冠修复及根管治疗同步治疗139例隐裂牙牙髓病患者的临床疗效观察

An observation of clinical efficacy of concurrent therapy of crown prothesis and root canal therapy in the treatment of 139 patients with pulposis of cracked teeth

目的探讨冠修复及根管治疗同步治疗隐裂牙牙髓病患者的临床疗效。方法选择我院2018年1月~2019年1月收治的278例隐裂牙牙髓病患者随机分为观察组(n=139)和对照组(n=139)。对照组采用先根管后冠修复治疗,观察组采用冠修复及根管同步治疗。观察比较两组的临床疗效,牙龈指数、出血指数、咀嚼效率、咬合力、松动度等牙功能指标及VAS评分。结果观察组显效94例(67.62%)、有效40例(28.78%)、无效5例(3.60%),整体临床疗效优于对照组(Z=-7.140,P=0.000);观察组临床总有效率为96.40%,明显高于对照组77.70%(χ^2=21.571,P=0.000);观察组牙龈指数(0.43±0.07)分,出血指数(0.29±0.04)分,显著低于对照组(t=-28.005,P=0.000;t=-39.873,P=0.000);咀嚼效率(0.93±0.11),咬合力(64.41±6.59)kg,松动度(0.89±0.09)分,显著高于对照组(t=22.537,P=0.000;t=18.515,P=0.000;t=39.293,P=0.000);治疗后,两组VAS评分下降(P<0.05),且观察组VAS评分(2.74±0.33)分显著低于对照组(4.81±0.52)分(t=-39.627,P=0.000)。结论冠修复及根管治疗同步治疗隐裂牙牙髓病临床疗效显著,可有效改善患者牙龈指数、出血指数等牙龈状况,增加患牙咬合力,恢复咀嚼功能,减轻疼痛程度,值得推广应用。

Objective To investigate clinical efficacy of concurrent therapy of crown prothesis and root canal therapy in the treatment of 139 patients with pulposis of cracked teeth.Methods 278 patients with pulposis of cracked teeth admitted to and treated in our hospital from January 2018 to January 2019 were selected and randomly divided into the observation group(n=139)and the control group(n=139).The control group was treated with root canal therapy followed by crown prothesis,while the observation group was treated with concurrent therapy of crown prothesis and root canal therapy.The clinical efficacy,VAS scores and indexes of dental function such as gingival index,bleeding index,masticatory efficiency,occlusal force,and mobility degree,etc.between the two groups were observed and compared.Results In the observation group,the treatment was markedly effective for 94 patients(67.62%),effective for 40 patients(28.78%),and ineffective for 5 patients(3.60%),and the overall clinical efficacy was better than that in the control group(Z=-7.140,P=0.000);the total clinical effective rate was 96.40%,significantly higher than 77.70%of the control group(χ^2=21.571,P=0.000).The gingival index of the observation group was(0.43±0.07),and the bleeding index was(0.29±0.04),significantly lower than those of the control group(t=-28.005,P=0.000;t=-39.873,P=0.000);the masticatory efficiency was(0.93±0.11),the occlusal force was(64.41±6.59)kg,and the mobility degree was(0.89±0.09),significantly higher than those of the control group(t=22.537,P=0.000;t=18.515,P=0.000;t=39.293,P=0.000).After treatment,the VAS scores decreased in both groups(P<0.05),and the VAS score of the observation group(2.74±0.33)were significantly lower than that of the control group(4.81±0.52)(t=-39.627,P=0.000).Conclusion Concurrent therapy of crown prothesis and root canal therapy has significant clinical efficacy in patients with pulposis of cracked teeth,which can effectively improve the gingival conditions such as gingival index and bleeding index of the patients,increase occlusal force of affected teeth,restore masticatory function and relieve the pain.It is worthy of promotion and application.