两种倒充填材料在显微根尖外科手术中的应用比较

Comparison of Application of Two Inverted Filling Materials in Endodontic Microsurgery

目的比较三氧化矿物凝聚体(MTA)和生物陶瓷材料iRoot BP Plus分别作为倒充填材料在显微根尖外科手术中的临床疗效。方法将2014年3月至2019年3月就诊于郑州市口腔医院符合入组标准的需行根尖外科手术的72例患者(80颗患牙)作为研究对象,按照随机数表法分为两组。于显微镜下使用显微手术和超声工作器械进行切开翻瓣、去骨开窗、根尖搔刮、根尖切除、根管倒预备,分别使用MTA(40颗患牙,MTA组)或iRoot BP Plus(40颗患牙,iRoot BP Plus组)作为倒充填材料行根管倒充填、瓣膜复位和缝合。术后1 a复查,通过临床症状和X线检查结果,评定两组临床疗效,并对两组成功率和预后影响因素进行统计学分析。结果72例患者的80颗患牙,MTA组术后1 a治疗成功率为90.0%(36/40),iRoot BP Plus组为92.5%(37/40),两组间成功率比较,差异无统计学意义(P>0.05)。MTA组患牙失败4例4颗,失败率为10.0%(4/40),其中2颗磨牙因为根折被拔除,2颗前牙术后再次出现瘘管。iRoot BP Plus组患牙失败3例3颗,失败率为7.5%(3/40),其中2颗前牙术后再次出现瘘管,1颗前磨牙因为根折被拔除。两组患者性别、年龄、牙位、根尖周病变直径对疗效均无影响(均P>0.05)。结论无论MTA或iRoot BP Plus作为显微根尖外科手术倒充填材料,均有良好的临床效果。

Objective To compare the clinical efficacy of mineral trioxide aggregate(MTA)and bioceramic materials iRoot BP Plus respectively as inverted filling materials in endodontic microsurgery.Methods Seventy-two patients(80 teeth)who met the criteria of group entry were selected in Zhengzhou Stomatological Hospital from March 2014 to March 2019.They were divided into two groups according to the random number table method.These teeth were treated by microsurgery using micro instruments,including incision and flap retraction,osteotomy,root tip scratches,apicoectomy,retro-preparation,root-end filling with MTA(40 affected teeth,MTA group)or iRoot BP Plus(40 affected teeth,iRoot BP Plus group),reset and suture under dental operate microscope.The patients were followed up one year after the operation,and the clinical efficacy of the two groups was evaluated by clinical and X-ray examination,and the potential prognostic factors were analyzed.Results The one year success rate of 72 patients(80 teeth)after operation was 90.0%(36/40)in MTA group and 92.5%(37/40)in iRoot BP Plus group.There was no difference in success rate between the two groups(P>0.05).In the MTA group,4 teeth failed in 4 cases,with a failure rate of 10.0%(4/40).In the 4 failure cases,two molars were removed due to root fracture,and two anterior teeth had fistulas again after operation.In the iRoot BP Plus group,3 teeth failed in 3 cases,with a failure rate of 7.5%(3/40).In the 3 cases of failure,two anterior teeth had fistula again after operation,and one premolars was removed due to root fracture.Gender,age,tooth position,periapical lesion size and other factors of the patients had no effect on the efficacy(all P>0.05).Conclusion Both MTA and iRoot BP Plus have good clinical effects as root-end filling materials in endodontic microsurgery.