根管治疗术对瘘管型根尖周炎患者根尖周炎症的影响

Effect of Root Canal Therapy on Periapical Inflammation in Patients with Fistula Periapical Periodontitis

目的探讨瘘管型根尖周炎患者应用根管治疗术对急性发病率及根尖周炎症程度的影响,旨在为临床治疗瘘管型根尖周炎提供参考依据。方法回顾性收集2017年8月~2019年8月我院口腔科收治的瘘管型根尖周炎患者98例(患牙98颗)临床资料,将采用一次性根管治疗术的50例患者研究资料纳入观察组,将采用传统多次根管治疗术的48例患者研究资料纳入对照组。比较治疗6个月后两组治疗效果、治疗时间、平均疼痛消失时间、根管微生物计数、根尖周指数(CPI)、菌斑指数(PLI)及急性发病率。结果观察组治疗总有效率为96.00%,高于对照组的89.58%,但差异无统计学意义(P>0.05);观察组治疗及平均疼痛消失时间均短于对照组,差异有统计学意义(P<0.05);两组治疗6个月后根管微生物计数、CPI指数及PLI均较治疗前降低,差异有统计学意义(P<0.05),组间比较,差异无统计学意义(P>0.05);观察组急性发病率为14.00%,较对照组的4.17%高,但差异无统计学意义(P>0.05)。结论瘘管型根尖周炎患者应用多次或一次根管治疗术的治疗效果相近,可有效缓解根尖周炎症程度,而一次性根管治疗术,可显著缩短治疗时间,但急性发病率较高,临床可依据患者实际情况选择治疗方式。

Objective To investigate the effect of root canal therapy on acute incidence and periapical inflammation in patients with fistula periapical periodontitis,and to provide reference for clinical treatment of fistula periapical periodontitis.Methods From August 2017 to August 2019,98 cases of fistula periapical periodontitis(98 teeth)were collected retrospectively.The data of 50 patients with one-time root canal therapy were included in the observation group,and 48 patients with traditional multiple root canal therapy were included in the control group.The treatment effect,treatment time,average pain disappearance time,root canal microbial count,periapical index(CPI),plaque index(PLI)and acute morbidity were compared between the two groups after 6 months of treatment.Results The total effective rate of treatment in the observation group was 96.00%,89.58%higher than the control group,but the difference was not statistically significant(P>0.05);Compared with the control group,the treatment of the observation group and the average time of pain disappearance were shortened,the difference was statistically significant(P<0.05);Root canal microbial count,CPI index and PLI were lower in both groups after 6 months,the difference was statistically significant(P<0.05);There was no statistically significant difference in root canal microbial count,CPI index and PLI between the two groups after 6 months of treatment(P>0.05);the acute incidence rate in the observation group was 14.00%,which was higher than 4.17%in the control group,but there was no significant difference(P>0.05).Conclusion The treatment effect of multiple or one root canal therapy in patients with fistula periapical periodontitis is similar,which can effectively alleviate the degree of periapical inflammation,while one-time root canal therapy can significantly shorten the treatment time,but the acute incidence is high.Therefore,clinical treatment can be selected according to the actual situation of patients.