应用水激光和超声进行单根管消毒的效果对比

Comparison of the effects of single root canal disinfection by water laser and ultrasound

目的比较水激光和超声在根管消毒方面的临床效果,为临床应用提供一定理论指导。方法选择乌鲁木齐市口腔医院牙体牙髓科2017年5月至2018年5月就诊的单根管慢性根尖周炎病人40例,根据随机数字表法分为两组,对根管进行常规的机械预备后分别采用水激光进行消毒处理(水激光组)和超声荡洗根管(超声组)。根管消毒处理前后,根管内分别取样进行厌氧菌接种培养,检测根管内厌氧菌数量变化,并于术后24 h评定病人疼痛率及舒适度。结果两组病人在根管预备前的细菌数量差异无统计学意义(P>0.05),根管预备后水激光组细菌下降差值为(5.92±0.31)CFU/mL,超声组细菌下降差值为(5.30±0.24)CFU/mL,两组的细菌数量均有明显减少,差异有统计学意义(P<0.05)。水激光组预备后的细菌数量减少显著大于超声组,差异有统计学意义(P<0.05);术后24 h临床评定疼痛率水激光组术后疼痛的发生率为5%,而超声组术后疼痛发生率为20%,两组差异有统计学意义(P<0.05);且水激光组的简化舒适状况量表各维度评分均高于超声组,差异有统计学意义(P<0.05)。结论根管预备后使用水激光消毒和超声荡洗消毒根管可明显减少根管内细菌数量,且应用水激光后细菌减少更明显,可以更好增加根管的消毒效果,同时病人术后疼痛的发生率也较低,临床诊疗舒适度也优于超声组。

Objective To compare the clinical effects of water laser and ultrasound in root canal disinfection,and to provide some theoretical guidance for clinical application.Methods Forty patients with single root canal chronic periapical periodontitis in the Department of Dentistry and Endodontics,Urumqi Stomatological Hospital from May 2017 to May 2018 were selected and randomly assigned into two groups according to the random number table method.After routine mechanical preparation,they were treated with water laser disinfection(water laser group)and ultrasonic root canal washing(ultrasound group).Before and after root canal disinfection,anaerobic bacteria were cultured in root canals,and the number of anaerobic bacteria in root canals was detected.The pain rate and comfort degree of patients were evaluated 24 hours after operation.Results There was no significant difference in the number of bacteria between the two groups before root canal preparation(P>0.05).After root canal preparation,the number of bacteria in water laser group and in ultrasound group was(5.92±0.31)CFU/mL and(5.30±0.24)CFU/mL,respectively,and the number of bacteria in the two groups decreased significantly.The number of bacteria decreased significantly in the water laser group than in the ultrasound group,and the difference was statistically significant(P<0.05);the incidence of the 24 hours postoperative pain was 5%in the water laser group was 20%in the ultrasound group(P<0.05),there was a significant difference in pain rate between the two groups at 24 hours after operation(P<0.05);The scores of each dimension of the general comfort questionnaire(GCQ)in the water laser group were higher than those in the ultrasound group,and the difference was statistically significant(P<0.05).Conclusion After root canal preparation,the number of bacteria in root canal can be significantly reduced by using water laser disinfection and ultrasonic washing disinfection,and the bacterial reduction is more obvious after using water laser,which can better increase the disinfection effect of root canal.At the same time,the incidence of post-operative pain is lower,and the clinical diagnosis and treatment comfort is also better than that of ultrasound group.