MTAD与洗必泰联合超声荡洗根管治疗难治性根尖周炎的效果比较

Antibacterial effect between MTAD, chlorhexidine combined with ultrasonic washing of root canal in the treatment of refractory periapical periodontitis

目的比较MTAD与洗必泰(CHX)联合超声荡洗根管在难治性根尖周炎感染治疗中的应用效果。方法选取2017年1月至2018年12月在重庆医科大学附属永川医院口腔科治疗的难治性根尖周炎患者60例(患牙60颗)用以研究,按随机数表法分为MTAD组(n=30)和CHX组(n=30),MTAD组采用MTAD加Na ClO进行超声荡洗,CHX组采用CHX加NaClO超声荡洗,所有的治疗操作均由同一名医生完成,治疗后6个月和1年复诊,比较两组患牙的治疗效果及患牙冲洗前后的主观感觉评分。结果MTAD组和CHX组患牙治疗后6个月的成功率分别为90.0%和86.7%,差异无统计学意义(P>0.05);治疗后1年,MTAD组患牙的成功率为86.7%,高于CHX组的63.3%,差异有统计学意义(P<0.05);MTAD组和CHX组患牙冲洗前患者的疼痛主观感觉评分分别为(78.13±8.25)分和(77.27±5.63)分,差异无统计学意义(P>0.05),冲洗后MTAD组和CHX组患者的主观感觉评分分别为(12.18±2.17)分和(36.52±4.85)分,MTAD组明显低于CHX组,差异有统计学意义(P<0.05)。结论在难治性根尖周炎感染治疗中,MTAD和CHX联合超声荡洗均具有较好的清洁能力和抗菌效果,达到良好的根管治疗效果,但相对而言MTAD冲洗抑菌效果比CHX更稳定持续。

Objective To compare the efficacy of MTAD,chlorhexidine(CHX)combined with ultrasonic washing in the treatment of refractory periapical periodontitis.Methods A total of 60 patients(60 teeth)with refractory periapical periodontitis treated in Yongchuan Hospital of Chongqing Medical University were selected for study.They were randomly divided into MTAD group(n=30)and CHX group(n=30).In the MTAD group,MTAD+Na ClO were used for ultrasonic washing,and in CHX group,CHX+NaClO was used for ultrasonic washing.All the treatment operations were completed by the same doctor.Six months and one year after treatment,the treatment effect of the two groups of affected teeth was compared and the subjective feelings were scored in the two groups before and after irrigation.Results The success rate of MTAD group and CHX group after six months of treatment was 90.0%and 86.7%,respectively,and the difference was not statistically significant(P>0.05).The success rate at 1 year after treatment was 86.7%in MTAD group,significantly higher than 63.3%in CHX group(P<0.05).The subjective sensory scores of patients in MTAD group and CHX group before irrigation were 78.13±8.25 and 77.27±5.63,respectively,with no statistically significant difference(P>0.05);after irrigation,the subjective sensory scores of MTAD group was 12.18±2.17,significantly lower than 36.52±4.85 in CHX group(P<0.05).Conclusion In the treatment of refractory periapical periodontitis,MTAD and CHX combined with ultrasonic washing has a good cleaning ability and antibacterial effect,achieving a good root canal treatment effect,but MTAD washing antibacterial effect is more stable and continuous than CHX.