control group( P < 0. 05). The levels of serum inflammatory factors [ tumor necrosis factor-α( TNF-α),interleukin-1β( IL-1β),high-sensitivity C-reactive protein( hs-CPR)] in the two groups were significantly lower than those before treatment( P < 0. 05),and those in the experimental group were significantly lower than those in the control group( P < 0. 05). 48 h after sealing drugs,the incidence of endodontic interappointment pain in the experimental group was 9. 60%( 12/125),which was significantly lower than 25. 60%( 32/125) in the control group(χ2 = 11. 033,P < 0. 05).During the treatment,no serious adverse reactions such as the digestive system and nervous system injury occurred in the two groups. The incidence of odor discomfort in the experimental group was significantly lower than that in the control group( P < 0. 05).Conclusion Tinidazole combined with root canal therapy with dexamethasone in the treatment of patients with combined periodontal-endodontic lesions can improve the efficacy and the periodontal status,it also can relieve the inflammatory response.