牙周翻瓣术配合根管治疗牙髓-牙周综合征的临床效果

Clinical Effect of Periodontal Flaps Surgery Combined with Root Canal in Treatment of Pulp-periodontal Syndrome

目的探讨牙周翻瓣术配合根管治疗牙髓-牙周综合征的临床价值。方法选取海南医学院第一附属医院2016年1月至2018年3月收治的102例牙髓-牙周综合征患者为研究对象,以随机数字表法分为对照组与观察组各51例,对照组接受根管治疗,观察组采用牙周翻瓣术配合根管治疗,对2组疗效、牙周健康指标、细菌感染率及清除率、炎性因子水平予以观察。结果观察组与对照组治疗总有效率分别为94.12%、80.39%,差异有统计学意义(P<0.05);治疗前,2组牙龈指数(GI)、牙周袋探诊深度(PD)、龈沟出血指数(SBI)、牙齿松动度(TM)等牙周健康指标,差异无统计学意义(P>0.05);治疗后,观察组上述指标与同期对照组对比,差异有统计学意义(P<0.05);治疗前,2组龈沟液高敏C-反应蛋白(hs-CRP)、白细胞介素-6 (IL-6)、肿瘤坏死因子-α(TNF-α)水平,差异无统计学意义(P>0.05);治疗后,观察组上述指标与同期对照组对比,差异有统计学意义(P<0.05);治疗前,细菌感染率观察组、对照组分别为90.20%、92.16%,差异无统计学意义(P>0.05),治疗后,观察组感染率为3.92%,感染清除率为95.65%,对照组治疗后细菌感染率为17.65%,清除率为80.85%,2组差异有统计学意义(P<0.05)。结论牙周翻瓣术配合根管治疗牙髓-牙周综合征效果满意,也能有效改善牙周健康指标,控制细菌感染率,下调龈沟液炎性因子水平,值得推广。

Objective To explore the clinical values of periodontal flaps surgery combined with root canal in treatment of pulp-periodontal syndrome. Methods 102 cases of patients with pulp-periodontal syndrome and who treated in our hospital from January,2016 to March,2018 were selected as the research objects,and were divided into the control group and the observation group by the random number table method,with 51 cases in each group.The control group were received root canal therapy,while the observation group were treated with periodontal flaps combined with root canal therapy.Then, the clinical effect, periodontal health index, bacterial infection rate,clearance rate and inflammatory factor level of two groups were observed. Results The total effective rates in observation group and control group were 94.12% and 80.39% respectively,and the difference was significant(P <0.05).There was no significant differences in gingival index(GI), periodontal pocket depth(PD), sulcus bleeding index(SBI) and tooth mobility(TM) between the two groups before treatment(P > 0.05).After treatment, the above indexes in the observation group were better than those in the control group, and the difference was statistically significant(P < 0.05).There was no significant difference in the levels of high-sensitivity C-reactive protein(hs-CRP), interleukin-6(IL-6) and tumor necrosis factor-alpha(TNF-alpha) in gingival crevicular fluid between the two groups before treatment(P > 0.05).After treatment,the levels of inflammatory factors in the observation group were lower than those in the control group in the same time, and the difference was statistically significant(P < 0.05).The rates of bacterial infection before treatment in the observation group and the control group were 90.20% and 92.16%, respectively,and there was no significant difference between the two groups(P > 0.05).After treatment, in the observation group,the infection rate was3.92% and the clearance rate was 95.65%,while in the control group,the bacterial infection rate and clearance rate were 17.65% and 80.85% after treatment,and there was significant difference between the two groups(P < 0.05).Conclusion The effect of periodontal flaps combined with root canal therapy on pulp-periodontal syndrome are satisfactory,which can also effectively improve periodontal health indicators, control bacterial infection rate and reduce the level of inflammatory factors in gingival crevicular fluid,thus it is worth promoting.